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  • 1. Agnew, Louise
    et al.
    Johnston, Venerina
    Ludvigsson, Maria Landen
    Peterson, Gunnel
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Overmeer, Thomas
    Johansson, Gun
    Peolsson, Anneli
    Factors associated with work ability in patients with chronic whiplash-associated disorder grade II-III: A cross-sectional analysis2015In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 47, no 6, p. 546-551Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate the factors related to self-perceived work ability in patients with chronic whiplash-associated disorder grades II-III. Design: Cross-sectional analysis. Patients: A total of 166 working age patients with chronic whiplash-associated disorder. Methods: A comprehensive survey collected data on work ability (using the Work Ability Index); demographic, psychosocial, personal, work- and condition-related factors. Forward, stepwise regression modelling was used to assess the factors related to work ability. Results: The proportion of patients in each work ability category were as follows: poor (12.7%); moderate (39.8%); good (38.5%); excellent (9%). Seven factors explained 65% (adjusted R-2 = 0.65, p < 0.01) of the variance in work ability. In descending order of strength of association, these factors are: greater neck disability due to pain; reduced self-rated health status and health-related quality of life; increased frequency of concentration problems; poor workplace satisfaction; lower self-efficacy for performing daily tasks; and greater work-related stress. Conclusion: Condition-specific and psychosocial factors are associated with self-perceived work ability of individuals with chronic whiplash-associated disorder.

  • 2.
    Alriksson-Schmidt, Ann I.
    et al.
    Lund Univ, Div Orthopaed, Dept Clin Sci, Lund, Sweden..
    Arner, Marianne
    Karolinska Inst, Dept Clin Sci & Educ, Stockholm, Sweden.;Soder Sjukhuset, Dept Hand Surg, Stockholm, Sweden..
    Westbom, Lena
    Lund Univ, Skne Univ Hosp, Dept Clin Sci, Paediat, Lund, Sweden.;Karolinska Inst, Astrid Lindgren Childrens Hosp, Dept Womens & Childrens Hlth, Stockholm, Sweden..
    Krumlinde-Sundholm, Lena
    Lund Univ, Dept Hlth Sci, Fac Med, Lund, Sweden..
    Nordmark, Eva
    Rodby-Bousquet, Elisabet
    Lund Univ, Div Orthopaed, Dept Clin Sci, Lund, Sweden.;Lund Univ, Dept Hlth Sci Fac Med, Lund, Sweden..
    Hägglund, Gunnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Lund Univ, Div Orthopaed, Dept Clin Sci, Lund, Sweden..
    A combined surveillance program and quality register improves management of childhood disability2017In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 39, no 8, p. 830-836Article in journal (Refereed)
    Abstract [en]

    Purpose: To describe a concept for prevention of secondary conditions in individuals with chronic neuromuscular disabilities by using two Swedish developed follow-up-programmes for cerebral palsy (CP; CPUP) and myelomeningocele (MMC; MMCUP) respectively as examples. Method: This paper describes and outlines the rationale, development and implementation of CPUP and MMCUP. Results: Both programmes are multidisciplinary longitudinal follow-up programmes that simultaneously serve as national registries. The programmes are population-based and set in Swedish habilitation clinics. Most children (95%) born 2000 or later with CP are enrolled in CPUP and the recruitment of adults is underway. CPUP has also been implemented in Norway, Denmark, Iceland, Scotland and parts of Australia. In MMCUP, almost all children with MMC born 2007 or later participate and individuals of all ages are now invited. The registries provide epidemiological profiles associated with CP and MMC and platforms for population-based research and quality of care improvement. Conclusions: Through multidisciplinary follow-up and early detection of emerging complications individuals with CP or MMC can receive less complex and more effective interventions than if treatment is implemented at a later stage. Possibilities and challenges to design, implement and continuously run multidisciplinary secondary prevention follow-up programmes and quality registries for individuals with CP or MMC are described and discussed.Implications for rehabilitationIndividuals with disabilities such as cerebral palsy or myelomeningocele are at risk of developing secondary conditions.Multidisciplinary population-based longitudinal follow-up programmes seem effective in preventing certain types of secondary conditions. IMPLICATIONS FOR REHABILITATION Individuals with disabilities such as cerebral palsy or myelomeningocele are at risk of developing secondary conditions. Multidisciplinary population-based longitudinal follow-up programmes seem effective in preventing certain types of secondary conditions.

  • 3.
    Andersson, Ellinor
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Asklöf, Josefine
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    CrossFit-tränares uppfattning av skadepreventiva åtgärder och betydelsen av tränarnärvaro: en intervjustudie2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background CrossFit is defined as constantly varied functional training and is performed in high intensity. It combines olympic lifting, gymnastics and metabolic conditioning. The rapid growth of the sport has caused concerns for injuries. There has been shown that the involvement and presence of CrossFit trainers reduces injury but there is no requirement for practitioners to participate in supervised training.

    Purpose To explore the facilitating and aggravating factors that CrossFit trainers experience for implementation of injury prevention. Furthermore, study the trainers’ view of how important the trainer’s prescense is for injury prevention.

    Design and method A qualitative design was used in this study. Five CrossFit trainers with more than one year experience of being a trainer participated. A qualitative content analysis was used according to Granehiem and Lundman’s inductive strategy for data processing.

    Results Among the faciliating factors were for example Competence described which included knowledge and education. Amongst aggravating factors insufficient knowledge were for exampel described. The presence of the trainer was described as meaningful to prevent injuries. Experiences of fewer injuries, correction of performance and greater focus on technique were brought to attention.

    Conclusion The result supports the importance of focusing on presence of the CrossFit trainer and presents facilitating and aggravating factors that may be relevant to the development of future education for CrossFit trainers.

  • 4.
    Andersson, Mikael
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Assessing Physical Activity and Physical Capacity in Subjects with Chronic Obstructive Pulmonary Disease2014Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of this thesis was to assess measurement properties of methods suitable for screening or monitoring of physical capacity and physical activity in subjects with chronic obstructive pulmonary disease (COPD), and to explore factors associated with physical activity levels.

    Methods: Four observational studies were conducted. Participants in studies I-III (sample sizes) (n=49, n=15, n=73) were recruited from specialist clinics, and in study IV from a population-based cohort (COPD n=470 and Non-COPD n=659). Psychometric properties of methods assessing physical capacity (study I) and physical activity (study II) were investigated in laboratory settings. Daily physical activity and clinical characteristics were assessed with objective methods (study III) and with subjective methods (study IV).

    Results: Physical capacity as measured by walking speed during a 30-metre walk test displayed high test-retest correlations (ICC>0.87) and small measurement error. The accuracy for step count and body positions differed between activity monitors and direct observations. In study III 92% of subjects had an activity level below what is recommended in guidelines. Forty five percent of subjects’ activity could be accounted for by clinical characteristics with lung function (22.5%), walking speed (10.1%), quadriceps strength (7.0%) and fat-free mass index (3.0%) being significant predictors. In study IV, low physical activity was significantly more prevalent in COPD subjects from GOLD grade ≥II than among Non-COPD subjects (22.4 vs. 14.6%, p = 0.016). The strongest factors associated with low activity in COPD subjects were a history of heart disease, OR (CI 95%) 2.11 (1.10-4.08) and fatigue, OR 2.33 (1.31-4.13) while obesity was the only significant factor in Non-COPD subjects, OR 2.26 (1.17-4.35).

    Conclusion: The 30 meter walk test and activity monitors are useful when assessing physical capacity and physical activity, respectively in patients with COPD. Impaired physical activity in severe COPD is related to low lung function, low walking speed, low muscle strength and altered body composition, whereas comorbidities and fatigue are linked to insufficient physical activity in patients with moderately severe COPD.

    List of papers
    1. Measuring walking speed in COPD: test-retest reliability of the 30-metre walk test and comparison with the 6-minute walk test
    Open this publication in new window or tab >>Measuring walking speed in COPD: test-retest reliability of the 30-metre walk test and comparison with the 6-minute walk test
    Show others...
    2011 (English)In: Primary Care Respiratory Journal, ISSN 1471-4418, E-ISSN 1475-1534, Vol. 20, no 4, p. 434-440Article in journal (Refereed) Published
    Abstract [en]

    AIMS:

    To examine test-retest reliability of the 30-metre walk test (30mWT) in patients with chronic obstructive pulmonary disease (COPD) and to compare the 30mWT with the 6-minute walk test (6MWT).

    METHODS:

    Forty-nine subjects with stable COPD were included. The 30mWT consists of walking at different walking intensities over a distance of 30 metres - self-selected speed (ss-30mWT) and maximal speed (ms-30mWT). The test was conducted twice and the time to walk 30 metres was recorded. The 6MWT was performed in duplicate on the same day.

    RESULTS:

    Test-retest reliability was high: intraclass correlation coefficient (ICC2.1) = 0.93 (95% CI 0.87 to 0.97) for maximal walking speed and 0.87 (95% CI 0.78 to 0.93) for self-selected walking speed. Both maximal and self-selected speed had a standard error of measurement (SEM) of 0.07 m/s and SEM% was 4.4 for maximal speed and 5.9 for self-selected speed. The correlation, criterion validity, between ms-30mWT and the 6MWT was r=0.78 (p<0.001). Heart rate, dyspnoea, exertion and oxygen saturation were more affected after the 6MWT than after the 30mWT (p<0.001).

    CONCLUSIONS:

    The 30mWT is a reliable submaximal test that is easy to perform and can be used to measure physical function (walking ability) in patients with COPD. It may be well suited for primary care settings.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-162963 (URN)10.4104/pcrj.2011.00082 (DOI)000304279300022 ()21938352 (PubMedID)
    Available from: 2011-12-06 Created: 2011-12-06 Last updated: 2017-12-08Bibliographically approved
    2. Accuracy of three activity monitors in patients with chronic obstructive pulmonary disease: A comparison with video recordings
    Open this publication in new window or tab >>Accuracy of three activity monitors in patients with chronic obstructive pulmonary disease: A comparison with video recordings
    2014 (English)In: COPD: Journal of Chronic Obstructive Pulmonary Disease, ISSN 1541-2555, E-ISSN 1541-2563, Vol. 11, no 5, p. 560-567Article in journal (Refereed) Published
    Abstract [en]

    Low physical activity and sedentary behaviour characterise the lives of patients with chronic obstructive pulmonary disease (COPD). Using activity monitors, assessment of both aspects are possible, but many outcomes are not well validated. The aim of this study was to assess the accuracy and equivalency of three activity monitors regarding steps, body position and their ability to differentiate between periods of physical activity and inactivity.

    Fifteen patients with COPD (8 females; median (interquartile range, IQR) age, 64 (59-69) years; forced expiratory volume in one second, 37 (28-48) % predicted; six-minute walk distance, 444 (410-519) m) were enrolled. The DynaPort ADL-monitor, the DynaPort MiniMod monitor and the SenseWear Armband Pro 3 monitor were assessed. Subjects performed a structured protocol alternating physical activity and inactivity while simultaneously wearing all three monitors and being video recorded.

    The mean difference (limits of agreement) in step count from monitors compared to manual step count was -69 (-443 to 305) for the ADL-monitor, -19 (-141 to 103) for the MiniMod and -479 (-855 to -103) for the SenseWear Armband. Compared to the video, the sitting time was 97 (94-100) % when measured by the ADL-monitor and 121 (110-139) % by the MiniMod. Standing time was 114 (107-122) % when measured by the ADL-monitor and 68 (47-106) % by the MiniMod.

    Activity monitors are not equivalent in their abilities to detect steps or body positions. The choice of monitor should be based on the particular outcome of interest. 

    Keywords
    Activity monitor, accuracy, validity, physical activity, sedentary, rehabilitation
    National Category
    Respiratory Medicine and Allergy
    Research subject
    Medical Science
    Identifiers
    urn:nbn:se:uu:diva-220595 (URN)10.3109/15412555.2014.898033 (DOI)000342056200012 ()24734942 (PubMedID)
    Available from: 2014-03-17 Created: 2014-03-17 Last updated: 2017-12-05Bibliographically approved
    3. Physical activity level and its clinical correlates in chronic obstructive pulmonary disease: a cross-sectional study
    Open this publication in new window or tab >>Physical activity level and its clinical correlates in chronic obstructive pulmonary disease: a cross-sectional study
    Show others...
    2013 (English)In: Respiratory research (Online), ISSN 1465-9921, E-ISSN 1465-993X, Vol. 14, p. 128-Article in journal (Refereed) Published
    Abstract [en]

    Background: Decreased physical activity is associated with higher mortality in subjects with COPD. The aim of this study was to assess clinical characteristics and physical activity levels (PALs) in subjects with COPD. Methods: Seventy-three subjects with COPD (67 +/- 7 yrs, 44 female) with one-second forced expiratory volume percentage (FEV1%) predicted values of 43 +/- 16 were included. The ratio of total energy expenditure (TEE) and resting metabolic rate (RMR) was used to define the physical activity level (PAL) (PAL = TEE/RMR). TEE was assessed with an activity monitor (ActiReg), and RMR was measured by indirect calorimetry. Walking speed (measured over 30-meters), maximal quadriceps muscle strength, fat-free mass and systemic inflammation were measured as clinical characteristics. Hierarchical linear regression was applied to investigate the explanatory values of the clinical correlates to PAL. Results: The mean PAL was 1.47 +/- 0.19, and 92% of subjects were classified as physically very inactive or sedentary. The walking speed was 1.02 +/- 0.23 m/s, the quadriceps strength was 31.3 +/- 11.2 kg, and the fat-free mass index (FFMI) was 15.7 +/- 2.3 kg/m(2), identifying 42% of subjects as slow walkers, 21% as muscle-weak and 49% as FFM-depleted. The regression model explained 45.5% (p < 0.001) of the variance in PAL. The FEV1% predicted explained the largest proportion (22.5%), with further improvements in the model from walking speed (10.1%), muscle strength (7.0%) and FFMI (3.0%). Neither age, gender nor systemic inflammation contributed to the model. Conclusions: Apart from lung function, walking speed and muscle strength are important correlates of physical activity. Further explorations of the longitudinal effects of the factors characterizing the most inactive subjects are warranted.

    Keywords
    Physical activity, Activity monitor, COPD, Physical function, Body composition
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-213928 (URN)10.1186/1465-9921-14-128 (DOI)000327845500003 ()
    Available from: 2014-01-05 Created: 2014-01-05 Last updated: 2017-12-06Bibliographically approved
    4. Physical activity and fatigue in chronic obstructive pulmonary disease: A population based study
    Open this publication in new window or tab >>Physical activity and fatigue in chronic obstructive pulmonary disease: A population based study
    Show others...
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    Introduction

    Dyspnea with exertion and fatigue are the cardinal symptoms of chronic obstructive pulmonary disease (COPD); impaired muscle function and reduced exercise capacity are also frequently associated with COPD. We aimed to assess the physical activity levels, in a population based sample study, of subjects with and without COPD. We also aimed to investigate the factors associated with low physical activity in these groups.

    Methods

    In this study, 470 subjects with COPD (FEV1/FVC< 0.70) and 569 subjects without COPD (Non-COPD) were analyzed. Physical activity was assessed with the International Physical Activity Questionnaire (IPAQ). Fatigue was investigated with the Functional Assessment of Chronic Illness Therapy - Fatigue scale (FACIT-F). An interview questionnaire was used to record the sample characteristics and history of heart disease. Binary logistic regression was used to investigate the factors associated with low physical activity.

    Results

    Low physical activity was significantly more prevalent in GOLD grade ≥II COPD subjects, and this prevalence was higher than that for Non-COPD subjects (22.4 vs. 14.6%, p = 0.016). The strongest factors associated with low physical activity in COPD subjects were a history of heart disease, OR (CI 95%) 2.11 (1.10 - 4.08), and clinically significant fatigue, OR 2.33 (1.31 - 4.13); obesity was the only significant factor in Non-COPD subjects, OR 2.26 (1.17 – 4.35).

    Conclusion

    Physical activity levels are reduced for COPD grade II and higher, and the factors associated with lower levels of physical activity are different for the COPD group compared to the Non-COPD group. We propose that measurements of fatigue and a history of heart disease are useful tools to include when screening subjects for pulmonary rehabilitation.

    Keywords
    COPD, physical activity, fatigue, questionnaire, IPAQ, FACIT-F
    National Category
    Medical and Health Sciences
    Research subject
    Medical Science
    Identifiers
    urn:nbn:se:uu:diva-220600 (URN)
    Available from: 2014-03-17 Created: 2014-03-17 Last updated: 2014-04-29
  • 5.
    Andersson, Nicklas
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Thörnell, Peter
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Plantar fasciit: Sjukgymnastiska behandlingsmetoder inom primärvården i Dalarnas-, Gävleborgs- och Västmanlands län2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Background: Plantar fasciitis is the most common heel injury and is a long-term pain syndrom in the attachment of the plantar fascia to the calcaneus bone. The condition is treated mainly in primary care, but there is currently no treatment guideline for the treatment of plantar fasciitis in Sweden. The purpose of this study was to investigate which treatment that occurred in primary care in Dalarna, Gävleborg and Västmanland counties, which treatments that were most common alone and in combination with each other. The aim was also to investigate if the four most commonly used treatment methods as physical therapists said they had used were supported in the literature, and if there was any difference between county employees and private physical therapists in the choice of treatment method.

    Method: 100 physiotherapists in primary care in Dalarna, Gävleborg and Västmanland counties, received a questionnaire by mail. 80 of the 100 physiotherapists were county employees and 20 were private employees. They were asked about what treatment methods they used for plantar fasciitis, both individual treatments and combination treatments. A comparison was made between county employees and private employees' choice of treatments and the four individual most frequently used treatments were examined on the basis of recent research.

    Results: 65 physiotherapists answered the survey, of which 61 of them treated patients with plantar fasciitis. The four most frequently used treatments were taping, stretch of the plantar fascia, advice about start using insoles and advice about changing of shoes. The first three treatments named above were also those most commonly used in combination with each other. This was true for physiotherapists in county as well as in private employment. There is some evidence that these three treatments relieve pain particularly in short term.

    Conclusion: The four most frequently used treatments were taping, stretch of the plantar fascia, advice about start using insoles and advice about changing of shoes. The conclusion drawn from the evidence currently available to taping, stretch of the plantar fascia and insoles is that it should be a part of the treatment plan for patients with plantar fasciitis. Further research is needed where larger studies and follow-up studies over a longer time is made. Studies of the most common combination treatments should be made, to mimic how they are used in everyday clinical practice.

     

  • 6.
    Andréasson, Amanda
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Wirén, Tove
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    ”För mig har det här varit livsavgörande”: En kvalitativ intervjustudie om upplevelser och erfarenheter av fysioterapeutiska åtgärder vid rehabilitering i varmt klimat hos individer med ankyloserande spondylit2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 7.
    Anens, Elisabeth
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Zetterberg, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Urell, Charlotte
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Emtner, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Hellström, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Self-reported physical activity correlates in Swedish adults with multiple sclerosis: a cross-sectional study2017In: BMC Neurology, ISSN 1471-2377, E-ISSN 1471-2377, Vol. 17, article id 204Article in journal (Refereed)
    Abstract [en]

    Background: The benefits of physical activity in persons with Multiple Sclerosis (MS) are considerable. Knowledge about factors that correlate to physical activity is helpful in order to develop successful strategies to increase physical activity in persons with MS. Previous studies have focused on correlates to physical activity in MS, however falls self-efficacy, social support and enjoyment of physical activity are not much studied, as well as if the correlates differ with regard to disease severity. The aim of the study was to examine associations between physical activity and age, gender, employment, having children living at home, education, disease type, disease severity, fatigue, self-efficacy for physical activity, falls self-efficacy, social support and enjoyment of physical activity in a sample of persons with MS and in subgroups with regard to disease severity.

    Methods: This is a cross-sectional survey study including Swedish community living adults with MS, 287 persons, response rate 58.2%. The survey included standardized self-reported scales measuring physical activity, disease severity, fatigue, self-efficacy for physical activity, falls self-efficacy, and social support. Physical activity was measured by the Physical Activity Disability Survey – Revised.

    Results: Multiple regression analyzes showed that 59% (F(6,3)=64.9, p=0.000) of the variation in physical activity was explained by having less severe disease (β=-0.30), being employed (β=0.26), having high falls self-efficacy (β=0.20), having high self-efficacy for physical activity (β=0.17), and enjoying physical activity (β=0.11). In persons with moderate/severe MS, self-efficacy for physical activity explained physical activity.

    Conclusions: Consistent with previous research in persons with MS in other countries this study shows that disease severity, employment and self-efficacy for physical activity are important for physical activity. Additional important factors were falls self-efficacy and enjoyment. More research is needed to confirm this and the subgroup differences.

  • 8. Antonsson, M.
    et al.
    Fagevik Olsén, M.
    Johansson, H.
    Sandström, L.
    Urell, C.
    Westerdahl, Elisabeth
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
    Wiklund, M.
    Lungefysioterapi ved abdominal- og thoraxkirurgi2011In: Fysioterapeuten, Vol. 9Article in journal (Other academic)
    Abstract [da]

    I snart hundrede år har fysioterapeuter arbejdet på at mindske risikoen for postoperative lungekomplikationer hos patienter, der skal opereres i brystkassen og abdominalregionen. Klinisk erfaring viser, at lungefysioterapi er vigtig, men hvad ved vi i dag om effekten af forskellige former for behandling? Hvilke indsatsområder skal man i første omgang vælge? Forfatterne til denne artikel har udarbejdet retningslinjer for lungefysioterapi til patienter, som gennemgår abdominal- og thoraxkirurgi. Målet med arbejdet med retningslinjerne har været at udrede og sammensætte eksisterende evidens for lungefysioterapeutiske behandlingsmetoder i forbindelse med abdominal- og thoraxkirurgiske indgreb.

    Den samlede evidens i kombination med ekspertgruppens kommentarer har ført til anbefalinger for den kliniske behandling. Disse anbefalinger er målrettet fysioterapeuter i den kliniske praksis, som arbejder med abdominal - og thoraxkirurgiske patienter. Sigtet er, at den aktuelle og systematisk indsamlede viden vil bidrage til diskussioner på de forskellige arbejdspladser, og at anbefalingerne for behandling vil blive tilpasset de lokale forhold. Denne artikel sammenfatter retningslinjerne, som er publiceret på fysioterapiforbundets (Legitimerede Sjukgymnasters) hjemmeside under profession. De kliniske retningslinjer omfatter desuden en komplet referenceliste.

  • 9.
    Ardern, Clare L.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Linkoping Univ, Dept Med & Hlth Sci, Physiotherapy, S-58183 Linkoping, Sweden.;Aspetar Orthopaed & Sports Med Hosp, Doha, Qatar.;La Trobe Univ, Sch Allied Hlth, Melbourne, Vic, Australia..
    Peterson, Gunnel
    Linkoping Univ, Dept Med & Hlth Sci, Physiotherapy, S-58183 Linkoping, Sweden..
    Ludvigsson, Maria Landen
    Linkoping Univ, Dept Med & Hlth Sci, Physiotherapy, S-58183 Linkoping, Sweden.;Linkoping Univ, Dept Rehabil, Rehab Vast, Motala, Sweden.;Linkoping Univ, Dept Med & Hlth Sci, Motala, Sweden..
    Peolsson, Anneli
    Linkoping Univ, Dept Med & Hlth Sci, Physiotherapy, S-58183 Linkoping, Sweden..
    Satisfaction With the Outcome of Physical Therapist-Prescribed Exercise in Chronic Whiplash-Associated Disorders: Secondary Analysis of a Randomized Clinical Trial2016In: Journal of Orthopaedic and Sports Physical Therapy, ISSN 0190-6011, E-ISSN 1938-1344, Vol. 46, no 8, p. 640-649Article in journal (Refereed)
    Abstract [en]

    STUDY DESIGN: Secondary analysis of a randomized clinical trial.

    BACKGROUND: Patient perception of the benefits gained from treatment is important, yet satisfaction with the outcome of treatment for chronic whiplash-associated disorders (WADs) has not been investigated.

    OBJECTIVES: To investigate whether satisfaction with the outcome of treatment for chronic WAD changed over time, and whether there were group differences.

    METHODS: Two hundred sixteen people with chronic WAD (66% women; mean age, 40.4 years) participated in a 3-month program of physical therapist-led neck-specific exercises with or without a behavioral approach, or received a prescription of general physical activity. The main outcome was satisfaction with the outcome of treatment, assessed at baseline and 3, 6, and 12 months later. Additional outcomes were enablement and expectation fulfillment.

    RESULTS: Satisfaction improved over time in the 3 groups (odds ratio = 1.15; 95% confidence interval: 1.10, 1.20; P < .001). There was a significant group-by-time interaction (P < 001), with increased odds of being satisfied in the groups receiving neck-specific exercises compared to general physical activity. Enablement increased after completion of the intervention in all groups (P < .001). People who received neck-specific exercises reported greater enablement and expectation fulfillment than people prescribed general physical activity (P < .01).

    CONCLUSION: Exercise interventions for chronic WAD led to increased satisfaction for 12 months following treatment that was unrelated to the type of exercise intervention received.

  • 10. Arkkukangas, Marina
    et al.
    Söderlund, Anne
    Eriksson, Staffan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy. Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden .
    Johansson, Ann-Christin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
    One-Year Adherence to the Otago Exercise Programme with or Without Motivational Interviewing In Community-Dwelling Older People2018In: Journal of Aging and Physical Activity, ISSN 1063-8652, E-ISSN 1543-267X, Vol. 26, no 3, p. 390-395Article in journal (Refereed)
    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.

  • 11.
    Arvidsson, Malin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Skogs, Lisa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Muskuloskeletal skadeprevalens i nedre extremitet hos rekryter efter genomförd grundläggande militär utbildning.2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    BACKGROUND: Previous studies have shown a high injury rate in the lower extremities among military recruits. A correlation has been shown between female gender or a low level of physical activity prior to basic military training and a higher risk of injury.

    AIM: To investigate the self-reported injury rate in the lower extremities among Swedish recruits and the difference in injury rate between men and women. Another aim was to investigate correlation between self-reported injury rate in the lower extremities and self-reported physical activity, and to study this correlation for both men and women.

    METHOD: A quantitative study with a prospective, descriptive, comparative and correlative design. Data from two different questionnaires were answered by 177 recruits.

    RESULTS: 26% of the recruits reported injury in lower extremities after completing the basic training. There was a significant difference (p=0.006) in self-reported injury between female and male recruits. The level of prior physical activity and the injury rate amongst the recruits had a low correlation.

    CONCLUSION: The results indicate a high injury rate among Swedish recruits, especially among the female recruits. No correlation between self-reported physical activity and the injury rate in lower extremities was found. 

  • 12.
    Barck, Eva
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Niemi-Andersson, Ewa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Sjukgymnasters upplevelse av rehabiliteringsplaner som en del i arbetet på strokeenhet2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Purpose: To investigate a group of physiotherapists’ experiences of using treatment plans for patients in stroke units in Landstinget Gävleborg.

    Design and method: Descriptive qualitative design. Semi-structured interviews. Qualitative content analysis was conducted.

    Results: The physiotherapists found treatment plans to be useful in early rehabilitation of stroke patients. Early goal setting assist to give the patients motivation and understanding of their situation, but brain injury could make participation difficult. Treatment plans was perceived to have the potential to act as a unifying document for the team though the physiotherapists felt a constant struggle for rehab thinking in the team. Technical problems hindered the transfer of treatment plans to the next level of care.

    Conclusion: The physiotherapists saw the benefits of early goal setting, but held a constant struggle to gather the team around the treatment plan. The study suggests that the treatment plan as working instrument is not being used in all its potential. The study may contribute when forming  routines for treatment plans in the future.

  • 13.
    Barck, Hanna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Estrada Hidalgo, Sebastian
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Upplevelser av dans hos personer med ryggmärgsskada - ett bio-psyko-socialt perspektiv2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: In physiotherapy you look at the individual through a bio-psycho-social perspective. “International Classification of Function, Disability and Health” (ICF) is an instrument to measure health from a bio-psycho-social perspective. The knowledge about how dance as a physical activity effects people with spinal cord injury is insufficient. Qualitative research in this area is nonexistent.     Purpose: The purpose with the study was to examine people with spinal cord injury’s experiences with dance as a physical activity in a bio-psycho-social manner. Method: The study design was qualitative and inductive, based on semi-structured interviews with five study-participants: two men and three women in the ages 21-57, who had been dancing in wheelchair 2-33 years. The data was analyzed with qualitative content analysis. Results: The participants experienced that dancing had an impact on bodily functions: improved strength, condition, flexibility, coordination and balance. Changes in body perception (more contact with the body). They had also reduced pain. They experienced effects in personal factors: Psychological wellbeing (improved self-efficacy, self-esteem and joy) and physical wellbeing. The dance had also been generating anxiety. They experienced impact on factors involving their surroundings: social (they got more friends, experienced a unique fellowship and developed social interaction skills). They had met acceptance, some ignorance but support from close ones. They experienced impact on their activity and participation: More independent in daily life (they had become better in locomotion). Participating in the community (participating in more activities, participating in having an impact on the community). Conclusion: People with spinal cord injury experience that dancing has many positive outcomes on bio-psycho-social factors.  Physiotherapists and other professionals in health care, and people with spinal cord injury need to get knowledge about the profits of dance as a physical activity for people with spinal cord injury so that more people can take part of the benefits of dancing.

  • 14.
    Bendrik, Regina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine. Reg Gavleborg, Gavle, Sweden..
    Kallings, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine. Swedish Sch Sport & Hlth Sci, Stockholm, Sweden..
    Broms, K.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Reg Gavleborg, Gavle, Sweden..
    Emtner, Morgan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Maximal Step-Up Test A New Functional Test In Hip Or Knee Osteoarthritis2016In: Osteoarthritis and Cartilage, ISSN 1063-4584, E-ISSN 1522-9653, Vol. 24, p. S471-S471Article in journal (Other academic)
  • 15.
    Benitez, Marcus
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Frantzén, Love
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Förväntat resultat (outcome expectations) av regelbunden fysisk aktivitet hos äldre.2011Independent thesis Basic level (degree of Bachelor), 15 credits / 22,5 HE creditsStudent thesis
    Abstract [en]

    Purpose: The purpose of this study was to examine outcome expectations in terms of physical, self-evaluative and social expectations of regular physical activity/exercise in physically active or physically inactive older adults, and compare the two groups and see if any difference existed.Method: The participants were 32 conveniently selected individuals, representing the population elderly (> 65 years) and healthy individuals who are regularly physically active or inactive. The participants answered a questionnarie regarding their level of physical activity during the last 12 months which divided them into two groups, physically active or physically inactive. The Multidimensional Outcome Expectations for Exercise Scale (MOEES) questionnaire was then used to measure the participant´s level of outcome expectations of regular physical activity/exercise.

    Results: The regularly physically active participants had higher scores on MOEES, in terms of physical expectations than participants who were physically inactive. No significant difference where seen between the two when comparing the total score of MOEES and the subgroups self-evaluative, and social expectations for regular physical activity/exercise.

    Conclusion: This study showed that there in older adults, is a relation between being physically active and having higher physical outcome expectations of physical activity/exercise. Further studies which examines outcome expectations in terms of physical, self-evaluative and social expectations of regular physical activity/exercise, in physically active or physically inactive older adults is warranted.

  • 16.
    Bergström, Aileen L.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    von Koch, Lena
    Andersson, Magnus
    Tham, Kerstin
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Participation in everyday life and life satisfaction in persons with stroke and their caregivers 3–6 months after onset2015In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 47, no 6, p. 508-515Article in journal (Refereed)
    Abstract [en]

    Objective: To explore and describe persons with stroke and their caregivers' restrictions in participation in everyday occupations, i.e. occupational gaps, 3-6 months post-stroke, in relation to life satisfaction, combined life satisfaction, caregiver burden, perceived impact of stroke, and activities of daily living. Design: Cross-sectional study. Subjects: Persons with stroke and their caregivers (105 dyads). Methods: The Occupational Gaps Questionnaire, Life Satisfaction Checklist, Caregiver Burden Scale, Stroke Impact Scale and Barthel Index were used. Correlations were analysed with Spearman's rank, and regression analyses used life satisfaction as the dependent variable. Results: At least one person in 86% of the dyads perceived restrictions in participation, with the most common gap in travelling for pleasure. Correlations were low between the numbers of occupational gaps and life satisfaction (R=-0.33, R=-0.31); however, life satisfaction accounted for occupational gaps both for persons with stroke and for caregivers. A greater number of occupational gaps were perceived in the dyads with combined low levels of life satisfaction compared with those with combined high levels of life satisfaction. Conclusion: Participation in everyday occupations is related to life satisfaction even for caregivers of persons with stroke. The results of this study add to our knowledge about the stroke-caregiver dyad and will help to inform family-centred approaches within stroke rehabilitation.

  • 17.
    Bergström, Aileen L.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    von Koch, Lena
    Andersson, Magnus
    Tham, Kerstin
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Participation in everyday life and life satisfaction in persons with stroke and their caregivers 3–6 months after onset2015In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 47, no 6, p. 508-515Article in journal (Refereed)
    Abstract [en]

    Objective: To explore and describe persons with stroke and their caregivers' restrictions in participation in everyday occupations, i.e. occupational gaps, 3-6 months post-stroke, in relation to life satisfaction, combined life satisfaction, caregiver burden, perceived impact of stroke, and activities of daily living. Design: Cross-sectional study. Subjects: Persons with stroke and their caregivers (105 dyads). Methods: The Occupational Gaps Questionnaire, Life Satisfaction Checklist, Caregiver Burden Scale, Stroke Impact Scale and Barthel Index were used. Correlations were analysed with Spearman's rank, and regression analyses used life satisfaction as the dependent variable. Results: At least one person in 86% of the dyads perceived restrictions in participation, with the most common gap in travelling for pleasure. Correlations were low between the numbers of occupational gaps and life satisfaction (R=-0.33, R=-0.31); however, life satisfaction accounted for occupational gaps both for persons with stroke and for caregivers. A greater number of occupational gaps were perceived in the dyads with combined low levels of life satisfaction compared with those with combined high levels of life satisfaction. Conclusion: Participation in everyday occupations is related to life satisfaction even for caregivers of persons with stroke. The results of this study add to our knowledge about the stroke-caregiver dyad and will help to inform family-centred approaches within stroke rehabilitation.

  • 18.
    Bergström, Johan
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Linnér, Marcus
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Kan en målad trappa förändra beteenden?: En interventionsstudie om människors beteende när miljön de interagerar med förändras.2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Infrastructure and how we choose to build our cities control the population's patterns of activity. Infrastructure and technology have evolved into society and provided alternative approaches to get up and down between different floors. More people choose the escalators and the elevator before the stairs and miss out on the positive effects that are connected to everyday stairwells. Purpose: The purpose of the study was to investigate whether it could affect people's behavior to take the stairs instead of the escalator, by changing the environment with a stairway painting. Method: The study was a prospective, quasi-experimental, descriptive intervention study with a consecutive selection. The people who passed the stairs / escalators for a predetermined period of time were studied. The measurements were made using a traffic measurement system (OTUS3D) and lasted for three weeks. First, a baseline was measured during week one, painting the staircase during week two, and measurement for the intervention week three. Summary of results: This study showed no improvement in behavioral change in pedestrians. The statistically significant decrease of pedestrians in the stairs can be explained by the large number of participants in the study. Conclusion: There are many unresolved questions about what affects people's behavior in their daily lives. The number of factors is greater than this study has tested. Other interventions in the form of another motive or architectural design may produce other results.

  • 19.
    Björnsdóttir, Sigrún Vala
    et al.
    Univ Iceland, Fac Med, Dept Phys Therapy, Reykjavik, Iceland.;Univ Iceland, Fac Med, Ctr Publ Hlth Sci, Reykjavik, Iceland..
    Arnljotsdottir, Margret
    HNLFI Rehabil Clin, Hverageroi, Iceland..
    Tomasson, Gunnar
    Univ Iceland, Fac Med, Ctr Publ Hlth Sci, Reykjavik, Iceland..
    Triebel, Jan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics. HNLFI Rehabil Clin, Hverageroi, Iceland..
    Valdimarsdottir, Unnur Anna
    Univ Iceland, Fac Med, Ctr Publ Hlth Sci, Reykjavik, Iceland.;Harvard Univ, Sch Publ Hlth, Dept Epidemiol, 665 Huntington Ave, Boston, MA 02115 USA..
    Health-related quality of life improvements among women with chronic pain: comparison of two multidisciplinary interventions2016In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 38, no 9, p. 828-836Article in journal (Refereed)
    Abstract [en]

    Purpose: To measure the effect of 4 weeks traditional multidisciplinary pain management program (TMP) versus neuroscience education and mindfulness-based cognitive therapy (NEM) on quality of life (HRQL) among women with chronic pain. Method: This observational longitudinal cohort study conducted in an Icelandic rehabilitation centre included 122 women who received TMP, 90 receiving NEM, and 57 waiting list controls. Pain intensity (visual analogue scale) and HRQL (Icelandic Quality of Life scale) were measured before and after interventions. ANOVA and linear regression were used for comparisons. Results: Compared with controls we observed statistically significant changes in pain intensity (p < 0.001) and HRQL (p < 0.001) among women receiving both interventions, while NEM participants reported significant improvements in sleep (8.0 versus 4.4 in TMP; p = 0.008). Head to head comparison between study groups revealed that pain intensity improved more among TMP participants (21.8 versus 17.2 mm; p = 0.013 adjusted). Women with low HRQL at baseline improved more than those with higher HRQL (mean TMP = 13.4; NEM = 12.9 if HRQL <= 35 versus mean TMP = 6.6 and NEM = 7.8 if HQRL > 35). Conclusions: Our non-randomized study suggests that both NEM and TMP programs improve pain and HRQL among women with chronic pain. Sleep quality showed more improvements in NEM while pain intensity in TMP. Longer-term follow-ups are needed to address whether improvements sustain. Implications for Rehabilitation Chronic pain is a debilitating condition affecting quality of life and restricting societal participation. Intensive multidisciplinary bio-psycho-social rehabilitation is essential for this patient group. This study shows improvement in health-related quality of life and pain intensity following such rehabilitation. Emphasizing mindfulness based cognitive therapy and neuroscience patient education improves sleep to more extend than more traditional approach.

  • 20.
    Bohlen, S
    et al.
    Department of Neurology, University Hospital Muenster, University of Muenster, Muenster, Germany;.
    Ekwall, Camilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Hellström, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Vesterlin, H
    Björnefur, M
    Wiklund, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
    Reilmann, R
    Physical therapy in Huntington's disease: towards objective assessments?2013In: European Journal of Neurology, ISSN 1351-5101, E-ISSN 1468-1331, Vol. 20, no 2, p. 389-393Article in journal (Refereed)
    Abstract [en]

    Background and purpose

    Physical therapy is recommended for the treatment of Huntington's disease, but reliable studies investigating its efficacy are almost non-existent. This may in part be due to the lack of suitable outcome measures. Therefore, we investigated the applicability of novel quantitative and objective assessments of motor dysfunction in the evaluation of physical therapy interventions aimed at improving gait and posture.

    Methods

    Twelve patients with Huntington disease received a predefined twice-weekly intervention focusing on posture and gait over 6 weeks. The GAITRite mat and a force plate were used for objective and quantitative assessments. The Unified Huntingtons Disease Rating Scale Total Motor Score, the timed Up &Go test, and the Berg Balance Scale were used as clinical outcome measures.

    Results

    Significant improvements were seen in GAITRite measures after therapy. Improvements were also seen in the Up & Go test and Berg Balance Scale, whereas force plate measures and Total Motor Scores did not change.

    Conclusions

    The results suggest that physical therapy has a positive effect on gait in Huntington's disease. The study shows that objective and quantitative measures of gait and posture may serve as endpoints in trials assessing the efficacy of physical therapy. They should be explored further in larger trials applying a randomized controlled setting.

  • 21.
    Boström, Fredrik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Thernström, Johannes
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Patienters skattning av hindrande smärta och self-efficacy före och efter diskbråcksoperation2010Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Objectives: The purpose of the study was to examine if a pre- and post-operative difference could be seen in self-reported pain disability and self-efficacy among patients undergoing surgery as treatment for spinal disc herniation in order to improve process of rehabilitation.

    Method: A quantitative and descriptive design was used. 10 patients awaiting surgical treatment for spinal disc herniation were included at Akademiska sjukhuset (The Academic Hospital) in Uppsala. Participation was voluntary and the selection was made by convenience. Data was collected using The Pain Disability Index and Self-Efficacy Scale by which the patient would estimate how hindered they felt because of their pain in everyday activities and their self-efficacy to perform everyday activities. This was done the day before surgery and two weeks after surgery. The data was analyzed with Wilcoxon’s signed rank test and statistical significance was set to p<0,05.

    Results: The majority of patients reported an improvement after herniated disc surgery regarding PDI and self-efficacy. Statistically significant differences were established regarding both PDI (p=0,012) and Self-Efficacy Scale (p=0,009) in patients (n=10) before and after herniated disc-surgery.

    Conclusion: The study showed that the majority of the patients reported an improvement in both PDI and Self-Efficacy Scale after surgery. However, no conclusion could be made through this study due to the low number of participants (n=10).

  • 22.
    Bratteby Tollerz, Linda U
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Olsson, Roger M
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Forslund, Anders H
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Norrlin, Simone E
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Reliability of energy cost calculations in children with cerebral palsy, cystic fibrosis and healthy controls2011In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 100, no 12, p. 1616-1620Article in journal (Refereed)
    Abstract [en]

    Aim: To study test-retest reliability of physiological cost index (PCI) and total cost index (TCI) in three groups of children. TCI modified PCI by excluding rest heart rate in calculation.

    Methods: Energy cost was evaluated from two consecutive walking tests, and results were compared between methods, tests and groups. Thirty-nine children, eight with cerebral palsy, 11 with cystic fibrosis and 20 healthy controls, aged 5-16 years participated in the study conducted at the Clinical Nutrition and Metabolism laboratory, University Hospital, Uppsala, Sweden. Heart rate was recorded during sitting and walking at self-selected speed. PCI and TCI were calculated using both non-steady-state and steady-state work heart rates. Test-retest reliability was analysed by mean of differences, pooled SD, coefficient of variation (CV%) and correlation coefficients.

    Results: Reliability was high for PCI and TCI. TCI showed consistently lower variation between tests than PCI for all groups. In the group with cerebral palsy, using non-steady-state showed highest reliability.

    Conclusion: Both PCI and TCI were reliable methods when calculating energy cost in children with cerebral palsy, cystic fibrosis and controls. TCI seemed to be a suitable alternative in the evaluation of gait efficiency in children.

  • 23.
    Bremfält, Julia
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Vesterlund, Anja
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    "Naturen sviker aldrig, den möter alltid": - En kvalitativ intervjustudie om fysioterapeuters erfarenheter av att använda naturen i arbetet med personer med utmattningssyndrom2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Background

     Long term sick leave due to stress-related diseases, including burnout syndrome, is an increasing problem in Sweden. A relatively new and sparsely studied treatment method is nature based therapy. Several clinics aim at rehabilitation of the burnout syndrome, where physiotherapist is one of the professions of a multimodal team.

     

    Purpose

     To study the physiotherapists experience in work with nature based rehabilitation for patients with burnout syndrome.

     

    Design and method

     A qualitative method was used in this study. Four physiotherapists which currently are working or have the experience from working with nature based rehabilitation were selected to participate. Semi-structured interviews were used followed by a content analysis with an inductive approach.

     

    Results

    The first theme from our result is stress reducing environment and the categories are Undemanding, Nature gives peace and quiet, Nature makes lines and gives a different focus, and Nature gives inspiration. The other theme is The physiotherapists guidance in body and mind and the categories are Guidance to physical activity in nature, Sensitive response to patient, Help to reflect, and Participating patient.

     

    Conclusion

    Physiotherapist can contribute with their knowledge of the body and mind in the rehabilitation of patients with burnout syndrome. In combination with a stress reducing environment that nature can offer, an effectual rehabilitation is possible.

     

    Key words

    Physiotherapy, nature based rehabilitation, burnout, mental health, nature assisted therapy

  • 24.
    Bring, Annika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    A Behavioural Medicine Perspective on Acute Whiplash Associated Disorders: Daily Coping, Prognostic Factors and Tailored Treatment2012Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of this thesis was to study the daily process of coping, potential prognostic factors for recovery and evaluating an individually tailored behavioural medicine intervention in the acute stage of Whiplash Associated Disorders (WAD). The studies comprised three samples of patients with acute Whiplash Associated Disorders (WAD). All patients were included within the first month after the whiplash occurrence and were recruited from hospital emergency wards in six Swedish communities.

    Study I and II included 51 participants generating 260 daily coping diaries (WAD-DCA) during seven days in the acute stage of WAD. In Study I daily stressors and primary appraisal were analysed and in Study II patterns between stressors, appraisals, coping strategy profiles, daily activity level and well-being were described. The results showed a large variety of situations that the individuals perceive as stressful, not only pain itself. High self-efficacy was associated with high degree of physical/mental well-being. Threatening stressors and catastrophic thoughts were associated with low degree of physical and mental well-being. In Study III potential prognostic factors for good as well as poor recovery were studied more closely in a mildly affected sample (MIAS) (n=98) from within the first month after the accident up to one year later. Pain-related disability at baseline emerged as the only indicator of prognosis after 12 months in MIAS. Study IV (n=55) was a randomised control study, were current clinical recommendations of standard self-care instructions (SC) for the management of acute WAD was compared to an individually tailored behavioural medicine intervention delivered via Internet or face-to-face. The results showed that SC was not as effective as the behavioural medicine intervention. By early identification of situation-specific factors and potential behavioural (physical, cognitive and affective) determinants of activity performance, it seems possible to tailor a self-management intervention that decreases pain-related disability, fear of movement and catastrophising and increases self-efficacy. The use of innovative methods such as the Internet of distributing treatment interventions showed to be a good alternative to more traditional forms.

    The results of this thesis uncover new insights in understanding the individual’s specific perspective as applied in a behavioural medicine approach in acute WAD.

    List of papers
    1. Daily stressors in patients with acute whiplash associated disorders
    Open this publication in new window or tab >>Daily stressors in patients with acute whiplash associated disorders
    2012 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 34, no 21, p. 1783-1789Article in journal (Refereed) Published
    Abstract [en]

    Purpose

    Stressors in acute whiplash associated disorders (WAD), as reported on a daily basis, have hitherto been neglected in research. The primary aim of this study was to describe the most stressful daily situation or event reported by individuals with acute WAD within a month of a whiplash trauma. Another aim was to describe the meaning and significance of these daily stressors, i.e. primary appraisal.

    Method

    A descriptive design with a content analysis approach was used. 260 WAD-daily coping assessments (WAD-DCA) generated during 1 week by 51 participants with acute WAD were included in the study. Stressors were analysed using qualitative content analysis.

     Results

    The reported stressors generated 13 categories covering a wide range of stressful situations in daily life related to (i) work, (ii) physical symptoms, (iii) feelings and cognitions, (iv) family and home responsibilities and (v) recreation. The majority of the stressors were appraised as "expected" as well as "disabling". Most threatening stressors were related to work, driving and feelings/cognitions.

    Conclusions

    The wide variety of stressors indicates that it is not only pain itself that influences daily life in acute WAD. Early identification of individual and situation-specific stressors gives new data regarding what bothers individuals suffering from WAD after a collision and may be helpful in understanding the coping process in relation to specific stressors and stressor appraisals.

    Keywords
    coping, daily assessments, whiplash associated disorders
    National Category
    Physiotherapy
    Identifiers
    urn:nbn:se:uu:diva-174497 (URN)10.3109/09638288.2012.662571 (DOI)000307851800003 ()22512410 (PubMedID)
    Available from: 2012-05-21 Created: 2012-05-21 Last updated: 2017-12-07Bibliographically approved
    2. Coping Patterns and Their Relation to Daily Activity, Worries, Depressed Mood, and Pain Intensity in Acute Whiplash-Associated Disorders
    Open this publication in new window or tab >>Coping Patterns and Their Relation to Daily Activity, Worries, Depressed Mood, and Pain Intensity in Acute Whiplash-Associated Disorders
    Show others...
    2013 (English)In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 20, no 2, p. 293-303Article in journal (Refereed) Published
    Abstract [en]

    BACKGROUND

    There is a lack of knowledge regarding how individuals with acute whiplash-associated disorders (WAD) appraise and cope with situation-specific stressors.

    PURPOSE

    The aim of the study was to describe the daily process of coping reported in a daily coping assessment by individuals with acute WAD within 1 month after the accident. More specifically, profiles of coping strategies were identified and patterns between stressors, primary and secondary appraisals, and coping strategy profiles were described in relation to reported level of activity, worries, depressed mood and pain intensity during the day.

    METHOD

    A descriptive and exploratory design was applied. Two hundred and twenty-nine whiplash-associated disorders-daily coping assessment (WAD-DCA) collected during seven consecutive days from 51 participants with acute WAD in Sweden, were included. Cluster analysis was used to obtain coping strategy profiles and data were graphically visualised as patterns through the coping process.

    RESULTS

    When measuring coping as a daily process relating to the specific stressful situation, different coping pocess patterns appeared. During days with a high degree of physical and mental well-being, high self-efficacy beliefs seemed to be working as an important secondary appraisal, whereas during days with a low degree of physical and mental well-being primary appraisals of the stressor as a threat and catastrophic thoughts were present in the coping process.

    CONCLUSIONS

    Early identification of situational- and individual-specific stressors, appraisals and coping efforts as measured by the WAD-DCA may contribute to the understanding of the coping process in the acute stage of WAD and its possible impact on recovery and adjustment.

    Keywords
    Coping, Daily assessments, Whiplash-associated disorders, Physical well-being, Emotional well-being
    National Category
    Physiotherapy
    Research subject
    Physiotherapy
    Identifiers
    urn:nbn:se:uu:diva-174498 (URN)10.1007/s12529-012-9220-y (DOI)000318505900017 ()22382932 (PubMedID)
    Available from: 2012-05-21 Created: 2012-05-21 Last updated: 2017-12-07Bibliographically approved
    3. The clinical course of pain-related disability over the first year in whiplash associated disorders: Description and prediction of outcome in an initially mildly affected sample
    Open this publication in new window or tab >>The clinical course of pain-related disability over the first year in whiplash associated disorders: Description and prediction of outcome in an initially mildly affected sample
    2013 (English)In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 14, p. 361-Article in journal (Refereed) Published
    Abstract [en]

    Background: Different recovery patterns are reported for those befallen a whip-lash injury, but little is known about the variability within subgroups. The aims were (1) to compare a self-selected mildly affected sample (MILD) with a self-selected moderately to severely affected sample (MOD/SEV) with regard to background characteristics and pain-related disability, pain intensity, functional self-efficacy, fear of movement/(re) injury, pain catastrophising, post-traumatic stress symptoms in the acute stage (at baseline), (2) to study the development over the first year after the accident for the above listed clinical variables in the MILD sample, and (3) to study the validity of a prediction model including baseline levels of clinical variables on pain-related disability one year after baseline assessments. Methods: The study had a prospective and correlative design. Ninety-eight participants were consecutively selected. Inclusion criteria; age 18 to 65 years, WAD grade I-II, Swedish language skills, and subjective report of not being in need of treatment due to mild symptoms. A multivariate linear regression model was applied for the prediction analysis. Results: The MILD sample was less affected in all study variables compared to the MOD/SEV sample. Pain-related disability, pain catastrophising, and post-traumatic stress symptoms decreased over the first year after the accident, whereas functional self-efficacy and fear of movement/(re) injury increased. Pain intensity was stable. Pain-related disability at baseline emerged as the only statistically significant predictor of pain-related disability one year after the accident (Adj r(2) = 0.67). Conclusion: A good prognosis over the first year is expected for the majority of individuals with WAD grade I or II who decline treatment due to mild symptoms. The prediction model was not valid in the MILD sample except for the contribution of pain-related disability. An implication is that early observations of individuals with elevated levels of pain-related disability are warranted, although they may decline treatment.

    Keywords
    acute whiplash associated disorders, whiplash injury, disease progression, recovery of function, risk factors
    National Category
    Physiotherapy
    Identifiers
    urn:nbn:se:uu:diva-180048 (URN)10.1186/1471-2474-14-361 (DOI)000329852100002 ()24359208 (PubMedID)
    Available from: 2012-08-28 Created: 2012-08-28 Last updated: 2017-12-07Bibliographically approved
    4. Individually tailored behavioural medicine intervention delivered via Internet or Face to face in acute Whiplash Associated Disorders: A randomized controlled trial
    Open this publication in new window or tab >>Individually tailored behavioural medicine intervention delivered via Internet or Face to face in acute Whiplash Associated Disorders: A randomized controlled trial
    (English)Article in journal (Other academic) Submitted
    Keywords
    whiplash associated disorders, whiplash injury, cognitive behavioural, physical therapist, randomized control trial, acute pain, Internet intervention, physiotherapy
    National Category
    Physiotherapy
    Identifiers
    urn:nbn:se:uu:diva-180049 (URN)
    Available from: 2012-08-28 Created: 2012-08-28 Last updated: 2013-01-30Bibliographically approved
  • 25.
    Bring, Annika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Bring, Johan
    University of Gävle, Gävle, Sweden.
    Söderlund, Anne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy. Department of Physiotherapy, School of Health, Care and Social wellfare, Vasteras , Sweden .
    Wasteson, Elisabet
    Division of Psychology, Department of Social Sciences, Mid Sweden University, Östersund , Sweden.
    Åsenlöf, Pernilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Coping Patterns and Their Relation to Daily Activity, Worries, Depressed Mood, and Pain Intensity in Acute Whiplash-Associated Disorders2013In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 20, no 2, p. 293-303Article in journal (Refereed)
    Abstract [en]

    BACKGROUND

    There is a lack of knowledge regarding how individuals with acute whiplash-associated disorders (WAD) appraise and cope with situation-specific stressors.

    PURPOSE

    The aim of the study was to describe the daily process of coping reported in a daily coping assessment by individuals with acute WAD within 1 month after the accident. More specifically, profiles of coping strategies were identified and patterns between stressors, primary and secondary appraisals, and coping strategy profiles were described in relation to reported level of activity, worries, depressed mood and pain intensity during the day.

    METHOD

    A descriptive and exploratory design was applied. Two hundred and twenty-nine whiplash-associated disorders-daily coping assessment (WAD-DCA) collected during seven consecutive days from 51 participants with acute WAD in Sweden, were included. Cluster analysis was used to obtain coping strategy profiles and data were graphically visualised as patterns through the coping process.

    RESULTS

    When measuring coping as a daily process relating to the specific stressful situation, different coping pocess patterns appeared. During days with a high degree of physical and mental well-being, high self-efficacy beliefs seemed to be working as an important secondary appraisal, whereas during days with a low degree of physical and mental well-being primary appraisals of the stressor as a threat and catastrophic thoughts were present in the coping process.

    CONCLUSIONS

    Early identification of situational- and individual-specific stressors, appraisals and coping efforts as measured by the WAD-DCA may contribute to the understanding of the coping process in the acute stage of WAD and its possible impact on recovery and adjustment.

  • 26.
    Bring, Annika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Martin, Cathrin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Åsenlöf, Pernilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    A New Core Curriculum For Integration Of Behavioural Medicine And Physiotherapy In Graduate Studies: Planning, Implementation, And Expected Outcomes2016In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 23, p. S18-S18Article in journal (Refereed)
  • 27.
    Bring, Annika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Söderlund, Anne
    Department of Physiotherapy, School of Health, Care and Social wellfare, Vasteras, Sweden .
    Wasteson, Elisabet
    Division of Psychology, Department of Social Sciences, Mid Sweden University, Östersund, Sweden.
    Åsenlöf, Pernilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Daily stressors in patients with acute whiplash associated disorders2012In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 34, no 21, p. 1783-1789Article in journal (Refereed)
    Abstract [en]

    Purpose

    Stressors in acute whiplash associated disorders (WAD), as reported on a daily basis, have hitherto been neglected in research. The primary aim of this study was to describe the most stressful daily situation or event reported by individuals with acute WAD within a month of a whiplash trauma. Another aim was to describe the meaning and significance of these daily stressors, i.e. primary appraisal.

    Method

    A descriptive design with a content analysis approach was used. 260 WAD-daily coping assessments (WAD-DCA) generated during 1 week by 51 participants with acute WAD were included in the study. Stressors were analysed using qualitative content analysis.

     Results

    The reported stressors generated 13 categories covering a wide range of stressful situations in daily life related to (i) work, (ii) physical symptoms, (iii) feelings and cognitions, (iv) family and home responsibilities and (v) recreation. The majority of the stressors were appraised as "expected" as well as "disabling". Most threatening stressors were related to work, driving and feelings/cognitions.

    Conclusions

    The wide variety of stressors indicates that it is not only pain itself that influences daily life in acute WAD. Early identification of individual and situation-specific stressors gives new data regarding what bothers individuals suffering from WAD after a collision and may be helpful in understanding the coping process in relation to specific stressors and stressor appraisals.

  • 28.
    Bring, Annika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Åsenlöf, Pernilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Söderlund, Anne
    Department of Physiotherapy, School of Health, Care and Social wellfare, Vasteras, Sweden .
    Individually tailored behavioural medicine intervention delivered via Internet or Face to face in acute Whiplash Associated Disorders: A randomized controlled trialArticle in journal (Other academic)
  • 29.
    Bring, Annika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Åsenlöf, Pernilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Söderlund, Anne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    What is the comparative effectiveness of current standard treatment, against an individually tailored behavioural programme delivered either on the Internet or face-to-face for people with acute whiplash associated disorder? A randomized controlled trial2016In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 30, no 5, p. 441-453Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate the comparative effectiveness of current standard treatment, against an individually tailored behavioural programme delivered via the Internet or face-to-face for people with acute whiplash associated disorders.

    DESIGN: A multicentre, randomized, three-group design, with concealed allocation.

    SUBJECTS AND SETTINGS: A total of 55 participants (37 female), age 18-65, with acute Whiplash Associated Disorder (Grade I-II), recruited at two emergency clinics in Sweden.

    INTERVENTIONS: Before randomization all participants received standard self-care instructions. The Internet and face-to-face groups followed a seven-week behavioural programme involving individual tailoring, via email (Internet group), or in sessions at a physical therapy unit (face-to-face group). The control group only received the self-care instructions.

    MAIN MEASURES: Pain-related disability, pain intensity, self-efficacy in daily activities, catastrophizing and fear of movement/(re)injury. Assessments were performed at baseline (2-4 weeks postinjury) and at three, six and 12 months postintervention.

    RESULTS: Both the Internet (n = 16) and face-to-face (n = 14) group showed a larger decrease in pain-related disability than the control group (n = 16); -12 and -11, respectively, compared with -5 in the control group at 12-months follow-up. Significant differences between the groups in overall treatment effect were shown in all outcomes except pain intensity. All groups improved significantly over time in all outcomes, except for fear of movement/(re)injury and catastrophizing in the control group.

    CONCLUSION: An individually tailored behavioural programme improved biopsychosocial factors in patients with whiplash associated disorders up to 12 months after treatment. Internet-delivered intervention was as effective as clinic-based face-to-face therapy sessions.

  • 30.
    Bring, Johan
    et al.
    Gävle Univ, Dept Math & Stat, Gävle, Sweden.
    Bring, Annika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Measuring gait – how the choice of measure can affect the statistical results and the clinical interpretation2017In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 19, no 1, p. 8-12Article in journal (Refereed)
    Abstract [en]

    Aims: The aim of this study was to illustrate how the choice of gait measure could affect the statistical analysis of data and the resulting clinical conclusions.

    Methodology: A descriptive design in which the results from different tests from 10 patients with normal pressure hydrocephalus illustrates the potential to generate different clinical conclusions.

    Major findings and principal conclusion: The results illustrate how the choice of measure can affect the statistical results and the clinical interpretation of a study. It is possible to have the paradoxical situation in which one group has a better walking ability if the variable speed is used but the other group has a better walking ability if the variable time is used. An important message is that the choice of measurement and the transformation of data are not primarily statistical issues. If the statistical results are to be useful for clinical decisions, the variables used must be directly related to the utility for the subjects. An understanding of the clinical relevance of different outcomes is required. The distinction between when numbers are purely descriptive and when numbers represent a valuation is subtle and difficult to comprehend.

  • 31.
    Brolin, Linda
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Värnqvist, Emma
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Morgonuppvärmning, smärta och livskvalitet hos byggarbetare – en jämförande studie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 32.
    Byfält, Lydia
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Hellerström, Charlotte
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Friskis&Svettis ”Börja träna”-kurs och skillnader på livskvalitet och skattad fysisk aktivitet2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Regelbunden fysisk aktivitet leder till positiva hälsoeffekter och är därmed viktig som primär- och sekundärprevention för flera olika sjukdomar och för tidig död. Primärprevention ges dock begränsat utrymme inom sjukvården och därmed kan ett samarbete med andra hälsofrämjande aktörer i samhället vara motiverat.

    Syfte: Att undersöka om deltagare skattar högre upplevd livskvalitet och fysisk aktivitetsnivå efter Friskis&Svettis (F&S) tio veckor långa ”Börja träna”-kurs samt undersöka om det fanns en korrelation mellan livskvalitet och fysisk aktivitetsnivå.

    Metod: 95 deltagare (81 kvinnor, 14 män) med en medelålder på 50 år fyllde i två enkäter, en före och en efter interventionen. En inomgruppsjämförelse samt en korrelationsanalys gällande livskvalitet och fysisk aktivitetsnivå gjordes.

    Resultat: Medianen för livskvalitet var 7 före interventionen och 8 efter vilket var en signifikant ökning (p=0,022). Även för fysisk aktivitet var ökningen signifikant med en median på 3 före interventionen och 4 efter (p<0,001). I studien sågs ett mycket svagt samband mellan livskvalitet och fysisk aktivitetsnivå före interventionen (r=-0,172, p=0,122).

    Konklusion: Efter deltagande i F&S ”Börja träna”-kurs skattade deltagarna högre livskvalitet och fysisk aktivitetsnivå. På grund av ett stort bortfall och flera metodologiska felkällor bör resultatet användas med försiktighet och vidare studier är därmed nödvändiga.

  • 33.
    Cahlenstein, Anna-Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Svensson, Klara
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Hälsorelaterad livskvalitet och fysisk aktivitet hos läkarstuderande och civilingenjörsstuderande vid Uppsala universitet2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 34.
    Cedervall, Ylva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Physical Activity and Alzheimer's Disease: Measurements, Observations and Subjective Experiences2014Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Gait disturbances such as slow walking speed and step-to-step variability have been reported among people with mild Alzheimer’s disease (AD) and as risk factors for functional decline, dependency, and falls. Additionally, AD-related emotional reactions and decreased initiative can lead to physical inactivity. The aims of this thesis, therefore, were to explore how the ability to be physically active is affected in the early years of AD, and how people with mild AD and their cohabitants reason about physical activity as part of their everyday life.

    To meet the aims, an approach inspired by mixed methods research was used, covering measurements, observations and subjective experiences. Data were collected from different sources in parallel. Participants with mild AD were recruited at the Memory Clinic, Uppsala University Hospital. In Study I, a case study with two couples in which one member had AD, in-depth interviews and participating interviews were performed. Physical activity such as walking was viewed as a meaningful routine improving well-being. Participants were positive about making adjustments to enable physical activity. In Study II, the 25 participants with AD showed a significant lower walking capacity (10 m comfortable walk test, 6-minute walk test, Timed-up-and-Go test) at baseline compared to controls. The decline continued during the subsequent two years. The influence of a cognitive task on walking was distinct, despite this, participants maintained a health-promoting level of physical activity during the two-year study-period. In Study III, gait testing in the motor laboratory of 21 participants with AD showed a marked impact on gait parameters (e.g. slowed speed, decreased step length) by a cognitive task. Additionally, specific dual-task gait disturbances were frequent. In Study IV, in-depth interviews with 14 participants with AD indicated that physical activity was viewed as a meaningful activity, used as a means to maintain well-being and selfhood, and contributed to continuity in life.

    In conclusion, walking capacity deteriorates and declines in the early stages of AD. A simple cognitive task can have a substantially negative impact on walking already in mild AD. In contrast, people with AD can also gain “self-promoting benefits” from physical activity beyond the common health-promoting benefits.

    List of papers
    1. Physical activity and implications on well-being in mild Alzheimer's disease: A qualitative case study on two men with dementia and their spouses
    Open this publication in new window or tab >>Physical activity and implications on well-being in mild Alzheimer's disease: A qualitative case study on two men with dementia and their spouses
    2010 (English)In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 26, no 4, p. 226-239Article in journal (Refereed) Published
    Abstract [en]

    To improve the understanding of experiences of people with mild Alzheimer's disease (AD) and their significant others, related to the physical activity of the afflicted persons and its perceived importance. A qualitative case study design was used. The study comprised two men with mild AD and their wives. Data were collected by qualitative interviews and participant observations. Data analysis followed a thematic guideline as described by Braun and Clarke ( 2006 ). Three central themes of experiences related to physical activity in AD were identified: 1) physical activity as health reinforcement; 2) barriers to physical activity; and 3) adaptation strategies. Important motivations for outdoor walks were enjoyable experiences of nature, body movement, and positive attitudes toward physical activity. Several factors were experienced as barriers to physical activity (e.g., tiredness, difficulties in finding one's way, and "peculiar behavior"). Significant others made considerable adjustments in everyday life to enable their partners to retain a physically active lifestyle. The findings indicate that in persons with AD, physical activities such as outdoor walking can play an important part in everyday life by creating meaningful routines and improving experienced well-being and health.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-144803 (URN)10.3109/09593980903423012 (DOI)20397857 (PubMedID)
    Available from: 2011-02-02 Created: 2011-02-02 Last updated: 2017-12-11Bibliographically approved
    2. Declining Physical Capacity But Maintained Aerobic Activity in Early Alzheimer's Disease
    Open this publication in new window or tab >>Declining Physical Capacity But Maintained Aerobic Activity in Early Alzheimer's Disease
    2012 (English)In: American Journal of Alzheimer’s Disease and Other Dementia, ISSN 1533-3175, E-ISSN 1938-2731, Vol. 27, no 3, p. 180-187Article in journal (Refereed) Published
    Abstract [en]

    The longitudinal influences on physical capacity and habitual aerobic activity level in the early stages of Alzheimer's disease (AD) are unclear. Therefore, changes in physical capacity and aerobic activity level were evaluated. Twenty-five individuals with AD were assessed annually for 2 years, by 10-m walk test, 6-minute walk test, and timed up-and-go (TUG) single/dual tasks. Habitual aerobic activity was assessed by diary registrations. The AD group showed a lower physical capacity than controls at baseline but comparable levels of aerobic activity. During the follow-up period, physical capacity declined in the AD group, but the aerobic activity levels changed only marginally. Our results show that in the early stages of AD, people are capable of maintaining health-promoting aerobic activity levels, despite a decline in their physical capacity. Additionally, it appears that cognitive dysfunction contributes to an impaired physical capacity. The TUG tasks might, therefore, be useful for detecting early signs of cognitive impairment.

    Keywords
    dementia, longitudinal, physical activity, timed up-and-go, walking
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-175200 (URN)10.1177/1533317512442996 (DOI)000303831300007 ()22573284 (PubMedID)
    Available from: 2012-06-07 Created: 2012-06-04 Last updated: 2017-12-07Bibliographically approved
    3. A longitudinal study of gait function and characteristics of gait disturbances in individuals with Alzheimer's disease
    Open this publication in new window or tab >>A longitudinal study of gait function and characteristics of gait disturbances in individuals with Alzheimer's disease
    2014 (English)In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 39, no 4, p. 1022-1027Article in journal (Refereed) Published
    Abstract [en]

    Walking in daily life places high demands on the interplay between cognitive and motor functions. A well-functioning dual-tasking ability is thus essential for walking safely. The aims were to study longitudinal changes in gait function during single- and dual-tasking over a period of two years among people with initially mild AD (n = 21). Data were collected on three occasions, twelve months apart. An optical motion capture system was used for three-dimensional gait analysis. Gait parameters were examined at comfortable gait speed during single-tasking, dual-tasking naming names, and naming animals. The dual-task cost for gait speed was pronounced at baseline (names 26%, animals 35%), and remained so during the study period. A significant (p < 0.05) longitudinal decline in gait speed and step length during single- and dual-tasking was observed, whereas double support time, step width and step height showed inconsistent results. Systematic visual examination of the motion capture files revealed that dual-tasking frequently resulted in gait disturbances. Three main characteristics of such disturbances were identified: Temporal disturbance, Spatial disturbance and Instability in single stance. These aberrant gait performances may affect gait stability and increase the risk of falling. Furthermore, the observed gait disturbances can contribute to understanding and explaining previous reported gait variability among individuals with AD. However, the role that dual-task testing and aberrant dual-task gait performance play in the identification of individuals with early signs of cognitive impairment and in predicting fall risk in AD remains to be studied.

    National Category
    Physiotherapy Control Engineering
    Identifiers
    urn:nbn:se:uu:diva-223680 (URN)10.1016/j.gaitpost.2013.12.026 (DOI)000333801400004 ()
    Available from: 2014-04-23 Created: 2014-04-23 Last updated: 2017-12-05Bibliographically approved
    4. Maintained well-being and selfhood through physical activity: the meanings that people with Alzheimer's disease attach to being active
    Open this publication in new window or tab >>Maintained well-being and selfhood through physical activity: the meanings that people with Alzheimer's disease attach to being active
    (English)Manuscript (preprint) (Other academic)
    National Category
    Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-223686 (URN)
    Available from: 2014-04-23 Created: 2014-04-23 Last updated: 2014-06-30
  • 35.
    Cedervall, Ylva
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Halvorsen, Kjartan
    Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Division of Systems and Control. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Automatic control.
    Åberg, Anna Cristina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    A longitudinal study of gait function and characteristics of gait disturbances in individuals with Alzheimer's disease2014In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 39, no 4, p. 1022-1027Article in journal (Refereed)
    Abstract [en]

    Walking in daily life places high demands on the interplay between cognitive and motor functions. A well-functioning dual-tasking ability is thus essential for walking safely. The aims were to study longitudinal changes in gait function during single- and dual-tasking over a period of two years among people with initially mild AD (n = 21). Data were collected on three occasions, twelve months apart. An optical motion capture system was used for three-dimensional gait analysis. Gait parameters were examined at comfortable gait speed during single-tasking, dual-tasking naming names, and naming animals. The dual-task cost for gait speed was pronounced at baseline (names 26%, animals 35%), and remained so during the study period. A significant (p < 0.05) longitudinal decline in gait speed and step length during single- and dual-tasking was observed, whereas double support time, step width and step height showed inconsistent results. Systematic visual examination of the motion capture files revealed that dual-tasking frequently resulted in gait disturbances. Three main characteristics of such disturbances were identified: Temporal disturbance, Spatial disturbance and Instability in single stance. These aberrant gait performances may affect gait stability and increase the risk of falling. Furthermore, the observed gait disturbances can contribute to understanding and explaining previous reported gait variability among individuals with AD. However, the role that dual-task testing and aberrant dual-task gait performance play in the identification of individuals with early signs of cognitive impairment and in predicting fall risk in AD remains to be studied.

  • 36.
    Centurion Arce, Linda
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Andersson, Catarina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Med tassar mot ett mål: kan vårdhund öka välbefinnande, motivation och aktivitet vid rehabilitering?2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The use of Animal Assisted Intervention (AAI) within Swedish health care has increased and as the number of studies done in the field of rehabilitation is few, this was considered a relevant field to explore.

    Aim: To investigate whether AAI could increase wellbeing, motivation and activity of patients in comparison with conventional rehabilitation.

    Method: Single case design. Two participants were studied at seven training sessions for four weeks with video recording, VAS and interview.

    Result: Self-assessment on VAS showed no differences between the various trainings, while observations showed that the participants smiled longer, had more physical contact, more fine motor skill exercises and half the time of gross motor exercises at AAI sessions. Participants described both trainings as valuable, rewarding and fun. AAI sessions were also described as easy-going and a moment of distraction from the bad things that had happened.

    Conclusions: According to VAS both trainings were equally appreciated, while the observations and interview showed that AAI provided increased wellbeing. Wellbeing is an important factor for motivation and activity. Thus more studies in the area are of interest since the use of AAI appears to be an important asset in rehabilitation.

  • 37.
    Cunningham, Gregory
    et al.
    Univ Hosp Geneva, Dept Surg, Div Orthoped & Trauma Surg, Geneva, Switzerland..
    Zanchi, Davide
    Univ Hosp Geneva, Dept Imaging & Med Informat, Geneva, Switzerland..
    Emmert, Kirsten
    Univ Hosp Geneva, Dept Imaging & Med Informat, Geneva, Switzerland.;Ecole Polytech Fed Lausanne, Inst Bioengn, Lausanne, Switzerland..
    Kopel, Rotem
    Univ Hosp Geneva, Dept Imaging & Med Informat, Geneva, Switzerland.;Ecole Polytech Fed Lausanne, Inst Bioengn, Lausanne, Switzerland..
    Van De Ville, Dimitri
    Univ Hosp Geneva, Dept Imaging & Med Informat, Geneva, Switzerland.;Ecole Polytech Fed Lausanne, Inst Bioengn, Lausanne, Switzerland..
    Laedermann, Alexandre
    Univ Hosp Geneva, Dept Surg, Div Orthoped & Trauma Surg, Geneva, Switzerland.;Univ Geneva, Fac Med, CH-1227 Geneva, Switzerland..
    Haller, Sven
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology. Univ Geneva, Fac Med, CH-1227 Geneva, Switzerland.;Univ Hosp Freiburg, Dept Neuroradiol, Freiburg, Germany.;Ctr Diagnost Radiol Carouge, Affidea, Carouge, Switzerland..
    Hoffmeyer, Pierre
    Univ Hosp Geneva, Dept Surg, Div Orthoped & Trauma Surg, Geneva, Switzerland.;Univ Geneva, Fac Med, CH-1227 Geneva, Switzerland..
    Neural Correlates of Clinical Scores in Patients with Anterior Shoulder Apprehension2015In: Medicine & Science in Sports & Exercise, ISSN 0195-9131, E-ISSN 1530-0315, Vol. 47, no 12, p. 2612-2620Article in journal (Refereed)
    Abstract [en]

    Introduction Anterior shoulder apprehension is a commonly reported complaint in anterior shoulder instability, which may lead to patient morbidity and impede shoulder function. It is the result of a cognitively complex mechanism, which includes anxiety, salience, fear, and anticipation. Purpose The aim of this prospective case-control study was to correlate five clinically established scores using functional magnetic resonance imaging to assess brain activation patterns in patients with apprehension related to anterior shoulder instability. Methods This study includes 28 consecutive male right-handed patients ( mean +/- SEM, 26.8 +/- 1.2 yr) with positive shoulder apprehension test and 10 healthy matched control participants without apprehension or a history of instability. Task- related and functional connectivity functional magnetic resonance imaging activation patterns occurring during apprehension video cue stimulation were correlated with five clinical tests and scores: Visual Analog Scale ( VAS), Rowe score for instability, Simple Shoulder Test, Subjective Shoulder Value ( SSV), and Western Ontario Shoulder Instability ( WOSI). Results Rowe, pain VAS, and WOSI scores correlated with prefrontal cortex, dorsolateral prefrontal cortex, dorsomedial prefrontal cortex, somatosensory area, and parieto-occipital and temporal areas (default mode network). Rowe score additionally correlated with frontal pole, anterior midcingulate cortex, and visual areas. Moreover, SSV correlated with task-related brain activity in the bilateral precentral gyrus, bilateral postcentral gyrus, and bilateral superior parietal lobe. Conclusions Overall, Rowe score provides the strongest link between shoulder apprehension and brain level alterations as it correlates with the highest number of independent components involving areas responsible for both motor and cognitive functions, whereas pain VAS and WOSI occupy an intermediately strong link recruiting less brain networks. Finally, Simple Shoulder Test and SSV have the weakest link at the brain level.

  • 38.
    Demmelmaier, Ingrid
    et al.
    Karolinska Institutet.
    Bergman, Patrick
    Linnéuniversitetet.
    Nordgren, Birgitta
    Karolinska Institutet.
    Jensen, Irene
    Karolinska Institutet.
    Opava, Christina H
    Karolinska Institutet.
    Current and maintained health-enhancing physical activity in rheumatoid arthritis: a cross-sectional study2013In: Arthritis Care and Research, ISSN 0893-7524, E-ISSN 1529-0123, Vol. 65, no 7, p. 1166-1176Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To describe and identify the explanatory factors of variation in current and maintained health-enhancing physical activity (HEPA) in persons with rheumatoid arthritis (RA).

    METHODS: In this cross-sectional study, current HEPA was assessed with the International Physical Activity Questionnaire and maintained HEPA with the Exercise Stage Assessment Instrument, the latter explicitly focusing on both aerobic physical activity and muscle strength training. Sociodemographic, disease-related, and psychosocial data were retrieved from the Swedish Rheumatology Quality (SRQ) registers and a postal questionnaire. The explained variations in the respective HEPA behaviors were analyzed with logistic regression.

    RESULTS: In all, 3,152 (58.5%) of 5,391 persons identified as eligible from the SRQ registers responded to the questionnaire. Current HEPA was reported by 69%, and maintained HEPA by 11% of the respondents. The most salient and consistent factors explaining variation in both current and maintained HEPA were self-efficacy, social support, and outcome expectations related to physical activity.

    CONCLUSION: To our knowledge, this is the first study exploring maintained physical activity in a large well-defined sample of persons with RA. Our results indicate that a minority perform maintained HEPA, including both aerobic physical activity and muscle strength training, and that psychosocial factors are the most salient and consistent in the explanation of HEPA variation.

  • 39.
    Djurback, Ingrid
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Rörlighet i ländryggen, sittposition och förekomst av ländryggssmärta hos landsvägscyklister.2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Ländryggsmärta orsakad av överbelastning är vanligt inom cykelidrotten med en prevalens mellan 15 % -60 % hos landsvägscyklister på motions- och elitnivå. Vid sittande förändras ryggradens kurvatur vilket gör att belastningen förändras och det ger obalanser och större risk för smärta och skada än vid stående och gående. Sittpositionen på cykeln kan anpassas genom justering av cykeln, även kallad bike fit. Det finns få vetenskapliga studier hur denna anpassning ska ske för att undvika ryggsmärta.

    Syfte: Syftet med studien var att undersöka hur strukturer i ländryggen och säte/ben påverkar sittposition och förekomsten av ländryggssmärta vid landsvägscykling.

    Metod: Totalt 33 deltagare analyserades för hamstringslängd, total lumbal flexion samt sittposition på cykeln. Deltagarna tillfrågades angående erfarenheter av ländryggssmärta vid cykling.

    Resultat: Studien kunde påvisa en signifikant korrelation (r=0,57, P= 0,00082) mellan sittposition på cykeln samt total lumbal flexion. Hamstringslängd eller lumbal flexion på cykel visade sig ej korrelera med ländryggssmärta på cykel. Ingen skillnad förelåg mellan de cyklister som rapporterat ländryggssmärta eller ej gällande total lumbal flexionsrörlighet, lumbal flexion på cykeln eller hamstringslängd visades.

    Konklusion: Rörlighet i ländryggen och position på cykel verkar inte ensamt kunna förklara förekomst av cykelrelaterad ländryggssmärta. Hamstringslängden tycks inte påverka sittposition eller ländryggssmärta vid cykling.

  • 40.
    Dodd-Reynolds, Caroline Jane
    et al.
    Univ Durham, Sch Appl Social Sci, Durham, England..
    Åsenlöf, Pernilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Hellström, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Editorial: Special issue - physical activity and health2017In: Physical Therapy Reviews, ISSN 1083-3196, E-ISSN 1743-288X, Vol. 22, no 3-4, p. 101-102Article in journal (Other academic)
  • 41.
    Dunder, Elin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Hovgard, Susanna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Fysioterapeuters syn på orsaker till skador samt hur dessa kan förebyggas, inom svensk elitfotboll - en intervjustudie2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Soccer is the world´s biggest sport and is responsible for a lot of all the sports related injuries. These injuries can result in impaired health, expenses for the society and the end of a career. The main focus of today´s research regarding injury preventions are different types of training. There may also be other components that might reduce the risk of getting injured that hasn´t been explored as much. 

    Purpose: The aim was to investigate the perceptions and experiences of physiotherapists working for elite soccer clubs, regarding causes of injuries and important injury preventive methods.

    Method: A qualitative descriptive design was used in this study. Five semi structured interviews were performed and a qualitative content analysis was used.

    Result: Based on ”Causes of injuries”, five categories were identified; "Physical load", "Psychological and social pressure", "Type of trainer", "Game situation" and "Social situation". ”Injury prevention methods” generated six categories; "The team´s resources", "Planning Load", "Communication between the medical team, coaches and players", "Education of the medical team, coaches and players", "Finding balance in players' everyday life," and "How the players feel physically and psyochologically."

    Conclusion: Several aspects affect the occurrence of injuries, and therefore several components need to be taken into account in the prevention of these. Further studies are needed to cover additional areas and to draw conclusions about which of the possible components that should be prioritized.

  • 42.
    Edlund, Hanna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Wahlqvist, Tobias
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Upplevelser av chorea och dess påverkan på fysisk aktivitet hos fem personer med Huntingtons sjukdom: En kvalitativ intervjustudie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Huntington's disease results in a combination of motor, cognitive and psychiatric symptoms. Chorea is an early symptom which entails involuntary movements that can affect various body parts. There are few studies addressing the subjective experiences of having chorea.

     

    Purpose: To investigate experiences of having chorea in five people with Huntington's disease and to investigate how the chorea affected their ability to be physically active.

     

    Design and method: Explorative qualitative design. Semi-structured interviews of five people with Huntington's disease. A qualitative content analysis was conducted.

    Results: Based on the two questions of the study, three themes were identified: Finding your place; Finding yourself in change; Revaluating movement. These themes consist of nine categories: Concern; Everyday obstacles; A disobedient body; Comprehension from others; An accepting approach; Surroundings; Facing setbacks; Finding the right strategies; Realizing your limitations.

     

    Conclusion: Some of the informants were unaware of their chorea while in others it caused a great suffering. They also underlined how chorea in different ways could imply a physical limitation. This could function as an incentive for person-centered care when meeting people with Huntington's disease.

  • 43.
    Ekberg, Theres
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Bergqvist, Agnes
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    En jämförande studie mellan styrketräning i gym och bodypump avseende skadeprevalens, typ och orsak till skada samt skillnader hos män respektive kvinnor.2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background

    Strength training has many positive health aspects, however, injuries are common. There has been no previous research comparing the injury prevalence of strength training on your own in the gym and at bodypump, two strength training exercise performed in slightly different ways, but both focusing on strength.

     

    The aim was to investigate whether there were differences regarding injury prevalence, type of injury between strength training on your own in the gym and bodypump and if there were any differences between men and between women, respectively. The study also aimed at investigating and describing the factors that seemed to have caused injuries in strength training on your own in the gym and at bodypump.

     

    Method

    The study had a descriptive and comparative design. A total of 60 people from SATS Sofo participated in the survey, 30 people who did strength training on their own in the gym and 30 people participating in bodypump. Data was collected by respondents to a self-designed questionnaire with questions about their training and possible injury and cause of injury.

     

    Results

    Differences in injury prevalence were seen between strength training on your own in gym and bodypump, p=0,01. On the other hand, no differences were observed regarding men’s injury prevalence (p=0,09) and in women (p=0,06) respectively, between the two types of exercise. There were also no differences regarding the type of injury between the two types of exercise (p=1), nor in men (p=1) or in women (p=1).

     

    Conclusion

    There is less risk for injuries at bodypump than at strength training on your own in the gym. More and larger studies are needed to be able to generalize the type of injury, cause and gender differences.

  • 44. Eklund, Elsine
    et al.
    Svensson, Elisabeth
    Häger-Ross, Charlotte
    Hand function and disability of the arm, shoulder and hand in Charcot-Marie-Tooth disease.2009In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 31, no 23Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The aim of the present study was to examine hand function and disability in persons with Charcot-Marie-Tooth disease (CMT) and to evaluate the possible correlations between hand function and disability.

    METHODS: Nine male, 11 female (24-73 yrs) persons with CMT in northern Sweden and a matched control group of 18 men, 22 women (21-73 yrs) participated in the study. Measurements applied were tests of dexterity (Box and Block Test; Nine-Hole Peg test), grip strength (Grippit), tactile gnosis (Shape Texture Identification test) and upper-limb disability (Disabilities of the Arm Shoulder and Hand questionnaire, DASH).

    RESULTS: Hand function in CMT was reduced (p < 0.001) to about 60% of normal, as indicated by each of the separate outcome measures as well as by a constructed summary index of hand function. DASH score median was 38.8 (range 0-66.7) and was clearly related to hand function (r = 0.64-0.83).

    CONCLUSION: Reduced hand function in CMT was found at different dimensions according to the International Classification of Functioning, Disability and Health (ICF). We suggest that DASH can be used in persons with CMT, though clinicians should be aware that patients might score lower than expected, possibly because of a long process of adaptation when learning to live with a slowly progressive disease.

  • 45.
    Eklundh, Emma
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Bergqvist, Hanna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Skillnader och samband mellan genus, ålder, utfallsförväntningar och self-efficacy inom kontexten fysisk aktivitet2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: In social cognitive theory, the terms self-efficacy and outcome expectations are often used. These can indirectly affect how physically active a person is, which is important for a physiotherapist to adress. To our knowledge, these terms have never been studied from an age and gender perspective in larger groups in Sweden.

     

    Purpose: To examine the estimated physical activity level as well as outcome expectations and self-efficacy in the context of physical activity from a gender and age perspective.

     

    Method: A cross sectional study using answers from three self-assessment forms: MOEES-SV, ESES-S and Frändin and Grimby's activity scale. The population consisted of 125 people (56 women and 69 men).

     

    Results: No statistical significant differences were found between how men and women estimate outcome expectations for physical activity, percieved activity level or self-efficacy in the context of physical activity. Regarding estimated outcome expectations, no statistical correlation between women and age or men and age was found.

     

    Conclusion: From an age and gender perspective, no differences or correlations were found regarding estimated physical activity level or outcome expectations and self-efficacy in the context of physical activity. Further studies on larger and more diverse groups are considered necessary to draw general conclusions on the subject.

  • 46.
    Ekstrand, Elisabeth
    et al.
    Lund Univ, Dept Hlth Sci, Lund, Sweden;Skane Univ Hosp, Dept Hand Surg, Malmo, Sweden.
    Lexell, Jan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine. Lund Univ, Dept Hlth Sci, Lund, Sweden.
    Brogårdh, Christina
    Lund Univ, Dept Hlth Sci, Lund, Sweden;Skane Univ Hosp, Dept Neurol & Rehabil Med, Lund, Sweden.
    Test-Retest Reliability of The Participation Domain of the Stroke Impact Scale in Persons with Chronic Stroke2018In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 50, no 9, p. 843-846Article in journal (Refereed)
    Abstract [en]

    Objective: To evaluate the test-retest reliability and variability of the Participation domain of the Stroke Impact Scale (SIS Participation) in persons with stroke as it is widely used to assess perceived participation in rehabilitation after stroke.

    Design: A test-retest design. Subjects: Forty-five persons (mean age 65 years) with mild to moderate disability at least 6 months post-stroke.

    Methods: The SIS Participation domain was rated on 2 occasions, 1 week apart. The test-retest reliability of the total score was evaluated using Kappa statistics. The 8 item scores were evaluated by the proportion of participants who rated the same score (percentage agreement, PA) or +/- 1 point (PA <= 1 point) at T1 and T2. The Svensson method was used to evaluate systematic and random disagreement.

    Results: The test-retest reliability of the total score showed excellent agreement (Kappa coefficient = 0.79). The items showed high PA <= 1 point (> 82%). No items, except 2, showed a systematic disagreement, and no items showed a random disagreement according to the Svensson method.

    Conclusion: The SIS Participation domain is reliable in persons with chronic stroke and mild to moderate disability and can be used to assess perceived participation in this population.

  • 47.
    Elmgren Frykberg, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Movement Control after Stroke: Studies on Sit-to-walk and on the Relations between Clinical and Laboratory Measures2010Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Aims: The principal aims of this research were 1) to extend existing knowledge of the everyday sit-to-walk (STW) transfer in subjects with stroke and in matched controls by exploring temporal, kinematic, and kinetic aspects, and 2) to investigate the relations between some clinical and laboratory measures of postural control and locomotion in stroke rehabilitation and research.

    Methods: Ten community-living subjects with stroke (mean age 59 years) and ten matched controls were enrolled in the STW studies (Studies I, II, and IV). In the study regarding relations between clinical and laboratory measures the same samples (part of Study II) and also 20 outpatient subjects with stroke (mean age 50 years) participated (Study III). Data collections were performed in laboratory environments with clinical assessment instruments, video cameras, force plates and a movement analysis system.

    Results: 1) Study I: A temporal aspect of STW was studied. Four phases were defined. The subjects with stroke used significantly more time during the 2nd STW phase, defined from seat-off to the loading peak of the 1st swing leg. Study II: A movement aspect of STW was investigated. The stroke subjects generated significantly less centre of mass momenta in horizontal and vertical directions, and the momenta peaks occurred significantly earlier than in the controls. Study IV: A force aspect of STW was explored. The subjects with stroke generated significantly larger propulsive impulse beneath the (non-paretic) stance buttock and significantly more braking impulses were exerted by both buttocks and particularly by the stance foot.

    2) Part of Study II: A strong correlation was found between the clinical measure Fluidity Scale and the laboratory measure Fluidity Index. Study III: Moderate correlations were shown between Berg Balance Scale, ratings of weight distribution during quiet stance, and force measures.

    Conclusions: The findings of the STW studies show a changed force interaction between the lower extremities post-stroke, likely influencing movement patterns and temporal characteristics of the everyday transfer. The results are considered to reflect compensatory motor strategies. The results of the studies on relations between some clinical and laboratory measures indicate that the strength of the relation is multidimensional.

     

    List of papers
    1. Temporal coordination of the sit-to-walk task in subjects with stroke and in controls
    Open this publication in new window or tab >>Temporal coordination of the sit-to-walk task in subjects with stroke and in controls
    Show others...
    2009 (English)In: Archives of Physical Medicine and Rehabilitation, ISSN 0003-9993, E-ISSN 1532-821X, Vol. 90, no 6, p. 1009-1017Article in journal (Refereed) Published
    Abstract [en]

    Objectives: To explore events and describe phases for temporal coordination of the sit-to-walk (STW) task, within a semistandardized set up, in subjects with stroke and matched controls. In addition, to assess variability of STW phase duration and to compare the relative duration of STW phases between the 2 groups.

    Design: Cross-sectional.

    Setting: Research laboratory.

    Participants: A convenience sample of persons with hemiparesis (n=10; age 50–67y), more than 6 months after stroke and 10 controls matched for sex, age, height, and body mass index.

    Interventions: Not applicable.

    Main Outcome Measures: Relative duration of STW phases, SE of measurement in percentage of the mean, and intraclass correlation coefficients (ICCs).

    Results: Four STW phases were defined: rise preparation, transition, primary gait initiation, and secondary gait initiation. The subjects with stroke needed 54% more time to complete the STW task than the controls did. ICCs ranged from .38 to .66 and .22 to .57 in the stroke and control groups, respectively. SEs of measurement in percentage of the mean values were high, particularly in the transition phase: 54.1% (stroke) and 50.4% (controls). The generalized linear model demonstrated that the relative duration of the transition phase was significantly longer in the stroke group.

    Conclusions: The present results extend existing knowledge by presenting 4 new phases of temporal coordination of STW, within a semistandardized set-up, in persons with stroke and in controls. The high degree of variability regarding relative STW phase duration was probably a result of both the semistandardized set up and biological variability. The significant difference in the transition phase across the 2 groups requires further study.

    Keywords
    stroke, motor activity, rehabilitation, reproducibility of results
    National Category
    Physiotherapy Control Engineering
    Research subject
    Rehabilitation Medicine
    Identifiers
    urn:nbn:se:uu:diva-120712 (URN)10.1016/j.apmr.2008.12.023 (DOI)000266787000016 ()19480878 (PubMedID)
    Available from: 2010-03-16 Created: 2010-03-16 Last updated: 2017-12-12Bibliographically approved
    2. Locomotor coordination during the sit-to-walk transfer is different in subjects with stroke and controls
    Open this publication in new window or tab >>Locomotor coordination during the sit-to-walk transfer is different in subjects with stroke and controls
    Show others...
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    Objectives: To describe and to compare coordination of centre of mass (COM) horizontal and vertical momenta, and fluidity during the sit-to-walk (STW) transfer in subjects with stroke and in matched controls.

    Design: Cross-sectional.

    Setting: Research laboratory.

    Participants: Ten subjects with stroke in the post-acute phase (> 6 months) and ten control subjects, matched for sex, age, height and weight, were recruited through a convenience sample.

    Interventions: Not applicable.

    Main Outcome Measures: Magnitudes and timing of COM peak horizontal and peak vertical momenta, scores on the Fluidity Scale (FS) and values of the Fluidity Index (FI).

    Results: The stroke subjects generated significantly less COM peak horizontal and peak vertical momenta. Latencies from STW-onset and seat-off to the peaks differed significantly between the two groups. The subjects with stroke displayed significantly lower scores on the FS as well as lower percentages of the FI.

    Conclusions: While rising to walk, scaling and timing parameters of COM horizontal and vertical momenta differed significantly between subjects with stroke and matched controls. This atypical motor strategy needs to be further investigated before it is possible to make clinical recommendations.

     

    Keywords
    Stroke, motor activity, rehabilitation
    National Category
    Physiotherapy
    Research subject
    Rehabilitation Medicine
    Identifiers
    urn:nbn:se:uu:diva-120630 (URN)
    Available from: 2010-03-16 Created: 2010-03-15 Last updated: 2010-03-21
    3. Correlation between clinical assessment and force plate measurement of postural control after stroke
    Open this publication in new window or tab >>Correlation between clinical assessment and force plate measurement of postural control after stroke
    2007 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 39, no 6, p. 448-453Article in journal (Refereed) Published
    Abstract [en]

    Objectives: To explore the correlation between clinical assessmentand force plate measurement of postural control after stroke when selected balance tasks are performed under similar spatial and temporal conditions, and to examine the inter-rater agreement of assessment of weight distribution during quiet stance in subjects with stroke.

    Design: A descriptive and correlational study.

    Methods: Clinical assessment of postural control using Berg Balance Scale, video recording for rating of weight distribution, and force plate measurement with the Vifor-system, were performed in 20 subjects with stroke.

    Results: Mean velocity of displacement of the centre of pressure in the anterior-posterior direction correlated moderately with scores from the Berg Balance Scale items “maintaining a position” in the whole sample (rs = –0.50, p <0.05) as well as in a subgroup of subjects with stroke with submaximal Berg Balance Scale scores (rs = –0.62, p < 0.05). Moderate correlation was found between ratings of each of 3 physiotherapistsand centre of pressure’s mean position in the frontal plane on the force plate, while the inter-rater agreement was poor.

    Conclusion: Clinical assessment of postural control and weight distribution showed moderate correlation with force plate measurement when the assessments were performed under similar conditions. The data suggest that the reliability of observational postural analysis needs to be improved.

    Keywords
    Postural control, stroke, Berg Balance Scale, force plate measures, weight distribution
    National Category
    Medical and Health Sciences
    Research subject
    Rehabilitation Medicine
    Identifiers
    urn:nbn:se:uu:diva-11302 (URN)10.2340/16501977-0071 (DOI)000248226400003 ()17624478 (PubMedID)
    Available from: 2007-11-19 Created: 2007-11-19 Last updated: 2017-12-11Bibliographically approved
    4. Impact of stroke on anterior–posterior force generation prior to seat-off during sit-to-walk
    Open this publication in new window or tab >>Impact of stroke on anterior–posterior force generation prior to seat-off during sit-to-walk
    Show others...
    2012 (English)In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 35, no 1, p. 56-60Article in journal (Refereed) Published
    National Category
    Physiotherapy Control Engineering
    Research subject
    Rehabilitation Medicine
    Identifiers
    urn:nbn:se:uu:diva-120704 (URN)10.1016/j.gaitpost.2011.08.005 (DOI)000300267400010 ()21900011 (PubMedID)
    Available from: 2011-09-06 Created: 2010-03-16 Last updated: 2017-12-12Bibliographically approved
  • 48.
    Elmgren Frykberg, Gunilla
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Thierfelder, Tomas
    Åberg, Anna Cristina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Halvorsen, Kjartan
    Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Division of Systems and Control. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Automatic control.
    Borg, Jörgen
    Hirschfeld, Helga
    Impact of stroke on anterior–posterior force generation prior to seat-off during sit-to-walk2012In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 35, no 1, p. 56-60Article in journal (Refereed)
  • 49.
    Elmgren Frykberg, Gunilla
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Åberg, Anna Cristina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Halvorsen, Kjartan
    Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Automatic control.
    Borg, Jörgen
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Hirschfeld, Helga
    Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy.
    Temporal coordination of the sit-to-walk task in subjects with stroke and in controls2009In: Archives of Physical Medicine and Rehabilitation, ISSN 0003-9993, E-ISSN 1532-821X, Vol. 90, no 6, p. 1009-1017Article in journal (Refereed)
    Abstract [en]

    Objectives: To explore events and describe phases for temporal coordination of the sit-to-walk (STW) task, within a semistandardized set up, in subjects with stroke and matched controls. In addition, to assess variability of STW phase duration and to compare the relative duration of STW phases between the 2 groups.

    Design: Cross-sectional.

    Setting: Research laboratory.

    Participants: A convenience sample of persons with hemiparesis (n=10; age 50–67y), more than 6 months after stroke and 10 controls matched for sex, age, height, and body mass index.

    Interventions: Not applicable.

    Main Outcome Measures: Relative duration of STW phases, SE of measurement in percentage of the mean, and intraclass correlation coefficients (ICCs).

    Results: Four STW phases were defined: rise preparation, transition, primary gait initiation, and secondary gait initiation. The subjects with stroke needed 54% more time to complete the STW task than the controls did. ICCs ranged from .38 to .66 and .22 to .57 in the stroke and control groups, respectively. SEs of measurement in percentage of the mean values were high, particularly in the transition phase: 54.1% (stroke) and 50.4% (controls). The generalized linear model demonstrated that the relative duration of the transition phase was significantly longer in the stroke group.

    Conclusions: The present results extend existing knowledge by presenting 4 new phases of temporal coordination of STW, within a semistandardized set-up, in persons with stroke and in controls. The high degree of variability regarding relative STW phase duration was probably a result of both the semistandardized set up and biological variability. The significant difference in the transition phase across the 2 groups requires further study.

  • 50.
    Elomaa, Angelica
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Wiberg, Mikaela
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Följsamhet till hemträningsprogram -primärvårdspatienters erfarenheter av att följa träningsråd.2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Home-based exercise program is a common form of physiotherapy treatment to reduce symptoms and improve function in various musculoskeletal disorders. Many patients don´t follow their training program which is ineffective. The patient's adherence to the prescribed treatment is important to achieve a good outcome. By finding out what factors influence adherence to home-exercise, the physiotherapy treatment results can improve.

    Purpose: The purpose of this study was to investigate primarycare patients perceived factors that could have influenced them to pursue, or not to pursue, the home-based exercise program they received from their physiotherapist.

    Method: A qualitative, exploratory and descriptive design was used. Semi-structured interviews were conducted in five patients from two physiotherapists in primarycare. Qualitative content analysis was conducted in the dataprocess.

    Results: Eleven categories of facilitating factors emerged: Have a goal, high confidence in training, routine, reminders, available time, trust in the physiotherapist, discipline, clarity, positive feedback, follow-up and pain management.

    Three categories of barriers emerged: Not individually tailored programs, the absence of a reminder and a lack of time

    Conclusions: This study shows several perceived facilitators and barriers to home-based exercise program among patients. More studies about how this can be implemented in the physiotherapy work is needed.

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