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Englund, Undis
Publications (10 of 10) Show all publications
Berggren, M., Karlsson, Å., Lindelöf, N., Englund, U., Olofsson, B., Nordstöm, P., . . . Stenvall, M. (2019). Effects of geriatric interdisciplinary home rehabilitation on complications and readmissions after hip fracture: a randomized controlled trial. Clinical Rehabilitation, 33(1), 64-73
Open this publication in new window or tab >>Effects of geriatric interdisciplinary home rehabilitation on complications and readmissions after hip fracture: a randomized controlled trial
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2019 (English)In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 33, no 1, p. 64-73Article in journal (Refereed) Published
Abstract [en]

Objective: This pre-planned secondary analysis of geriatric interdisciplinary home rehabilitation, which was initially found to shorten the postoperative length of stay in hospital for older individuals following hip fracture, investigated whether such rehabilitation reduced the numbers of complications, readmissions, and total days spent in hospital after discharge during a 12-month follow-up period compared with conventional geriatric care and rehabilitation.

Design: Randomized controlled trial.

Setting: Geriatric department, participants' residential care facilities, and ordinary housing.

Subjects: Individuals aged ⩾70 years with acute hip fracture (n = 205) were included.

Intervention: Geriatric interdisciplinary home rehabilitation was individually designed and aimed at early discharge with the intention to prevent, detect, and treat complications after discharge.

Main measures: Complications, readmissions, and days spent in hospital were registered from patients' digital records and interviews conducted during hospitalization and at 3- and 12-month follow-up visits.

Results: No significant difference in outcomes was observed. Between discharge and the 12-month follow-up, among participants in the geriatric interdisciplinary home rehabilitation group (n = 106) and control group (n = 93), 57 (53.8%) and 44 (47.3%) had complications (P = 0.443), 46 (43.4%) and 38 (40.9%) fell (P = 0.828), and 38 (35.8%) and 27 (29.0%) were readmitted to hospital (P = 0.383); the median total days spent in hospital were 11.5 and 11.0 (P = 0.353), respectively.

Conclusion: Geriatric interdisciplinary home rehabilitation for older individuals following hip fracture resulted in similar proportions of complications, readmissions, and total days spent in hospital after discharge compared with conventional geriatric care and rehabilitation.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
Falls, home rehabilitation, randomized controlled trial, hip fracture
National Category
Geriatrics Physiotherapy
Identifiers
urn:nbn:se:umu:diva-142127 (URN)10.1177/0269215518791003 (DOI)000454521300008 ()30064264 (PubMedID)2-s2.0-85052213545 (Scopus ID)
Note

Originally included in thesis in manuscript form with title: "Geriatric interdisciplinary home rehabilitation - effects on complications and readmissions after hip fracture: a randomized controlled trial"

Available from: 2017-11-22 Created: 2017-11-22 Last updated: 2019-01-14Bibliographically approved
Berggren, M., Stenvall, M., Englund, U., Olofsson, B. & Gustafson, Y. (2016). Co-morbidities, complications and causes of death among people with femoral neck fracture: a three-year follow-up study. BMC Geriatrics, 16, Article ID 120.
Open this publication in new window or tab >>Co-morbidities, complications and causes of death among people with femoral neck fracture: a three-year follow-up study
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2016 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 16, article id 120Article in journal (Refereed) Published
Abstract [en]

Background: The poor outcome after a hip fracture is not fully understood. The aim of the study was to describe the prevalence of co-morbidities, complications and causes of death and to investigate factors that are able to predict mortality in old people with femoral neck fracture. Methods: Data was obtained from a randomized, controlled trial with a 3-year follow-up at Umea University Hospital, Sweden, which included 199 consecutive patients with femoral neck fracture, aged >= 70 years. The participants were assessed during hospitalization and in their homes 4, 12 and 36 months after surgery. Medical records and death certificates were analysed. Results: Multivariate analysis revealed that cancer, dependence in P-ADL (Personal Activities of Daily Living), cardiovascular disease, dementia at baseline or pulmonary emboli or cardiac failure during hospitalization were all independent predictors of 3-year mortality. Seventy-nine out of 199 participants (40 %) died within 3 years. Cardiovascular events (24 %), dementia (23 %), hip-fracture (19 %) and cancer (13 %) were the most common primary causes of death. In total, 136 participants suffered at least one urinary tract infection; 114 suffered 542 falls and 37 sustained 56 new fractures, including 13 hip fractures, during follow-up. Conclusion: Old people with femoral neck fracture have multiple co-morbidities and suffer numerous complications. Thus randomized intervention studies should focus on prevention of complications that might be avoidable such as infections, heart diseases, falls and fractures.

Keywords
Hip fracture, Cause of death, Complications
National Category
Geriatrics Nursing
Identifiers
urn:nbn:se:umu:diva-123051 (URN)10.1186/s12877-016-0291-5 (DOI)000377191100002 ()27260196 (PubMedID)
Available from: 2016-08-15 Created: 2016-06-27 Last updated: 2018-06-07Bibliographically approved
Englund, U., Nordström, P., Nilsson, J., Hallmans, G., Svensson, O., Bergström, U. & Pettersson Kymmer, U. (2013). Active commuting reduces the risk of wrist fractures in middle-aged women: the UFO study. Osteoporosis International, 24(2), 533-540
Open this publication in new window or tab >>Active commuting reduces the risk of wrist fractures in middle-aged women: the UFO study
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2013 (English)In: Osteoporosis International, ISSN 0937-941X, E-ISSN 1433-2965, Vol. 24, no 2, p. 533-540Article in journal (Refereed) Published
Abstract [en]

Middle-aged women with active commuting had significantly lower risk for wrist fracture than women commuting by car/bus.

INTRODUCTION: Our purpose was to investigate whether a physically active lifestyle in middle-aged women was associated with a reduced risk of later sustaining a low-trauma wrist fracture.

METHODS: The Umeå Fracture and Osteoporosis (UFO) study is a population-based nested case-control study investigating associations between lifestyle and fragility fractures. From a cohort of ~35,000 subjects, we identified 376 female wrist fracture cases who had reported data regarding their commuting habits, occupational, and leisure physical activity, before they sustained their fracture. Each fracture case was compared with at least one control drawn from the same cohort and matched for age and week of reporting data, yielding a total of 778 subjects. Mean age at baseline was 54.3 ± 5.8 years, and mean age at fracture was 60.3 ± 5.8 years.

RESULTS: Conditional logistic regression analysis with adjustments for height, body mass index, smoking, and menopausal status showed that subjects with active commuting (especially walking) were at significantly lower risk of sustaining a wrist fracture (OR 0.48; 95 % CI 0.27-0.88) compared with those who commuted by car or bus. Leisure time activities such as dancing and snow shoveling were also associated with a lower fracture risk, whereas occupational activity, training, and leisure walking or cycling were unrelated to fracture risk.

CONCLUSION: This study suggests that active commuting is associated with a lower wrist fracture risk, in middle-aged women.

Place, publisher, year, edition, pages
Springer, 2013
National Category
Orthopaedics
Identifiers
urn:nbn:se:umu:diva-29829 (URN)10.1007/s00198-012-1988-8 (DOI)000314274400015 ()22525983 (PubMedID)
Available from: 2009-11-25 Created: 2009-11-24 Last updated: 2018-06-08Bibliographically approved
Englund, U., Nordström, P., Nilsson, J., Bucht, G., Björnstig, U., Hallmans, G., . . . Pettersson Kymmer, U. (2011). Physical activity in middle-aged women and hip fracture risk: the UFO study. Osteoporosis International, 22(2), 499-505
Open this publication in new window or tab >>Physical activity in middle-aged women and hip fracture risk: the UFO study
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2011 (English)In: Osteoporosis International, ISSN 0937-941X, E-ISSN 1433-2965, Vol. 22, no 2, p. 499-505Article in journal (Refereed) Published
Abstract [en]

Summary: In a population-based case-control study, we demonstrate that middle-aged women who were active with walking or in different physical spare time activities were at lower risk of later sustaining a hip fracture compared to more sedentary women.

Introduction: In middle-aged women participating in the Umeå Fracture and Osteoporosis (UFO) study, we investigated whether physical activity is associated with a subsequent decreased risk of sustaining a hip fracture.

Methods: The UFO study is a nested case-control study investigating associations between bone markers, lifestyle, and osteoporotic fractures. We identified 81 female hip fracture cases that had reported lifestyle data before they sustained their fracture. Each case was compared with two female controls who were identified from the same cohort and matched for age and week of reporting data, yielding a total cohort of 237 subjects. Mean age at baseline was 57.2 ± 5.0 years, and mean age at fracture was 65.4 ± 6.4 years.

Results: Conditional logistic regression analysis with adjustments for height, weight, smoking, and menopausal status showed that subjects who were regularly active with walking or had a moderate or high frequency of physical spare time activities (i.e. berry/mushroom picking and snow shovelling) were at reduced risk of sustaining a hip fracture (OR 0.14; 95% CI; 0.05–0.53 for walking and OR 0.19; 95% CI; 0.08–0.46, OR 0.17, 95% CI; 0.05–0.64 for moderate and high frequency of spare time activities, respectively) compared to more sedentary women.

Conclusion: An active lifestyle in middle age seems to reduce the risk of future hip fracture. Possible mechanisms may include improved muscle strength, coordination, and balance resulting in a decreased risk of falling and perhaps also direct skeletal benefits.

Keywords
Epidemiology, Hip fracture, Physical activity, Risk factors, Women
National Category
Geriatrics
Identifiers
urn:nbn:se:umu:diva-29823 (URN)10.1007/s00198-010-1234-1 (DOI)
Available from: 2009-11-24 Created: 2009-11-24 Last updated: 2018-06-08Bibliographically approved
Englund, U., Littbrand, H., Sondell, A., Bucht, G. & Pettersson, U. (2009). The beneficial effects of exercise on BMC are lost after cessation: a 5-year follow-up in older post-menopausal women. Scandinavian Journal of Medicine and Science in Sports, 19(3), 381-388
Open this publication in new window or tab >>The beneficial effects of exercise on BMC are lost after cessation: a 5-year follow-up in older post-menopausal women
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2009 (English)In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 19, no 3, p. 381-388Article in journal (Refereed) Published
Abstract [en]

This study investigates whether the positive effects on bone mineral density (BMD, g/cm2) and neuromuscular function following a combined weight-bearing program are sustained in older women, a longer period after cessation of training. Thirty-four women (18 exercisers and 16 controls) aged 73–88 years, who completed a 12-month randomized-controlled trial, were invited to a 5-year follow-up assessment of BMD and neuromuscular function. Both groups sustained significant losses in BMD of the femoral neck, trochanter, and Ward's triangle during the follow-up period. Significant losses were also seen in all neuromuscular function tests. The inter-group change was, however, significant only for maximal walking speed where the exercise group had a significantly greater loss. In conclusion, this study suggests that gains in bone density and neuromuscular functions achieved by training are lost after cessation of training. Continuous high-intensity weight-loading physical activity is probably necessary to preserve bone density and neuromuscular function in older women.

Place, publisher, year, edition, pages
Copenhagen: Munksgaard, 2009
Keywords
bone density, muscle strength, detraining, post-menopausal, women
National Category
Geriatrics
Identifiers
urn:nbn:se:umu:diva-29822 (URN)10.1111/j.1600-0838.2008.00802.x (DOI)
Available from: 2009-11-24 Created: 2009-11-24 Last updated: 2018-06-08Bibliographically approved
Olofsson, B., Stenvall, M., Lundström, M., Carlsson, M., Englund, U., Berglund, M., . . . Gustafson, Y. (2008). Vårdprogram för patienter med höftfrakturer, andra upplagan: ortoped-geriatriskt preoperativt vårdprogram för alla patienter med höftfraktur och postoperativt vårdprogram för patienter över 80 år med cervikala och basocervikala höftfrakturer som behandlas vid Norrlands universitets sjukhus i Umeå. Umeå: Västerbottens läns landsting
Open this publication in new window or tab >>Vårdprogram för patienter med höftfrakturer, andra upplagan: ortoped-geriatriskt preoperativt vårdprogram för alla patienter med höftfraktur och postoperativt vårdprogram för patienter över 80 år med cervikala och basocervikala höftfrakturer som behandlas vid Norrlands universitets sjukhus i Umeå
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2008 (Swedish)Report (Other academic)
Place, publisher, year, edition, pages
Umeå: Västerbottens läns landsting, 2008. p. 27
Series
Äldrecentrum Västerbotten ; 2007:1
National Category
Geriatrics
Identifiers
urn:nbn:se:umu:diva-86382 (URN)
Available from: 2014-02-25 Created: 2014-02-25 Last updated: 2018-06-08Bibliographically approved
Stenvall, M., Olofsson, B., Lundström, M., Englund, U., Borssén, B., Svensson, O., . . . Gustafson, Y. (2007). A multidisciplinary, multifactorial intervention program reduces postoperative falls and injuries after femoral neck fracture.. Osteoporosis International, 18(2), 167-175
Open this publication in new window or tab >>A multidisciplinary, multifactorial intervention program reduces postoperative falls and injuries after femoral neck fracture.
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2007 (English)In: Osteoporosis International, ISSN 0937-941X, E-ISSN 1433-2965, Vol. 18, no 2, p. 167-175Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: This study evaluates whether a postoperative multidisciplinary, intervention program, including systematic assessment and treatment of fall risk factors, active prevention, detection, and treatment of postoperative complications, could reduce inpatient falls and fall-related injuries after a femoral neck fracture.

METHODS: A randomized, controlled trial at the orthopedic and geriatric departments at Umeå University Hospital, Sweden, included 199 patients with femoral neck fracture, aged >or=70 years.

RESULTS: Twelve patients fell 18 times in the intervention group compared with 26 patients suffering 60 falls in the control group. Only one patient with dementia fell in the intervention group compared with 11 in the control group. The crude postoperative fall incidence rate was 6.29/1,000 days in the intervention group vs 16.28/1,000 days in the control group. The incidence rate ratio was 0.38 [95% confidence interval (CI): 0.20 - 0.76, p=0.006] for the total sample and 0.07 (95% CI: 0.01-0.57, p=0.013) among patients with dementia. There were no new fractures in the intervention group but four in the control group.

CONCLUSION: A team applying comprehensive geriatric assessment and rehabilitation, including prevention, detection, and treatment of fall risk factors, can successfully prevent inpatient falls and injuries, even in patients with dementia.

Keywords
Accidental Falls/*prevention & control, Aged, Aged; 80 and over, Delirium/complications, Dementia/complications, Female, Femoral Neck Fractures/complications/*surgery, Humans, Kaplan-Meiers Estimate, Male, Patient Care Team, Postoperative Care/*methods, Postoperative Complications/*prevention & control, Program Evaluation/methods, Risk Factors
National Category
Geriatrics
Identifiers
urn:nbn:se:umu:diva-8291 (URN)10.1007/s00198-006-0226-7 (DOI)17061151 (PubMedID)
Available from: 2008-01-16 Created: 2008-01-16 Last updated: 2018-06-09Bibliographically approved
Lundström, M., Olofsson, B., Stenvall, M., Karlsson, S., Nyberg, L., Englund, U., . . . Gustafson, Y. (2007). Postoperative delirium in old patients with femoral neck fracture: a randomized intervention study.. Aging Clinical and Experimental Research, 19(3), 178-186
Open this publication in new window or tab >>Postoperative delirium in old patients with femoral neck fracture: a randomized intervention study.
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2007 (English)In: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 19, no 3, p. 178-186Article in journal (Refereed) Published
Abstract [en]

BACKGROUND AND AIMS: Delirium is a common postoperative complication in elderly patients which has a serious impact on outcome in terms of morbidity and costs. We examined whether a postoperative multi-factorial intervention program can reduce delirium and improve outcome in patients with femoral neck fractures.

METHODS: One hundred and ninety-nine patients, aged 70 years and over (mean age+/-SD, 82+/-6, 74% women), were randomly assigned to postoperative care in a specialized geriatric ward or a conventional orthopedic ward. The intervention consisted of staff education focusing on the assessment, prevention and treatment of delirium and associated complications. The staff worked as a team, applying comprehensive geriatric assessment, management and rehabilitation. Patients were assessed using the Mini Mental State Examination and the Organic Brain Syndrome Scale, and delirium was diagnosed according to DSM-IV criteria.

RESULTS: The number of days of postoperative delirium among intervention patients was fewer (5.0+/-7.1 days vs 10.2+/-13.3 days, p=0.009) compared with controls. A lower proportion of intervention patients were delirious postoperatively than controls (56/102, 54.9% vs 73/97, 75.3%, p=0.003). Eighteen percent in the intervention ward and 52% of controls were delirious after the seventh postoperative day (p<0.001). Intervention patients suffered from fewer complications, such as decubitus ulcers, urinary tract infections, nutritional complications, sleeping problems and falls, than controls. Total postoperative hospitalization was shorter in the intervention ward (28.0+/-17.9 days vs 38.0+/-40.6 days, p=0.028).

CONCLUSIONS: Patients with postoperative delirium can be successfully treated, resulting in fewer days of delirium, fewer other complications, and shorter length of hospitalization.

Keywords
Aged, Aged; 80 and over, Delirium/etiology/*therapy, Female, Femoral Neck Fractures/*surgery, Humans, Male, Postoperative Complications/etiology/*therapy, Time Factors
National Category
Geriatrics
Identifiers
urn:nbn:se:umu:diva-8279 (URN)10.1007/BF03324687 (DOI)17607084 (PubMedID)
Available from: 2008-01-17 Created: 2008-01-17 Last updated: 2018-06-09Bibliographically approved
Englund, U., Littbrand, H., Sondell, A., Pettersson, U. & Bucht, G. (2005). A 1-year combined weight-bearing training program is beneficial for bone mineral density and neuromuscular function in older women. Osteoporosis International, 16(9), 1117-1123
Open this publication in new window or tab >>A 1-year combined weight-bearing training program is beneficial for bone mineral density and neuromuscular function in older women
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2005 (English)In: Osteoporosis International, ISSN 0937-941X, E-ISSN 1433-2965, Vol. 16, no 9, p. 1117-1123Article in journal (Refereed) Published
Abstract [en]

Forty-eight community living women 66–87 years old volunteered to participate in a 12-month prospective, randomized, controlled, trial. The aim was to determine if a combined weight-bearing training program twice a week would be beneficial to bone mineral density and neuromuscular function. The participants were pairwise age-matched and randomly assigned to either an exercise group (n=24) or a control group (n=24). Twenty-one subjects in the intervention group and 19 in the control group completed the study. The exercise program lasted for 50 min and consisted of a combination of strengthening, aerobic, balance and coordination exercises. The mean percentage of scheduled sessions attended for the exercise group was 67%. At the completion of the study, the intervention group showed significant increments in bone mineral density of the Wards triangle (8.4%, P<0.01) as well as improvement in maximum walking speed (11.4%, P<0.001) and isometric grip strength (9.9%, P<0.05), as compared to the control group. The conclusion was that a combined weight-bearing training program might reduce fracture risk factors by improving bone density as well as muscle strength and walking ability. This program could be suitable for older community living women in general, and might, therefore, have important implications for fracture prevention.

Place, publisher, year, edition, pages
Springer, 2005
Keywords
Bone mass, Neuromuscular improvement, Training, Women
National Category
Geriatrics
Identifiers
urn:nbn:se:umu:diva-29821 (URN)10.1007/s00198-004-1821-0 (DOI)
Available from: 2009-11-24 Created: 2009-11-24 Last updated: 2018-06-08Bibliographically approved
Lundström, M., Olofsson, B., Stenvall, M., Elinge, E., Englund, U., Edlund, A., . . . Gustafson, Y. (2004). Vårdprogram för patienter med höftfrakturer: ortoped-geriatriskt preoperativt vårdprogram för alla patienter med höftfraktur och postoperativt vårdprogram för patienter över 80 år med cervikala och basocervikala höftfrakturer som behandlas vid Norrlands universitets sjukhus i Umeå. Umeå: Västerbottens läns landsting
Open this publication in new window or tab >>Vårdprogram för patienter med höftfrakturer: ortoped-geriatriskt preoperativt vårdprogram för alla patienter med höftfraktur och postoperativt vårdprogram för patienter över 80 år med cervikala och basocervikala höftfrakturer som behandlas vid Norrlands universitets sjukhus i Umeå
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2004 (Swedish)Report (Other academic)
Place, publisher, year, edition, pages
Umeå: Västerbottens läns landsting, 2004. p. 26
Series
Äldrecentrum Västerbotten ; 2004:3
National Category
Geriatrics
Identifiers
urn:nbn:se:umu:diva-86379 (URN)
Available from: 2014-02-25 Created: 2014-02-25 Last updated: 2018-06-08Bibliographically approved
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