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Johansson, Ann-Christin
Publications (10 of 10) Show all publications
Arkkukangas, M., Söderlund, A., Eriksson, S. & Johansson, A.-C. (2019). Fall Preventive Exercise With or Without Behavior Change Support for Community-Dwelling Older Adults: A Randomized Controlled Trial With Short-Term Follow-up. Journal of Geriatric Physical Therapy, 42(1), 9-17
Open this publication in new window or tab >>Fall Preventive Exercise With or Without Behavior Change Support for Community-Dwelling Older Adults: A Randomized Controlled Trial With Short-Term Follow-up
2019 (English)In: Journal of Geriatric Physical Therapy, ISSN 1539-8412, E-ISSN 2152-0895, Vol. 42, no 1, p. 9-17Article in journal (Refereed) Published
Abstract [en]

BACKGROUND AND PURPOSE: In Western countries, falls and fall-related injuries are a well-known threat to health in the aging population. Studies indicate that regular exercise improves strength and balance and can therefore decrease the incidence of falls and fall-related injuries. The challenge, however, is to provide exercise programs that are safe, effective, and attractive to the older population. The aim of this study was to investigate the short-term effect of a home-based exercise program with or without motivational interviewing (MI) compared with standard care on physical performance, fall self-efficacy, balance, activity level, handgrip strength, adherence to the exercise, and fall frequency.

METHOD: A total of 175 older adults participated in this randomized controlled study. They were randomly allocated for the Otago Exercise Program (OEP) (n = 61), OEP combined with MI (n = 58), or a control group (n = 56). The participants' mean age was 83 years. The recruitment period was from October 2012 to May 2015. Measurements of physical performance, fall self-efficacy, balance, activity level, handgrip strength, adherence to the exercise, and fall frequency were done before and 12 weeks after randomization.

RESULTS AND DISCUSSION: A total of 161 participants were followed up, and there were no significant differences between groups after a period of 12 weeks of regular exercise. Within the OEP + MI group, physical performance, fall self-efficacy, physical activity level, and handgrip strength improved significantly; likewise, improved physical performance and fall self-efficacy were found in the control group. A corresponding difference did not occur in the OEP group. Adherence to the exercise was generally high in both exercise groups.

CONCLUSION: In the short-term perspective, there were no benefits of an exercise program with or without MI regarding physical performance, fall self-efficacy, activity level, handgrip strength, adherence to the exercise, and fall frequency in comparison to a control group. However, some small effects occurred within the OEP + MI group, indicating that there may be some possible value in behavioral change support combined with exercise in older adults that requires further evaluation in both short- and long-term studies.

National Category
Geriatrics
Identifiers
urn:nbn:se:uu:diva-342495 (URN)10.1519/JPT.0000000000000129 (DOI)000457564600002 ()28244890 (PubMedID)
Funder
Swedish National Board of Health and Welfare
Available from: 2018-02-21 Created: 2018-02-21 Last updated: 2019-03-01Bibliographically approved
Tuvemo Johnson, S., Martin, C., Anens, E., Johansson, A.-C. & Hellström, K. (2018). Older adults' opinions on fall prevention in relation to physical activity level. Journal of Applied Gerontology, 37(1), 58-78
Open this publication in new window or tab >>Older adults' opinions on fall prevention in relation to physical activity level
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2018 (English)In: Journal of Applied Gerontology, ISSN 0733-4648, E-ISSN 1552-4523, Vol. 37, no 1, p. 58-78Article in journal (Refereed) Published
Abstract [en]

The purpose of this study was to explore and describe older adults' opinions regarding actions to prevent falls and to analyze differences in the opinions of highly versus less physically active older adults. An open-ended question was answered by 262 individuals aged 75 to 98 years living in the community. The answers were analyzed using qualitative content analysis, and differences in the categories were compared between highly and less physically active persons. Physical activity was measured according to a five-level scale. The content analysis resulted in eight categories: assistive devices, avoiding hazards, behavioral adaptive strategies, being physically active, healthy lifestyle, indoor modifications, outdoor modifications, and seeking assistance. Behavioral adaptive strategies were mentioned to a greater extent by highly active people, and indoor modifications were more often mentioned by less active older adults. Support for active self-directed behavioral strategies might be important for fall prevention among less physically active older adults.

National Category
Other Medical Sciences
Identifiers
urn:nbn:se:uu:diva-278203 (URN)10.1177/0733464815624776 (DOI)000417697100005 ()26769824 (PubMedID)
Available from: 2016-02-24 Created: 2016-02-24 Last updated: 2018-02-07Bibliographically approved
Arkkukangas, M., Söderlund, A., Eriksson, S. & Johansson, A.-C. (2018). One-Year Adherence to the Otago Exercise Programme with or Without Motivational Interviewing In Community-Dwelling Older People. Journal of Aging and Physical Activity, 26(3), 390-395
Open this publication in new window or tab >>One-Year Adherence to the Otago Exercise Programme with or Without Motivational Interviewing In Community-Dwelling Older People
2018 (English)In: Journal of Aging and Physical Activity, ISSN 1063-8652, E-ISSN 1543-267X, Vol. 26, no 3, p. 390-395Article in journal (Refereed) Published
Abstract [en]

This study investigated if behavioral factors, treatment with behavioral support, readiness to change, fall self-efficacy and activity habits could predict long-term adherence to an exercise program. Included in this study were 114 community-dwelling older people who had participated in one of two home-based exercise interventions. Behavioral factors associated with adherence to the exercise program over 52 weeks were analyzed. The behavioral factors, specifically activity habits at baseline, significant predicted adherence to the exercise program, with an odds ratio (OR) of 3.39 and 95% CI = 1.38-8.32 for exercise and an OR of 6.11 and 95% CI = 2.34-15.94 for walks. Being allocated to a specific treatment including motivational interviewing (MI) was also significantly predictive: OR = 2.47 and 95% CI = 1.11-5.49 for exercise adherence. In conclusion, activity habits and exercise in combination with MI had a significant association with adherence to the exercise program at a one-year follow up.

Keywords
motivational interviewing, older adults, physical activity
National Category
Physiotherapy
Identifiers
urn:nbn:se:uu:diva-342494 (URN)10.1123/japa.2017-0009 (DOI)000441464400005 ()28952864 (PubMedID)
Available from: 2018-02-21 Created: 2018-02-21 Last updated: 2018-10-15Bibliographically approved
Johansson, A.-C., Öhrvik, J. & Söderlund, A. (2016). Associations among pain, disability and psychosocial factors and the predictive value of expectations on returning to work in patients who undergo lumbar disc surgery. European spine journal, 25(1), 296-303
Open this publication in new window or tab >>Associations among pain, disability and psychosocial factors and the predictive value of expectations on returning to work in patients who undergo lumbar disc surgery
2016 (English)In: European spine journal, ISSN 0940-6719, E-ISSN 1432-0932, Vol. 25, no 1, p. 296-303Article in journal (Refereed) Published
Abstract [en]

PURPOSE: The aim of this study was to describe the associations among pain, disability and psychosocial factors preoperatively as well as 3 and 24 months later for patients who undergo first time discectomy and to analyse the predictive value of psychosocial factors on the outcome 24 months after surgery.

METHODS: Fifty-nine patients, 41 % women, with a mean age of 40 years and without comorbidities were included, of whom 56 responded to the 24-month follow-up; at that point, they were divided into patients with complaints (C, n = 36) and patients without complaints (NC, n = 20). Correlations among the pain intensity, disability and psychosocial factors were analysed preoperatively, 3 and 24 months after discectomy, and regression analyses of psychosocial factors on the outcome at 24 months were performed.

RESULTS: Psychosocial variables were weakly correlated with the pain intensity and disability preoperatively. High expectations on the return to work were predictive of both pain intensity (β = 8.0, p = 0.03) and disability (β = 9.1, p < 0.001) at 24 months. Associations between psychosocial variables and outcome variables were strengthened at the 3-month follow-up in the C group, and this association remained 24 months after surgery. Fear of movement was most strongly correlated with leg pain intensity (r (s) 0.64, p < 0.001) and the ability to decrease pain was the most correlated with disability (r (s) 0.78, p < 0.001).

CONCLUSION: Having high expectations on the return to work after surgery was the strongest predictor for a favourable outcome. Therefore, low preoperative expectations on return to work convey an important prognostic signal.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-281757 (URN)10.1007/s00586-015-3820-6 (DOI)25716659 (PubMedID)
Available from: 2016-03-30 Created: 2016-03-30 Last updated: 2017-05-04Bibliographically approved
Lindblad, K., Bergkvist, L. & Johansson, A.-C. (2016). Evaluation of the treatment of chronic chemotherapy-induced peripheral neuropathy using long-wave diathermy and interferential currents: a randomized controlled trial.. Supportive Care in Cancer, 24(6), 2523-2531
Open this publication in new window or tab >>Evaluation of the treatment of chronic chemotherapy-induced peripheral neuropathy using long-wave diathermy and interferential currents: a randomized controlled trial.
2016 (English)In: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 24, no 6, p. 2523-2531Article in journal (Refereed) Published
Abstract [en]

PURPOSE: The purpose was to investigate the effects of long-wave diathermy in combination with interferential currents (interferential therapy and long-wave diathermy at high power (ITH)) in comparison with long-wave diathermy at a power below the active treatment dose (long-wave diathermy at low power (LDL), control group) on sensory and motor symptoms in patients with chronic chemotherapy-induced peripheral neuropathy (CIPN) in the lower extremities.

METHODS: Sixty-seven patients with chronic CIPN were randomized to 12 weeks of either ITH or LDL. Follow-up assessments were performed after the treatment period and at 37 weeks after randomization. The primary outcome was pain (Numeric Rating Scale (NRS)), and the secondary outcomes were discomfort, nerve symptoms, subjective measurement of dizziness (Dizziness Handicap Inventory), and balance. Differences within and between groups were analyzed.

RESULTS: Pain intensity decreased significantly only in the LDL group directly after the treatment period from NRS median 25 to median 12.5 (P = 0.017). At the 37-week follow-up, no changes were detected, irrespective of group (NRS 13 vs. 20, P = 0.885). Discomfort decreased significantly in both groups at both 12 and 37 weeks after the baseline (P < 0.05). Balance disability showed significant declines in both groups at 12 and 37 weeks (P = 0.001/0.025 in the ITH group vs P = 0.001/<0.001 in the LDL group). Balance ability (tightened Romberg test) increased significantly at both 12 and 37 weeks in both groups (P = 0.004/<0.040 in the ITH group) but did not improve in the LDL group at any of the follow-up time points (P = 0.203 vs P = 0.383). The one-legged stance test was unchanged in the ITH group after 12 weeks but improved 37 weeks after baseline (P = 0.03). No significant changes were observed in the LDL group at any of the follow-up time points.

CONCLUSION: This study provides no support for the use of a combination of long-wave diathermy and ITH as a treatment option for patients with chronic CIPN. However, the chronic CIPN symptoms decreased with time irrespective of the treatment.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-281762 (URN)10.1007/s00520-015-3060-7 (DOI)000374983300017 ()26687020 (PubMedID)
Available from: 2016-03-30 Created: 2016-03-30 Last updated: 2017-11-30Bibliographically approved
Arkkukangas, M., Tuvemo Johnson, S., Hellström, K., Söderlund, A., Eriksson, S. & Johansson, A.-C. (2015). A feasibility study of a randomised controlled trial comparing fall prevention using exercise with or without the support of motivational interviewing. Preventive Medicine Reports, 2, 134-140
Open this publication in new window or tab >>A feasibility study of a randomised controlled trial comparing fall prevention using exercise with or without the support of motivational interviewing
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2015 (English)In: Preventive Medicine Reports, ISSN 0350-1159, E-ISSN 2211-3355, Vol. 2, p. 134-140Article in journal (Refereed) Published
National Category
Health Sciences
Identifiers
urn:nbn:se:uu:diva-278198 (URN)10.1016/j.pmedr.2015.01.007 (DOI)
Available from: 2016-02-24 Created: 2016-02-24 Last updated: 2018-02-21Bibliographically approved
Rodby-Bousquet, E., Agustsson, A., Jonsdottir, G., Czuba, T., Johansson, A.-C. & Hagglund, G. (2014). Interrater reliability and construct validity of the Posture and Postural Ability Scale in adults with cerebral palsy in supine, prone, sitting and standing positions. Clinical Rehabilitation, 28(1), 82-90
Open this publication in new window or tab >>Interrater reliability and construct validity of the Posture and Postural Ability Scale in adults with cerebral palsy in supine, prone, sitting and standing positions
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2014 (English)In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 28, no 1, p. 82-90Article in journal (Refereed) Published
Abstract [en]

Objective:To evaluate reliability, internal consistency and construct validity of the Posture and Postural Ability Scale for adults with cerebral palsy. Design:Psychometric evaluation of a clinical assessment tool. Setting:Rehabilitation centres in Sweden and Iceland. Subjects:Thirty adults with cerebral palsy aged 19-22 years, six people at each level I-V of the Gross Motor Function Classification System. Main measures:The Posture and Postural Ability Scale contains a 7-point ordinal scale for postural ability in supine, prone, sitting and standing, and items for assessment of posture. Posture and postural ability was rated from photos and videos by three independent assessors. Interrater reliability was calculated using weighted kappa. Internal consistency was analysed with Cronbach's alpha if item deleted and corrected item-total correlation. Construct validity was evaluated based on known groups, using Jonckheere Terpstra for averaged values of the three raters relative to the Gross Motor Function Classification System. Results:There was an excellent interrater reliability (kappa = 0.85-0.99) and a high internal consistency (alpha = 0.96-0.97, item-total correlation = 0.60-0.91). Median values differed (P < 0.02) between known groups represented by the levels of gross motor function, showing construct validity for all items. Conclusion:The Posture and Postural Ability Scale showed an excellent interrater reliability for experienced raters, a high internal consistency and construct validity. It can detect postural asymmetries in adults with cerebral palsy at all levels of gross motor function.

Keywords
Posture, postural control, assessment, cerebral palsy, reliability, validity
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-223584 (URN)10.1177/0269215512465423 (DOI)000332823700008 ()
Available from: 2014-04-24 Created: 2014-04-22 Last updated: 2017-12-05Bibliographically approved
Rothman, M. G., Ortendahl, M., Rosenblad, A. & Johansson, A.-C. (2013). Improved Quality of Life, Working Ability, and Patient Satisfaction After a Pretreatment Multimodal Assessment Method in Patients With Mixed Chronic Muscular Pain: A Randomized-controlled Study. The Clinical Journal of Pain, 29(3), 195-204
Open this publication in new window or tab >>Improved Quality of Life, Working Ability, and Patient Satisfaction After a Pretreatment Multimodal Assessment Method in Patients With Mixed Chronic Muscular Pain: A Randomized-controlled Study
2013 (English)In: The Clinical Journal of Pain, ISSN 0749-8047, E-ISSN 1536-5409, Vol. 29, no 3, p. 195-204Article in journal (Refereed) Published
Abstract [en]

Objective:

To investigate whether a pretreatment multimodal (MM) assessment of patients with chronic muscular pain has an impact on treatment outcome.

Methods:

The present randomized-controlled study evaluated an MM assessment compared with routine multidisciplinary assessment given to a control group. The study population consisted of primary care patients with mixed chronic muscular pain. Variables assessed were: pain intensity, depression, life stress, quality of life (QOL), disability, working ability, and treatment satisfaction. Follow-up was performed at 15 months and 182 patients of 220 (83%) completed the study.

Results:

Univariate and multivariate logistic regression showed from baseline to 15 months a significant improvement in QOL as measured by Short-Form 36 in the MM group compared with the control group on the domains of physical function (odds ratio 2.40; 95% confidence interval 1.32-4.37), role physical (2.37; 1.10-5.09), and role emotional (2.05; 1.05-3.96). Working ability improved more significantly in the MM group (46% vs. 35%) and impairment was less (1% vs. 15%) compared with the control group (P = 0.016). Satisfaction with the assessment was, on average, higher (P < 0.001) in the MM group than in the control group.

Discussion:

Patients who underwent an MM assessment before treatment in comparison with patients receiving routine multidisciplinary assessment improved QOL, working ability, and were also significantly more satisfied. This result indicates that MM pretreatment assessment could be advantageous in the selection of patients for suitable rehabilitation treatment in a primary care setting, and also be used to prepare patients for future rehabilitation.

Keywords
chronic pain, multimodal, assessment, quality of life, working ability
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-196515 (URN)10.1097/AJP.0b013e318250e544 (DOI)000314630600002 ()
Available from: 2013-03-13 Created: 2013-03-11 Last updated: 2017-12-06Bibliographically approved
Johansson, A.-C., Gunnarsson, L.-G., Linton, S. J., Bergkvist, L., Stridsberg, M., Nilsson, O. & Cornefjord, M. (2008). Pain, disability and coping reflected in the diurnal cortisol variability in patients scheduled for lumbar disc surgery. European Journal of Pain, 12(5), 633-640
Open this publication in new window or tab >>Pain, disability and coping reflected in the diurnal cortisol variability in patients scheduled for lumbar disc surgery
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2008 (English)In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 12, no 5, p. 633-640Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

Symptoms of lumbar disc herniation can be induced by both mechanical compression of the nerve roots and by biochemical irritants from the disc tissues. Proinflammatory cytokines, as well as stress are potent stimulators of the hypothalamic-pituitary-adrenal axis, reflected in enhanced release of cortisol from the adrenal cortex. Altered cortisol production is also associated to behaviour and coping patterns. The aim of the present study was to explore the relation between pain, physical function, psychosocial factors and quality of life to the diurnal cortisol variability, in patients with lumbar disc herniation.

METHOD:

This study had a cross-sectional design. Forty-two patients with lumbar disc herniation, verified by magnetic resonance imaging and a clinical examination by an orthopaedic surgeon, were included in the study. All patients were scheduled for disc surgery. The diurnal cortisol variability was examined before surgery. The patients were dichotomised into two groups based on low or high diurnal cortisol variability. Pain, disability, work related stress, quality of life, coping and fear avoidance beliefs, were estimated by standardised questionnaires.

RESULTS:

The low diurnal cortisol variability group was distinguished by a higher median score regarding leg pain at activity and significantly more disability (p<0.05). The patients with a low diurnal cortisol variability had significantly lower coping self-statement scores, but higher pain coping catastrophising scores (p<0.05).

CONCLUSION:

Patients with lumbar disc herniation and a low diurnal cortisol variability had lower physical function, perceived lower possibilities of influencing their pain, and were more prone to catastrophise than patients with lumbar disc herniation and a high diurnal cortisol variability.

Keywords
disc herniation, pain, disability, coping, salivary cortisol
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-98669 (URN)10.1016/j.ejpain.2007.10.009 (DOI)000256355700012 ()18077197 (PubMedID)
Available from: 2009-03-02 Created: 2009-03-02 Last updated: 2017-12-13Bibliographically approved
Johansson, A.-C., Cornefjord, M., Bergkvist, L., Öhrvik, J. & Linton, S. J. (2007). Psychosocial stress factors among patients with lumbar disc herniation, scheduled for disc surgery in comparison with patients scheduled for arthroscopic knee surgery. European spine journal, 16(7), 961-970
Open this publication in new window or tab >>Psychosocial stress factors among patients with lumbar disc herniation, scheduled for disc surgery in comparison with patients scheduled for arthroscopic knee surgery
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2007 (English)In: European spine journal, ISSN 0940-6719, E-ISSN 1432-0932, Vol. 16, no 7, p. 961-970Article in journal (Refereed) Published
Abstract [en]

Returning to work after disc surgery appears to be more heavily influenced by psychological aspects of work than by MR-identified morphological alterations. It is still not known whether psychosocial factors of importance for outcome after disc surgery are present preoperatively or develop in the postoperative phase. The aim of this study was to investigate the presence of work-related stress, life satisfaction and demanding life events, among patients undergoing first-time surgery for lumbar disc herniation in comparison with patients scheduled for arthroscopic knee surgery. Sixty-nine patients with disc herniation and 162 patients awaiting arthroscopy were included in the study, during the time period March 2003 to May 2005. Sixty-two percent of the disc patients had been on sick leave for an average of 7.8 months and 14 percent of the knee patients had been on sick leave for an average of 4.2 months. The psychosocial factors were investigated preoperatively using a questionnaire, which was a combination of the questionnaire of quality of work competence (QWC), life satisfaction (LiSat9) and life events as a modification of the social readjustment scale. There were no significant differences between the two groups in terms of work-related stress or the occurrence of demanding life events. The disc patients were significantly less satisfied with functions highly inter-related to pain and discomfort, such as present work situation, leisure-time, activities of daily living (ADL) function and sleep. Patients with disc herniation on sick leave were significantly less satisfied with their present work situation than knee patients on sick leave; this sub-group of patients with disc herniation also reported significantly higher expectations in relation to future job satisfaction than knee patients. The results indicate that psychosocial stress is not more pronounced preoperatively in this selected group of disc patients, without co-morbidity waiting for first-time disc surgery, than among knee patients awaiting arthroscopy. It was notable that the disc patients had high expectations in terms of improved job satisfaction after treatment by surgery.

Keywords
Lumbar disc herniation, Disc surgery, Psychosocial factors, Job satisfaction, Stress
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-11429 (URN)10.1007/s00586-007-0319-9 (DOI)000248051000012 ()17347823 (PubMedID)
Available from: 2007-09-13 Created: 2007-09-13 Last updated: 2017-12-11Bibliographically approved
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