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  • 1.
    Ahlström, Isabell
    et al.
    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.
    Emtner, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Anens, Elisabeth
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Reliability of the Swedish version of the Exercise Self-Efficacy Scale (S-ESES): a test-retest study in adults with neurological disease2015In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 31, no 3, p. 194-199Article in journal (Refereed)
    Abstract [en]

    Objective: To examine the test-retest reliability of the Swedish translated version of the Exercise Self-Efficacy Scale (S-ESES) in people with neurological disease and to examine internal consistency.

    Design: Test-retest study.

    Subjects: A total of 30 adults with neurological diseases including: Parkinson's disease; Multiple Sclerosis; Cervical Dystonia; and Charcot Marie Tooth disease.

    Method: The S-ESES was sent twice by surface mail. Completion interval mean was 16 days apart. Weighted kappa, intraclass correlation coefficient 2,1 [ICC (2,1)], standard error of measurement (SEM), also expressed as a percentage value (SEM%), and Cronbach's alpha were calculated.

    Results: The relative reliability of the test-retest results showed substantial agreement measured using weighted kappa (MD = 0.62) and a very high-reliability ICC (2,1) (0.92). Absolute reliability measured using SEM was 5.3 and SEM% was 20.7. Excellent internal consistency was shown, with an alpha coefficient of 0.91 (test 1) and 0.93 (test 2).

    Conclusion: The S-ESES is recommended for use in research and in clinical work for people with neurological diseases. The low-absolute reliability, however, indicates a limited ability to measure changes on an individual level.

  • 2.
    Arkkukangas, Marina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Sundler, Annelie J
    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.
    Johansson, Ann-Christin
    Older persons' experiences of a home-based exercise program with behavioral change support2017In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 33, no 12, p. 905-913Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: It is a challenge to promote exercise among older persons. Knowledge is needed regarding the maintenance of exercise aiming at preventing falls and promoting health and well-being in older persons.

    PURPOSE: This descriptive study used a qualitative inductive approach to describe older persons' experiences of a fall-preventive, home-based exercise program with support for behavioral change.

    METHODS: Semi-structured interviews were conducted with 12 elderly persons aged 75 years or older, and a qualitative content analysis was performed.

    RESULTS: Four categories emerged: facilitators of performing exercise in everyday life, the importance of support, perceived gains from exercise, and the existential aspects of exercise.

    CONCLUSION: With support from physiotherapists (PTs), home-based exercise can be adapted to individual circumstances in a meaningful way. Including exercises in everyday life and daily routines could support the experience of being stronger, result in better physical functioning, and give hope for an extended active life in old age.

  • 3.
    Boll, Madeleine
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Research and Development, Gävleborg.
    Boström Lindberg, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Research and Development, Gävleborg.
    Physiotherapists’ understanding and approach to health promotion work in compulsory school: perceiving and supporting coherence2010In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 26, no 5, p. 318-326Article in journal (Refereed)
    Abstract [en]

    Gaining knowledge in the field of health promotion may help physiotherapists acquire a new understanding of the way movement promotes health, as related to environmental influences. The aim of the present study was to describe how physiotherapists working in a programme of health promotion in compulsory school understand and approach their work. Seven physiotherapists in primary care, working partly with health promotion in compulsory school, were interviewed. A descriptive design of qualitative content analysis was chosen to analyse interviews that had already been conducted in a local evaluation of the programme. This resulted in a main theme, described as Perceiving and Supporting Coherence. This understanding and approach were discussed in relation to challenges of a historically embedded constitution of physiotherapy when entering the area of health promotion in compulsory school.

  • 4.
    Cedervall, Ylva
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Åberg, Anna Cristina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Physical activity and implications on well-being in mild Alzheimer's disease: A qualitative case study on two men with dementia and their spouses2010In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 26, no 4, p. 226-239Article in journal (Refereed)
    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.

  • 5.
    Demmelmaier, Ingrid
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Denison, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Lindberg, Per
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Åsenlöf, Pernilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Physiotherapists' telephone consultations regarding back pain: a method to analyze screening of risk factors2010In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 26, no 7, p. 468-475Article in journal (Refereed)
    Abstract [en]

    Background and aims

    There is a gap between guidelines and clinical management of risk factors for prolonged disability in back pain. The aims of this study were; 1) to evaluate the inter-rater reliability of a research protocol designed to analyse screening of physical and psychosocial risk factors for prolonged disability in back pain during telephone consultations, and; 2) to describe the overall content and the nature and extent of physical and psychosocial risk factors assessed by physiotherapists in telephone consultations for diagnostic screening of patients with back pain. 

    Method

     The material consisted of 17 initial telephone consultations regarding back pain recorded by five physiotherapists. A research protocol covering eight evidence-based risk factors was developed. Three raters performed separate analyses according to the protocol.

    Results

    Intraclass correlation of how many risk factors that were investigated was 0.82 (p<0.001.) Kappa values (pair-wise) of which risk factors that were screened were 0.79, 0.73 and 0.66 (p<0.001). A median of 2 risk factors were screened in each consultation; most frequent was signs of spinal pathology/radiating pain, followed by sick leave, disability, coping with pain and negative beliefs. Rating of pain intensity, depression and expectations of long-term pain were not screened.

    Conclusions

    The method of analysis appears reliable. It will be used in an intervention study that evaluates to what extent physiotherapists can learn to screen in concordance with guidelines in initial telephone consultations.

  • 6.
    Demmelmaier, Ingrid
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Denison, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Lindberg, Per
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Åsenlöf, Pernilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Tailored skills training for practitioners to enhance assessment of prognostic factors for persistent and disabling back pain: Four quasi-experimental single subject studies2012In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 28, no 5, p. 359-372Article in journal (Refereed)
    Abstract [en]

    The well-known gap between guidelines and behaviour in clinical practice calls for effective behaviour change interventions. One example showing this gap is physiotherapists' insufficient assessment of psychosocial prognostic factors in back pain (i.e., yellow flags). The present study aimed to evaluate an educational model by performing a tailored skills training intervention for caregivers and studying changes over time in physiotherapists' assessment of prognostic factors in telephone consultations. A quasi-experimental single-subject design over 36 weeks was used, with repeated measurements during baseline, intervention, and postintervention phases. Four physiotherapists in primary health care audiorecorded a total of 63 consultations with patients. The tailored intervention included individual goal setting, skills training, and feedback on performance. The primary outcome was the number of assessed prognostic factors (0–10). Changes were seen in all four participants. The amount of assessed prognostic factors increased from between 0 and 2 at baseline to between 6 and 10 at postintervention. Time spent on assessment of psychosocial factors increased, and time spent on discussions about biomedical pain symptoms decreased. Knowledge and biopsychosocial attitudes toward back pain were congruent with guidelines at inclusion and did not change markedly during the intervention. Self-efficacy for assessment of cognitive and emotional prognostic factors increased during the study phases. The results suggest that a tailored skills training intervention using behaviour change techniques, such as individual goal setting, skills training, and feedback on performance, is effective in producing change in specific clinical behaviours in physiotherapists.

  • 7. Langhammer, Birgitta
    et al.
    Stanghelle, Johan K
    Lindmark, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    An evaluation of two different exercis regimes during the first year following stroke: a randomised controlled trail2009In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 25, no 2, p. 55-68Article in journal (Refereed)
    Abstract [en]

    The purpose of this randomised controlled trial was to evaluate the effects of two different exercise approaches during the first 12 months post stroke on Instrumental Activities of Daily Living (IADL), motor function, gait performance, balance, grip strength, and muscle tone. This study is a double-blind longitudinal randomised trial of first-time-ever stroke patients. Seventy-five patients were included: 35 in an intervention group and 40 in a self-initiated exercise group. After discharge from acute rehabilitation, patients assigned in the intervention group had physiotherapy for a minimum amount of 80 hours during the first year. Patients in the self-initiated exercise group were not recommended any specific therapy besides treatment when needed. Main outcome measures were Instrumental Activities of Daily Living according to Fillenbaum, Motor Assessment Scale, 6-Minute Walk Test, Berg Balance Scale, Timed Up-and-Go Test, grip strength, Modified Ashworth Scale, and pulse monitoring. The patients were tested on admission, at discharge, and after 3, 6, and 12 months post stroke by an experienced investigator, blinded to group assignment. Twelve months post stroke showed higher levels of independence in all items of the Instrumental Activities of Daily Living Test and improvements in the results of Motor Assessment Scale, 6-Minute Walk Test, Berg Balance Scale, Timed Up-and-Go, and grip strength in both groups. Only a few significant differences were seen between groups, and they were in favour of the self-initiated exercise group (e.g., ability to use the telephone independently). Attending examination sessions following each intervention phase appeared to be strong motivators for training, irrespective of group allocation.

  • 8.
    Lindberg, Per
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Tailored skills training for practitioners to enhance assessment of prognostic factors for persistent and disabling back pain: Four quasi-experimental single subject studies.2011In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, no 28, p. 1-14Article in journal (Refereed)
  • 9.
    Lövgren, Anneli
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Hellström, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Reliability and validity of measurement and associations between disability and behavioural factors in patients with Colles' fracture2012In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 28, no 3, p. 188-197Article in journal (Refereed)
    Abstract [en]

    The aims of the study were to 1) investigate the test-retest reliability, the internal consistency in instruments that measure behavioural factors and disability as well as to investigate convergent validity between the Disabilities of the Arm, Shoulder, and Hand Outcome Questionnaire (DASH) and the Patient-Rated Wrist Evaluation (PRWE), in patients with Colles' fracture; and 2) assess the relationship between the behavioural measures and the region-specific measures addressing the patient perceptions of impairment, functional loss, and disability. Two samples (sample 1 = 16; sample 2 = 16) of patients with the fracture immobilised in plaster cast were included. The participants answered the Patient-Rated Wrist Evaluation (PRWE), Disabilities of the Arm, Shoulder, and Hand Outcome Questionnaire (DASH), Tampa Scale of Kinesophobia (TSK), Catastrophizing Subscale (CAT) of the Coping Strategies Questionnaire (CSQ), and Self-Efficacy Scale (SES) twice. Test-retest reliability was satisfactory for all instruments. The internal consistency examined with Cronbach's alpha was between 0.68 and 0.97. Because acceptable to good test-retest reliability and internal consistency were demonstrated for the PRWE, DASH, TSK, CAT of the CSQ, and SES, they can be used to detect and monitor fear of movement/(re)injury, catastrophic cognitions, and self-efficacy in patients with radius fracture in the acute and subacute phase. Generally low to moderate correlations were found between behavioural and region-specific measures, indicating that there are two distinct concepts that are not interchangeable.

  • 10.
    Nessen, Thomas
    et al.
    Karolinska Inst, Div Physiotherapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.
    Opava, Christina H.
    Karolinska Inst, Div Physiotherapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.
    Martin, Cathrin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Demmelmaier, Ingrid
    Karolinska Inst, Div Physiotherapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.
    Physiotherapists' management of challenging situations in guiding people with rheumatoid arthritis to health-enhancing physical activity2019In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 35, no 1, p. 31-39Article in journal (Refereed)
    Abstract [en]

    Objectives: To explore strategies used by physiotherapists (PTs) in guiding people with rheumatoid arthritis to health-enhancing physical activity (HEPA) in a group setting during a 1-year intervention study.

    Methods: Exploratory design with qualitative video analysis performed in three steps. Eleven female PTs were video recorded while leading support group sessions aiming at facilitating HEPA (twice-weekly exercise sessions at public gyms and 150 weekly minutes of moderately intense aerobic physical activity).

    Results: Three categories of challenging situations emerged. They occurred when the HEPA intervention participants reported barriers to performing physical activity, when they neglected to use the planning tool for physical activity as intended in the program, and when they received negative results from physical capacity tests. PTs used different strategies to manage these challenges, with main focus either on information-giving, corresponding to a traditional health professional approach, or utilizing group resources by organizing participation.

    Conclusions: This study provides detailed descriptions of PTs’ clinical behavior in video-recorded sessions. The results imply that motivated PTs can, despite their biomedical and practitioner-focused training, learn to adapt their communication strategies to different situations, altering between traditional information-giving and utilizing group resources by organizing participation.

  • 11.
    Ribom, Eva L.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Kindmark, Andreas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Endocrinology and mineral metabolism.
    Ljunggren, Östen
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Endocrinology and mineral metabolism.
    Hyperkyphosis and back pain are not associated with prevalent vertebral fractures in women with osteoporosis2015In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 31, no 3, p. 182-185Article in journal (Refereed)
    Abstract [en]

    Vertebral fractures (VFs) are the clinical consequence of spinal osteoporosis and may be associated with back pain and aggravated kyphosis. However, the relative importance of VFs as an underlying cause of kyphosis and chronic back pain is not known. The aim of this study was to investigate the relationship between prevalent VFs and the size of kyphosis, and back pain in osteoporotic women. Thirty-six women, aged 74.6 +/- 8.3 years, were consecutively recruited from the osteoporosis unit at Uppsala University Hospital. The patients had 1-9 radiographic verified VFs. Tragus wall distance (TWD) and numeric rating scale were used to measure kyphosis and pain. All patients had a hyperkyphosis (TWD >= 10 cm). Notably, there were no associations between numbers or location of VFs versus size of kyphosis (rho = 0.15, p = 0.4; rho = -0.27, p = 0.12) or severity of back pain (rho = -0.08, p = 0.66; rho = 0.16, p = 0.35). Furthermore, no association was evident between kyphosis and back pain (rho = -0.02, p = 0.89). There was, however, an association between size of kyphosis and age (R = 0.44, p = 0.008). In conclusion, these data suggest that prevalent VFs are not significantly associated with kyphosis or chronic back pain, in patients with manifest spinal osteoporosis.

  • 12. Strandkvist, Viktor
    et al.
    Andersson, Mikael
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research.
    Backman, Helena
    Larsson, Agneta
    Stridsman, Caroline
    Lindberg, Anne
    Hand grip strength is associated with fatigue among men with COPD: epidemiological data from northern Sweden2018In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, p. 1-9Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate if hand grip strength (HGS) is associated with: 1) fatigue, and specifically clinically relevant fatigue (CRF); 2) low physical activity; and 3) fatigue independent of physical activity level, among individuals with and without COPD. Data were collected from the Obstructive Lung Disease in Northern Sweden (OLIN) COPD-study in 2014. HGS was measured with a hand-grip dynamometer, fatigue and physical activity were assessed by questionnaires; FACIT-Fatigue respectively IPAQ. Among individuals with COPD (n = 389), but not without COPD (n = 442), HGS was lower among those with CRF than those without CRF, significantly so among men (p = 0.001) and close to among women (p = 0.051). HGS was not associated with physical activity levels within any of the groups. HGS was associated with fatigue among men, but not women, with COPD independent of physical activity level, age, height, and smoking habits (Beta = 0.190, 95% CI 0.061–0.319, respectively Beta = 0.048, 95% CI−0.056–0.152), while there were no corresponding significant findings among individuals without COPD. In summary, HGS was associated with CRF among individuals with COPD in this population-based study. Among men with COPD, HGS was associated with fatigue independent of physical activity level and common confounders.

  • 13.
    Torstensson, Thomas
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Lindgren, Anne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Kristiansson, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Improved function in women with persistent pregnancy-related pelvic pain after a single corticosteroid injection to the ischiadic spine: a randomized double blind controlled trial2013In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 29, no 5, p. 371-378Article in journal (Refereed)
    Abstract [en]

    Background: Pregnancy-related low back and pelvic pain is a worldwide problem. A large proportion of women still experience disabling daily back pain 2 years after childbirth, resulting in major changes in activities and general well-being. In spite of this, the source of pain and effective treatment are uncertain. Objective: To evaluate the short-term effects on function of a single corticosteroid injection treatment to the ischiadic spine in women with persistent pregnancy-related pelvic pain (PPPP). Methods: Thirty-six women were allocated to injection treatment with slow-release triamcinolone and lidocain or saline and lidocain, given once at the sacrospinous ligament insertion on the ischiadic spine bilaterally with follow-up at 4 weeks. Outcome measures were Disability Rating Index (DRI), self-rated functional health (SF-36), gait speed and endurance (6MWT), and strength and endurance of trunk muscles (isometric trunk extensor and flexor tests). Results: Women in the triamcinolone group showed significantly improved DRI (p  =  0.046), 6MWT (p  =  0.016), and isometric trunk extensor tests (p  =  0.004), as compared with the saline group. Close co-variation was shown between improved function and reduced pain intensity. Conclusions: Improved function was achieved among women with PPPP after a single injection treatment with slow-release corticosteroid. The effect was positively correlated to the reduced pain intensity.

  • 14.
    Vahlberg, Birgit
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Bring, Annika
    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.
    Zetterberg, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Level of physical activity in men and women with chronic stroke2018In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, p. 1-9Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Community-dwelling stroke survivors generally show low levels of physical activity (PA). An improved understanding of the factors influencing participation in PA after stroke is imperative to improve levels of PA. Furthermore, gender differences in PA have received little attention in stroke research. The objective of this study was to examine gender differences in PA, physical functioning and psychological factors and the association between these factors and PA in men and women 1-3-year post-stroke.

    MATERIALS AND METHODS: A total of 187 community-dwelling individuals with stroke (65-85 years old, 29% women) were included in a secondary analysis based on data from a cross-sectional study. The exclusion criteria were severe cognitive or language dysfunction or dementia. The level of PA was measured by the Physical Activity Scale for the Elderly. Physical function included balance, walking speed and mobility. Psychological factors included depression, health-related quality of life and fall-related self-efficacy. Falls and fear of falling were each measured with a single question.

    RESULTS: There were no significant differences in PA levels between men and women. In multiple regression analyses, walking speed (p < 0.001) was associated with PA in men, and balance (p = 0.038) was associated with PA in women.

    CONCLUSIONS: The results indicate that strategies to increase PA levels 1-3-year post-stroke could be improved by considering gender-specific factors.

  • 15.
    Zetterberg, Lena
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Halvorsen, Kjartan
    Färnstrand, Catarina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Clinical Neurophysiology.
    Aquilonius, Sten-Magnus
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurology.
    Lindmark, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Physiotherapy in Cervical Dystonia: Six experimental single-case studies2008In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 24, no 4, p. 275-290Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to explore the outcome of a physiotherapy program targeted to improve the quality of life of people with cervical dystonia (CD) by reducing pain, improving awareness of postural orientation, increasing muscle strength, and reducing the effort of moving the head and neck. In six single case studies, the primary outcome measure for each case was the Cervical Dystonia Questionnaire (CDQ) to measure the impact of the program on the individuals' quality of life. Secondary outcome measures were identified for the different components of the physiotherapy program: Visual Analogue Scale (pain); Postural Orientation Index (postural orientation awareness); and Movement Energy Index (effort of moving head and neck). Each of the cases had the severity of their problems scored on the Toronto Western Spasmodic Torticollis Scale. The study period was 26 weeks: 2 weeks' baseline period, 4 weeks' treatment period, and 20 weeks' follow-up. All measures except the Movement Energy Index (MEI) and CDQ-24 were taken three times per week for the first 6 weeks of the study and then once at 3 and 6 months. The MEI was taken once a week during the pretreatment and the treatment periods and during the first 2 weeks of follow-up and also after 3 and 6 months of follow-up. The CDQ-24 was taken once in the pretreatment period, once after completion of treatment, once 2 weeks after treatment, and once at 3 and 6 months of follow-up. Five of the six case studies reported an increase in quality of life at 6-month follow-up, as measured on the CDQ-24. Three of the six cases reported a reduction in pain and severity of the dystonia and had improved scores on the postural orientation measure at 6-month follow-up. All six patients had a reduction in the movement energy scores, but this was not significant. The outcomes of the six case studies would suggest that further investigation is required to show the effectiveness of physiotherapy programs in the management of CD.

  • 16.
    Åkerström, Mona-Lisa
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Grimby-Ekman, Anna
    Univ Gothenburg, Sahlgrenska Acad, Occupat & Environm Med, Gothenburg, Sweden..
    Lundberg, Mari
    Karolinska Inst, Div Physiotherapy, Dept Neurobiol Care Sci & Sociol, Huddinge, Sweden..
    Work ability is influenced by kinesiophobia among patients with persistent pain2017In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 33, no 8, p. 634-643Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to investigate how kinesiophobia fluctuates in patients over a four weeks multimodal rehabilitation program and to study the relationship between work ability and kinesiophobia. The study included 112 patients (94 women, 18 men). Measurements were made before, directly after, 2months after, and 12months after the program. The level of work ability was rated by the patients on a scale from 0% to 100%, and kinesiophobia was measured by the Swedish version of the Tampa Scale for Kinesiophobia (TSK-SV). Kinesiophobia decreased between the start of the multimodal rehabilitation program and the follow-up periods. Work ability increased over time, but not between baseline and the 2-month follow-up. Decreases in the TSK-SV score between baseline and the 2-month follow-up were related to the increased probability of improved work ability at the 12-month follow-up. In conclusion, a decrease in kinesiophobia seems to be related to increased work ability of patients participating in a 4-week multimodal rehabilitation program.

  • 17.
    Åsenlöf, Pernilla
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Denison, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Lindberg, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Behavioral goal assessment in patients with persistent musculoskeletal pain2004In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 20, no 4, p. 243-254Article in journal (Refereed)
    Abstract [en]

    Identification and achievement of behavioral goals is an important issue in pain rehabilitation. For this dual purpose, we developed a patient-specific clinical tool—the Patient Goal Priority Questionnaire (PGPQ). Using the PGPQ, this study identifies patients' behavioral goals for physical therapy (PT) in a primary health care sample of patients with persistent musculoskeletal pain. In addition, this study examines the concurrent validity of the PGPQ in relation to a generic measure of disability, the Pain Disability Index (PDI). In all, 197 subjects participated in the study. The behavioral goals differed among the patients, comprehending several everyday activities and behaviors, and thus an individualized and behavioral focus was relevant for these patients. The PGPQ was negatively and moderately correlated with the PDI, indicating patient-specific properties of the new instrument. An elaborated version of the PGPQ can serve (a) as a clinical tool for identification of the patient's priorities of behavioral goals for PT, (b) as a clinical tool for collaborative formative evaluation during treatment, and (c) as a complementary measure in research for assessment of clinically significant changes related to behavioral performance.

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