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Background: Patient participation is important in the treatment of long-term medical conditions such as eating disorders and patients' experience can provide an important basis for research and clinical implications. Finding out how people with experience of eating disorder experienced the encounter with a physiotherapist is interesting to understand how thephysiotherapeutic intervention could be improved.

Aim: To investigate the experience of physiotherapy during recovery from an eating disorder.

Method: Thirteen women were interviewed in a qualitative interview study with semi structured interviews, interpreted with thematic analysis with an inductive approach.

Results: The analysis resulted in two main themes and 9 sub-themes. Main theme 1: The body in focus and 2: Significant for treatment. Physiotherapeutic treatment was perceived to be able to contribute with knowledge about the body and be a help in finding a healthy approach to physical activity. Knowledge of eating disorders, humanity, goals, and objectives, getting enough time and that the physiotherapist interacted with other healthcare professions were also highlighted as significant factors for a good experience.

Conclusion: The results suggest that the bodily perspective is important, and that the physiotherapist can have a central role in the treatment of eating disorders. Significant for physiotherapy treatment is that it is person centered and evidence based, that enough time is given in treatment and that the physiotherapist can interact with other professions. It is also relevant to increase knowledge about eating disorders among physiotherapists and in general in healthcare.  

Background Most people with Parkinson's disease (PD) experience at least one fall during the course of their disease. Several interventions designed to reduce falls have been studied. An up-to-date synthesis of evidence for interventions to reduce falls in people with PD will assist with informed decisions regarding fall-prevention interventions for people with PD. Objectives To assess the effects of interventions designed to reduce falls in people with PD. Search methods CENTRAL, MEDLINE, Embase, four other databases and two trials registers were searched on 16 July 2020, together with reference checking, citation searching and contact with study authors to identify additional studies. We also conducted a top-up search on 13 October 2021. Selection criteria We included randomised controlled trials (RCTs) of interventions that aimed to reduce falls in people with PD and reported the effect on falls. We excluded interventions that aimed to reduce falls due to syncope. Data collection and analysis We used standard Cochrane Review procedures. Primary outcomes were rate of falls and number of people who fell at least once. Secondary outcomes were the number of people sustaining one or more fall-related fractures, quality of life, adverse events and economic outcomes. The certainty of the evidence was assessed using GRADE. Main results This review includes 32 studies with 3370 participants randomised. We included 25 studies of exercise interventions (2700 participants), three studies of medication interventions (242 participants), one study of fall-prevention education (53 participants) and three studies of exercise plus education (375 participants). Overall, participants in the exercise trials and the exercise plus education trials had mild to moderate PD, while participants in the medication trials included those with more advanced disease. All studies had a high or unclear risk of bias in one or more items. Illustrative risks demonstrating the absolute impact of each intervention are presented in the summary of findings tables. Twelve studies compared exercise (all types) with a control intervention (an intervention not thought to reduce falls, such as usual care or sham exercise) in people with mild to moderate PD. Exercise probably reduces the rate of falls by 26% (rate ratio (RaR) 0.74, 95% confidence interval (CI) 0.63 to 0.87; 1456 participants, 12 studies; moderate-certainty evidence). Exercise probably slightly reduces the number of people experiencing one or more falls by 10% (risk ratio (RR) 0.90, 95% CI 0.80 to 1.00; 932 participants, 9 studies; moderate-certainty evidence). We are uncertain whether exercise makes little or no difference to the number of people experiencing one or more fall-related fractures (RR 0.57, 95% CI 0.28 to 1.17; 989 participants, 5 studies; very low-certainty evidence). Exercise may slightly improve health-related quality of life immediately following the intervention (standardised mean difference (SMD) -0.17, 95% CI -0.36 to 0.01; 951 participants, 5 studies; low-certainty evidence). We are uncertain whether exercise has an effect on adverse events or whether exercise is a cost-effective intervention for fall prevention. Three studies trialled a cholinesterase inhibitor (rivastigmine or donepezil). Cholinesterase inhibitors may reduce the rate of falls by 50% (RaR 0.50, 95% CI 0.44 to 0.58; 229 participants, 3 studies; low-certainty evidence). However, we are uncertain if this medication makes little or no difference to the number of people experiencing one or more falls (RR 1.01, 95% CI 0.90 to 1.14230 participants, 3 studies) and to health-related quality of life (EQ5D Thermometer mean difference (MD) 3.00, 95% CI -3.06 to 9.06; very low-certainty evidence). Cholinesterase inhibitors may increase the rate of non fall-related adverse events by 60% (RaR 1.60, 95% CI 1.28 to 2.01; 175 participants, 2 studies; low-certainty evidence). Most adverse events were mild and transient in nature. No data was available regarding the cost-effectiveness of medication for fall prevention. We are uncertain of the effect of education compared to a control intervention on the number of people who fell at least once (RR 10.89, 95% CI 1.26 to 94.03; 53 participants, 1 study; very low-certainty evidence), and no data were available for the other outcomes of interest for this comparison We are also uncertain (very low-certainty evidence) whether exercise combined with education makes little or no difference to the number of falls (RaR 0.46, 95% CI 0.12 to 1.85; 320 participants, 2 studies), the number of people sustaining fall-related fractures (RR 1.45, 95% CI 0.40 to 5.32,320 participants, 2 studies), or health-related quality of life (PDQ39 MD 0.05, 95% CI -3.12 to 3.23, 305 participants, 2 studies). Exercise plus education may make little or no difference to the number of people experiencing one or more falls (RR 0.89, 95% CI 0.75 to 1.07; 352 participants, 3 studies; low-certainty evidence). We are uncertain whether exercise combined with education has an effect on adverse events or is a cost-effective intervention for fall prevention. Authors' conclusions Exercise interventions probably reduce the rate of falls, and probably slightly reduce the number of people falling in people with mild to moderate PD. Cholinesterase inhibitors may reduce the rate of falls, but we are uncertain if they have an effect on the number of people falling. The decision to use these medications needs to be balanced against the risk of non fall-related adverse events, though these adverse events were predominantly mild or transient in nature. Further research in the form of large, high-quality RCTs are required to determine the relative impact of different types of exercise and different levels of supervision on falls, and how this could be influenced by disease severity. Further work is also needed to increase the certainty of the effects of medication and further explore falls prevention education interventions both delivered alone and in combination with exercise.

Background There are no guidelines for treatment of exhaustion disorder. Recommendations are multimodal rehabilitation where the individual is supported by several professions. Treatment should strive to support the maintenance of routines in everyday life, where, among other things, regular physical activity plays a crucial role in improving symptoms and returning to work. At the same time, these people have an increased mental and physical fatigue, which could be a challenge when implementing physical activity. Therefore, knowledge is needed about how these people experience physical activity as well as obstacles and promoting factors to perform it.Purpose The aim of the study was to investigate experiences of physical activity as well as obstacles and promoting factors for physical activity among people with exhaustion disorder.Method A qualitative method with semi-structured interviews was applied. Participants were recruited from two Facebook groups that were focused on exhaustion disorder. Tenwomen with exhaustion disorder in the age range 24-59 years were included in the study. Data processing was carried out through a qualitative content analysis.Results The analysis resulted in three main categories and eight subcategories. The three main categories consisted of: Promotes physical activity, Obstacles to physical activity, Environment matters.Conclusion This study showed that adaptive activity, healthcare support and experienced increased well-being of physical activity functioned as promoting factors for this in people with exhaustion syndrome. Difficulty finding balance and receiving maladaptive treatment acted as barriers to physical activity. The environment was important for how the physical activity was experienced; outdoors in nature was experienced positively while social environments were more stressful for the participants. 

Background: Chronic pain implies a big suffering for individuals. Multimodal rehabilitation has a positive impact on chronic pain, but it is unknown which rehabilitation that is the most effective. Increased knowledge of which parts in pain rehabilitation that are effective is important to be able to optimize the care of these individuals.

Purpose: The purpose of this study was to investigate interoception, exercise self-efficacy and level of self-assessed physical activity in people suffering from chronic pain and explore if these variables are changed by multimodal pain rehabilitation. The purpose was also to investigate the correlation between interoception and execise self-efficay.

Method: The study had a descriptive, correlating experimental within-group design. Patients with chronic pain that were enrolled for inpatient care 4 weeks of multimodal pain rehabilitation answered the questionnaires Multidimensional Assessment of Interoception Awareness (MAIA) and swedish version of Exercise Self-Efficacy Scale (S-ESES) and the Swedish social welfare boards indicator questions of level of physical activity before and after the intervention.

Results: Twenty five persons participated in the study. The intervention increased some dimensions of interoception and the exercise self-efficacy. The self-assessed level of physical activity was low and did not increase. The correlation between MAIA and S-ESES was strengthened by the intervention.

Conclusion: Multimodal pain rehabilitation can for people with chronic pain increase interoception and exercise self-efficacy.

Background: Manual therapies such as stretching and joint mobilization are used in veterinary physical rehabilitation of dogs. No consensus exists in which indication mobilization and manipulation can be used with expected positive effect or in what dosage. There is a lack of evidence regarding the effects of stretching of musculature on joint mobility and pain in dogs with unspecified pain conditions in the musculoskeletal system.

Objective: The aim of this study was to explore the acute effect of static stretching of m.iliopsoas and hamstrings on muscle length, function and pain in dogs with unspecified lower back pain. 

Method: This study was conducted as a Single-Case Experimental Design (SCED). The three participating dogs, veterinary diagnosed with unspecified lower back pain, were recruited through the author’s business. The participating dog owners carried out the intervention consisting of static stretching during three weeks. The data collection was conducted by measuring muscle length twice a week during baseline and intervention phases and the participating dog owners filling in the questionnaire Canine Brief Pain Inventory – S (CBPI –S) once a week. The results were presented in diagrams and text.

Results: Increased muscle length was measured in one out of three participants and two out of three participants showed reduced estimated pain intensity and increased estimated function.

Conclusion: The current study showed no conclusive results regarding the effect of static stretching on muscle length, estimated pain intensity and estimated function in dogs with unspecified lower back pain.

Background

Osteoarthritis is a common orthopedic disease affecting dogs, > 90% over 5 years are estimated to have the disease. The treatment goal is to inhibit progression, reduce pain and maintain/increase quality of life. Treatment is often multimodal where physiotherapeutic rehabilitation is important.  

Objective

The aim was to investigate which rehabilitation methods that are used for dogs with osteoarthritis at animal clinics in Sweden. Further was to investigate differences between clinics regarding how often dogs with osteoarthritis are treated and if a licensed physiotherapist work or not. 

Method

A quantitative descriptive comparative cross-sectional study was conducted, data was collected through a self-constructed survey. Total 64 respondents answered who represent a selection of rehabilitation clinics, animal hospitals and veterinary clinics. Data was analyzed descriptive and group comparison with Chi2-test. Significance level was set to p ≤ 0,05. 

Result

The most common rehabilitation method used in clinic was physical exercise and weight loss as take-home advice. Clinics that treated more dogs used hydrotherapy more often while clinics that treated fewer dogs used massage more often. Clinics with licensed physiotherapists used more hydrotherapy, acupuncture, home-exercises, passive rehabilitation methods and activity-adjustment, while clinics without remitted more often.  

Conclusion

Current study maps rehabilitation methods used for osteoarthritis in dogs at Swedish clinics. The chosen methods differ between clinics with licensed physiotherapist and depending on how many dogs are treated at the clinic. This suggests that owners who seek care may receive different interventions depending on the choice of clinic.

Background: Physical activity improves mental and physical health. Physical inactivity and sedentary is an expanding societal problem where physically inactive professions are common. Another societal problem is stress-related disorders. Physical activity can reduce stress levels and motivation is important for physical activity. There is a knowledge gap regarding physical activity, sedentary, motivation and stress in individuals with physically inactive professions. 

Purpose: Describe physical activity, sedentary, motivation and stress in individuals with physically inactive professions and examine gender differences. Also study correlation between stress and physical activity and stress and sedentary behaviour. 

Method: A quantitative questionnaire study with descriptive, correlative and comparative design was conducted. The National Board of Health and Welfare's indicator questions about physical activity and sedentary, BREQ-2 about motivation for physical activity and PSS-10 about perceived stress were answered by 53 individuals from three workplaces with physically inactive professions. The data were analysed using non-parametric statistics. 

Results: 52 participants were included, 50% were women. The participants reported 285 activity minutes/week, 660 sedentary minutes/day, moderate levels of perceived stress and 38% had intrinsic regulation as motivational factor for physical activity. Small positive non-significant correlations were seen between stress and physical activity and stress and sedentary. There were no significant gender differences regarding all variables. 

Conclusion: The individuals were physically active, motivated by intrinsic regulation and had many sedentary minutes/day. The results highlight the importance of taking sedentary and psychosocial factors into consideration when identifying physical activity. More studies are required that examine gender differences regarding examined variables.

Background: Generalized anxiety disorder (GAD) is a common diagnosis with negative consequences both on an individual and societal level. In order for physiotherapists to be able to catch these patients and then have good knowledge of different forms of exercise as reliable treatment, it was considered beneficial to investigate the scientific basis for resistance exercise training as a treatment method.

Objective: The aim of this literature review was to investigate the scientific basis for the effect of resistance exercise training, in comparison with other or no intervention, as a treatment method to reduce worry and anxiety symptoms in adults aged 18-64 with GAD.

Method: A literature review of randomized controlled trials where the population was adults between 18-64 years old with GAD. Searches were conducted in the databases PubMed, Cochrane, PEDro and Psycinfo. Four studies were included and reviewed with PEDro. The combined reliability of the results of three studies was assessed using GRADEstud.

Results: The scientific basis for resistance exercise training as a treatment for people with GAD is too limited to be able to draw any strong conclusions. However, all included studies showed a reduction in worry and anxiety symptoms, both of which are characteristic symptoms of GAD.

Conclusion: The combined results indicate that strength training could be an alternative treatment method for this patient group. However, more research is needed to be able to evaluate the effect of strength training as a treatment for people with GAD.

Bakgrund Omvårdnadspersonalen är viktig för fallpreventivt arbete inom särskilt boende för äldre då de arbetar närmast patienterna. Det är viktigt att undersöka omvårdnadspersonalens syn på fallpreventivt arbete för att få ökad förståelse för hur omvårdnadspersonal kan stöttas i det fallpreventiva arbetet.

Syfte Att utforska omvårdnadspersonalens upplevelser av fallprevention och samarbete med fysioterapeut i det fallpreventiva arbetet på särskilt boende.

Metod En kvalitativ metod med semistrukturerade intervjuer. 11 personer som arbetade på särskilda boenden ingick i studien. Databearbetning genomfördes i form av en kvalitativ innehållsanalys.

Resultat Analysen gav fem kategorier och tjugo subkategorier, De fem huvudkategorierna bestod av: Miljöfaktorer påverkar fallrisk, Individfaktorer påverkar fallrisk, Strategier som omvårdnadspersonalen använder vid ökad fallrisk direkt gentemot kunden, Samarbetsstrategier som omvårdnadspersonalen använder vid ökad fallrisk, Samarbete mellan omvårdnadspersonal och fysioterapeut.

Konklusion Studien visade att omvårdnadspersonalens upplevelser av det fallpreventiva arbetet innefattade identifiering av riskfaktorer hos individ och miljö. De använde strategier vid ökad fallrisk direkt gentemot kund och ett bra kommunikativt samarbete med fysioterapeut, anhöriga och övrig vårdpersonal var betydelsefullt för det fallpreventiva arbetet på särskilt boende. Omvårdnadspersonal önskade stöd från fysioterapeut i form av praktisk hjälp med fallriskbedömning och information om specifika och generella fallpreventiva åtgärder.

Background

Ground glass opacity (GGO) is the main HRCT feature representing alveolitis in systemic sclerosis-associated interstitial lung disease (SSc-ILD), but may also represent other conditions such as atelectasis or edema. It is unclear how much this is affected by the HRCT scan protocol used. We aimed to compare the performance of three different HRCT protocols to evaluate the degree of SSc-ILD related changes.

Methods

Eleven patients with SSc underwent chest HRCT scan by three different protocols: First, a supine scan after lying down for 15 minutes, then two scans in alternating order: A prone position scan, and a supine position scan after performing 10 deep breaths using a positive expiratory pressure (PEP) device. The HRCT scans were evaluated by the Warrick score system for ILD-related findings.

Results

The three HRCT protocols were compared and resulted in different mean (95% CI) Warrick scores: 9.4 (5.3–13.4) in supine after rest; 7.5 (95% CI 3.8–11.1) in prone and 7.6 (95% CI 4.2–11.1) in supine after PEP. When comparing supine after rest to prone and supine after PEP, the latter two scans had a significantly lower score (p = 0.001 for both comparisons). In all cases, only sub-scores for ground glass opacities differed, while sub-scores for fibrosis-related changes did not change.

Conclusions

Different HRCT scan protocols significantly altered the Warrick severity score for SSc-ILD findings, primarily because of changes in ground glass opacities. These differences may be clinically meaningful.

Background: Migraine and tension-type headache (TTH) are two common health problems. These health problems are traditionally treated pharmacologically but physical therapy has lately gained popularity as a treatment option. Aerobic exercise is one of many physiotherapeutic treatments that can reduce pain for these patients. Purpose: To examine the effect of aerobic exercise on perceived pain level for individuals with migraine and/or TTH.

Method: The study design was literature review. Systematic searches were performed in the databases PubMed and PEDro. The search result was reviewed according to the selection criteria. The risk of bias in the included articles was assessed using PEDro scale and the certainty in evidence of the articles summarized outcomes was assessed using GRADEstud. 

Results: Eight randomized controlled studies were included after the selection process. One article was considered to have high quality and the remaining seven to have fair quality. The results were sub-grouped due to differences in the included articles regarding intervention and population. Number of days with migraine per month decreased within all groups with training as intervention but the between group comparisons were not statically significant. The same reduction could not be found regarding TTH. The certainty in evidence of the articles summarized outcomes was considered to be low or very low in all subgroups.

Conclusion: No certain conclusion could be drawn regarding the effect of aerobic exercise on perceived pain level in individuals with migraine and TTH based on the articles results, low quality, and low certainty in evidence. More studies are needed.

ABSTRACT 

Background: Musculoskeletal pain is one of the leading causes of both sick leave and health care consumption in most western societies. Musculoskeletal pain is defined as pain in organs such as muscles, joints, skeletal parts or associated soft tissues. Treatment of musculoskeletal pain often includes physical activity. Physical activity is defined as all body movement that increases energy consumption in addition to the energy consumption we have at rest. In order for physical activity to have the desired effect, compliance with the physical activity is required. 

Objective: The aim is to use the results of other studies to compile the effect of interventions whose purpose is to increase adherence to treatment with physical activity in patients with musculoskeletal pain.

Methods: Systematic review. The search was conducted in the databases PubMed, CINAHL, AMED and PEDRO. The studies were assessed according to template for quality review of randomized studies and GRADE from Statens beredning för medicinsk och social utvärdering. 

Results: A literature search found 514 articles that corresponded to purpose and issues. After reviewing the title and abstract, there were 38 articles left, after reading the entire study, there were 10 articles left that were included in the literature study. The 10 articles had varying degrees of quality. None of the studies had full quality on all parts included in the quality review. Evidence grading according to GRADE shows a moderate basis for behavioral medicine interventions to increase adherence to physical activity for adult patients with musculoskeletal pain. 

Conclusion: This literature study shows a weak correlation regarding whether behavioral drug interventions can increase adherence can increase adherence to physical activity in adults with musculoskeletal pain. In supportive activities, no positive effect was found on compliance with physical activity in adult patients with musculoskeletal pain. 

Background: Sports can be performed in many forms and is being performed by a wide population. In different sports it’s beneficial to have good jumping ability and to be fast. Many physical factors affect the ability to jump and sprint, where muscle strength and explosiveness are two of them. Plyometric training (PT) is a training form that utilizes the stretch-shortening-cycle (SSC). SSC is an eccentric muscle contraction followed by concentric contraction of the same muscle that aims to train muscle explosiveness.   

Objective: Evaluate the effect of plyometric training on jumping ability and sprinting within athletes compared with athletes only performing ordinary sport training. 

Method: A systematic review. The search was performed on the databases PubMed, PEDro, Cochrane Library and Cinahl. The included studies quality was examined with TESTEX and the reliability with GRADEstud. 

Results: Nine randomized controlled trials were included. The quality of the studies varied between 8 to 12 points. The reliability, examined with GRADEstud, was deemed very low (+). The effect of PT on jumping and sprinting for athletes compared with the control groups varied. None of the studies reported injuries associated with PT.

Conclusion: The studies included had, due to differences in intervention and results, a low level of evidence. PT has a certain effect on jumping ability and sprinting for athletes compared with athletes only performing ordinary sport training. No injuries were reported by the studies included. More homogeneous studies are required to clarify the effect of PT on jump ability and sprint in athletes. 

Background: Ankle sprains are a commonly encountered sport injury and without proper treatment, ankle sprains can cause long-lasting complaints. So far, there has been a lack of clarification of what physiotherapeutic interventions that Swedish physical therapists utilize to treat ankle sprains. Furthermore, there are currently no national or regional guidelines for physical therapists to follow. Recent studies have shown differences in patient satisfaction levels between private and public primary care centers (PCC) but limited research has been conducted on the specific interventions physical therapists provide to patients with ankle sprains. 

Objective: The purpose of this study was to survey the occurrence and frequency of the physiotherapeutic interventions utilized by physical therapists to treat ankle sprains during the subacute phase in Swedish PCC. It was also investigated what differences exist between the treatments chosen by physical therapists in private versus public PCC.

Design: A quantitative study with descriptive and comparative design. The data collection was conducted using a self-constructed questionnaire, which was posted in the Facebook group “Fysioterapeuternas framtidsgrupp” and was completed by 83 physical therapists. The differences between public and private PCC were analyzed by Mann Whitney U test. 

Results: Overall, 18 different physiotherapeutic interventions were utilized for subacute ankle sprains in Swedish PCC. Basic strength training (for instance, toe raises), active range of motion exercises and neuromuscular balance exercises were the most frequently utilized interventions among physical therapists. No significant difference was found in the occurrence and frequency of physiotherapeutic interventions in public and private PCC. 

BACKGROUND: Exercise-induced bronchoconstriction (EIB) and exercise-induced laryngeal obstruction (EILO) are common in elite athletes. Knowledge of which factors are related to incident EIB and EILO is limited. The aim of this study was to explore the course of EIB and EILO in adolescent athletes over a 2 years period and baseline characteristics related to incident EIB.

METHODS: Questionnaire data on respiratory symptoms, asthma, and aeroallergy and results of objective EIB and EILO tests were collected from 58 participants (27 tested for EILO) at baseline and after 2 years (follow-up). Associations between incident EIB and baseline asthma-like symptoms, exercise-induced symptoms, fractional exhaled nitric oxide (FeNO), aeroallergy, and sex were assessed using logistic regression models.

RESULTS: Ten participants had incident EIB, and eight participants had persistent EIB. Five were EIB positive at baseline but negative at follow-up, while 35 participants were EIB negative at both time points. Having incident EIB was associated with reporting waking up with chest tightness (OR = 4.38; 95% CI: 1.06, 22.09). Reporting an increased number of asthma-like symptoms increased the likelihood of incident EIB (OR = 2.78; 95% CI: 1.16, 6.58). No associations were found between exercise-induced symptoms, FeNO, aeroallergy, or sex and incident EIB. Incident EILO was found in three and persistent EILO in two of the 27 participants tested.

CONCLUSION: Two in nine had incident EIB and one eighth had incident EILO, suggesting that recurrent testing for EIB and EILO may be relevant in young athletes. Particularly, EIB-negative athletes reporting multiple asthma-like symptoms could benefit from recurrent EIB testing.

Objective: To explore physical activity patterns, including conditioning exercise and sport-specific training, and management routines utilized by handlers of Swedish sporting and working dogs participating in agility, obedience, rally obedience and working trial disciplines.

Procedures: Dog handlers provided information on competition-level dogs through an internet-based cross-sectional and descriptive survey on physical activity, sport-specific training and management. Results are reported overall and stratified by participation in specific disciplines.

Results: We received 1615 replies to the questionnaire. After data cleaning, 1582 dogs (98%) remained for the analysis. Of these, 430 participated in agility, 790 in obedience, 596 in rally obedience, and 847 dogs had competed in a working trial, i.e., messenger, protection, search or tracking. Number of disciplines performed by each dog varied between one and five. Most common was participation in one (n = 767, 48%) or two (n = 541, 34%) disciplines. Out of the dogs competing in one discipline, 38% (n = 294) were considered to be specialized as they actively trained only that discipline for >= 10 months per year. The vast majority of the dogs (n = 1129, 71%) received more than 1 h of daily physical activity, e.g., walks, and only n = 51 (3%) were never exercised off-leash. Preferred self-selected gait was trot (n = 907, 57%) and gallop (n = 499, 32%). A fifth (n = 319, 20%) never played with other dogs. The majority (n = 1328, 84%) received more than 1 h of vigorous physical conditioning exercise per week. Almost three quarters (n = 1119, 71%) participated in physical conditioning exercise. Two thirds (n = 953, 60%) participated in at least 3 h of sport-specific training per week and only a very small portion (n = 35, 2%) trained their specific discipline less than once per week. Median total work load, i.e., all daily physical activity, vigorous physical conditioning exercise and sport-specific training, was 16.5 h per week.

Conclusion and clinical relevance: We observe physical activity at moderate to high durations and moderate to vigorous intensities among Swedish sporting and working trial dogs. Most dogs received physical conditioning exercise, but not all dogs were warmed up before training and competition. Our study provides veterinary professionals and dog trainers with valuable insights on the physical exposures and management routines of sporting and working trial dogs.

Dog trials and competitions involve various sport disciplines, e.g., obedience, agility, working dog trials and rally obedience. Dog handlers navigate their dogs through physically and mentally demanding tasks. The purpose of this study was to gain a better understanding of barriers and facilitators to canine health promotion and injury prevention described by dog handlers.

Methods: Qualitative inductive content analysis was applied to systematically organize and interpret narrative data from 654 respondents' answers to open-ended questions in an anonymous online inquiry.

Results: Two categories, with seven sub-categories, emerged from the analysis: (1) Challenges in applying the regulations in dog trials and competitions, and (2) Implementation of animal welfare and canine well-being approaches. Respondents described the challenges in applying regulations in dog trials and competitions and lack of scientific research as barriers to their intent to prevent injuries in their dogs. Implementation of animal welfare and canine well-being approaches were described as facilitators.

Conclusion: The findings imply that the stakeholders continuously need to work on bridging possible gaps between the canine welfare criteria and the scientific and empirical knowledge in canine sports and performance medicine.

Background: Parkinson’s Disease (PD) is a chronic disease with a progressive course, where impaired balance and increased risk of falls becomes a problem. In recent times alternative forms of training, which include compensatory stepping responses among other things, have been adopted for people with PD. However, the scientific evidence about its efficacy is unclear.

Purpose: To systematically review the evidence surrounding alternative training methods such as tai chi, dance and boxing as a treatment for imparied balance in people with Parkinson's disease. The result presents relevant effects on balance, as well as a grading of the quality of the evidence.

Method: The search for literature was carried out on the databases PubMed and PEDro. The authors reviewed the quality of the included studies with the assessment tool TESTEX. After that the results of the studies were reviewed, and lastly the reliability was assessed with GRADEstud.

Results: Nine studies with a total of 608 participants were included in the study. Studies ranged from 8-12 points in the quality assessment. Four studies found significant improvement in balance in comparison to control. One of the included studies examined boxing, the study found no difference between groups. The reliability of evidence for tai chi and dance as treatment for impaired balance was assessed to be low, mainly because of heterogeneity in the studies. Boxing did not meet the requirements for an assessment of the reliability.

Conclusion: The result does not provide us with enough knowledge to determine whether these training methods are effective for improving balance in PS, but there were indications of a positive impact on balance caused by the interventions. More research with high methodological quality and larger sample groups is needed.

Background:Chronic pain is defined as pain that remains in more than 3 months. Chronic pain is a widespread problem worldwide and there are many people who seek health care for their problems. Pain is a complex syndrome which impacts several aspects of the individual's life but also the society, which brings challenges in the assessment and the choice of treatment. 

Purpose:The purpose of the study was to explore physiotherapists' clinical reasoning when choosing a treatment for patients with chronic pain in primary care. 

Method:The study is a qualitative method based on semi-structured interviews which was analyzed with a qualitative content analysis. 

Results:Factors that played a big part in the choice of treatment were the physiotherapist and the patient characteristics and experiences, the relationship between them and the significance of the examination. The guidelines that were used were considered to support the choice but were also seen to be difficult to apply, as the treatment always needs to be individualized because of the complexity in the patient group. The ability of cooperation was considered as a key factor to broaden the perspective and offer the patient different treatment alternatives. The treatments intended to increase function, knowledge and pain-management which had an impact on the clinical reasoning.

Conclusion:Many factors play a part in the clinical reasoning for choosing treatment for patients with chronic pain. The physiotherapists experience was a crucial part of the decision and therefore it could be of importance that newly graduated physiotherapists get the possibility to cooperate with colleagues who have more experience of the patient group. 

Background: Despite evidence that physical activity and training in coronary artery disease are important from a lifelong perspective for individuals with coronary artery disease, there is limited research on which methods that can support physical activity maintenance after center-based training. 

Aim: The aim of this literature study was to examine the effect of maintenance cardiac rehabilitation (M-CR) on physical activity and physical capacity for six months or more in individuals with coronary artery disease after center-based cardiac rehabilitation. The aim was also to examine the quality and reliability of included articles.

Method: Systematic searches in the AMED, PubMed and PsycINFO databases. Ten randomized controlled trials were included. Quality was assessed using the PEDro scale.The overall reliability of the results was assessed according to SBU GRADE guidelines.

Result: The quality of included articles was moderate to average. Reliability was assessed as low to very low according to SBU GRADE. The result indicated, despite variation of interventions, that M-CR can have an effect on physical activity and to some extent on physical capacity (fitness). For muscle strength, no significant effect is seen.

Conclusion: Individual articles show significant results indicating that M-CR can have an effect on physical activity and capacity in individuals with coronary artery disease. The quality of the included articles was moderate to average. The overall reliability on physical activity was assessed as low according to SBU GRADE. And the overall reliability on physical capacity (fitness and muscle strength) was assessed as very low according to SBU GRADE.

Background: Physiotherapists active in women's health have good knowledge of the musculoskeletal system with the competence to, among other things, assess pelvic floor muscles, support return to physical activity and be available as support and counselors. Sweden's municipalities and regions believe that access to physiotherapeutic competence in women's health should be improved. There is currently a lack of studies on Swedish physiotherapists' perceptions of their role in aftercare after childbirth.

Aim: The aim was to investigate how physiotherapists working with women's health and who meet post-pregnant women in their work perceives their role in aftercare after childbirth.Design and method: The study was of qualitative descriptive design and its content is based on semi-structured interviews with five licensed physiotherapists active in women's health. The data has been analyzed with qualitative content analysis.

Results: Four categories and 14 subcategories were identified during the data processing process. The categories came to be called the Physiotherapist as a support and advisor in aftercare, the Physiotherapist's unique pelvic floor competence, Future aftercare and Challenges for the physiotherapist in aftercare. Within these categories, descriptions emerged about the physiotherapist's role in supporting return to physical activity, challenges in reaching out to patients and wishes to offer routine follow-up to a physiotherapist.

Conclusion: The interviewed physiotherapists perceive that their role in aftercare after childbirth includes being emotional support, being a support and counselor and that they have a unique pelvic floor competence with the opportunity to individualize pelvic floor muscle training. They feel that women's health is de-prioritized, that there is a lack of competence in this subject and that they find collaboration with other professions challenging. It also emerged that the physiotherapists wish to be able to offer routine follow-ups after childbirth.

Background: Running is a popular activity in Sweden today. However, injuries are common and almost 80% of runners get injured each year. Discussions about whether barefoot running could alter the biomechanics and decrease the risk of injury, and improve the running economy and increase a runner's performance, has risen amongst runners and researchers.

Purpose: To examine the effects of barefoot running (minimalist footwear) on biomechanics measured with ground reaction force (GRF) and running economy measured with oxygen consumption compared to shod running. 

Method: A systematic review. Articles were found using the Pubmed and Chochrane database. Randomised controlled trials (RCT) or Cross-over studies were included. Assessment of study quality was measured with the PEDro-scale and the reliability of the result assessed with GRADEstud.

Result: Eight articles were included, three about biomechanics and five about running economy. Inconclusive results were found on the effects of barefoot running on GRF, one study showed a significant reduction in GRF and the other two showed increase in GRF. Positive tendencies were found concerning running economy, two studies showed a significant increase. The quality of the studies were moderate and the reliability of the result were very low.

Conclusion: Barefoot running showed positive findings on running economy, while the effects on GRF were inconclusive. The evidence was considered very low. There is a need for more high-quality studies examining the long-lasting and acute effects of barefoot running on running economy and biomechanics to be able to draw conclusions and implement the knowledge in clinical physiotherapy.