Agneta Ståhle

Karolinska Institutet | KI · Department of Neurobiology, Care Sciences and Society - NVS

Background The use of information technology can make pulmonary rehabilitation interventions in people with chronic obstructive pulmonary disease (COPD) more flexible and thereby has the potential to reach a larger proportion of the population. However, the success of using information technology in pulmonary rehabilitation is dependent on the end-...

Objective The aim of this study was to investigate if mobilization out of bed, within 2 hours after abdominal surgery, improved participants´ respiratory function and whether breathing exercises had an additional positive effect. Methods Participants were 214 consecutively recruited patients who underwent elective open or robot-assisted laparoscop...

Background The StayBalanced programme has shown positive effects on fall prevention, balance control and fear of falling. Despite convincing evidence on the efficacy and effectiveness of balance training, there is a gap between research findings and what is provided in community-based and clinical health care settings. Therefore, transferring evide...

The HiBalance program is a progressive and highly challenging balance training intervention incorporating Parkinson’s disease (PD) specific balance components. The program improves balance and gait and increases the amount of ambulation in short-term, in older adults with PD. Yet, potential short- and long-term effects on habitual physical activity...

Background: People with Parkinson’s disease find that exercise helps to improve their physical performance. However, when performed in a group, they also tend to appreciate each other’s company. Purpose: After people with Parkinson’s disease participated in a community-based group balance exercise program, our aims were to explore the participants’...

Purpose: To evaluate the effects of the Stay Balanced program when this is transferred into a clinical setting regarding balance, gait speed, leg muscle strength, concerns about falling, and physical activity. Method: Implementation pilot study with a pre-post intervention design. Fifteen older adults, 75–91 years of age, participated in a progress...

Purpose: To evaluate the long-term effects from a 12-week balance-training programme on self-rated physical function and disability in healthy older adults with a tendency to fall and fear of falling. Method: RCT, 59 participants, 67–93 years (42 women). The participants were randomised to an exercise group (n = 38) and a control group (n = 21). Th...

Aims: The aims of this study were: (1) To explore the experience of people with Parkinson’s disease from participating in a group exercise balance program and (2) To suggest aspects of life that such group training can affect for people with Parkinson’s disease. Background: Parkinson’s disease changes the life course; however, there are individual...

Purpose: To describe the ability to take a rapid step forward, and to investigate the relationship between a rapid step forward, concerns about falling (CAF) and balance performance. Materials and methods: A cross-sectional study including 96 elderly people, aged 66–87, with osteoporosis and fear of falling. The ability to take a rapid step forward...

Purpose: To study the effect of Somatosensory Focused Balance Training without Cues, on gait and balance in people with early Parkinson’s disease. Materials and methods: This was a randomised pilot study. Twenty-eight community-dwelling people with early Parkinson’s disease were randomised to immediate or delayed start of a 8w-group training in a c...

Purpose: Investigate the psychometric properties of the Swedish version of the Falls Efficacy Scale-International (FES-I). Method: Cross-sectional study. Community-dwelling older adults with self-reported balance deficits and fear of falling were recruited from an ongoing randomised controlled study to evaluate the psychometric properties of the FE...

Background: There is a need for a valid assessment test of balance in early Parkinson's disease (PD). Objective: To validate the Bäckstrand Dahlberg Liljenäs Balance Scale (BDL), a test of balance performance constructed to assess mild to moderate balance disability due to neurological disease, for use in persons with early PD. Methods: Cross-...

Questions: What is the 1-year incidence of falls and injurious falls in a representative cohort of community-dwelling ambulatory individuals with chronic spinal cord injury? What are the predictors of recurrent falls (more than two/year) and injurious falls in this population? Design: One-year longitudinal observational multi-centre study. Particip...

Objective: To identify risk indicators for, and incidence of, recurrent falls and fall-related injuries in wheelchair users with traumatic spinal cord injury. Design: Prospective multi-centre study. Subjects: One hundred and forty-nine wheelchair users with spinal cord injury attending follow-up in Sweden and Norway. Methods: Inclusion crite...

Objective: To evaluate long-term effects of balance-training on concerns about falling, gait, balance performance, and physical function in older adults with osteoporosis and increased risk of falling. Design: Randomized controlled trial, including three groups (training, training+physical activity, and control group), with follow-ups at three, nin...

Background: The desirable effects of physical activity in individuals with Parkinson's disease are well-known, although according to results from previous studies factors associated with objectively assessed physical activity are not fully investigated. Objective: To investigate demographic, disease-related and mobility-related factors that asso...

Objective: To identify factors associated with recurrent falls in individuals with traumatic SCI. Design: Cross-sectional multi-center study. Setting: Two specialized Rehabilitation Centers in Europe PARTICIPANTS: Included: individuals with traumatic SCI ≥1 year post-injury, ≥ 18 years of age. Excluded: individuals with motor complete injuries...

To define accelerometer cut points for different walking speeds in older adults with mild to moderate Parkinson's disease. A volunteer sample of 30 older adults (mean age 73; SD 5.4 years) with mild to moderate Parkinson's disease walked at self-defined brisk, normal, and slow speeds for three minutes in a circular indoor hallway, each wearing an a...

Physical activity (PA) is essential for older adults with osteoporosis, and health care professionals play important roles in promoting PA and encouraging patients to make healthy choices. However, many factors influence habitual PA and we have only limited knowledge about the perceptions and experiences of PA among older women with osteoporosis. T...

To explore how older women with osteoporosis perceive fall-related concerns and balance in daily life after having participated in balance training. Explorative study. Semi-structured interviews were conducted with 19 women (66-84 years), with osteoporosis recruited from an ongoing RCT; participants were asked about their perceived fall-related con...

Objective: To evaluate long-term effects of balance-training on concerns about falling, gait, balance performance, and physical function in older adults with osteoporosis and increased risk of falling. Design: Randomized controlled trial, including three groups (training, training+physical activity, and control group), with follow-ups at three,...

To describe objectively measured physical activity levels and patterns among community-dwelling older adults with osteoporosis, impaired balance, and fear of falling, and to explore the associations with gait, balance performance, falls self-efficacy, and health-related quality of life (HRQoL). Ninety-four individuals (75.6 ±5.4 years) were include...

Background and purpose: We have developed a 12-week balance training program for older adults shown to improve fall-related concerns, gait speed, balance performance, and physical function. We hypothesized that this balance training would also contribute to higher habitual physical activity (PA) levels and improved health-related quality of life (...

Background: Highly challenging exercises have been suggested to induce neuroplasticity in individuals with Parkinson's disease (PD); however, its effect on clinical outcomes remains largely unknown. Objective: To evaluate the short-term effects of the HiBalance program, a highly challenging balance-training regimen that incorporates both dual-ta...

Background The Mini-BESTest is a clinical balance test that has shown a high sensitivity in detecting balance impairments in elderly with Parkinson's disease (PD). However, its reproducibility between different raters and between test occasions has yet to be investigated in a clinical context. Moreover, no one has investigated the reproducibility o...

Objective: To give the rationale and evidence for and a detailed description of a rehabilitation programme of proven effectiveness in improving balance in older adults. Background theory and evidence: Based on the knowledge that balance loss usually occurs in situations when attention is divided, especially when being older, and that balance con...

Objective: To evaluate the effects of a 12-week balance training programme on self-assessed function and disability in healthy community-dwelling older adults with self-perceived balance deficits and fear of falling. Design: A prospective, randomized controlled trial. Setting: Stockholm County, Sweden. Participants: A total of 59 community-d...

Objective: To evaluate the effects of a balance training program including dual- and multi-task exercises on fall-related self-efficacy, fear of falling, gait and balance performance, and physical function in older adults with osteoporosis with an increased risk of falling and to evaluate whether additional physical activity would further improve...

To compare self-reported pedometer steps with accelerometer steps under free-living conditions in individuals with Parkinson's disease (PD) or osteoporosis (OP). Seventy-three individuals with PD and 71 individuals with OP wore a pedometer (Yamax LS2000) and an accelerometer (Actigraph GT1M/GT3X+) simultaneously for one week. Fifty-one individuals...

To develop a highly challenging and progressive group balance-training regime specific to Parkinson's disease (PD) symptoms and to investigate its feasibility in elderly individuals with mild to moderate PD. Intervention study, before-after trial with a development and feasibility design. University hospital setting. Feasibility was evaluated in fi...

Ageing affects gait characteristics during walking under single- and dual-task conditions. Osteoporosis in elderly with fear of falling may further implicate gait alterations. The aims were to characterize spatiotemporal gait parameters, by comparing gait performance at comfortable speed to gait at maximal speed and while performing a dual task, re...

Purpose To translate and perform a cross-cultural adaptation of the Late-Life Function and Disability Instrument (LLFDI) to Swedish, to investigate absolute and relative reliability, concurrent validity, and floor and ceiling effects within a Swedish-speaking sample of community-dwelling older adults with self-reported balance deficits and fear of...

The Falls Efficacy Scale-International (FES-I) is a highly reliable questionnaire for assessing fear of falling in elderly individuals with increased fall risk and has low or no convergent validity with balance performance tests and health-related quality of life (HRQL) among elderly women with osteoporosis, which indicates that both measurements s...

Objective: To evaluate the long-term effects of a progressive and specific balance group-based program in healthy elderly individuals with increased risk of falling. Design: Follow-up of a randomized controlled trial at nine and 15 months on a population that has previously been described at three months. Setting: The study was conducted in St...

Background There is increasing scientific knowledge about the interaction between physiological (musculoskeletal, neuromuscular, cognitive and sensory) systems and their influence on balance and walking impairments in Parkinson’s disease. We have developed a new conceptual framework for balance training, emphasising specific components of balance c...

Purpose: To evaluate the relative and absolute test-re-test reliability of a new step-execution test, "Step-Ex", for clinical use in elderly with and without balance problems. Method: Test-re-test design to assess intrarater reliability. Thirty-four healthy community-dwelling elderly (65-87 years), 16 with balance problems, were tested twice two...

To compare the influence of dietary management and/or physical exercise on ovarian function and metabolic variables in women with polycystic ovary syndrome (PCOS). Randomized 4-month trial with three interventions and a long-term follow-up. Women's health clinical research unit at a university hospital. Fifty-seven overweight/obese women with PCOS....

To evaluate the effects of a new, individually adjusted, progressive and specific balance group training programme on fear of falling, step execution, and gait in healthy elderly people with fear of falling and tend to fall. Randomized controlled trial. The study was conducted in Stockholm County, Sweden. Fifty-nine community dwelling elderly peopl...

To assess the long-term effect of spinal cord stimulation (SCS) on angina symptoms and quality of life in patients with refractory angina pectoris defined as severe angina due to coronary artery disease resistant to conventional pharmacological therapy and/or revascularisation. During 2003-2005, all patients with refractory angina referred for SCS...

Written prescriptions of physical activity have increased in popularity. Such schemes have mostly been evaluated in terms of efficacy in clinical trials. This study reports on a physical activity prescription referral scheme implemented in routine primary health care (PHC) in Sweden. The aim of this study was to evaluate patients' self-reported adh...

Appendix A & B. Variables used from the population survey and physical activity index including questions and response items.

Health care providers in many countries have delivered interventions to improve physical activity levels among their patients. Thus far, less is known about the population's interest to increase their physical activity levels and their opinion about the health care provider's role in physical activity promotion. The aims of this paper were to inves...

Physical activity referral (PAR) schemes or concepts occur in varying forms. Because few physical activity intervention studies have been carried out in routine health care settings, it is difficult to translate research findings into daily practice. The aim of this study was to analyze the effectiveness of a PAR scheme implemented in routine prima...

Aerobic group-training of elderly patients recovering from an acute coronary event has been shown to increase exercise capacity and quality of life. The aim of this randomized, controlled study was to study the effects of a 3 months aerobic group training programme on muscular endurance and recovery in elderly patients after an acute coronary event...

The aim of this randomized controlled study was to evaluate healthcare consumption, self-reported health-related quality of life and to calculate the costs of the training programme, in a cohort of 101 consecutive elderly patients ≥65 years admitted to the Coronary Care Unit at Karolinska University Hospital, Stockholm, Sweden due to an acute coron...

Physical activity on prescription, as a method for increasing physical activity, has attracted attention in recent years. However, few studies have examined adherence as a primary outcome variable. The aim of this article was to examine self-reported adherence to individualized prescribed physical activity in a routine primary health care setting....

Insufficient physical activity (PA), overweight and abdominal obesity are increasing global public health problems. Randomized controlled 6-month intervention study. One hundred and one 68-year-old individuals (57% female) with low PA, overweight (BMI 25-40 kg/m) and abdominal obesity (waist circumference >88 cm in women and >102 cm in men), were r...

Over the past decade, practitioners in primary health care (PHC) settings in many countries have issued written prescriptions to patients to promote increased physical activity or exercise. The aim of this study is to describe and analyse a comprehensive physical activity referral (PAR) scheme implemented in a routine PHC setting in Ostergötland Co...

To evaluate how spontaneously used pursed lips breathing influences walking endurance, oxygen saturation and dyspnoea in patients with moderate to severe chronic obstructive pulmonary disease. A randomized open-label, cross-over study of chronic obstructive pulmonary disease patients participating in a rehabilitation programme. Outpatient pulmonary...

To examine whether physical activity on prescription in routine primary care patients would influence physical activity level and quality of life 6 months later. In 2001-2003, 13 Swedish primary health care units took part in an uncontrolled clinical study. If a patient in primary health care needed physical activity preventively or for treatment o...

Background and Hypothesis: Dobutamine stress echocardiography is a well-established diagnostic method for investigating patients with suspected ischemic coronary disease. A positive test result is based on systolic parameters, but left ventricular filling parameters also are affected by myocardial ischemia. The aim of the present study was to study...

To evaluate the impact of predictors of adopting a healthy lifestyle in Swedish schoolchildren. A sample of 1409 Swedish schoolchildren (mean age 12.5 years) representative of different socio-economic and geographical living areas participated in a questionnaire-based survey on healthy habits and knowledge of healthy behaviour. A logistic regressio...

Information on trends in healthy and unhealthy habits among children are important for the development of programmes intended to foster and consolidate a healthy lifestyle. This report studied the importance of time and age on the health behaviour of Swedish school children. A comparison between health behaviours derived from repeated evaluations o...

To measure physical activity by means of daily pedometer steps, body composition, expressed as body mass index (BMI) and bioelectrical impedance as percent body fat, and perceived physical self-esteem and additionally, to evaluate eventual predictors for a healthy lifestyle i.e., highly physically active, normal weighted and a high physical self-es...

The effect of exercise training and acarbose on glycemic control, insulin sensitivity, and phenotype was investigated in mild type 2 diabetes. Sixty-two men and women with type 2 diabetes were randomized to 12 weeks of structured exercise training with or without acarbose treatment or to acarbose alone. Glycemic control was determined by HbA(1c) (A...

The study was designed to evaluate whether changes in malonyl-CoA and the enzymes that govern its concentration occur in human muscle as a result of physical training. Healthy, middle-aged subjects were studied before and after a 12-wk training program that significantly increased VO2 max by 13% and decreased intra-abdominal fat by 17%. Significant...

Background: Aiming at an active lifestyle, healthy food habits and non-smoking among Swedish children, the Swedish Heart Lung Foundation initiated the health educational programme 'An adventure with Pelle Pump'. A study kit, including theoretical and practical material on heart-lung function and healthy behaviour, was offered to all fourth graders...

Aiming at an active lifestyle, healthy food habits and non-smoking among Swedish children, the Swedish Heart Lung Foundation initiated the health educational programme 'An adventure with Pelle Pump'. A study kit, including theoretical and practical material on heart-lung function and healthy behaviour, was offered to all fourth graders in Sweden. T...

This study validated the Swedish translation of the Children and Youth--Physical Self-Perception Profile (CY-PSPP) scale and examined the relation between physical self-perception and daily physical activity as well as the relationship between physical self-perception and body mass index (BMI) among Swedish school children. Forty-eight children age...

Coronary heart disease, i.e. angina pectoris or myocardial infarction, is one of our most common diseases. Age, gender and heredity, as well as smoking, hypertension, physical inactivity, diabetes, overweight and stress are risk factors for the disease. Regular physical activity and exercise training positively influences several of these risk fact...

y mother is a walking miracle. I'm not the kind of person who tries to be cool or trendy, I'm definitely an individual. If you can do what you do best and be happy, you're further along in life than most people.

The aims of this study were to investigate outcomes of older people's use of powered wheelchairs and risk factors for negative outcomes. The study was a cross-sectional interview-study including 111 powered wheelchair users over 65 years of age. All participants used their powered wheelchair in the summer; nearly all users regarded it as important...

The aims of this study were to identify current levels of physical activity and to study the relationship between physical activity and body mass index (BMI) using international cut-off points. 871 children, aged 7-14 y, were measured for height and weight and the activity levels were analysed using pedometers to measure mean step counts for 4 cons...

Physical activity and exercise as part of cardiac rehabilitation after an acute coronary event improves exercise capacity and quality of life in most patients. The aim of the present study was to evaluate physical activity level, health-related quality of life (HRQL) and perceived health three to six years after an acute myocardial infarction or an...

Effects of organized aerobic group training in elderly patients discharged after an acute coronary syndrome. A randomized controlled study [Scandinavian Journal of Rehabilitation Magazine 1999;31(2):101-7]

The aim of this study was to identify and describe the factors of importance for elderly (> or =65 years) patients in being physically active one year after acute myocardial infarction. Forty-three consecutive elderly patients with a recent myocardial infarction were randomized either to a supervised outpatient-group training programme, 50 min thre...

Reduced heart rate variability is associated with an unfavourable prognosis in patients with ischaemic heart disease. Whether physical training can modify this risk factor is not definitely proven. Our hypothesis was that training might increase both physical capacity and heart rate variability in elderly patients recovering from an acute coronary...

Cardiac rehabilitation including exercise training is of proven value in ischaemic heart disease. However, elderly patients frequently are not encouraged to participate in such programmes. This study evaluates the physiological effects and self-reported quality of life after an aerobic outpatient group-training programme in subjects above the age o...

The aim of this study was to compare the physiological effects of an individually adjusted outpatient group training programme to the standardized recommendations of walking in elderly patients (>65 years) discharged after an acute coronary episode. In all, 101 patients, 20 women and 81 men, aged 65-84 (mean 71) years, were randomized either to a s...