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  • 1.
    Aasa, Björn
    et al.
    Norrlandsklinikens hälsocentral, Umeå.
    Hellqvist, Jonas
    Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Berglund, Lars
    Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Michaelson, Peter
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Aasa, Ulrika
    Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy.
    A characterisation of pain, disability, kinesiophobia and physical capacity in patients with predominantly peripherally mediated mechanical low back pain2011Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 97, nr Suppl. 1, s. eS18-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: The specific objectives were to: 1) describe the level of pain intensity, disability, activity limitation, kinesiophobia and physical capacity in patients with predominantly peripherally mediated mechanical back pain, and 2) investigate whether differences between these patients in physical and psychosocial factors can be distinguished when the patients are further sub-grouped.Relevance: To improve assessment among patients with chronic low back pain (CLBP) it is important to investigate the prevalence of physical and psychosocial features in homogenous sub-groups.Participants: Seventy-one patients with CLBP, 20-60 years old, with peripherally mediated mechanical pain at the the moment for the study, were included and each patient was sub-classified into one of five sub-groups based on their pain behaviour and functional movement pattern (flexion n=20, flexion/lateral shift, n=11, active extension n=23 , passive extension n=8, and multidirectional pattern n=9).Methods: Data on pain intensity (Visual Analogue Scale), disability (the Roland and Morris Questionnaire), activity limitation (the Patient Specific Functional Scale), kinesiophobia (the Tampa Scale of Kinesiophobia) and physical capacity (lifting capacity and trunk extensor endurance) was collected.Analysis: Mean and standard deviation for parametric and median and interquartile range for non-parametric data were used for descriptive statistics. One-way ANOVA for normally distributed data and Kruskal-Wallis for non-normally distributed data were used for analyses of differences between the sub-groups. The subjects were also divided into two age-groups (20-40 and 41-60 years) and measures of physical capacity were compared to women and men at the ages of 34 and 50, respectively, in the general Swedish population using one sample T-test.Results: The patients reported low to moderate pain intensity (3.1/10±2.4), disability (RMDQ (7.27/24 ±4.2) and kinesiophobia (33.4/68 ±7) and these levels were lower than reported levels in other studies including more heterogenous groups of patients with CLBP. The patiens reported activity limitations (PSFS 13/30±23). Lifting capacity and trunk extensor endurance were significantly lower than in the general population in the youngest age-group. No significant differences in pain intensity, disability, kinesiophobia or physical capacity were found between the sub-groups.Conclusions: This research highlights that patients with predominantly peripherally mediated mechanical back pain may differ from other sub-groups of patients with CLBP (e.g., patients with central sensitization as dominating pain mechanism) regarding physical and psychosocial factors. The individual variation in pain intensity, disability, kinesiophbia and physical capacity among the patients indicates the importance to assess these factors in every patient. Due to the fact that there were few patients in the sub-groups, further research is necessary to explore whether there are differences, that we were not able to disingjish, between patients with different movement patterns.

  • 2.
    Abbott, Allan
    et al.
    Department of Physical Therapy, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Science, Intervention and Technology, Division of Orthopaedics, Karolinska Institute, Stockholm, Sweden.
    Tyni-Lenné, Raija
    Department of Physical Therapy, Karolinska University Hospital, Stockholm, Sweden.
    Hedlund, Rune
    Institute for Clinical Sciences, Department for Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden.
    The influence of psychological factors on pre-operative levels of pain intensity, disability and HRQOL in lumbar spinal fusion surgery patients2010Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 96, nr 3, s. 213-221Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES:

    To assess the extent to which perceived pain and psychological factors explain levels of disability and health-related quality of life (HRQOL) in patients scheduled for lumbar fusion surgery, and to test the hypothesis that relationships between pain intensity, mental health, fear of movement/(re)injury, disability and HRQOL are mediated by cognitive beliefs and appraisals.

    DESIGN:

    Cross-sectional, correlation study.

    SETTING:

    Orthopaedic outpatient setting in a tertiary hospital.

    PARTICIPANTS:

    One hundred and seven chronic back pain patients scheduled for lumbar fusion surgery.

    MEASURES:

    Visual analogue scale for pain intensity, Short Form 36 mental health subscale, Tampa Scale for Kinesiophobia, Back Beliefs Questionnaire, Self-efficacy Scale, Coping Strategy Questionnaire, Oswestry Disability Index and European Quality of Life Questionnaire.

    RESULTS:

    The group effect of multiple mediators significantly influenced the relationships between pain intensity and mental health, fear of movement/(re)injury, functional disability and HRQOL. Pain catastrophising significantly mediated the relationship between pain intensity and mental health, control over pain significantly mediated the relationship between mental health and functional disability, self-efficacy and pain outcome expectancy significantly mediated the relationship between mental health and HRQOL, and self-efficacy also significantly mediated the relationship between pain intensity, fear of movement/(re)jury and functional disability. The model explained 28, 30, 52 and 42% of the variation in mental health, fear of movement/(re)injury, functional disability and HRQOL, respectively.

    CONCLUSIONS:

    This study highlights the strong influence and mediation roles of psychological factors on pain, mental health, fear of movement/(re)injury, disability and HRQOL in patients scheduled for lumber fusion. Future research should focus on screening as well as pre- and post-operative interventions based on these psychological factors for the potential improvement of lumber fusion surgery outcomes.

    Copyright 2010 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  • 3. Alghadir, A. H.
    et al.
    Anwer, S.
    Zafar, Hamayun
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi. Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
    Iqbal, Z. A.
    Effect of localised vibration on muscle strength in healthy adults: a systematic review2018Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 104, nr 1, s. 18-24Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Objective To investigate the effects of local vibration on muscle strength in healthy adults.

    Data sources The electronic databases PubMed, CINAHL, Scopus and Web of Science were searched using a combination of the following keywords: vibration, vibration therapy, power, maximal voluntary contraction, performance, rate of force development and vibratory exercise. In addition, the Medical Subject Headings 'vibration', 'strength' and 'exercise' were used. The bibliographical search was limited to articles published in English.

    Study selection Trials that evaluated the effect of localised vibration on muscle strength in healthy humans were included.

    Data extraction Two independent evaluators verified the quality of the selected studies using the PEDro Scale and the Cochrane Collaboration's tool for assessing the risk of bias. Muscle strength was calculated for each intervention.

    Results In total, 29 full-text studies were assessed for eligibility. Eighteen studies did not match the inclusion criteria, and were excluded. The 11 studies included in this review had an average PEDro score of 5.36/10. Most of the studies reported significant improvements in muscle strength after the application of local vibration. There was considerable variation in the vibration training parameters and target muscle location.

    Conclusions The use of local vibration on the target muscle can enhance muscle strength in healthy adults. Further well-designed controlled studies are required to confirm the effect of local vibration training on muscle strength. 

  • 4. Anwer, Shahnawaz
    et al.
    Alghadir, Ahmad
    Zafar, Hamayun
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi. Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
    Al-Eisa, Einas
    Effect of whole body vibration training on quadriceps muscle strength in individuals with knee osteoarthritis: a systematic review and meta-analysis2016Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 102, nr 2, s. 145-151Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Background Several studies have reported the effects of whole body vibration (WBV) training on muscle strength. This systematic review investigates the current evidence regarding the effects of WBV training on quadriceps muscle strength in individuals with knee osteoarthritis (OA). Data sources We searched PubMed, CINAHL, Embase, Scopus, PEDro, and Science citation index for research articles published prior to March 2015 using the keywords whole body vibration, vibration training, strength and vibratory exercise in combination with the Medical Subject Heading 'Osteoarthritis knee'. Study selection This meta-analysis was limited to randomized controlled trials published in the English language. Data extraction The quality of the selected studies was assessed by two independent evaluators using the PEDro scale and criteria given by the International Society of Musculoskeletal and Neuronal Interactions (ISMNI) for reporting WBV intervention studies. The risk of bias was assessed using the Cochrane collaboration's tool for domain-based evaluation. Isokinetic quadriceps muscle strength was calculated for each intervention. Results Eighteen studies were identified in the search. Of these, four studies met the inclusion criteria. Three of these four studies reached high methodological quality on the PEDro scale. Out of the four studies, only one study found significantly greater quadriceps muscle strength gains following WBV compared to the control group. Conclusions In three of the four studies that compared a control group performing the same exercise as the WBV groups, no additional effect of WBV on quadriceps muscle strength in individuals with knee OA was indicated.

  • 5.
    Berglund, Lars
    et al.
    Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hellqvist, Jonas
    Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Aasa, Björn
    Norrlandsklinikens hälsocentral, Umeå.
    Michaelson, Peter
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Holmberg, David
    Cederkliniken Primary Health Care Centre.
    Aasa, Ulrika
    Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Which patients with persistent mechanical low back pain will respond to high load motor control training?2011Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 97, nr Suppl. 1, s. eS124-eS125Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: The aim of this study was to explore variables influencing success or failure of eight weeks of high load motor control training with the conventional deadlift exercise.Relevance: Researching viable exercises for rehabilitation of specific sub-groups of persistent low back pain is relevant for physical therapists in order to develop tailored treatment regimes for patients with persistent low back pain. This study contributes to this research by exploring which variables characterize the ideal patient for the conventional deadlift exercise.Participants: Thirty-five patients with persistent mechanical low back pain were recruited consecutively from two occupational health care services in Umeå, Sweden . Inclusion and exclusion criteria were designed to include patients with persistent mechanical low back pain.Methods: The study design was a prospective cohort study. The intervention consisted of eight weeks of training with the conventional deadlift exercise. To discriminate between patients with a successful or failed outcome of treatment, change in the patient-specific functional scale was used and a cut-off at 50 % improvement was set. Possible predictive variables collected at baseline included physical activity level, pain intensity (Visual Analogue Scale), activity limitation (the Roland and Morris Disability Questionnaire and the Patient-Specific Functional Scale), kinesiophobia (Tampa Scale of Kinesiophobia), specific anamnestic questions regarding patients' history and symptoms of low back pain, test of active movement control of the low back, trunk muscle endurance(Prone bridge test, Side-bridge test, Biering-Sörensen test) and lift strength (static two-hand lift test), two-point discrimination of the low back and ultrasound imaging of the mm. multifidi.Analysis: Student´s T-test for normally distributed continuous data, Mann Whitney for non-normally distributed continuous data and chi-square tests or Fisher´s Exact tests for categorical variables were used for analyses of differences between the success and the failure group.Results: No significant differences between groups were found in background, anamnestic or physical performance variables. After eight weeks of training, 15 patients (43 %) were categorized as treatment success and 20 patients (57 %) were categorized as treatment failure according to the cut-off set for the PSFS. The patients reported difficulty in performing a wide variation of activities, ranging from not being able to sit for longer than 15 minutes, to stand upright and watch their children play football games, and to not being able to run long distances, play football or perform different lifting tasks.Conclusions: We conclude that the conventional deadlift exercise may be considered a possible exercise to improve patients' activity limitations, if administered by a therapist experienced in resistance training and analyzing movement patterns. However, further research is needed to explore which variables can define patients in the successful and in the failure group, respectively.Implications: The results of this study imply that the conventional deadlift exercise can be used in treatment of patients with mechanical low back pain in order to increase activity limitation. However, it is still unclear on what grounds treatment with the conventional deadlift exercise is indicated to achieve these results.

  • 6.
    Blomqvist, Sven
    et al.
    Swedish Development Centre for Disability Sport, Bollnäs, Sweden; Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
    Wester, Anita
    Department of Research and Evaluation, Swedish National Agency for Education, Stockholm, Sweden .
    Sundelin, Gunnevi
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umea University, Umea, Sweden .
    Rehn, Börje
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umea University, Umea, Sweden .
    Test-retest reliability, smallest real difference and concurrent validity of six different balance tests on young people with mild to moderate intellectual disability2012Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 98, nr 4, s. 313-319Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES:

    Some studies have reported that people with intellectual disability may have reduced balance ability compared with the population in general. However, none of these studies involved adolescents, and the reliability and validity of balance tests in this population are not known. The purpose of this study was to examine the reliability of six different balance tests and to investigate their concurrent validity.

    DESIGN:

    Test-retest reliability assessment.

    SETTINGS:

    All subjects were recruited from a special school for people with intellectual disability in Bollnäs, Sweden.

    PARTICIPANTS:

    Eighty-nine adolescents (35 females and 54 males) with mild to moderate intellectual disability with a mean age of 18 years (range 16 to 20 years).

    INTERVENTIONS:

    All subjects followed the same test protocol on two occasions within an 11-day period.

    MAIN OUTCOMES:

    Balance test performances.

    RESULTS:

    Intraclass correlation coefficients greater than 0.80 were achieved for four of the balance tests: Extended Timed Up and Go Test, Modified Functional Reach Test, One-leg Stance Test and Force Platform Test. The smallest real differences ranged from 12% to 40%; less than 20% is considered to be low. Concurrent validity among these balance tests varied between no and low correlation.

    CONCLUSION:

    The results indicate that these tests could be used to evaluate changes in balance ability over time in people with mild to moderate intellectual disability. The low concurrent validity illustrates the importance of knowing more about the influence of various sensory subsystems that are significant for balance among adolescents with intellectual disability.

  • 7.
    Blomqvist, Sven
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Wester, Anita
    Sundelin, Gunnevi
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Rehn, Börje
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Test-retest reliability, smallest real difference and concurrent validity of six different balance tests on young people with mild to moderate intellectual disability2012Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 98, nr 4, s. 313-319Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives Some studies have reported that people with intellectual disability may have reduced balance ability compared with the population in general. However, none of these studies involved adolescents, and the reliability and validity of balance tests in this population are not known. The purpose of this study was to examine the reliability of six different balance tests and to investigate their concurrent validity.

    Design Test-retest reliability assessment.

    Settings All subjects were recruited from a special school for people with intellectual disability in Bollnas, Sweden.

    Participants Eighty-nine adolescents (35 females and 54 males) with mild to moderate intellectual disability with a mean age of 18 years (range 16 to 20 years).

    Interventions All subjects followed the same test protocol on two occasions within an 11-day period.

    Main outcomes Balance test performances.

    Results Intraclass correlation coefficients greater than 0.80 were achieved for four of the balance tests: Extended Timed Up and Go Test, Modified Functional Reach Test, One-leg Stance Test and Force Platform Test. The smallest real differences ranged from 12% to 40%; less than 20% is considered to be low. Concurrent validity among these balance tests varied between no and low correlation.

    Conclusion The results indicate that these tests could be used to evaluate changes in balance ability over time in people with mild to moderate intellectual disability. The low concurrent validity illustrates the importance of knowing more about the influence of various sensory subsystems that are significant for balance among adolescents with intellectual disability.

    (C) 2011 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  • 8.
    Bohannon, Richard W
    et al.
    School of Allied Health, Physical Therapy, University of Connecticut, USA.
    Peolsson, Anneli
    Linköpings universitet, Institutionen för hälsa och samhälle. Linköpings universitet, Hälsouniversitetet.
    Massy-Westropp, Nicola
    School of Health Sciences, University of South Australia, Adelaide, Australia.
    Desrosiers, Johanne
    Research Center on Aging and Faculty of Medicine, Department of Family Medicine, Université de Sherbrooke, Sherbrooke, Québec, Canada.
    Bear-Lehman, Jane
    Steinhardt School of Education, New York University and College of Physicians and Surgeons, Columbia University, New York, NY, USA.
    Reference values for adult grip strength measured with a Jamar dynamometer: a descriptive meta-analysis2006Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 92, nr 1, s. 11-15Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The purpose of this meta-analysis was to consolidate the results of studies presenting normative values for grip strength obtained with the Jamar dynamometer in accordance with the recommendations of the American Society of Hand Therapists. Relevant data from 12 sources (3317 subjects) were employed. Means and 95% confidence intervals are presented for the left and right sides of men and women in 12 age groups (20–24, 25–29, 30–34, 35–39, 40–44, 45–49, 50–54, 55–59, 60–64, 65–69, 70–74, 75+ years). The consolidated grip strength reference values offer a better standard for comparison than provided by any single study alone. Limitations in the meta-analysis notwithstanding, the lower limit of the 95% confidence interval can serve as a reasonable threshold for establishing grip strength impairment among adults.

  • 9. de Zoete, Annemarie
    et al.
    Rubinstein, Sidney M
    de Boer, Michiel R
    Ostelo, Raymond
    Underwood, Martin
    Hayden, Jill A
    Buffart, Laurien M
    van Tulder, Maurits W
    The effect of spinal manipulative therapy on pain relief and function in patients with chronic low back pain: An individual participant data meta-analysis2021Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 112, s. 121-134, artikkel-id S0031-9406(21)00025-0Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: A 2019 review concluded that spinal manipulative therapy (SMT) results in similar benefit compared to other interventions for chronic low back pain (LBP). Compared to traditional aggregate analyses individual participant data (IPD) meta-analyses allows for a more precise estimate of the treatment effect.

    PURPOSE: To assess the effect of SMT on pain and function for chronic LBP in a IPD meta-analysis.

    DATA SOURCES: Electronic databases from 2000 until April 2016, and reference lists of eligible trials and related reviews.

    STUDY SELECTION: Randomized controlled trials (RCT) examining the effect of SMT in adults with chronic LBP compared to any comparator.

    DATA EXTRACTION AND DATA SYNTHESIS: We contacted authors from eligible trials. Two review authors independently conducted the study selection and risk of bias. We used GRADE to assess the quality of the evidence. A one-stage mixed model analysis was conducted. Negative point estimates of the mean difference (MD) or standardized mean difference (SMD) favors SMT.

    RESULTS: Of the 42 RCTs fulfilling the inclusion criteria, we obtained IPD from 21 (n=4223). Most trials (s=12, n=2249) compared SMT to recommended interventions. There is moderate quality evidence that SMT vs recommended interventions resulted in similar outcomes on pain (MD -3.0, 95%CI: -6.9 to 0.9, 10 trials, 1922 participants) and functional status at one month (SMD: -0.2, 95% CI -0.4 to 0.0, 10 trials, 1939 participants). Effects at other follow-up measurements were similar. Results for other comparisons (SMT vs non-recommended interventions; SMT as adjuvant therapy; mobilization vs manipulation) showed similar findings. SMT vs sham SMT analysis was not performed, because we only had data from one study. Sensitivity analyses confirmed these findings.

    LIMITATIONS: Only 50% of the eligible trials were included.

    CONCLUSIONS: Sufficient evidence suggest that SMT provides similar outcomes to recommended interventions, for pain relief and improvement of functional status. SMT would appear to be a good option for the treatment of chronic LBP. Systematic Review Registration Number PROSPERO CRD42015025714.

    Fulltekst (pdf)
    fulltext
  • 10.
    Dean, Elizabeth
    et al.
    Univ British Columbia, Fac Med, Dept Phys Therapy, Vancouver, BC, Canada..
    Söderlund, Anne
    Mälardalens universitet, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Malardalen Univ, Sch Hlth Care & Social Welf, Div Physiotherapy, Vasteras, Sweden..
    Gosselink, Rik
    Katholieke Univ Leuven, Fac Movement & Rehabil Sci, Dept Rehabil Sci, Leuven, Belgium..
    Jones, Alice Y. M.
    Univ Queensland, Sch Hlth & Rehabil Sci, Brisbane, Australia..
    Yu, Homer Peng-Ming Yu
    Sichuan Univ, Rehabil Med Coll, Fac Phys Therapy, Chengdu, Peoples R China.;Sichuan Univ, West China Hosp, Rehabil Med Coll, Chengdu, Peoples R China..
    Skinner, Margot
    Univ Otago, Sch Physiotherapy, Div Hlth Sci, Dunedin, New Zealand..
    Immuno-modulation with lifestyle behaviour change to reduce SARS-CoV-2 susceptibility and COVID-19 severity: goals consistent with contemporary physiotherapy practice2022Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 114, s. 63-67Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Lifestyle-related non-communicable diseases (NCDs) and their risk factors are unequivocally associated with SARS-CoV-2 susceptibility and COVID-19 severity. NCD manifestations and their lifestyle risks are associated with chronic low-grade systemic inflammation (CLGSI). This review supports that immuno-modulation with positive lifestyle change aimed at reducing SARS-CoV-2 susceptibility and COVID-19 severity, is a goal consistent with contemporary physiotherapy practice. Physiotherapists have a long tradition of managing a , thus, managing CLGSI is a logical extension. Improving patients' lifestyle practices also reduces their NCD risks and increases activity/exercise capacity, health and wellbeing - all principal goals of contemporary physiotherapy. The COVID-19 pandemic lends further support for prioritising health and lifestyle competencies including smoking cessation; whole food plant-based nutrition; healthy weight; healthy sleep practices; and stress management; in conjunction with reducing sedentariness and increasing physical activity/exercise, to augment immunity as well as function and overall health and wellbeing. To support patients' lifestyle change efforts, physiotherapists may refer patients to other health professionals. The authors conclude that immuno-modulation with lifestyle behaviour change to reduce susceptibility to viruses including SARS-CoV-2, is consistent with contemporary physiotherapy practice. Immuno-modulation needs to be reflected in health competencies taught in physiotherapy professional education curricula and taught at standards comparable to other established interventions.(c) 2021 The Author(s).

  • 11.
    Edvinsson, Siv
    et al.
    Örebro universitet, Hälsoakademin.
    Lundqvist, Lars-Olov
    Association between orofacial function, gross motor function and manual ability in children and young adults with cerebral palsy2011Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 97, nr Suppl 1, s. eS302-eS303Artikkel i tidsskrift (Fagfellevurdert)
  • 12.
    Elvén, Maria
    et al.
    Mälardalens universitet, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Boersma, Katja
    Örebro University, Sweden.
    Overmeer, Thomas
    Mälardalens universitet, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Assessing clinical reasoning in physical therapy: discriminative validity of the Reasoning 4 Change instrument2022Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 117, s. 8-15Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: To evaluate discriminative validity of the Reasoning 4 Change (R4C) instrument by investigating differences in clinical reasoning skills between first semester, final semester physical therapy students and physical therapy experts.

    Design:Cross-sectional design

    Setting: University and physical therapy practiceParticipantsStudents from the first (n = 87) and final semester (n = 47) of an entry-level physical therapy program and experts in physical therapy with a behavioral medicine approach (n = 14).

    Methods: The students and experts answered the web-based R4C instrument on one occasion. The R4C instrument includes four domains designed to assess physical therapists’ clinical reasoning skills with a focus on supporting clients’ behavior change and has demonstrated acceptable content validity, convergent validity and reliability. Data was analyzed with one-way analysis of variance and Games-Howell post hoc test.

    Results: Differences in all domains and subscale scores were found between the three groups. Pairwise comparisons demonstrated that experts scored higher (better clinical reasoning skills) than first semester students in all domains and subscales; and higher scores than final semester students, except for two subscales. Final semester students scored higher than first semester students, except for one subscale.

    Conclusions: The findings highlight differences in clinical reasoning skills focusing on clients’ behavior change among physical therapy students with different degrees of training and education in clinical reasoning and physical therapists with extensive experience and expertise. The results provide evidence for the discriminative validity of the R4C instrument which support the use of the R4C instrument in education, research and clinical practice.

  • 13.
    Elvén, Maria
    et al.
    Division of Physiotherapy, School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
    Boersma, Katja
    Örebro universitet, Institutionen för juridik, psykologi och socialt arbete.
    Overmeer, Thomas
    Division of Physiotherapy, School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
    Assessing clinical reasoning in physical therapy: discriminative validity of the Reasoning 4 Change instrument2022Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 117, s. 8-15Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: To evaluate discriminative validity of the Reasoning 4 Change (R4C) instrument by investigating differences in clinical reasoning skills between first semester, final semester physical therapy students and physical therapy experts.

    DESIGN: Cross-sectional design SETTING: University and physical therapy practice PARTICIPANTS: Students from the first (n = 87) and final semester (n = 47) of an entry-level physical therapy program and experts in physical therapy with a behavioral medicine approach (n = 14).

    METHODS: The students and experts answered the web-based R4C instrument on one occasion. The R4C instrument includes four domains designed to assess physical therapists' clinical reasoning skills with a focus on supporting clients' behavior change and has demonstrated acceptable content validity, convergent validity and reliability. Data was analyzed with one-way analysis of variance and Games-Howell post hoc test.

    RESULTS: Differences in all domains and subscale scores were found between the three groups. Pairwise comparisons demonstrated that experts scored higher (better clinical reasoning skills) than first semester students in all domains and subscales; and higher scores than final semester students, except for two subscales. Final semester students scored higher than first semester students, except for one subscale.

    CONCLUSIONS: The findings highlight differences in clinical reasoning skills focusing on clients' behavior change among physical therapy students with different degrees of training and education in clinical reasoning and physical therapists with extensive experience and expertise. The results provide evidence for the discriminative validity of the R4C instrument which support the use of the R4C instrument in education, research and clinical practice.

    Contribution of the Paper

    • The study results provide evidence for the discriminative validity of the R4C instrument, thus strengthening its validity evidence.

    • The findings highlight the differences in clinical reasoning skills focusing on clients’ behavior change amongst first semester students, final semester students and physical therapy experts.

    • The R4C instrument may be used as part of regular quality assurance of physical therapy curricula and investigations of students’ and practitioners’ client-centered approach and behavioral considerations in clinical reasoning. For example, repeated measures over time may reveal changes in students’ learning and comparisons between groups may identify strengths and weaknesses in students’ and practitioners’ clinical reasoning, which may guide curricula modifications and interventions in practice.

  • 14.
    Elvén, Maria
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Dean, Elizabeth
    University of British Columbia, Canada .
    Factors influencing physiotherapists' clinical reasoning: a meta-synthesis2015Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 101, s. e360-e361Artikkel i tidsskrift (Fagfellevurdert)
    Fulltekst (pdf)
    fulltext
  • 15.
    Elvén, Maria
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Hochwälder, Jacek
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Dean, Elizabeth
    University of British Columbia, Canada .
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    An innovative instrument to assess physiotherapists’ clinical reasoning focused on clients’ behaviour change: Its development and validation.2016Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 102, nr s1, s. e155-e155Artikkel i tidsskrift (Fagfellevurdert)
  • 16. Gard, Gunvor
    Increased focus on values: a tool in stress prevention?2003Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 89, nr 5, s. 282-9Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background and purpose: Can an increased focus on values in working life be a factor in stress prevention? Values are defined as the shared principles which guide behaviour in an organisation. The purpose of this study was to describe how patients with musculoskeletal pain perceive the importance of values in relation to coping with daily stress and in relation to health. Methods: Patients receiving physiotherapy for various musculoskeletal disorders at three primary healthcare centres in the north of Sweden participated in the study, in total 95 patients. They answered a questionnaire covering values, work situation, coping behaviour and health and the relationship between these aspects. Results: All patients perceived that it was important to have values to follow at work, such as doing one's best, setting priorities, following one's priorities and having open and direct communication with others. A significant positive relationship was shown between having motivating values and low emotion-focused strategies, in this case behavioural and cognitive coping strategies. A positive relationship was also shown between having motivating values and low occurrence of symptoms (good perceived health). Conclusion: Values and effective coping strategies may be motivating factors preserving health

  • 17. Gard, Gunvor
    et al.
    Gyllensten, Amanda Lundvik
    University of Lund, Department of Physical Therapy.
    Salford, Eva
    University of Lund, Department of Physical Therapy.
    Ekdahl, Charlotte
    University of Lund, Department of Physical Therapy.
    Physical therapists' emotional expressions in interviews about factors important for interaction with patients2002Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 86, nr 5, s. 229-40Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Interactions: between patients and physiotherapists have been studied by various researchers. Some results indicate that physiotherapists have an awareness of underlying emotions, but often respond only on an intellectual level. It seems that verbally expressed emotions may be important for interaction between physiotherapists and patients during treatment. Aim: The aim of this study was to investigate how many and what verbally expressed emotions physiotherapists state during interviews between physiotherapists and patients. Method: The study was a qualitative case study with cross-case analysis according to Shepard et al (1993) and Merriam (1988). Ten informants participated, all of them 'experts in interaction with patients', women, Swedish-speaking, and with at least five years' experience in primary health care. The physiotherapists' emotions were categorised according to Tomkins (1984) and Izard (1977) in the categories of interest/excitement, surprise/startle, enjoyment/joy, sadness, anger/rage, fear/terror, shame/humiliation, contempt and disgust. Results: Positive emotions such as interest and joy were expressed most often in the interviews, in situations where physiotherapy had been successful, as joyful contacts with colleagues, or in situations where humour was used as a therapeutic instrument. Surprise, sadness and anger were expressed more seldom and contempt or disgust were not expressed at all in the interviews. Conclusion: Verbal expressions of emotions in treatment situations in physiotherapy practice should be promoted more emphatically. This may start a reflective process in both patients and physiotherapists and deepen the understanding of the interaction.

  • 18. Gard, Gunvor
    et al.
    Larsson, Ingalill
    Lund University Hospital, Department of Health Sciences, Division of Physiotherapy.
    Conceptions of physiotherapy knowledge among Swedish physiotherapists: a phenomenographic study2006Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 92, nr 2, s. 110-115Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives and design Knowledge in physiotherapy is based on both scientific evidence and clinical practice. Different perspectives of knowledge generate different implications for theory development. The aim of this qualitative, phenomenographic study was to describe physiotherapists’ conceptions of physiotherapy knowledge. Intervention and participants Open, semi-structured interviews were conducted with 10 physiotherapists working in different sectors of physiotherapy. The transcribed material was analysed according to phenomenographic analysis. Results The physiotherapists’ conceptions of various aspects of physiotherapy knowledge are described by four qualitatively different categories: (a) interaction, i.e. the ability to create opportunities for patients and develop patients’ competencies, equally influenced by both theoretical and practical knowledge, with a patient-oriented perspective conceiving the physiotherapist as a coach; (b) personal competencies, i.e. the ability to provide good therapy influenced more by practical knowledge oriented towards the physiotherapist; (c) professional demands, i.e. the ability to be professional according to rules and scientifically proven interventions, influenced more by theoretical knowledge oriented towards the physiotherapist; and (d) scientific areas, i.e. the ability to use different knowledge, as an expert, in the interaction with the patient, strongly influenced by theoretical knowledge and oriented towards the patient. Conclusions The results can contribute to physiotherapy students’ understanding of the multi-dimensional nature of physiotherapy. The paradigm of physiotherapy must be studied further in order to understand and explain its complexity

  • 19. Gard, Gunvor
    et al.
    Sundén, Bente Thrane
    Lund University, Department of Physical Therapy.
    Life-views of physiotherapy students compared to medical and nursing student2000Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 86, nr 11, s. 576-582Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A life-view is an overall view of man and the world, forming a central value system and giving expression to a fundamental attitude. Research has shown that life-views are established early in childhood, are influenced by social environment and are relatively constant over time. An individual's view of life determines the response to reality and influences decision-making and treatment of other people. The aim of this study was to compare life-views and ethical standpoints of physiotherapy, nursing and medical students at the beginning of their professional education. All physiotherapy students beginning their education at Lund University during 1996 to 1998 answered a questionnaire developed by Josephsson (1994), in total 187 students. The life-views of the physiotherapy students were compared with those of 385 medical students from the Karolinska Institute in Stockholm and 36 student nurses from Lulea University who answered the same questionnaire, which required them to indicate their agreement or otherwise with statements reflecting different life-views. The result showed that all student groups had high or moderate levels of agreement with the sentences reflecting a religious and evolutionary life-view and low agreement with a scientific life-view in Josephsson's terms. When comparing the groups, medical students had the lowest and nursing students the highest agreement with the religious life-view. Physiotherapy students had the highest agreement with the evolutionary life-view. No significant differences were noted between physiotherapy and nursing students in religious, scientific or evolutionary life-views. Women had higher agreements than men with the religious life-view. Men had higher agreements than women with the scientific and evolutionary life-view. No significant differences were noted in life-views between younger and older students within any student group. All student groups were patient-centred in their opinions on clinical ethical questions

  • 20.
    Hjalmarson, Jenny
    et al.
    KTH, Skolan för teknik och hälsa (STH), Centra, Centrum för hälsa och byggande, CHB.
    Glimskär, Bo
    KTH, Skolan för teknik och hälsa (STH), Centra, Centrum för hälsa och byggande, CHB.
    Getting up from the floor: Older peroples´ abilities and experiencesInngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [en]

    Objectives: To analyse the movement patterns of people over 75 years of age when getting up from the floor, and to find out what they describe as critical moments in getting up.

    Design: Observation of old people performing get up from floor and evaluation of experiences in VIDAR evaluation program.

    Setting: Tests were made in a laboratory environment

    Participants: 20 participants, eleven women and nine men. The mean age was 79 years.

    Result: Most elderly persons in this case did experience difficulties in getting up. The difficulties were mainly described in legs and were related to discomfort, weakness and balance issues. Most of the participants 18 of 20 made the getting up by themselves. The most of the participants 18 of 20 preferred a getting up including a position kneeling. The most critical part in getting were lifting one leg forward and then stretch the legs after kneeling, 17 of 18 described difficulties in this part.

    Conclusions: When developing aids to help persons to get up the main goal should be to reduce load on legs and support balance for the user. Training should include balance and muscle exercise of the leg.

  • 21.
    Holmes, Melissa N. Galea
    et al.
    Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Psychol, Hlth Psychol Sect, Guys Hosp Campus, London SE1 9RT, England.;UCL, Dept Appl Hlth Res, London, England..
    Wileman, Vari
    Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Psychol, Hlth Psychol Sect, Guys Hosp Campus, London SE1 9RT, England..
    McCracken, Lance M.
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi. Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Psychol, Hlth Psychol Sect, Guys Hosp Campus, London SE1 9RT, England..
    Critchley, Duncan
    Kings Coll London, Fac Life Sci & Med, Sch Populat Hlth & Environm Sci, Dept Physiotherapy, Guys Campus London, London SE1 1UL, England..
    March, Marie K.
    Western Sydney Local Hlth Dist, Physiotherapy Dept, Blacktown Mt Druitt Hosp, Blacktown Rd, Blacktown, NSW 2147, Australia.;Univ Sydney, Fac Med & Hlth, Discipline Physiotherapy, Sydney, NSW 2006, Australia..
    Norton, Sam
    Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Psychol, Hlth Psychol Sect, Guys Hosp Campus, London SE1 9RT, England.;Kings Coll London, Fac Life Sci & Med, Ctr Rheumat Dis, Sch Immunol & Microbial Sci, Guys Hosp Campus, London SE1 9RT, England..
    Moss-Morris, Rona
    Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Psychol, Hlth Psychol Sect, Guys Hosp Campus, London SE1 9RT, England..
    Noonan, Sandra
    Guys & St Thomas Hosp NHS Fdn Trust, Dept Physiotherapy, London SE1 9RT, England..
    Barcellona, Massimo
    Kings Coll Hosp NHS Fdn Trust, London SE5 9RS, England..
    Godfrey, Emma
    Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Psychol, Hlth Psychol Sect, Guys Hosp Campus, London SE1 9RT, England.;Kings Coll London, Fac Life Sci & Med, Sch Populat Hlth & Environm Sci, Dept Physiotherapy, Guys Campus London, London SE1 1UL, England..
    Experiences of training and delivery of Physical therapy informed by Acceptance and Commitment Therapy (PACT): a longitudinal qualitative study2021Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 112, s. 41-48Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives Physiotherapy informed by Acceptance and Commitment Therapy (PACT) is a novel intervention that is related to improved disability and functioning in people with chronic lowback pain. This study explored physiotherapists experiences over time of the PACT training programme and intervention delivery. Design A longitudinal qualitative study using semi-structured, in-depth, individual interviews at three time points was conducted. Methods A phenomenological approach underpinned the methods. Interviews followed topic-guides developed a priori. Transcribed interviews were coded inductively to generate themes. Data were member checked by participants and validated by two researchers. Participants Eight clinical physiotherapists from three secondary care centres in the United Kingdom (n = 5 female; age, 24 to 44 years; duration of practice, 3 to 14 years) were included. Results Five themes emerged from the data. Experiential learning techniques were challenging but valued because they bridged theoretical principles and concepts with practice. Ongoing individual and group supervision was beneficial, but required tailoring and tapering. PACT delivery extended physiotherapy skills and practice, including techniques that acknowledged and addressed patient treatment expectations. With experience, participants desired greater flexibility and autonomy to tailor PACT delivery. Conclusions PACT training and delivery were acceptable to physiotherapists. Existing skills were developed and additional, applicable approaches were provided that addressed psychosocial and behavioural aspects of chronic low back pain. (c) 2021 Chartered Society of Physiotherapy. 

  • 22.
    Hébert-Losier, K.
    et al.
    The University of Waikato, Tauranga, New Zealand.
    Wessman, C.
    The Sahlgrenska Academy, University of Gothenburg.
    Alricsson, Marie
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap.
    Svantesson, U.
    University of Gothenburg.
    Updated reliability and normative values for the standing heel-rise test in healthy adults2017Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 103, nr 4, s. 446-452Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: The heel-rise test is used to assess the strength and endurance of the plantar flexors in everyday clinical practice. However, several factors may affect outcomes, including sex, age, body mass index and activity level. The aims of this study were to revisit the reliability and normative values of this test, and establish normative equations accounting for several factors. Design: Cross-sectional observational study with test-retest. Setting: Community. Participants: Volunteers (n = 566, age 20 to 81 years). Interventions: Subjects performed single-legged heel rises to fatigue, standing on a 10° incline, once on each leg. A subset of subjects (n = 32) repeated the test 1 week later. Reliability was quantified using intraclass (ICC) correlation coefficients and Bland-Altman plots (mean difference [95% limits of agreement (LOA)]), whereas the impact of sex, age, body mass index and activity level on the number of heel rises was determined using non-parametric regression models. Results: The test showed excellent reliability (ICC = 1.0 right leg, 1.0 left leg), with mean between-day differences in the total number of heel-rise repetitions of 0.2 (95% LOA -6.2 to 6.5) and 0.1 (95% LOA -6.1 to 6.2) for right and left legs, respectively. Overall, males completed more repetitions than females (median 24 vs 21). However, older females (age >60. years) outperformed older males. According to the model, younger males with higher activity levels can complete the most heel rises. Conclusions: The heel-rise test is highly reliable. The regression models herein can be employed by clinicians to evaluate the outcomes of heel-rise tests of individuals against a comparable normative population.

  • 23.
    Hébert-Losier, K.
    et al.
    The University of Waikato, New Zealand.
    Wessman, C.
    University of Gothenburg, Sweden.
    Alricsson, Marie
    Mid Sweden University, Sweden.
    Svantesson, U.
    University of Gothenburg, Sweden.
    Updated reliability and normative values for the standing heel-rise test in healthy adults2017Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 103, nr 4, s. 446-452Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives

    The heel-rise test is used to assess the strength and endurance of the plantar flexors in everyday clinical practice. However, several factors may affect outcomes, including sex, age, body mass index and activity level. The aims of this study were to revisit the reliability and normative values of this test, and establish normative equations accounting for several factors.

    Design

    Cross-sectional observational study with test–retest.

    Setting

    Community.

    Participants

    Volunteers (n = 566, age 20 to 81 years).

    Interventions

    Subjects performed single-legged heel rises to fatigue, standing on a 10° incline. A subset of subjects (n = 32) repeated the test 1 week later. Reliability was quantified using intraclass (ICC) correlation coefficients and Bland-Altman plots {mean difference [95% confidence interval (CI)]}, whereas the impact of sex, age, body mass index and activity level on the number of heel rises was determined using non-parametric regression models.

    Results

    The test showed excellent reliability (ICC = 0.96), with mean between-day differences in the total number of heel-rise repetitions of 0.2 (95% CI −6.2 to 6.5) and 0.1 (95% CI −6.1 to 6.2) for right and left legs, respectively. Overall, males completed more repetitions than females (median 24 vs 21). However, older females (age >60 years) outperformed older males. According to the model, younger males with higher activity levels can complete the most heel rises.

    Conclusions

    The heel-rise test is highly reliable. The regression models herein can be employed by clinicians to evaluate the outcomes of heel-rise tests of individuals against a comparable normative population.

  • 24.
    Hébert-Losier, Kim
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap.
    Holmberg, Hans-Christer
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap.
    Exercise prescription to prevent injuries during recreational skiing and snowboarding2015Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 101, nr Suppl. 1, s. e552-Artikkel i tidsskrift (Fagfellevurdert)
    Fulltekst (pdf)
    fulltext
  • 25.
    Hébert-Losier, Kim
    et al.
    Mittuniversitetet, Avdelningen för hälsovetenskap.
    Holmberg, Hans-Christer
    Mittuniversitetet, Avdelningen för hälsovetenskap.
    Exercise prescription to prevent injuries during recreational skiing and snowboarding2015Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 101, nr Suppl. 1, s. e552-Artikkel i tidsskrift (Fagfellevurdert)
  • 26.
    Janaudis-Ferreira, Tania
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Sundelin, Gunnevi
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Wadell, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Comparison of the 6-minute walk distance test performed on a non-motorised treadmill and in a corridor in healthy elderly subjects2010Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 96, nr 3, s. 234-239Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To compare the 6-minute walk distance (6MWD) test performed on a non-motorised treadmill (6MWD-T) with the 6MWD test performed in a corridor (6MWD-C) in healthy elderly subjects.

    PARTICIPANTS: Sixteen healthy elderly individuals.

    DESIGN: Participants performed three 6MWD-T tests and three 6MWD-C tests on two different days.

    OUTCOME MEASURES: Distance walked was recorded in metres. Perceived exertion and leg fatigue were rated on the modified Borg scale before and after each test.

    RESULTS: Using the Bland and Altman limits of agreement analysis method, the mean difference between the two methods was 153.3m (limits of agreement: 28 to 278). The mean difference between days 1 and 2 for the 6MWD-C test was -7.2m (limits of agreement: -45.4 to 30.8), and the mean difference between days 1 and 2 for the 6MWD-T test was -1.6m (limits of agreement: -64.0 to 60.7). The mean difference between the first and second repetitions of the 6MWD-C test was -5m (limits of agreement: -41 to 31), and the mean difference between the first and second repetitions of the 6MWD-T test was -17m (limits of agreement: -85 to 51).

    CONCLUSIONS: The 6MWD-C and 6MWD-T tests are not interchangeable. However, the results showed good test-retest reliability between days and between test repetitions for both tests. Therefore, the 6MWD-T test may offer an alternative option to the 6MWD-C test when a 30-m corridor is not available. These findings may have implications for execution of the 6MWT-T test within cardiac and pulmonary rehabilitation.

  • 27.
    Jonsson, Marcus
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Physiotherapy.
    Hurtig-Wennlöf, Anita
    Örebro universitet, Institutionen för hälsovetenskaper. Department of Medical Diagnostics.
    Ahlsson, Anders
    Cardiovascular Division, Karolinska University Hospital, Stockholm, Sweden.
    Vidlund, Mårten
    Department of Vascular and Cardiothoracic Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Cao, Yang
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Westerdahl, Elisabeth
    Örebro universitet, Institutionen för hälsovetenskaper. Region Örebro län. Department of Physiotherapy.
    In-hospital physiotherapy improves physical activity level after lung cancer surgery: a randomized controlled trial2019Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 105, nr 4, s. 434-441Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: Patients undergoing lung cancer surgery are routinely offered physiotherapy. Despite its routine use, effects on postoperative physical recovery have yet not been demonstrated. The aim of this study was to investigate whether physiotherapy could improve postoperative in-hospital physical activity level and physical capacity.

    DESIGN: Single-blind randomized controlled trial.

    SETTING: Thoracic surgery department at a University Hospital.

    PARTICIPANTS: Patients undergoing elective thoracic surgery (n=94) for confirmed or suspected lung cancer were assessed during hospital stay.

    INTERVENTION: Daily physiotherapy, consisting of mobilization, ambulation, shoulder exercises and breathing exercises. The control group received no physiotherapy treatment.

    OUTCOMES: In-hospital physical activity assessed with the Actigraph GT3X+ accelerometer, six-minute walk test, spirometry and dyspnea scores.

    RESULTS: The treatment group reached significantly more accelerometer counts (2010 (1508) vs 1629 (1146), mean difference 495 [95% CI 44 to 1109]), and steps per hour (49 (47) vs 37 (34), mean difference 14 [95% CI 3 to 30]), compared to the control group, during the first three postoperative days. No significant differences in six-minute walk test (percent of preoperative 71% vs 79%, P=0.13), spirometry (FEV1 percent of preoperative 69% vs 69%, P=0.83) or dyspnoea (M-MRC 2 vs 2, P=0.74) between the groups were found.

    CONCLUSIONS: Patients receiving in-hospital physiotherapy showed increased level of physical activity during the first days after lung cancer surgery, compared to an untreated control group. However, no effects on the six-minute walk test or spirometric values were found. The clinical importance of an increased physical activity level during the early postoperative period needs to be further evaluated.

    CLINICAL TRIAL REGISTRATION NUMBER: NCT01961700.

  • 28.
    Köhn, M.
    et al.
    Nora Health Care Centre, Örebro County Council, Nora, Sweden.
    Persson Lundholm, U.
    Nora Health Care Centre, Örebro County Council, Nora, Sweden.
    Bryngelsson, I.
    Department of Occupational and Environmental Medicine, Örebro University Hospital, Örebro, Sweden.
    Anderzen-Carlsson, Agneta
    Centre for Health Care Sciences, Örebro University Hospital, Örebro, Sweden.
    Westerdahl, Elisabeth
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Örebro University Hospital, Örebro, Sweden.
    Medical yoga for patients with stress-related symptoms in primary health care2015Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 101, nr Sup. 1, artikkel-id e1621Artikkel i tidsskrift (Fagfellevurdert)
  • 29.
    Landén Ludvigsson, Maria
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för sjukgymnastik. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Primärvården i västra länsdelen.
    Enthoven, Paul
    Linköpings universitet, Institutionen för medicin och hälsa, Sjukgymnastik. Linköpings universitet, Hälsouniversitetet.
    Evaluation of physiotherapists as primary assessors of patients with musculoskeletal disorders seeking primary health care2012Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 98, nr 2, s. 131-137Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives To evaluate primary physiotherapist assessment and management of patients with musculoskeletal disorders in primary care, and to compare patient satisfaction with primary assessment by a physiotherapist or a general practitioner (GP). less thanbrgreater than less thanbrgreater thanDesign An observational, retrospective cohort study reviewing medical records, and a separate consecutive non-randomised study of patient satisfaction. less thanbrgreater than less thanbrgreater thanSetting Primary healthcare centre. less thanbrgreater than less thanbrgreater thanParticipants Four hundred and thirty-two patients with musculoskeletal disorders, primarily assessed by a physiotherapist. Fifty-one of these patients primarily assessed by a physiotherapist and 42 patients assessed by a GP answered a patient satisfaction questionnaire. less thanbrgreater than less thanbrgreater thanInterventions Primary assessment and management of patients with musculoskeletal disorders. less thanbrgreater than less thanbrgreater thanMain outcome measures Data from medical records within 3-month after the visit, and patient satisfaction questionnaire. less thanbrgreater than less thanbrgreater thanResults Eighty-five percent (367/432) of patients did not need to see a GP. Serious pathologies were found among the 6% (26/432) of patients who were referred to a GP by a physiotherapist, but no serious pathologies were found among the 9% (39/432) of patients who subsequently returned for a GP appointment for the same disorder. Patients assessed by a physiotherapist were more satisfied with the information received about their disorder and self-care than patients assessed by a GP. Patients also had higher confidence in the ability of physiotherapists to assess their disorder (P andlt; 0.002). less thanbrgreater than less thanbrgreater thanConclusion Physiotherapists can be considered primary assessors of patients with musculoskeletal disorders in primary care as few patients needed additional assessment by a GP, patients with confirmed serious pathologies were identified by the physiotherapists, and patients were satisfied with assessment by a physiotherapist.

    Fulltekst (pdf)
    fulltext
  • 30.
    Mikaelsson, Katarina
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Michaelson, Peter
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Inactivity in adolescents, what are the effects on physical capacity?2011Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 97, nr Suppl. 1, s. eS808-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: The aim of the study was to investigate the effect of physical activity on physical capacity among graduates from upper secondary school.Relevance: Physical activity and physical fitness are important health related parameters, which both have declined the last decades. Adolescents who are about to leave compulsory school and physical education are supposed to peak regarding physical capacity. Therefore it is interesting to investigate the effect physical inactivity (according to WHO-recommendation) have on physical performance.Participants: The participants where third grade students (38 female and 61 male) from upper secondary school (18 - 20 years).Methods: International Physical Activity Questionnaire (IPAQ) was used to estimate the level of physical activity. The participants were divided, in accordance with World Health Organizations recommendations for physical activity, to A) physically inactive or B) physically active. Physical fitness was tested using the Åstrand bicycle test and functional tests of muscular strength and balance.Analysis: By Student's independent t-test, separate for females and males, differences in aerobic capacity, push-ups, grip strength, vertical jump height, sit-ups and balance, between physically inactive and active were tested.Results: Maximum oxygen uptake differed significantly between physically inactive and active males (mean ± SD: 3.0 ± 0.6 l/kg, vs. 3.6 ± 0.7 p = 0.002) and females (2.5± 0.3 l/kg, vs. 3.0 ± 0.6 p = 0.016). There was a difference among physically inactive and active males regarding push-ups (28.5 ± 7.0 vs. 37.1 ± 9.0, p < 0.001) and sit-ups (39.6 ± 19.4 vs. 59.2 ± 30.2, p = 0.010). No significant differences were found regarding vertical jump or grip strength among males, any of the muscle strength measurements among females, and balance (in any sex).Conclusions: The level of physical activity was related to aerobic capacity in both sexes, but did not seem to have the same impact on muscular fitness and balance, especially concerning the females. Since aerobic capacity is an important parameter in preventing future health problems, it is crucial to engage all adolescents in physical activity.Implications: According to this study physical activity have positive effects on aerobic capacity, without similar trend in muscle strength. Addressing strength training, as complement to aerobic training should be recommended regardless of level of physical activity performed. Therefore we see a future need for promoting and designing detailed guidelines regarding strength training for children and adolescents.

  • 31.
    Mikaelsson, Katarina
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Michaelson, Peter
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Is self-rated physical activity a good indicator of physical capacity and is time spent sitting negative for physical capacity?2011Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 97, nr Suppl. 1, s. eS805-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: The aim of this study was to relate levels of physical activity to physical capacity and to study whether time sitting influences physical capacity among students in upper secondary school.Relevance: Physical activity and physical fitness are important health related parameters. Modern living habits with increased time spent on sedentary behaviors like watching TV and computer gaming have a potential for a negative influence. This calls for reliable and cost-effective measures of physical activities as indicators of physical capacity as tools for identifying people with an inactive lifestyle.Participants: Research participants where 99 third grade students (38 female, 61 male) from upper secondary school in Sweden (18-20 years).Methods: Levels of physical activity was established using the International Physical Activity Questionnaire (IPAQ) and determined for both 1) Level of activity (Total, Vigorous, Moderate, Walking), 2) IPAQ-classification Amount of activity (High, Medium, Low) and 3) Time sitting. Physical fitness was measured using the Åstrand bicycle test and functional tests of muscular strength.Analysis: The relation between 1) Level of activity, 2) IPAQ- amount of activity and 3) Time sitting and physical capacity was investigated by separate linear regression analyses.Results: There were a relation between Total level of activity and A) aerobic capacity (l/min2) (R2 = 0.1, p = 0.001), B) push-ups (R2 = 0.05, p = 0.011), and C) sit-ups (R2 = 0.046, p = 0.016), while other measure of physical capacity was non significant. An identical pattern was reveled for activity performed on Vigorous level with A) aerobic capacity (l/min2) (R2 = 0.2, p < 0.000), B) push-ups (R2 = 0.16, p < 0.000) and C) sit-ups (R2 = 0.082, p = 0.023). For activity on Moderate level the only significant relation was with aerobic capacity (R2 = 0.033, p = 0.033). For Walking no relation was significant. Regarding the IPAQ-classification of High-, Medium, and Low physical activity, no relation with any measures of physical capacity was found. Further, surprisingly, no relation was found between Time sitting and any measures of physical capacity.Conclusions: The results imply that the intensity of physical activity is of importance for achieving high aerobic capacity, while the amount of activity is not. Further, our results indicate that time sitting is not related to physical capacity.Implications: The self-rated questionnaire IPAQ can be questioned for use as a direct indicator of health parameters as physical capacity. Further, it seems that the intensity of activity is of importance for physical performance.

  • 32.
    Nordqvist, Jenny
    et al.
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten.
    Öberg, Birgitta
    Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård.
    Adolfsson, Lars
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Avdelningen för kirurgi, ortopedi och onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Ortopedkliniken i Linköping.
    Holmgren, Theresa
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Ortopedkliniken i Linköping. Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Avdelningen för kirurgi, ortopedi och onkologi.
    Johansson, Kajsa
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i östra Östergötland, Rehab Öst.
    Heterogeneity among patients with subacromial pain – variabilities within clinical presentation and its impact on daily life2021Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 112, s. 113-120Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: The primary aim was to describe the variability within clinical presentation of patients with subacromial pain in primary care, secondly to investigate associations between clinical presentation and self-reported pain intensity, shoulder function, level of anxiety and depression, and health-related quality of life. Design and setting A cross-sectional study based on data from two clinical studies in primary care, one randomized controlled trial and one implementation study. Three components: active range of motion (AROM), rotator cuff function and scapular kinematics were analyzed to describe variability within clinical presentation and patient-reported measurements were used to investigate the impact on daily life. Participants Patients aged 30-67 years, describing pain for more than two weeks, and positive signs for a minimum of three out of the following five clinical tests: impingement sign according to Neer, impingement test according to Hawkins-Kennedy, Pattes maneuver, Jobe’s test, and painful arc. Results Among the 164 patients included, 24% displayed dysfunction in one, 50% two and 24% in all three components. Limited AROM was seen in 46%, rotator cuff dysfunction in 91% and scapular dyskinesia in 57% of the patients. Conclusions These results reveal a heterogeneity among primary care patients with subacromial pain confirming a large variability regarding the components AROM, rotator cuff function and scapular kinematics. All three components appear unique (not significantly correlated) where a rotator cuff dysfunction is very frequent while limited AROM and scapular dyskinesia are more inconsistent. There are significant, but rather weak, associations between clinical presentation and impact on daily life.

  • 33.
    Olsson, Lillemor Lundin
    et al.
    Umeå universitet, Institutionen för Samhällsmedicin och Rehabilitering. Sjukgymnastik.
    Pohl, Petra
    Umeå universitet, Institutionen för Samhällsmedicin och Rehabilitering. Sjukgymnastik.
    Sandlund, Marlene
    Umeå universitet, Institutionen för Samhällsmedicin och Rehabilitering. Sjukgymnastik.
    Ahlgren, Christina
    Umeå universitet, Institutionen för Samhällsmedicin och Rehabilitering. Sjukgymnastik.
    Bergvall-Kåreborn, Birgitta
    Luleå tekniska universitet, Institutionen för system- och rymdteknik, Datavetenskap.
    Melander-Wikman, Anita
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Fall risk awareness in older community-dwelling people in northern Sweden: A qualitative study with focus groups2015Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 101, nr Suppl. 1, s. e1217-Artikkel i tidsskrift (Fagfellevurdert)
  • 34.
    Overmeer, Thomas
    et al.
    Örebro universitet, Hälsoakademin.
    Linton, Steven J.
    Örebro universitet, Institutionen för beteende-, social- och rättsvetenskap.
    Boersma, Katja
    Department of Occupational and Environmental Medicine, Örebro University Hospital, Örebro, Sweden.
    Do physical therapists recognise established risk factors?: Swedish physical therapists' evaluation in comparison to guidelines2004Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 90, nr 1, s. 35-41Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background and purpose The Swedish Council on Technology Assessment in Health Care has widely distributed the most recent Swedish evidence-based review on neck and back pain. In this review psychosocial factors were acknowledged as important risk factors for developing chronic pain. We surveyed physical therapists’ evaluation of risk factors for the development of chronic pain. The results were compared to the review of the Swedish Council on Technology Assessment in Health Care.

    Methods A postal questionnaire was sent to all 117 physical therapists working in primary care in Örebro County, Sweden.

    Results The survey was responded to by 102 physical therapists (87%). Over 50% of them indicated as important more than twice as many risk factors than are supported by the evidence-based review.

    More than 50% of the physical therapists pointed out all eight evidence-based factors described in the evidence-based review but they also indicated a median of 10 additional factors with little or no support in the literature. More than 80% of the physical therapists responded according to the recommendations of the evidence-based review concerning sick leave and instructions to patients regarding activities and pain relief. Forty-four physical therapists (43%) indicated that they could predict which patients would develop chronic pain in the future.

    Conclusions Physical therapists represented by this sample were well aware of the importance of psychosocial risk factors, but because of the large number of additional factors indicated it seems physical therapists lack specificity about which factors are important.

  • 35. Peolsson, A.
    et al.
    Peolsson, Michael
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Kemiska institutionen.
    Jull, G.
    Löfstedt, Tommy
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Kemiska institutionen.
    Trygg, Johan
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Kemiska institutionen.
    O'Leary, S.
    Preliminary evaluation of dorsal muscle activity during resisted cervical extension in patients with longstanding pain and disability following anterior cervical decompression and fusion surgery2015Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 101, nr 1, s. 69-74Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives To compare mechanical activity (deformation and deformation rate) of the dorsal neck muscles between individuals with longstanding symptoms after anterior cervical decompression and fusion (ACDF) surgery and healthy controls.

    Design Preliminary cross-sectional study.

    Setting Neurosurgery clinic.

    Participants Ten individuals {mean age 60 [standard deviation (SD) 7.111 who had undergone ACDF surgery 10 to 13 years previously and 10 healthy age- and sex-matched controls.

    Main outcomes Mechanical activity of the different layers of dorsal neck muscles, measured at the C4 segment using ultrasonography (speckle tracking analysis) during a standardised, resisted cervical extension task.

    Results A significant group x muscle interaction was found for muscle deformation (P<0.03) but not for deformation rate (P>0.79). The ACDF group showed significantly less deformation of the semispinalis capitis muscle during the extension task compared with the control group [mean 3.12 (SD 2.06) and 6.64 (SD 4.17), respectively; mean difference 3.34 (95% confidence interval 0.54 to 7.21)].

    Conclusions As the semispinalis capitis muscle is a powerful neck extensor, the finding of altered activation following ACDF surgery lends support to the inclusion of exercise to train neck muscle performance in the management of these patients.

  • 36.
    Peolsson, Anneli
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. University of Queensland, Australia.
    Peolsson, M.
    Umeå University, Sweden; Umeå University, Sweden.
    Jull, G.
    University of Queensland, Australia.
    Loefstedt, T.
    Umeå University, Sweden.
    Trygg, J.
    Umeå University, Sweden.
    OLeary, S.
    University of Queensland, Australia; Royal Brisbane and Womens Hospital, Australia.
    Preliminary evaluation of dorsal muscle activity during resisted cervical extension in patients with longstanding pain and disability following anterior cervical decompression and fusion surgery2015Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 101, nr 1, s. 69-74Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives To compare mechanical activity (deformation and deformation rate) of the dorsal neck muscles between individuals with longstanding symptoms after anterior cervical decompression and fusion (ACDF) surgery and healthy controls. Design Preliminary cross-sectional study. Setting Neurosurgery clinic. Participants Ten individuals {mean age 60 [standard deviation (SD) 7.111 who had undergone ACDF surgery 10 to 13 years previously and 10 healthy age- and sex-matched controls. Main outcomes Mechanical activity of the different layers of dorsal neck muscles, measured at the C4 segment using ultrasonography (speckle tracking analysis) during a standardised, resisted cervical extension task. Results A significant group x muscle interaction was found for muscle deformation (Pless than0.03) but not for deformation rate (Pgreater than0.79). The ACDF group showed significantly less deformation of the semispinalis capitis muscle during the extension task compared with the control group [mean 3.12 (SD 2.06) and 6.64 (SD 4.17), respectively; mean difference 3.34 (95% confidence interval 0.54 to 7.21)]. Conclusions As the semispinalis capitis muscle is a powerful neck extensor, the finding of altered activation following ACDF surgery lends support to the inclusion of exercise to train neck muscle performance in the management of these patients. (C) 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

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    fulltext
  • 37. Rasmussen-Barr, E.
    et al.
    Granstrom, H.
    Äng, Björn
    Inter- and intra-observer reliability of three movement control tests for the lumbo-pelvic complex2015Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 101, nr suppl. 1, s. e1259-e1260Artikkel i tidsskrift (Fagfellevurdert)
  • 38.
    Rehn, Börje
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Occurence and type of neck pain among drivers of forest machines and the sociation with whole-body vibration exposere2007Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 93, s. S323-Artikkel i tidsskrift (Fagfellevurdert)
  • 39.
    Sandlund, Jonas
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning. Department for Community Medicine and Rehabilitation, Umeå University.
    Srinivasan, Divya
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Mathiassen, Svend Erik
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Consistency of individual motor variability patterns in repetitive precision work2015Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 101, nr Suppl. 1, s. e1334-e1335Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [en]

    Background:

    A longstanding hypothesis in physical therapy and occupational research is that workers repeating a task very stereotypically will be more prone to develop musculoskeletal disorders than workers that manage to vary postures and loads. Increased movement variability (MV), presumably, modify tissue loads, distribute stresses more equally, and thus reduce the cumulative load on any particular tissue. A handful of studies of MV have indicated less overuse injuries and faster recovery from musculoskeletal pain disorders. Even when repeating strictly controlled tasks individuals may differ in motor consistency, some showing higher levels of MV than others. However, whether the extent of MV is indeed a consistent individual trait across different tasks and different days is not known.

    Purpose:

    To investigate whether individual profiles of MV is stabile between days, the consistency of MV patterns from kinematic recordings, repeated across three days, was studied when performing repetitive upper-extremity precision work.

    Methods:

    A laboratory-based simulation of precision work; a 'pipetting' task paradigm, was developed in which liquid was repeatedly transferred from one tube to another, with a cycle time of 2.8s. Fourteen healthy female subjects, aged 20-45 years, right-handed and with experience in pipetting participated on 3 different days under identical conditions. Kinematic data were obtained using an electromagnetic motion capture system (FASTRAK). MV in shoulder elevation, elbow flexion and shoulder-elbow coordination were operationalized using cycle-to-cycle standard deviations across 20 pipetting cycles of kinematics parameters including joint range of motion, average and peak velocities, time to peak velocities, average angle and phase. Multivariate analysis was conducted using principal component analysis (PCA) (SIMCA+P, 12.0) to analyze relationships among variables and individual patterns in the data matrix of the recordings from day1. Thereafter, in order to confirm the observed structure of inter-individual MV patterns, classification of the data from day2 and day3 was performed using the parameters of the model from day1.

    Results:

    Four PCA components (Eigenvalues>1) accounted for 80 percent of the total variance in the model for day1. In the subsequent prediction model where data from day2 and 3 were projected into the model of day1, all subject observations except one could be predicted with 95% confidence (Hotelling T2). And individual data scores from all three days were clustered in relative proximity to each other, indicating consistency in MV between days.

    Conclusion(s):

    The findings indicate, even in this small and homogenous sample of young healthy females, that there may indeed be consistent individual traits in motor variability. A next step would be to answer whether these traits remain consistent if work factors such as work pace or precision are altered, and whether individual profiles of MV are associated with physiological responses related to risk for developing musculoskeletal disorders.

    Implications:

    Consistency of individual MV patterns substantiate previous notions that some people appear prone to repeat themselves while others tend to vary their motor behavior when performing the same task. Assessment of MV by physical therapists in research and practice could be valuable to further explore and address the relation of MV and musculoskeletal health.

  • 40.
    Westerdahl, Elisabeth
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Deep breathing techniques after cardiac surgery2015Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 101, nr Sup. 1, s. e1622-e1623Artikkel i tidsskrift (Fagfellevurdert)
  • 41.
    Westerdahl, Elisabeth
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Wittrin, A.
    Örebro University Hospital, Örebro, Sweden.
    Kånåhols, M.
    Örebro University Hospital, Örebro, Sweden.
    Gunnarsson, Martin
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Nilsagård, Ylva
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Breathing exercises for patients with multiple sclerosis: a randomized controlled trial2015Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 101, nr Sup. 1, artikkel-id e1622Artikkel i tidsskrift (Fagfellevurdert)
  • 42. Wolf, S. L.
    et al.
    Kwakkel, G.
    Bayley, M.
    McDonnell, M. N.
    Best practice for arm recovery post stroke: an international application2016Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 102, nr 1, s. 1-4Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To develop an evidence-based application ('app') for post-stroke upper extremity rehabilitation that can be used globally by therapists.

    PARTICIPANTS: Twenty-three experienced neurorehabilitation therapists, applied scientists and physicians, and 10 consultants dedicated to the provision of best practice to stroke survivors.

    DESIGN: This team evaluated the evidence to support the timely and appropriate provision of interventions and the most defensible outcome measures during a 4-year voluntary information gathering and assimilation effort, as a basis for the sequencing of an algorithm informed by the data and directed by changes in impairment and chronicity.

    OUTCOME MEASURES: The primary outcome was the formulation of a testable app that will be available for minimal user cost. The app is for a smartphone, and the comments of a focus group (audience at a World Confederation for Physical Therapy 2015 presentation, approximate n=175) during a 30-minute 'Questions and Answers' session were assessed.

    RESULTS: Analysis of documented, extensive input offered by the audience indicated a highly favourable disposition towards this novel tool, with provision of concrete suggestions prior to launching the final version. Suggestions centred on: inclusion of instructions; visuals and demonstrations; monitoring of adverse responses; availability of updates; autonomous use by patients; and potential to characterise practice.

    CONCLUSIONS: A simple, user-friendly app for decision making in the treatment of upper extremity impairments following stroke is feasible and welcomed.

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