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Introduction: Poor mental health in young people has become a growing problem globally over the past decades. However, young people have also been shown to underutilize available healthcare resources. The World Health Organisation (WHO) has formulated guidelines for youth-friendly health services (YFHSs) to increase youth participation in healthcare. Still, little is known about how young people using these services perceive mental health, indicating a knowledge gap concerning the subjective evaluation of their mental health.

Aim: To investigate how young people visiting youth health clinics (YHC) perceive the concept of mental health and factors they view as central to maintaining mental health.

Methods: In total 21 interviews were carried out, 16 in 2018, and 5 in 2023 to assure no changes in findings after the COVID-19 pandemic. Subjects were recruited during visits to youth health clinics (YHCs) in mid-Sweden and were aged 15–23 years. Recruitment strived to achieve heterogeneity in the sample concerning gender, sexual orientation, gender identity and age. Interviews were transcribed and analysed using qualitative content analysis.

Findings: Findings of the analysis revealed two themes, “Mental health is helped and hindered by the surroundings” and “Mental health is difficult to understand and difficult to achieve”. The participants described their health as highly dependent on their social surroundings, and that these are important to maintaining health but may also affect health negatively. They described mixed experiences of the health care services and mentioned prerequisites for seeking care for mental health problems such as accessibility and respect for their integrity, including the right to turn down offered treatment. The informants also viewed mental health as an ongoing undertaking that one must work for, and that it is sometimes difficult to know what constitutes mental health. They also expressed a need from healthcare services to enquire about their health, and to show an active interest in how they are doing.

Conclusions: Findings underline the need of young people’s individual needs to be met in the healthcare system and their vulnerability to their social surroundings. Health status assessments in young people should consider social and individual factors to fully capture mental health.

Background: Tension type headache is the most common type of headache and occurs in approximately 40 % of the world's adult population. The physiotherapist can contribute with several pain-relieving methods where muscle-strengthening physical activity can be an alternative. As of today, there is no systematic review that has compiled research in this field.

Aim: To compile the current scientific evidence regarding muscle-strengthening physical activity in the neck and shoulders on the frequency, duration and intensity of headaches and compare it with other treatments given to adults with tension-type headaches.

Method: A systematic review. A systematic search was carried out in the database PubMed and reviewed according to the selection criteria. The included articles were assessed for risk of bias based on the PEDro review template and the overall reliability was evaluated using a modified version of GRADE.

Results: 7 randomized controlled trials were included after the selection process. All articles were judged to be of high quality and thus have a low risk of bias. 4 of 7 studies showed a significant improvement in muscle-strengthening physical activity on either frequency, duration or intensity compared to other treatments. When assessing the overall reliability of the articles, the articles were divided into two subgroups according to intervention. Three studies with strength training for the neck and shoulders were considered to be of low quality, and four studies with strength training of deep neck muscles were considered to be of very low quality.

Conclusion: It is not possible to draw any conclusions about the effects of muscle-strengthening physical activity on tension type headache. Several randomized controlled trials are needed in the field to ensure evidence of muscle-strengthening physical activity in tension type headache.

Background: A neutral spinal alignment is considered important during the execution of the deadlift exercise to decrease the risk of injury. Since male and female powerlifters experience pain in different parts of their backs, it is important to examine whether men and women differ in spinal alignment during the deadlift.

Objectives: The purpose of this study was to quantify the spinal alignment in the upper (thoracolumbar, T11-L2) and lower (lumbopelvic, L2-S2) lumbar spine during the deadlift exercise in male and female lifters. Secondary aims were to compare lumbar spine alignment during the deadlift to standing habitual posture, and determine whether male and female lifters differ in these aspects.

Study Design: Observational, Cross-sectional.

Methods: Twenty-four (14 men, 10 women) lifters performed three repetitions of the deadlift exercise using 70% of their respective one-repetition maximum. Spinal alignment and spinal range of motion were measured using three inertial measurement units placed on the thoracic, lumbar and sacral spine. Data from three different positions were analyzed; habitual posture in standing, and start and stop positions of the deadlift, i.e. bottom and finish position respectively.

Results: During the deadlift, spinal adjustments were evident in all three planes of movement. From standing habitual posture to the start position the lumbar lordosis decreased 13 degrees in the upper and 20 degrees in the lower lumbar spine. From start position to stop position the total range of motion in the sagittal plane was 11 degrees in the upper and 22 degrees in the lower lumbar spine. The decreased lumbar lordosis from standing habitual posture to the start position was significantly greater among men.

Conclusions: Men and women adjust their spinal alignment in all three planes of movement when performing a deadlift and men seem to make greater adjustments from their standing habitual posture to start position in the sagittal plane.

Background: Maintaining neutral spinal alignment is considered important when performing the barbell back squat exercise. Since male and female lifters may differ in injury location it is important to examine whether they differ in spinal alignment during the back squat.

Objectives: The study aimed to quantify the spinal alignment in the upper and lower lumbar spine during the barbell back squat exercise in male and female lifters. Secondary aims were to compare alignment during the back squat to standing habitual lumbar spine alignment and determine whether male and female lifters differ in these aspects.

Study design: Observational, Cross-sectional.

Methods: Competitive power- and weightlifters were recruited and performed three repetitions of the barbell back squat exercise using a load equivalent to 70% of their one-repetition maximum. Spinal alignment and range of motion were measured using inertial measurement units placed on the thoracic, lumbar and sacral spine. Data was presented descriptively and comparisons between men and women as well as spinal alignment in four different positions were done with a factorial repeated measures analysis of variance.

Results: Twenty-three (14 males, 9 females) were included. During execution of the squat, spinal alignment adjustments in the lumbar spine were made in all three planes of movement, compared to the start position, in both male and female lifters. Compared to their standing habitual posture, all lifters adjusted their upper lumbar spine to a less lordotic position when in the start position of the back squat (standing upright with the barbell on their back). Only male lifters assumed a less lordotic alignment in their lower lumbar spine in the start position compared their habitual posture.

Conclusions: Adjustments of spinal alignment, predominantly in the sagittal plane, are made during execution of the back squat in both male and female lifters. Further, lifters adopt a less lordotic alignment with a heavy barbell on their upper back, more so in male than female lifters. In conclusion, it seems that spinal alignment changes noticeably during the barbell back squat.

Background: Obesity is a global occurrence, the reasons behind an unwanted weight gain are complex where biological, environmental and behavioral factors all play a role. Prior research has shown that stigmatization of people with obesity is common in society and in healthcare. No prior research could be found regarding the experiences of obese people in encounters with physiotherapists in Sweden, this gap in knowledge is the focus of this paper.

Objective: To investigate if people with obesity within Swedish physiotherapy care are affected by any stigmatization or discrimination.

Method: This study utilized a qualitative method based on semi-structured interviews. Five participants were included in the study and were interviewed through the web based video software Zoom. The data was analyzed by way of qualitative content analysis

Results: Three categories were identified with subsequent subcategories. One out of five participants described discrimination by their physiotherapist, the remaining participants described positive experiences. A common theme among the participants was the desire to be seen as an individual and that their physiotherapist should be honest and direct regarding the subject of weight as long as it is relevant to the context of their visit. 

Conclusion: The results of this study cannot be generalized on Swedish physiotherapy care as a whole, however it does offer an opportunity to investigate relevant patterns internally in this study and compare them in relation to similar studies performed on the subject.

Background: Young adults reported the highest proportion of mental health issues, and stress is a common cause for sick leave. Physical activity is considered “protective” against mental health issues and helps quality of life. Physically active young adults still seem to have mental challenges. There’s a lack of research regarding mental health factors in this group, and whether there’s any gender differences.

Aim: To examine physically active young adult’s stress and quality of life and explore potential differences between the genders. In addition, identify any correlations between stress and quality of life for the total group and for the genders separately.

Method: This cross-sectional study included 70 physically active young adults, 47% women and 53% men, and with an average age of 23 years. Participants completed a web-based survey using the Perceived Stress Scale (PSS-14) and the Brunnsviken Brief Quality of Life Scale (BBQ) and demographic questions.

Results: Stress – level were 21 points and quality of life 62 points. There was a statistically significant difference in stress between women and men, while quality of life showed no significant difference. There’s a moderately negative correlation between stress and quality of life in the overall group and among men.

Conclusion: Physically active young adults have higher quality of life compared with recent studies on people with mental health issues. Studies with similar populations align regarding the negative correlation between quality of life and stress within the total group and amongst men.

Background: Obstructive sleep apnea (OSA) can be positively affected by physiotherapeutic interventions. It is therefore interesting to know how motivation and self-efficacy affects lifestyle changes in the form of physical activity level and physical capacity.

Purpose: To analyze how initial motivation and self-efficacy changes physical activity levels, and how initial motivation changes physical capacity, in people with OSA.

Method: Quantitative data analysis using data from a previous RCT in which people with OSA were treated with Behavioral Sleep Medicine. Motivation (at baseline) and self-efficacy (at baseline) was correlated with the change in physical activity levels (from baseline to 6 months), and motivation (at baseline) was correlated with the change in physical capacity (from baseline to 6 months). The difference in the change in activity levels from baseline to 6 months was also compared between the control and intervention groups.

Results: No statistically significant correlations were found between motivation and physical activity level (p = 0.439 and 0.615 for the control and intervention group respectively), motivation and physical capacity (p = 0.538 and 0.375 for the control and intervention group respectively), self-efficacy and change of physical activity level (p = 0.392 and 0.925 for the control and intervention group respectively), or difference in the control versus intervention group regarding change in physical activity level (p = 0.545).

Conclusion: No clear connection between initial motivation and self-efficacy to change in physical activity levels and physical capacity could be found in people with OSA.

Background: Normal pressure hydrocephalus (NPH) is a neurological condition that causes cognitive symptoms, dementia, incontinence and difficulties with walking. The treatment for this is shunt surgery. The ability to walk is examined with walking tests before and after a tap test, which then forms the basis for a diagnosis.  

Purpose: The purpose of the study was to examine patients with NPH ability to walk through comparison of the results of walking tests measured in seconds before lumbar puncture test and shunt surgery with the results three months after shunt surgery, as well as comparing differences between men and women.  

Method: A quantitative method with a descriptive and comparative design was chosen for this study. Data in the current study comes from an ongoing research project at a university hospital that has c ollected data of results of three walking tests before and three months after shunt surgery. In total data from 161 patients with NPH was collected of which 129 patients was included in the current study. Of these were 65 men and 64 women. The walking tests compared are Timed up and go (TUG), 10 meter walk test (10MWT) and 3 meter backwards walk (3MBW) 

Results: The results showed a significant improvement in all walking tests before compared to three months after shunt surgery and that there was no significant difference between men and women. The results of TUG improved by 5 seconds, 10MWT by 4 seconds and 3MBW by 4 seconds. 

Conclusion: The results show that there is a significant improvement in walking tests for patients with NPH who have undergone shunt surgery. Further research is required to ensure that the walking tests are relevant for people with NPH, as well as to achieve a standardized test battery that can be applied to the entire population.  

The term “psychologically informed health care” refers to the comprehensive integration of psychological principles into health care. Psychologically informed health care has the potential to lead to a transformation of care, resulting in truly transdisciplinary care. To facilitate its future development, we discuss key characteristics of this approach. These include the direct mode (psychologists assessing and treating patients themselves) and indirect mode (psychologists working through other health care providers) of integrating psychological principles into healthcare; the range of health domains targeted using this approach; transdisciplinary care, transcending traditional disciplinary boundaries; and the positioning of care. We describe a framework for transdisciplinary care, which we refer to as the Framework for Catalytic Collaboration. This framework comprises six dimensions: setting, disciplines, patients/clients, mode of psychological care, primary components of care, and primary targets of care. We also provide four brief illustrations of psychologically informed health care. Finally, we discuss future directions, including the need for professional recognition of the indirect mode, financing of the indirect mode, cross-disciplinary training and trans-disciplinary research.

Background: Subacromial pain syndrome is a common musculoskeletal condition. The treatment consists of either physiotherapy, corticosteroid injection or a combination of the two.

Objective: To research the effects of a combined treatment compared to exclusively resistance training in individuals with subacromial pain syndrome and to assess the quality of the evidence as well as the overall reliability. 

Method: A systematic review. Systematic searches were conducted using the databases AMED, CINAHL, PEDro, PubMed and Web of Science. The quality of the evidence was assessed using the PEDro scale. The overall reliability was assessed using “Bedömningen av den sammanvägda tillförlitligheten i systematiska översikter”. 

Results: Contradictory results were found regarding the effect of combined treatment. A total of 8 studies were included in the quality assessment, with results varying from moderate to high quality. Of these, the overall reliability was assessed in 6 studies. The reliability for the outcome measure of function was assessed as moderately high that no effect of the intervention could be observed. Effects from the intervention on pain and range of motion were found to have low and very low reliability, respectively. 

Conclusion: It has not been possible to determine the effect of combined treatment compared to resistance training on pain, function and range of motion in the short term, as the results have been conflicting. No long term effects have been observed. Overall reliability for the outcome measure of function was assessed as moderately high that no effect could be seen from the intervention. Effects on pain and range of motion from the intervention were found to have low and very low reliability, respectively. Future research should focus on conducting studies with more comparable interventions to evaluate the effect of combined treatment compared to resistance training for individuals with subacromial pain.

Background Evidence based medicine (EBM) should be an endeavor within all healthcare professions. Knowledge and understanding of science are important prerequisites of EBM.

Objective The aim was to examine and compare perspectives on science and perceived inhibiting and facilitating factors for the assimilation and implementation of scientific information among clinically working specialist- and nonspecialist physiotherapists in Sweden.

Methods A cross-sectional survey study was conducted via a web-based questionnaire. Clinically active physiotherapists in Sweden were invited to participate. Attitudes and perspectives were compared between physiotherapists with completed or on-going specialist training, and non-specialists.

Results In total, 1165 physiotherapists responded to the survey (75.5%, (n = 870) women, mean age 44.8 (SD 12.1), whereof 25.5% (n = 319) with completed or ongoing specialist training). The majority of participants had a high interest in science but did not consider a general scientific approach to be applied within physiotherapy. The main perceived inhibiting factor for a clinical practice more based on scientific evidence was lack of time. Specialists had in general higher interest and ability to interpret and evaluate science, and prioritized scientific evidence to a higher extent.

Conclusion Among respondents, a scientific approach was considered valuable within physiotherapy but not considered fully applied in practice. The higher interest and perceived ability to interpret science among specialists indicates that further education and specialist training can increase both interest and understanding of science among physiotherapists. 

Background: The diagnosis of gestational diabetes implies glucose intolerance, which can have significantconsequences such as birth complications, macrosomia, or type 2 diabetes. Risk factors fordeveloping gestational diabetes include a high BMI, age >35 years and low physical activitylevels. The current treatment provided involves advice on diet and exercise, and if necessary,medication can also be prescribed.

Objective: To gather the current scientific evidence regarding the prevention of gestational diabetes withphysical activity for women at risk of developing gestational diabetes.

Methods: This work was a systematic literature review of randomized controlled trials obtained throughthe databases PubMed and Scopus. Review of the risk of bias was assessed using TESTEX,and the reliability of the aggregated result was evaluated using a local template from UppsalaUniversity. 

Results: Eight articles were included in the literature review. Seven articles scored between 10-13points after the TESTEX evaluation. One article did not reach the threshold for sufficientquality to be included in the combined results. The seven articles with the lowest risk of biasindicated that exercise did not have a significant effect in preventing the onset of gestationaldiabetes. However, the reliability of the aggregated result was assessed as low.

Conclusions: Based on the findings from this review, it is observed that exercise does not have a significanteffect in preventing gestational diabetes for women with either high BMI or low physicalactivity levels. However, due to the low reliability of the combined results, more research isneeded in this area. 

Background: Balance is important for performing activities and sports in daily life. Although it is widely accepted, that warming up can increase readiness for exercise, the effect of warming up on balance is unclear as results vary between studies. As warm-up can potentially affect the Star Excursion Balance Test (SEBT) results and physiotherapists use tests to evaluate the effects of interventions, it is important to perform tests in a standardised way.

Aim: To investigate the effect of warm-up on dynamic control among injury-free 20–30 year old individuals.

Design: Randomised cross-over study.

Method: 18 participants performed test A and B, where test A included a warm-up programme and SEBT, and B included only SEBT. The test each participant started with was randomised. Normalised and composite SEBT scores were used to analyse the data.

Result: There was no statistically significant difference in SEBT scores for either the dominant or non-dominant leg when compared with and without warm-up. When analysing the difference in mean (SEBT composite %) between with and without warm-up for dominant versus non-dominant legs, a small but significant difference was seen, in the form of a positive effect of warm-up for the non-dominant leg.

Conclusion: The results showed that warm-up had no statistically significant effect on either the dominant or non-dominant leg. The difference between the effect of warm-up on the dominant and non-dominant leg was statistically significant as the non-dominant leg was not affected in the same way. Further research is needed to confirm these results.

Background: JIA (juvenile idiopathic arthritis) is the most common rheumatic disease among children. Exercise is an important part of the treatment, and physiotherapists have primary responsibility for the treatment plan. Previous research suggests that children with JIA are not as physically active as their healthy peers, and currently, there is a lack of in-depth knowledge about factors that affect physical activity in children with JIA. 

Objectives: The aim of this study was to explore the experiences of factors influencing a child's physical activity for guardians of children with JIA. 

Method: A qualitative design was conducted through five semi-structured interviews with guardians of children with JIA. Convenience sampling was used to identify participants. The data was processed through qualitative content analysis. 

Result: The analysis revealed five categories of factors that influence physical activity: the role of medication in promoting physical activity, guardians’ responsibility to find and convey information, adaptations in school environment, the importance of normalcy in life with JIA and preferences for expanded healthcare interventions. 

Conclusion: Guardians of children with JIA experienced that adequate medication was a factor that facilitated physical activity. Moreover, the guardians of children with JIA felt that they had a responsibility to seek information about the disease and convey it to relevant parties such as schools and sports organizations to promote their child's physical activity. Insufficient knowledge about the disease in society was considered a hindering factor for children to be physically active, while awareness and adaptations in school and sports settings were facilitating factors. The informants expressed a desire for improved continuity in healthcare to streamline treatment.

Background: Pain originating from the shoulder joint is frequent among swimmers, therefore the term “swimmer’s shoulder” was constructed. However, the etiology of the condition has not yet been established and numerous studies indicate varying origins. Divided opinions have formed about effective interventions due to the confusion regarding swimmer’s shoulder. Several studies have investigated the interaction between various interventions and their effect on swimmer’s shoulders, however only a few have studied the effect strength training has on pain in the shoulder joint due to the condition. 

Purpose: The aim of this study was to investigate at an individual level, how strength training of the shoulders affects active swimmers with shoulder pain, concerning pain and function.

Method: This study is designed after a single-case experimental design (SCED), with an AB-design. Three swimmers from a swimming club in Stockholm participated. During a total of nine weeks, the participants had to assess pain via the numeric rating scale (NRS) and shoulder function via the Western Ontario Shoulder Instability Index (WOSI).

Results: One participant acquired significant improvement in self-rated pain. Regarding self-rated function two participants showed significant impairment. One participant acquired a stable baseline. The remaining two participants reported scattered values during all phases for both NRS and WOSI. 

Conclusion: No specific conclusions can be made based on the results of the study as only one participant achieved a stabile baseline, and there is ambiguity regarding the causes of pain among the swimmers.

Background: Chronic pain is a common diagnosis, also among young adults. Pain conditions often have an impact on daily life by causing patients to be less physically active and hence affecting their functional capacity. In order to improve functional capacity, multimodal rehabilitation programmes are often recommended. However, there is a significant knowledge gap in how young adults with chronic pain experience such programmes.

Objective: To examine young adults’ experience of participating in a multimodal pain rehabilitation programme, and how they consider the programme having affected their functional capacity and thoughts about being physically active.

Method: A qualitative, semi structured interview study. Ten participants were recruited based on convenience sampling. The data analysis was performed using qualitative content analysis.

Results: The participants described the rehabilitation programme as a safe and validating environment. They were helped to develop a new, more accepting, approach to life with pain. Many participants described a new attitude towards physical activity, which involved paying attention to signals from the body and adjusting activities accordingly. Several participants wished for the programme to have a greater focus on physical activity.

Conclusion: The study shows that young adults with chronic pain experienced being understood and validated when attending a rehabilitation programme. The programme provided new skills that improved daily life, and gave rise to new attitudes towards a life with pain and the possibility of being physically active. More research on the subject is important in order to ensure that young adults with chronic pain are offered well suited rehabilitation programmes.

Background: Providing children and young people with the prerequisites for good health and well-being is a human right that strengthens their opportunity to healthy development. School is an important environment that reaches children and young people. To promote their physical and mental health, movement and physical activity is fundamental. Student health play an important role, which can offer services at three different levels to work with health promotion, prevention, and remedial measures. Region Gotland has introduced a physiotherapist in two pilot-schools to strengthen the student health services.

Purpose: The aim of this study was to examine school staff’s experiences of having access to physiotherapy services in education settings.

Method: A qualitative study with semi-structured interviews was carried out. Ten participants were recruited based on strategic sampling. The data analysis was performed using systematic text condensation. 

Results: The analysis resulted in three main themes and seven code groups. The three main themes consisted of “The role and influence of the physiotherapist”, “Cooperation and relationships” and “Change of work in the organization”.

Conclusion: The results showed that the school staff's experience was generally positive and that physiotherapy skills could make a difference in the school's organisation. School staff  at the schools that were part of the project felt that they were given the opportunity for support and that the students were strengthened when a new perspective was added. They experienced organizational challenges around finances and that the project lacked grounding among the school staff.

Background

The Patient-Reported Outcomes Measurement Information System (PROMIS®) Sexual Function and Satisfaction (SexFS) version 2.0 measurement tool was developed to assess sexual functioning and satisfaction in the general population regardless of health condition and sexual orientation.

Aim

The study aimed to evaluate the psychometric properties of the Swedish version of the PROMIS SexFS measure in clinical and nonclinical populations of young adults (aged <40 years).

Methods

The SexFS was answered by a clinical population of young adult women (n = 180) and men (n = 110) with breast cancer and testicular cancer, respectively, and a nonclinical population of young adult women (n = 511) and men (n = 324) from the general population. Psychometric properties were evaluated by examining data quality (score distribution, floor and ceiling effects, proportion of missing data), construct validity (corrected item, total correlation, scaling success), and reliability (Cronbach α).

Outcomes

The following domains of the SexFS 2.0 were investigated: Vaginal Lubrication, Vaginal Discomfort, Vulvar Discomfort- Clitoral, Vulvar Discomfort- Labial, Erectile Function, Interest in Sexual Activity, Satisfaction With Sex Life, Orgasm– Ability, and Orgasm- Pleasure.

Results

The Swedish version of the SexFS 2.0 generated data of acceptable quality. Some noteworthy floor or ceiling effects were identified across domains and respondent groups. Corrected item totals were used to express the coherence between an item and the other items in the domain. The correlation coefficients were above 0.40 for all items, except for 1 of the items within the Vaginal Discomfort domain and for the items in the Erectile Function domain in the nonclinical group of men. High proportions of scaling success were noted across domains (96%-100%). Reliability was satisfactory (α = 0.74-0.92) for all domains, expect for Erectile Function of the nonclinical group (α = 0.53), due to low variability in item responses, which was improved somewhat (α = 0.65) when combined with the clinical group.

Clinical Implications

A flexible tool to measure self-reported sexual function and satisfaction in young men and women is available for researchers and clinicians in Sweden.

Strengths and Limitations

The nationwide population-based sample of patients with cancer, identified from national quality registers, minimized selection bias. However, men in the general population had a lower response rate (34%) compared to the other groups, which introduced a risk of bias in estimates. The psychometric evaluation was limited to young adults (aged 19-40 years).

Conclusion

The results provide evidence for the validity and reliability of the Swedish version of the SexFS measure for the assessment of sexual functioning and satisfaction in young adults from both clinical and nonclinical populations.

Background: Intermittent claudication is common in the elderly population and causes physical and psychological problems such as impaired walking ability and poorer quality of life. Physical activity is an important physiotherapeutic method that has shown promising results for this population. Therefore, it is important to summarize current evidence in order to increase new knowledge and make it available.

Purpose: The aim of this literature study was to examine the scientific evidence for physical activity as a treatment, and its effect on walking capacity and quality of life in patients with intermittent claudication 

Method: The design of the study was literature study. A literature search for randomized controlled trials was conducted in the PubMed database. The quality of the included studies was examined by the PEDro scale, and the reliability of the results was assessed with ”Bedömning av den sammanvägda tillförlitligheten i systematiska översikter”.

Result:  Six studies were included in the literature study. The best results regarding walking ability and quality of life were obtained by the groups that underwent endovascular revascularization in combination with an intervention that included physical activity. All studies received high quality according to PEDro. According to with ”Bedömning av den sammanvägda tillförlitligheten i systematiska översikter”, the reliability of the combined results was considered low.

Conclusion: The combination of endovascular revascularization and physical activity had a positive effect on the outcome measures walking ability and quality of life in patients with intermittent claudication. No difference between different types of physical activity could be seen. More studies of high quality comparing similar interventions are needed to be able to determine, with high reliability, which treatment produces the best effect.

Background: The diving reflex is a response triggered when mammals hold their breath and receptors in the face are exposed to cold. It's an evolutionary adaptation developed to conserve oxygen in situations where fresh oxygen isn't readily available. The oxygen-conserving function activates even with just facial cold stimulation. This study explored the impact of the diving reflex on recovery after aerobic submaximal physical activity.

Objective: The purpose of the study was to investigate if the diving reflex affects recovery following aerobic submaximal physical activity in terms of heart rate and perceived exertion.

Method: The study design was a randomized crossover design. Participants acted as their own controls. The intervention was cold stimulus (5–10°C) to the forehead and eyes after completing submaximal aerobic physical activity. The same procedure was conducted in the control test, but with skin-tempered water (27–33°C). Collected data included pulse recovery and perceived exertion at 60 seconds and 180 seconds after completing submaximal aerobic physical activity.

Results: The median difference between HRR60s with and without cold showed a 0.5 bpm greater recovery with the intervention. The median difference for HRR180s with and without cold showed a 2 bpm greater recovery with the intervention. The self-assessed results using Borgs RPE60s and Borgs RPE180s displayed a 0.5 scale higher median difference with the intervention. The significance level was set at P = 0.05. The test results showed P = 0.286 for HRR60s, P = 0.212 for HRR180s, P = 0.374 for Borgs RPE60s, and P = 1.000 for Borgs RPE180s.

Conclusion: The results do not show any statistically significant difference in terms of pulse recovery and self-perceived exertion between the intervention using facial cold application and the control test with application of skin-temperature water on the face.

Background

Pelvic girdle pain, low back pain, and pelvic floor dysfunction can affect women's mobility, quality of life, and well-being during pregnancy and the postpartum period. Digital interventions for treating perinatal depression and lifestyle changes have been studied. Research on digital physiotherapy for musculoskeletal issues related to pregnancy and the postpartum period is sparse.

Methods

This qualitative study involved in-depth, semi-structured interviews with 19 participants, of whom six were pregnant and 13 had given birth. Participants were recruited from a private clinic in Sweden through convenience sampling and had received digital physiotherapy prior to the interviews. An interview guide with questions exploring participants' experiences of digital physiotherapy, including its impact on musculoskeletal issues and daily life, and their motivation for seeking digital healthcare was used. Data were analyzed using a qualitative content analysis with an inductive approach.

Results

The analysis resulted in two main categories: Finding a new way into physiotherapy treatment and Personalized progress through tailored physiotherapy. These main categories encompassed four generic categories: Convenience and dissatisfaction motivators for digital physiotherapy, A dual experience – appreciated but not always comprehensive, Being involved in the rehabilitation process, and Perceived physical and mental improvements after digital physiotherapy.

Conclusion

Digital physiotherapy was well-accepted and perceived as beneficial for managing musculoskeletal symptoms during pregnancy and after childbirth. High accessibility and flexibility were considered advantages. However, inability to undergo a physical assessment was a challenge. Digital physiotherapy may be recommended as a complement to usual care, particularly for women with limited access to a physiotherapist specialized in women's health. Future studies exploring digital physiotherapy's efficacy for musculoskeletal issues during pregnancy and after childbirth are highly recommended.

Background: Pelvic floor dysfunction means abnormal function of the pelvic floor muscles caused by increased or decreased muscle tone and reduced coordination of the pelvic floor muscles. It includes several different functional problems such as urological, gynecological or colorectal. Biofeedback is a device that can be used as an addition to regular pelvic floor training. It helps people to use the right technique and to control and identify the right muscles. Biofeedback can be used to train strength, endurance, coordination and relaxation.