uu.seUppsala University Publications
Change search
Refine search result
123 1 - 50 of 134
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the Create feeds function.
  • 1.
    Abbaspour, Kristina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Lindén, Charlotta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Primärvårdsjukgymnastens yrkesroll och kompetens, nu och i framtiden.2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 2.
    Adelsköld, Signe
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Thalin, Hanna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Reliabilitets- och validitetsprövning av Modifierad Self-efficacy Scale för patienter med långvarig smärta2010Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Studiens syfte var att reliabilitetspröva stabiliteten för M-SES för patienter med långvarig smärta genom test-retest metoden. Syftet var även att undersöka samtidig validitet för M-SES, genom att utföra M-SES och SES mätt vid samma tillfälle.

    Metod: I studien undersöktes self-efficacy instrumentet M-SES på Uppsala Akademiska sjukhus, på avdelningarna för Smärtcentrum och Smärtrehabilitering. Frågeställningarna berörde vilken stabilitets reliabilitet mätt med test-retest som förelåg hos M-SES, samt vilken grad av samtidig validitet som förelåg för M-SES korrelerat med SES. Den slutliga undersökningsgruppen bestod i frågeställningen om stabilitets reliabilitet av 29 patienter (23 kvinnor, sex män), och i frågeställning om samtidig validitet av 22 patienter (17 kvinnor, fem män).

    Resultat: Vid prövning av stabilitets reliabilitet för M-SES visade resultatet en stark korrelation, med korrelationskoefficient 0,92 och p<0,05. Det förelåg även en god överrensstämmelse för test-retest undersökningen. Prövningen av samtidig validitet för M-SES visade en stark korrelation, med koefficienten 0,88 och p<0,05.

    Konklusion: Studiens resultat visade att det förelåg en stark stabilitets reliabilitet och samtidig validitet för M-SES för patienter med långvarig smärta. Då studien genomfördes med få deltagare bör resultatet tolkas med försiktighet.

  • 3.
    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.

  • 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, Mikael
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    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.
    Accuracy of three activity monitors in patients with chronic obstructive pulmonary disease: A comparison with video recordings2014In: COPD: Journal of Chronic Obstructive Pulmonary Disease, ISSN 1541-2555, E-ISSN 1541-2563, Vol. 11, no 5, p. 560-567Article in journal (Refereed)
    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. 

  • 6.
    Andersson, Mikael
    et al.
    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.
    Moberg, Linda
    Svantesson, Ulla
    Sundbom, Ann
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Johansson, Henrik
    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.
    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.
    Measuring walking speed in COPD: test-retest reliability of the 30-metre walk test and comparison with the 6-minute walk test2011In: Primary Care Respiratory Journal, ISSN 1471-4418, E-ISSN 1475-1534, Vol. 20, no 4, p. 434-440Article in journal (Refereed)
    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.

  • 7.
    Andersson, Mikael
    et al.
    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.
    Slinde, Frode
    Groenberg, Anne Marie
    Svantesson, Ulla
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    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.
    Physical activity level and its clinical correlates in chronic obstructive pulmonary disease: a cross-sectional study2013In: Respiratory research (Online), ISSN 1465-9921, E-ISSN 1465-993X, Vol. 14, p. 128-Article in journal (Refereed)
    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.

  • 8.
    Andersson, Mikael
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Stridsman, Caroline
    Luleå University of Technology.
    Rönmark, Eva
    Umeå University.
    Lindberg, Anne
    Umeå University.
    Emtner, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Physical activity and fatigue in chronic obstructive pulmonary disease: A population based studyManuscript (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.

  • 9.
    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.

     

  • 10.
    Andersson, Sandra
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Larsson, Sofie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Förslag till rekommenderade referensvärden för Falls Efficacy Scale (Swedish version) för friska äldre2010Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med studien var att undersöka fallrelaterad self-efficacy mätt med Falls Efficacy Scale (Swedish version) (FES(S)) samt att beräkna rekommenderade referensvärden för totalpoängen på FES(S) hos friska äldre män och kvinnor indelade i åldersgrupperna 65-75 år samt > 75 år. Vidare syftade studien till att undersöka om det fanns några skillnader i resultatet mellan åldersgrupperna samt mellan män och kvinnor.

    Undersökningsgruppen bestod av totalt 70 individer över 65 års ålder, varav 45 var kvinnor och 25 var män. Testdeltagarna kontaktades via PRO i Uppsala. Även vänner och bekanta till författarna deltog i studien. Testdeltagarnas fallrelaterade self-efficacy undersöktes med hjälp av instrumentet FES(S), där testdeltagarna fick skatta hur säkra de känner sig på att utföra 13 olika vardagsaktiviteter utan att falla, maximal poäng 130.

    Resultatet visade att det rekommenderade referensvärdet för totalpoängen på FES(S) blev 124 poäng för kvinnor i åldern 65-75 år och 126 poäng för män i samma ålder. För kvinnor > 75 år ålder blev det rekommenderade referensvärdet 118 poäng och för män 105 poäng. Det fanns en statistiskt signifikant skillnad för totalpoängen på FES(S) mellan de två åldersgrupperna, p=0,005. Ingen statistiskt signifikant skillnad kunde påvisas mellan könen, p=0,632. För att få fram mer generaliserbara referensvärden behövs ytterligare studier med ett mer representativt urval och en större undersökningsgrupp.

  • 11.
    Arne, Mats
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Janson, Staffan
    Karlstad University, Department of Social Sciences.
    Boman, Gunnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Lindqvist, Ulla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Internal Medicine.
    Berne, Christian
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Internal Medicine.
    Emtner, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Physical activity and quality of life in subjects with chronic disease: chronic obstructive pulmonary disease compared with rheumatoid arthritis and diabetes mellitus2009In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 27, no 3, p. 141-147Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Chronic diseases interfere with the life situation of the affected person in different ways. The aim was to compare the burden of disease in three chronic diseases - chronic obstructive pulmonary disease (COPD), rheumatoid arthritis (RA), diabetes mellitus (DM) - and in healthy subjects, with a particular interest in physical activity, quality of life, and psychological health. DESIGN: Cross-sectional, observational study. SETTING AND SUBJECTS: Postal survey questionnaire to a stratified, random population of 68 460 subjects aged 18-84 years in Sweden. The subjects included were 40-84 years old (n = 43 589) and data were analysed for COPD (n = 526), RA (n = 1120), DM (n = 2149) and healthy subjects (n = 6960). RESULT: Some 84% of subjects with COPD, 74% (RA), 72% (DM), and 60% in healthy subjects (p < 0.001, COPD versus RA, DM, and healthy subjects) had a physical activity level considered too low to maintain good health according to guidelines. Quality of life (EuroQol five-dimension questionnaire, EQ-5D) was lower in COPD and RA than in DM. Anxiety/depression was more common in subjects with COPD (53%) than in those with RA (48%) and DM (35%) (p < 0.001, COPD versus RA and DM), whereas mobility problems were more common in RA (55%) than COPD (48%) and DM (36%) (p < 0.001, RA versus COPD and DM). All differences between groups remained significant after adjusting for age, sex, and socioeconomic background factors. CONCLUSION: Subjects with chronic diseases had a low level of physical activity, most evident in subjects with COPD. COPD and RA had a higher negative impact on quality of life than DM. Our results indicate that increased attention regarding physical inactivity in subjects with chronic diseases is needed to minimize the burden of disease.

  • 12.
    Arne, Mats
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Lisspers, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology.
    Ställberg, Björn
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i D län (CKFD).
    Boman, Gunnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Hedenström, Hans
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    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.
    How often is diagnosis of COPD confirmed with spirometry?2010In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 104, no 4, p. 550-556Article in journal (Refereed)
    Abstract [en]

    Background: Chronic obstructive pulmonary disease (COPD) is an important cause of morbidity and mortality worldwide. Diagnosis is customarily confirmed with spirometry, but there are few studies on documented spirometry use in everyday clinical practice. Methods: In a cross-sectional survey and study of the medical records of primary and secondary care COPD patients aged 18-75 in a Swedish region, patients with COPD were randomly selected from the registers of 56 primary care centres and 14 hospital outpatient clinics. Spirometry data at diagnosis ±6 months were analyzed. Results: From 1,114 patients with COPD, 533 with a new diagnosis of COPD during the four-year study period were identified. In 59% (n=316), spirometry data in connection with diagnosis were found in the medical records. Spirometry data with post-bronchodilator forced expiratory volume in one second (FEV1)/ vital capacity (VC) ratios were available in 45% (n=241). FEV1/VC ratio <0.70 were found in 160 patients, which corresponds to 30% of the patients with a new diagnosis. Lower age, female gender, current smoking, higher body mass index (BMI) and shorter forced exhalation time were related to COPD diagnosis despite an FEV1/VC ratio of ≥0.70. The most common problem in the quality assessment was an insufficient exhalation time. Conclusions: Only a third of Swedish patients with COPD had their diagnosis confirmed with spirometry. Our data indicate that female gender, current smoking, higher BMI and short exhalation time increase the risk of being diagnosed with COPD without fulfilling the spirometric criteria for the disease.

  • 13.
    Arne, Mats
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Lundin, Fredrik
    Boman, Gunnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Janson, Staffan
    Emtner, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Factors associated with good self-rated health and quality of life in subjects with self-reported COPD2011In: The International Journal of Chronic Obstructive Pulmonary Disease, ISSN 1176-9106, E-ISSN 1178-2005, Vol. 6, p. 511-519Article in journal (Refereed)
    Abstract [en]

    Background: Recent guidelines for chronic obstructive pulmonary disease (COPD) state that COPD is both preventable and treatable. To gain a more positive outlook on the disease it is interesting to investigate factors associated with good, self-rated health and quality of life in subjects with self-reported COPD in the population.

    Methods: In a cross-sectional study design, postal survey questionnaires were sent to a stratified, random population in Sweden in 2004 and 2008. The prevalence of subjects (40–84 years) who reported having COPD was 2.1% in 2004 and 2.7% in 2008. Data were analyzed for 1475 subjects. Regression models were used to analyze the associations between health measures (general health status, the General Health Questionnaire, the EuroQol five-dimension questionnaire) and influencing factors.

    Results: The most important factor associated with good, self-rated health and quality of life was level of physical activity. Odds ratios for general health varied from 2.4 to 7.7 depending on degree of physical activity, where subjects with the highest physical activity level reported the best health and also highest quality of life. Social support and absence of economic problems almost doubled the odds ratios for better health and quality of life.

    Conclusions: In this population-based public health survey, better self-rated health status and quality of life in subjects with self-reported COPD was associated with higher levels of physical activity, social support, and absence of economic problems. The findings indicated that of possible factors that could be influenced, promoting physical activity and strengthening social support are important in maintaining or improving the health and quality of life in subjects with COPD. Severity of the disease as a possible confounding effect should be investigated in future population studies.

  • 14.
    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.

  • 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. Bergland, A
    et al.
    Narum, I
    Grönstedt, H
    Hellström, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Helbostad, J
    Puggaard, L
    Andresen, M
    Granbo, R
    Frändin, K
    Evaluating the feasibility and intercorrelation of measurements on the functioning of residents living in Scandinavian nursing homes. 2010In: Physical & Occupational Therapy in Geriatrics, ISSN 0270-3181, E-ISSN 1541-3152, Vol. 28, no 2, p. 154-169Article in journal (Refereed)
    Abstract [en]

    Background

    The purpose of this study is to investigate the feasibility of measurements of muscle strength, balance, cognitive function, mobility, activities of daily living (ADL), and physical activity for use in a Scandinavian nursing home population and to examine intercorrelations between these measurements.

    Method

    The design was cross-sectional and 322 residents’ functions were evaluated by grip strength, the Timed Chair Stand Test, Berg’s Balance Scale, Falls Efficacy Scale, Swedish version of Mini-Mental State Examination, 10-m walking and wheelchair propulsion at self-selected and maximum speed, functional independence measure, physiotherapy clinical outcome variables, and the Nursing Home Life Space Diameter.

    Results

    The mean age of the group was 85 years. Sixty-four percent were able to walk with or without walking aids, and 59% were able to rise independently from chair once. The level of participation in the tests was 70% or more, except for the 10-m walking/wheeling test and the Timed Chair Stand Test. No floor or ceiling effect was discovered. The significant correlation coefficients between different measurements of muscle strength, balance, cognitive function, mobility, ADL, and physical activity range from 0.14 to 0.90.

    Conclusion

    The instruments seem to be feasible for residents in Scandinavian nursing homes, and the residents appear to be a heterogeneous group with respect to functioning, mostly at low level.

  • 17. Bergström, Sten Erik
    et al.
    Emtner, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Hedenström, Hans
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
    Sundberg, Carl Johan
    Fysisk träning av vuxna med kronisk lungsjukdom2009In: Fysisk ansträngning vid lungsjukdom / [ed] Kjell Larsson, Södertälje: AstraZeneca AB , 2009Chapter in book (Other academic)
  • 18.
    Björkegren, Karin
    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.
    Andersson, Agneta
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Ahlqvist, Kerstin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Holm, Marta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Wohlin, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    A student run open health clinic2011In: AMEE 2011, 2011, p. 72-72Conference paper (Other academic)
  • 19.
    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.

  • 20.
    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).

  • 21.
    Botvalde, Lina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Åslund, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Fallrelaterad self-efficacy, gångförmåga och antal vårddagar hos äldre personer som opererats för höftfraktur2010Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Fall orsakar de allra flesta höftfrakturerna och en tredjedel av alla över 65 år i Sverige faller varje år. En persons self-efficacy kan påverka hur aktiv personen vågar vara efter en höftfraktur vilket torde påverka den postoperativa rehabiliteringen. Syfte: Syftet var att vid hemgång från ortopedavdelning efter operation för höftfraktur undersöka om fallrelaterade self-efficacy skiljer sig i olika äldre åldersgrupper samt samband mellan fallrelaterad self-efficacy, gångförmågan och antalet vårddagar. Metod: Medelåldern i studien var 78 år. 14 personer ingick i studien. 6 av personerna tillhörde gruppen äldre/äldre (≥80 år) och resterande tillhörde gruppen yngre/äldre (65-79 år). Personerna som ingick hade ingen till mild kognitiv nedsättning. Frågeformuläret Falls-efficacy scale svenska versionen (FES(S)) även gångtestet Timed Up and Go användes. Resultat: Studien kunde inte påvisa några statistiskt signifikanta skillnader i fallrelaterad self-efficacy mellan yngre/äldre och äldre/äldre på FES(S) och dess delskalor. De äldre/äldre skattade dock sin fallrelaterade self-efficacy högre än yngre/äldre. Sambandet mellan FES(S) delskala för personliga aktiviteter i dagliga livet (PADL) och TUG i gruppen äldre/äldre var statistiskt signifikant. Sambanden mellan antalet vårddagar och resultaten på FES(S) var lågt till måttligt. Konklusion: Att äldre/äldre skattar högre på FES(S) och har ett starkt samband med resultaten på TUG är något som avdelningar skulle kunna ta hänsyn till i sin rehabilitering genom att träna vardagsaktiviteter för att tillägna sig ökad förståelse av vad de möts av vid hemgång.

  • 22.
    Brandt, Katarina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Loelv, Sara
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Experiences of Barriers and Facilitators for Physical Activity from People with Mental Disorders who Participated in a Physical Activity Project: - An Interview Study2012Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Experiences of Barriers and Facilitators for Physical Activity from People with Mental Disorders who Participated in a Physical Activity Project

    - An Interview Study

     

    Purpose: To explore the experiences regarding perceived barriers and facilitators for physical activity of three participants with mental disorders who took part in the Norwegian Physical Activity Mentor project.

    Design and methods: Descriptive qualitative design. Individual semi-structured interviews were used for data collection. Data from the interviews was used in two separate bachelor theses, written by Swedish and Norwegian physiotherapy students. This cooperation was part of the NordPlus Higher Education Program Joint Physiotherapy Education in Bachelor Thesis Module. Qualitative content analysis was used in processing the data.

    Findings: Perceived barriers for physical activity were: mental disorder symptoms, antipsychotics, undertaking physical activity independently and physical experiences. Perceived facilitators for physical activity were: positive mental effects, intrinsic and extrinsic motivational factors, goal setting and routine. The experiences from the Physical Activity Mentor project, including the possibility of self-selected activities, were mainly positive. The support provided by the physical activity mentor was an important facilitator.

    Conclusion: Disease-related problems were perceived as barriers for physical activity. The most important perceived facilitator for physical activity was mental benefits from being physically active. External support from a physical activity mentor might facilitate physical activity for psychiatric outpatients.

     

     

    Key words: mental disorder, physical activity, barriers, facilitators, mentor

  • 23.
    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
  • 24.
    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.

  • 25.
    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.

  • 26.
    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)
  • 27.
    Cassel, Emelie
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Grundel, Emelie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Sex-minuters gångtest med olika grad av uppmuntran2011Independent thesis Basic level (degree of Bachelor), 15 credits / 22,5 HE creditsStudent thesis
    Abstract [en]

    Aim: to examine whether or not the results from 6-minute walk test (6MWT) was effected by increased level of encouragement.

    Methods: 30 participants ≥60 years old was recruited by convenience sample. All participants performed three 6MWT. One test (test A) was a trial run and one was performed with standardized encouragement according to the American Thoracic Society (ATS). One test (test B) was performed with increased level of encouragement. Examined variables were walking distance, heart-rate and Ratings of Perceived Exertion according to Borg’s-RPE-scale (6-20).

    Results: Out of the 30 participants 19 of them (63 %) walked longer when given increased level of encouragement. The mean value for the walk distance in test A was 580 ±56 meters and in test B 592 ±64 meters (p= 0.01). The mean value for heart rate in test A was 116 ±15 beats/minute and in test B 119 ±17 beats/minute (p= 0.103). The median for ratings according to the Borg’s-RPE-scale in test A and test B was 13. Highest/lowest rating were 18/8 in both test A and test B with an interquartile range of2.0 in test A and3.3 in test B  (p= 0.12).

    Conclusions: The results suggest that an increased level of encouragement leads to a longer walking distance in 6MWT. A high level of encouragement might give a more true picture of the test persons capability in the 6MWT. Further and larger studies are needed to determine the effect increased level of encouragement might have on healthy subjects and on subjects with different diseases.

  • 28.
    Danielsson, Anna
    et al.
    Institutionen för neurovetenskap och fysiologi vid Göteborgs universitet.
    Zetterberg, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Muskeltonus: Definition, undersökning och behandling2011In: Fysioterapi, ISSN 1653-5804, no 11, p. 30-36Article, review/survey (Other (popular science, discussion, etc.))
  • 29.
    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.

  • 30.
    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.

  • 31.
    Demmelmaier, Ingrid
    et al.
    Karolinska Institutet.
    Åsenlöf, Pernilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Opava, Christina H
    Karolinska Institutet.
    Supporting stepwise change: Improving health behaviors in rheumatoid arthritis with physical activity as the example2013In: International Journal of Clinical Rheumatology, Vol. 8, no 1, p. 89-94Article in journal (Refereed)
    Abstract [en]

    Management of chronic diseases such as rheumatoid arthritis includes behavior change towards smoking cessation, healthy eating and sufficient physical activity. To initiate and maintain behavior change over time, individual, behavioral and contextual factors should be included. This paper presents some issues on the implementation of physical activity behavior in rheumatoid arthritis, describing motivational and self-regulatory aspects and how they relate to long-term maintenance. We also point out implications for healthcare and directions for future research.

  • 32.
    Ekström, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Hälsa och funktion i kvalitetsregistret för uppföljning av cererbral pares - CPUP: En genomlysning utifrån den internationella klassifikationen av funktion, funktionshinder och hälsa för barn och ungdom2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract:

    Objective: This study aimed at describing the health concept in the Swedish follow up programme for cerebral palsy (CPUP), with main focus on how aspects of participation is expressed in the agenda of the programme. Design: Document analysis: The home-page of CPUP was searched for three types of written material; references to the nature and aim of the programme, protocols used for data collection and abstracts from articles and reports on the list of publications. Within these all expressions of health, with bio-psycho-social understanding of the concept, were extracted and condensed with manifest content analysis. The meaning units obtained were linked to the International Classification of Function, Disability and Health – Child/Youth (ICF-CY). All resulting codes of participation were further compaired to an alternative model for describing the activity/participation component where the notion of "social participation" requires an aspect of role taking. The involvement of children/ youths and parents by the follow up routines were estimated and related to the results of the coding process. Results: 1276 meaning units were identified.The health focus of the CPUP involving data collected from children was on body and movement functions. The aspects in which parents were involved included more health aspects, especially if an optional assessment protocol aiming performance was used. Defined as peformance participation accounted for 19% of the meaning units (7% whitout the optional instrument). Defined as "societal participation" the rate of participation was under 3%. Conclusion: CPUP focuses on body-related aspects of health. The participation perspective needs strengthening to ensure the information needed to plan and implement interventions that have an impact on the self image of involved children. Thereby CPUP would gain an even stronger relation with the overall goal of Swedish habilitation services.

  • 33.
    Ekwall, Anna Ingrid Camilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Physiotherapy for Patients with Huntington´s Disease: Effects of a Treatment Program with focus on balance and transitions and the Intercorrelation between Assessment Tools2010Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Objective: To evaluate the effect of a physiotherapeutic exercise programme for patients with Huntington´s Disease (HD) concerning motor function and disability, balance and fall related self-efficacy, and to investigate the correlation between the seven assessment tools.

    Participants: Twelve persons with genetically confirmed HD at an early or middle stage of the disease and with a mean age of 52 (16) years.

    Methods: The intervention comprised physiotherapy (PT) focused on training of transitions, balance and fall-related self efficacy, twice a week for six weeks. Each treatment session lasted for one hour, was individual and took place at an out-patient clinic. Baseline assessments including five clinical tests and two questionnaires were made 6 and 0 weeks prior to the intervention and 0 and 6 weeks after the intervention.

    Outcome measures: Motor function and disability were measured with the Unified Huntington's disease Rating Scale; the Total Motor Score and the Total Functional Assessment. Static and dynamic balance was measured with the One- leg stance- test, the Timed Up and GO Test, the Figure of Eight-test and the Berg Balance Scale.  Fall-related self-efficacy was measured with the Falls Efficacy Scale.

    Results: The physiotherapeutic exercise programme demonstrated a significant improvement in balance measured with the Berg Balance Scale (p=.045). The significant correlation coefficients between the different measurements of motor function, disability, balance and fall related self-efficacy ranged from 0.68 to 0.87.

    Conclusions: The contents of the out-patient clinic physiotherapeutic exercise programme, with a focus on balance and transitions, seemed to have clinical relevance. PT in different kinds of settings should be studied further to get a better knowledge about the effects of PT and physical activity at home, at an out- patient setting or at the hospital for patients with HD.

    Key Words: Huntington's disease; Physiotherapy; Motor function; Disability; Balance; Fall- related self efficacy.

  • 34.
    Emtner, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.