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  • 151.
    Lauche, Romy
    et al.
    University of Duisburg-Essen, Germany .
    Cramer, Holger
    University of Duisburg-Essen, Germany .
    Langhorst, Jost
    University of Duisburg-Essen, Germany .
    Dobos, Gustav
    University of Duisburg-Essen, Germany .
    Gerdle, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Neck pain intensity does not predict pressure pain hyperalgesia: re-analysis of seven randomized controlled trials2014Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 46, nr 6, s. 553-560Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES:

    To determine factors, including pain intensity, associated with pressure pain sensitivity in chronic non-specific neck pain and with changes after therapeutic interventions.

    METHODS:

    This re-analysis used pooled data from 7 randomized controlled clinical trials. Pressure pain thresholds were assessed at the hand and at the site of maximal pain in the neck region before and after different non-pharmacological interventions. Age, gender, neck pain intensity and duration, mental health, expectancy and time interval between measurements were used to determine factors influencing pressure pain thresholds as well as pressure pain threshold changes.

    RESULTS:

    A total of 346 patients (77 males, 269 females, mean age 52.6 years (standard deviation 12.0 years)) were included in study, 306 of whom provided a complete data-set for analysis. Pressure pain thresholds at the neck area or the hand did not correlate with pain intensity. Changes in pressure pain thresholds correlated with time between measurements, indicating time-sensitive changes.

    DISCUSSION:

    No coherent correlations between pressure pain thresholds and pain intensity were found. Further research is needed to evaluate the relationship between pain intensity and pressure pain thresholds before its use as a valid substitute of pain rating can be supported. Until then, the results of trials with respect to using pressure pain thresholds as an outcome variable must be interpreted with care.

  • 152.
    Lemming, Dag
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Graven-Nielsen, Thomas
    Aalborg University, Denmark .
    Sörensen, Jan
    Linköpings universitet, Institutionen för medicin och hälsa, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Arendt-Nielsen, Lars
    Aalborg University, Denmark .
    Gerdle, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Widespread pain hypersensitivity and facilitated temporal summation of deep tissue pain in whiplash associated disorder: an explorative study of women2012Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 44, nr 8, s. 648-657Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: Widespread deep tissue pain hyperalgesia was evaluated in women with chronic whiplash associated disorder (n=25) and controls (n=10) using computerized cuff pressure algometry and hypertonic saline infusion. Methods: A pneumatic double-chamber cuff was placed around: (i) the arm and (ii) the leg. Cuff inflation rate was constant and the pain intensity was registered continuously on a visual analogue scale (VAS); thresholds of detection and tolerance were extracted. For assessment of spatial summation the protocol was repeated with a single-chamber cuff inflated around the leg. Temporal summation of pain was assessed from the leg with constant cuff pressure stimulation at 2 different pressure intensities for 10 min. Hypertonic saline was infused in the tibialis anterior muscle. Results: Cuff pressure pain thresholds were lower in subjects with whiplash associated disorder compared with controls (pless than0.05). Tonic pressure stimulation evoked higher maximal VAS and larger areas under the VAS curve in subjects with whiplash associated disorder compared with controls (pless than0.05). The pain threshold and tolerance were higher during single cuff than double cuff stimulation. The area under the VAS curve after intramuscular saline infusion was larger in whiplash associated disorder (pless than0.05). Conclusion: The results indicated widespread hyperalgesia in chronic whiplash associated disorder and facilitated temporal summation outside the primary pain area, suggesting involvement of central sensitization.

  • 153. Lexell, Jan
    et al.
    Flansbjer, Ulla-Britt
    Department of Rehabilitation, Lund University Hospital, Sweden.
    Holmbäck, Anna Maria
    Department of Rehabilitation, Lund University Hospital, Sweden.
    Downham, David
    Department of Rehabilitation, Lund University Hospital, Sweden.
    Patten, Carolynn
    Department of Rehabilitation, Lund University Hospital, Sweden.
    Reliability of gait performance tests in men and women with hemiparesis after stroke.2005Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 37, nr 2, s. 75-82Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To assess the reliability of 6 gait performance tests in individuals with chronic mild to moderate post-stroke hemiparesis. Design: An intra-rater (between occasions) test-retest reliability study. Subjects: Fifty men and women (mean age 58+/-6.4 years) 6-46 months post-stroke. METHODS: The Timed "Up & Go" test, the Comfortable and the Fast Gait Speed tests, the Stair Climbing ascend and descend tests and the 6-Minute Walk test were assessed 7 days apart. Reliability was evaluated with the intraclass correlation coefficient (ICC(2,1)), the Bland & Altman analysis, the standard error of measurement (SEM and SEM%) and the smallest real difference (SRD and SRD%). RESULTS: Test-retest agreements were high (ICC(2,1) 0.94-0.99) with no discernible systematic differences between the tests. The standard error of measurement (SEM%), representing the smallest change that indicates a real (clinical) improvement for a group of individuals, was small (< 9%). The smallest real difference (SRD%), representing the smallest change that indicates a real (clinical) improvement for a single individual, was also small (13-23%). CONCLUSION: These commonly used gait performance tests are highly reliable and can be recommended to evaluate improvements in various aspects of gait performance in individuals with chronic mild to moderate hemiparesis after stroke

  • 154. Lexell, Jan
    et al.
    Holmbäck, Anna-Maria
    Department of Physical Therapy, Lund University.
    Downham, David
    Department of Mathematical Sciences, University of Liverpool.
    Porter, Michell M
    Faculty of Physical Education and Recreation Studies, University of Manitoba, Winnipeg, Manitoba.
    Ankle dorsiflexor muscle performance in healthy young men and women: reliability of eccentric peak torque and work measurements2001Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 33, nr 2, s. 90-96Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aims of this study were: (i) to assess the test-retest intrarater reliability of eccentric ankle dorsiflexor muscle performance in young healthy men and women using the Biodex dynamometer; and (ii) to examine different statistical indices for the interpretation of reliability. Thirty men and women (age 22.5 +/- 2.5 years, mean +/- S.D.) performed three maximal eccentric contractions at 30 degrees/second and 90 degrees/second, with 7-10 days between test sessions. Reliability was evaluated with three intraclass correlation coefficients (ICC1,1, ICC2,1 and ICC3,1), and was excellent for peak torque (ICC 0.90-0.96) and good to excellent for work (ICC 0.69-0.83), with no discernible differences among the three ICCs. Method errors, assessed by the standard error of the measurement (S.E.M.) and S.E.M.%, were low. The Bland & Altman graphs and analyses indicated no significant systematic bias in the data. In conclusion, measurements of eccentric ankle dorsiflexor muscle performance in young healthy individuals using the Biodex are highly reliable.

  • 155. Lexell, Jan
    et al.
    Malec, James F.
    Rehabilitation Hospital of Indiana and Indiana University School of Medicine.
    Jacobsson, Lars J.
    Medical Rehabilitation Section, Department of General Medicine, Kalix Hospitral.
    Mapping the Mayo-Portland Adaptability Inventory to the International Classification of Functioning, Disability and Health2012Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 44, nr 1, s. 65-72Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To examine the contents of the Mayo-Portland Adaptability Inventory (MPAI-4) by mapping it to the International Classification of Functioning, Disability and Health (ICF). Methods: Each of the 30 scoreable items in the MPAI-4 was mapped to the most precise ICF categories. Results: All 30 items could be mapped to components and categories in the ICF. A total of 88 meaningful concepts were identified. There were, on average, 2.9 meaningful concepts per item, and 65% of all concepts could be mapped. Items in the Ability and Adjustment subscales mapped to categories in both the Body Functions and Activity/Participation components of the ICF, whereas all except 1 in the Participation subscale were to categories in the Activity/Participation component. The items could also be mapped to 34 (13%) of the 258 Environmental Factors in the ICF. Conclusion: This mapping provides better definition through more concrete examples (as listed in the ICF) of the types of body functions, activities, and participation indicators that are represented by the 30 scoreable MPAI-4 items. This may assist users throughout the world in understanding the intent of each item, and support further development and the possibility to report results in the form of an ICF categorical profile, making it universally interpretable

  • 156.
    Lindberg, Thomas
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Laboratoriet för biomekanik och motorisk kontroll (BMC).
    Arndt, Anton
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Laboratoriet för biomekanik och motorisk kontroll (BMC).
    Norrbrink, Cecilia
    Department of Clinical Sciences, Karolinska Institutet Danderyd Hospital, Stockholm, Sweden.
    Wahman, Kerstin
    Department of Neurobiology, Care Sciences and Society (NVS), Division of Neurorehabilitation, Karolinska Institutet.
    Bjerkefors, Anna
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Laboratoriet för biomekanik och motorisk kontroll (BMC).
    Effects of seated double-poling ergometer training on aerobic and mechanical power in individuals with spinal cord injury2012Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 44, nr 10, s. 893-898Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To determine whether regular interval training on a seated double-poling ergometer can increase physical capacity and safely improve performance towards maximal level in individuals with spinal cord injury.

    METHODS: A total of 13 subjects with spinal cord injury (injury levels T5-L1) performed 30 sessions of seated double-poling ergometer training over a period of 10 weeks. Sub-maximal and maximal double-poling ergometer tests were performed before (test-retest) and after this training period. Oxygen uptake was measured using the Douglas Bag system. Three-dimensional kinematics were recorded using an optoelectronic system and piezoelectric force sensors were used to register force in both poles.

    RESULTS: The mean intra-class correlation coefficient for test-retest values was 0.83 (standard deviation 0.11). After training significant improvements were observed in people with spinal cord injury in oxygen uptake (22.7%), ventilation (20.7%) and blood lactate level (22.0%) during maximal exertion exercises. Mean power per stroke and peak pole force increased by 15.4% and 23.7%, respectively. At sub-maximal level, significantly lower values were observed in ventilation (-12.8%) and blood lactate level (-25.0%).

    CONCLUSION: Regular interval training on the seated double-poling ergometer was effective for individuals with spinal cord injury below T5 level in terms of improving aerobic capacity and upper-body power output. The training was safe and did not cause any overload symptoms.

  • 157.
    Lindner, Helen Y. N.
    et al.
    Örebro universitet, Hälsoakademin. Centre for Rehabilitation Research, Örebro University Hospital, Örebro, Sweden.
    Linacre, John M.
    Department of Occupational Therapy, University of Sydney, Sydney, Australia.
    Hermansson, Liselotte M. N.
    Centre for Rehabilitation Research, Örebro University Hospital, Örebro, Sweden.
    Assessment of capacity for myoelectric control: evaluation of construct and rating scale2009Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 41, nr 6, s. 467-474Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To examine the construct and rating scale of the Assessment of Capacity for Myoelectric Control, an assessment to evaluate ability in using a prosthetic hand.

    Design: Cross-sectional study. Subjects: Upper limb prosthesis users with different prosthetic levels/sides and prosthetic experience were included (n=96).

    Methods: Subjects' assessments with the Assessment of Capacity for Myoelectric Control were collected by 6 raters during their regular hospital visits. Rasch analysis was used, since it allowed an analysis of the data at the item and category levels. Dimension, item hierarchy and item fit statistics were used to examine the construct. Different Rasch parameters were used to examine rating scale structure and its use.

    Results: The consistency of item difficulties with clinical knowledge and the unidimensionality confirmed that the construct is valid. Two items functioned unexpectedly (misfit), but the misfit was idiosyncratic to the sample, not systematic to the items. The 4-point rating scale usefully differentiated the subjects on the basis of their abilities. The use of category 2 was somewhat redundant.

    Conclusion: The Assessment of Capacity for Myoelectric Control is a valid assessment that evaluates ability in using a prosthetic hand. Revision of the category 2 definition would improve the functioning of the rating scale.

  • 158.
    Lindström, Britta
    et al.
    Umeå University, Department of Community Medicine and Rehabilitation.
    Röding, Jenny
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Sundelin, Gunnevi
    Umeå University, Department of Community Medicine and Rehabilitation.
    Positive attitudes and preserved high level of motor performance are important factors for return to work in younger persons after stroke: a national survey2009Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 41, nr 9, s. 714-718Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: Significant numbers of younger persons with stroke should be given the opportunity to return to work. The aim of this study was to investigate factors of importance for return to work among persons after first ever stroke, in the age range 18-55 years. Methods: A questionnaire was sent to all persons who had experienced a first ever stroke, 18-55 years of age, registered in the Swedish national quality register for stroke care, Riks-Stroke. Of the 1068 who answered the questionnaire, 855 (539 men and 316 women) were in paid employment before their stroke, and were included in this study. Results:Sixty-five percent returned to work and, of these, an equal proportion were men and women. Significant factors associated with return to work were the perceived importance of work (odds ratio (OR) 5.10), not perceiving themselves as a burden on others (OR 3.33), support from others for return to work (OR 3.66), retaining the ability to run a short distance (OR 2.77), and higher socioeconomic codes (OR 2.12). A negative association was found between those rehabilitated in wards intended for younger persons and return to work (OR 0.37). Conclusion: External support from others, and positive attitudes towards return to work, were factors associated with successful return to work after stroke. Contrary to what was expected, independence in personal activities of daily living and cognitive factors were not associated with return to work to the same extent as persistent higher level of physical functions, such as ability to run a short distance.

  • 159.
    Lindström, Britta
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Röding, Jenny
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Sundelin, Gunnevi
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Positive attitudes to work and preserved high level of motor performance are important factors for return to work in younger persons after stroke: A national survey2009Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 41, s. 714-718Artikkel i tidsskrift (Fagfellevurdert)
  • 160.
    Lo, Hiu Kwan
    et al.
    Univ Queensland, Australia.
    Johnston, Venerina
    Univ Queensland, Australia.
    Landen Ludvigsson, Maria
    Linköping Univ, Sweden.
    Peterson, Gunnel
    Linköping Univ, Sweden.
    Overmeer, Thomas
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Örebro University, Sweden.
    David, Michael
    Univ Queensland, Australia.
    Peolsson, Anneli
    Linköping Univ, Sweden.
    Factors associated with work ability following exercise interventions for people with chronic whiplash-associated disorders: Secondary analysis of a randomized controlled trial2018Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 50, nr 9, s. 828-836Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To investigate the efficacy of exercise interventions and factors associated with changes in work ability for people with chronic whiplash-associated disorders. Design: Secondary analysis of a single-blind, randomized multi-centre controlled trial. Setting: Interventions were conducted in Swedish primary care settings. Patients: A total of 165 individuals with chronic whiplash-associated disorders grade II-III. Methods: Participants were randomly allocated to neck-specific exercise, neck-specific exercise with a behavioural approach, or prescribed physical activity interventions. Work ability was evaluated with the Work Ability Index at baseline, 3, 6 and 12 months. Results: The neck-specific exercise with a behavioural approach intervention significantly improved work ability compared with the prescribed physical activity intervention (3 months, p = 0.03; 6 months, p = 0.01; 12 months, p = 0.01), and neck-specific exercise at 12 months (p = 0.01). Neck-specific exercise was better than the prescribed physical activity intervention at 6 months (p = 0.05). An increase in work ability from baseline to one year for the neck-specific exercise with a behavioural approach group (p < 0.01) was the only significant within-group difference. Higher self-rated physical demands at work, greater disability, greater depression and poorer financial situation were associated with poorer work ability (p < 0.01). Conclusion: This study found that neck-specific exercise with a behavioural approach intervention was better at improving self-reported work ability than neck-specific exercise or prescribed physical activity. Improvement in work ability is associated with a variety of factors.

  • 161.
    Lo, Hiu Kwan
    et al.
    The University of Queensland, Australia.
    Johnston, Venerina
    The University of Queensland, Australia.
    Landén Ludvigsson, Maria
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i västra Östergötland, Rehab Väst.
    Peterson, Gunnel
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Overmeer, Thomas
    Mälardalen University, Sweden, Örebro University, Sweden.
    David, Michael
    The University of Queensland, Australia; The University of Newcastle, Newcastle, Australia.
    Peolsson, Anneli
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Factors associated with work ability following exercise interventions for people with chronic whiplash-associated disorders: Secondary analysis of a randomized controlled trial.2018Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 50Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To investigate the efficacy of exercise interventions and factors associated with changes in work ability for people with chronic whiplash-associated disorders.

    DESIGN: Secondary analysis of a single-blind, randomized multi-centre controlled trial.

    SETTING: Interventions were conducted in Swedish primary care settings.

    PATIENTS: A total of 165 individuals with chronic whiplash-associated disorders grade II-III.

    METHODS: Participants were randomly allocated to neck-specific exercise, neck-specific exercise with a behavioural approach, or prescribed physical activity interventions. Work ability was evaluated with the Work Ability Index at baseline, 3, 6 and 12 months.

    RESULTS: The neck-specific exercise with a behavioural approach intervention significantly improved work ability compared with the prescribed physical activity intervention (3 months, p = 0.03; 6 months, p = 0.01; 12 months, p = 0.01), and neck-specific exercise at 12 months (p = 0.01). Neck-specific exercise was better than the prescribed physical activity intervention at 6 months (p = 0.05). An increase in work ability from baseline to one year for the neck-specific exercise with a behavioural approach group (p < 0.01) was the only significant within-group difference. Higher self-rated physical demands at work, greater disability, greater depression and poorer financial situation were associated with poorer work ability (p < 0.01).

    CONCLUSION: This study found that neck-specific exercise with a behavioural approach intervention was better at improving self-reported work ability than neck-specific exercise or prescribed physical activity. Improvement in work ability is associated with a variety of factors.

  • 162.
    Lo, Hiu Kwan
    et al.
    Univ Queensland, Div Physiotherapy, Sch Hlth & Rehabil Sci, Brisbane, Qld, Australia.
    Johnston, Venerina
    Univ Queensland, Div Physiotherapy, Sch Hlth & Rehabil Sci, Brisbane, Qld, Australia; Univ Queensland, Recover Injury Res Ctr, Brisbane, Qld, Australia.
    Landén Ludvigsson, Maria
    Linköping Univ, Dept Med & Hlth Sci, Div Physiotherapy, Linköping, Sweden; Cty Council Östergötland, Rehab Vast, Motala, Sweden; Linköping Univ, Dept Rehabil, Linköping, Sweden; Linköping Univ, Dept Med & Hlth Sci, Linköping, Sweden.
    Peterson, Gunnel
    Linköping Univ, Dept Med & Hlth Sci, Div Physiotherapy, Linköping, Sweden.
    Overmeer, Thomas
    Mälardalen Univ, Sch Hlth Care & Social Welf, Physiotherapy Dept, Västerås, Sweden; Örebro Univ, Ctr Hlth & Med Psychol, Örebro, Sweden.
    David, Michael
    Univ Queensland, Sch Publ Hlth, Brisbane, Qld, Australia; Univ Newcastle, Sch Med & Publ Hlth, Newcastle, NSW, Australia.
    Peolsson, Anneli
    Linköping Univ, Dept Med & Hlth Sci, Div Physiotherapy, Linköping, Sweden.
    Factors associated with work ability following exercise interventions for people with chronic whiplash-associated disorders: Secondary analysis of a randomized controlled trial2018Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 50, nr 9, s. 828-836Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To investigate the efficacy of exercise interventions and factors associated with changes in work ability for people with chronic whiplash-associated disorders.

    Design: Secondary analysis of a single-blind, randomized multi-centre controlled trial.

    Setting: Interventions were conducted in Swedish primary care settings.

    Patients: A total of 165 individuals with chronic whiplash-associated disorders grade II–III.

    Methods: Participants were randomly allocated to neck-specific exercise, neck-specific exercise with a behavioural approach, or prescribed physical activity interventions. Work ability was evaluated with the Work Ability Index at baseline, 3, 6 and 12 months.

    Results: The neck-specific exercise with a behavioural approach intervention significantly improved work ability compared with the prescribed physical activity intervention (3 months, p = 0.03; 6 months, p = 0.01; 12 months, p = 0.01), and neck-specific exercise at 12 months (p = 0.01). Neck-specific exercise was better than the prescribed physical activity intervention at 6 months (p = 0.05). An increase in work ability from baseline to one year for the neck-specific exercise with a behavioural approach group (p < 0.01) was the only significant within-group difference. Higher self-rated physical demands at work, greater disability, greater depression and poorer financial situation were associated with poorer work ability (p < 0.01).

    Conclusion: This study found that neck-specific exercise with a behavioural approach intervention was better at improving self-reported work ability than neck-specific exercise or prescribed physical activity. Improvement in work ability is associated with a variety of factors.

  • 163.
    Ludvigsson, Maria Landen
    et al.
    Linkoping Univ, Div Physiotherapy, Dept Med & Hlth Sci, SE-58183 Linkoping, Sweden.;Cty Council Ostergotland, Rehab Vast, Motala, Sweden..
    Peterson, Gunnel
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Linkoping Univ, Div Physiotherapy, Dept Med & Hlth Sci, SE-58183 Linkoping, Sweden.;Cty Council Sormland, Katrineholm, Sweden..
    Dedering, Asa
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Physiotherapy, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Phys Therapy, Stockholm, Sweden..
    Peolsson, Anneli
    Linkoping Univ, Div Physiotherapy, Dept Med & Hlth Sci, SE-58183 Linkoping, Sweden..
    One- And Two-Year Follow-Up Of A Randomized Trial Of Neck Specific Exercise With Or Without A Behavioural Approach Compared With Prescription Of Physical Activity In Chronic Whiplash Disorder2016Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 48, nr 1, s. 56-64Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To explore whether neck-specific exercise, with or without a behavioural approach, has benefits after 1 and 2 years compared with prescribed physical activity regarding pain, self-rated functioning/disability, and self-efficacy in management of chronic whiplash. Design: Follow-up of a randomized, assessor blinded, clinical trial. Patients: A total of 216 volunteers with chronic whiplash associated disorders, grades 2 or 3. Methods: Participants were randomized to 1 of 3 exercise interventions: neck-specific exercise with or without a behavioural approach, or physical activity prescription. Self-rated pain (visual analogue scale), disability/functioning (Neck Disability Index/Patient Specific Functional Scale) and self-efficacy (Self-Efficacy Scale) were evaluated after 1 and 2 years. Results: Both neck-specific exercise groups maintained more improvement regarding disability/functioning than the prescribed physical activity group at both time-points (p <= 0.02). At 1 year, 61% of subjects in the neck-specific group reported at least 50% pain reduction, compared with 26% of those in the physical activity prescription group (p < 0.001), but at 2 years the difference was not significant. Conclusion: After 1-2 years, participants with chronic whiplash who were randomized to neck-specific exercise, with or without a behavioural approach, remained more improved than participants who were prescribed general physical activity.

  • 164.
    Lundström, Erik
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Neurologi.
    Smits, Anja
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Neurologi.
    Terént, Andreas
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Borg, Jörgen
    Time-course and determinants of spasticity during the first six months following first-ever stroke2010Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 42, nr 4, s. 296-301Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose:

    To explore the occurrence of and risk factors for spasticity until six months after first-ever stroke.

    Methods:

    Forty-nine patients were examined at day 2-10, at one month, and at six months. The Modified Ashworth Scale (MAS) was used to assess resistance to passive movements. A comprehensive clinical examination was performed to identify other positive signs of the upper motor neuron syndrome, in accordance with a broader definition of spasticity, and to evaluate if spasticity was disabling. Neurological impairments were determined by use of the National Institutes of Health Stroke Scale and global disability by use of the modified Rankin Scale.

    Results:

    Spasticity was present in two patients (4%) at day 2-10, in 13 patients (27%) at one month, and in 11 patients (23%) at six months. Severe paresis at day 2-10 was associated with a 10-fold higher risk for spasticity at one month (OR=10, 95% CI 2-48). Disabling spasticity was present  in one patient at one month and in 6 patients (13%) at six months.

    Conclusions:

    Spasticity according to MAS usually occurs within one month and disabling spasticity later in a subgroup. Severe paresis of the arm is a risk factor for spasticity.

  • 165.
    Lydell, Marie
    et al.
    Physiotherapy Unit, Primary Health Care, PO Box 113, SE-311 22 Falkenberg, Sweden.
    Baigi, Amir
    Research and Development Unit, Primary Health Care, PO Box 113, SE-311 22 Falkenberg, Sweden.
    Marklund, Bertil
    Research and Development Unit, Primary Health Care, PO Box 113, SE-311 22 Falkenberg, Sweden.
    Månsson, Jörgen
    Research and Development Unit, Primary Health Care, PO Box 113, SE-311 22 Falkenberg, Sweden.
    Predictive factors for work capacity in patients with musculoskeletal disorders2005Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 37, nr 5, s. 281-285Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To identify predictive factors for work capacity in patients with musculoskeletal disorders. 

    Design: A descriptive, evaluative, quantitative study. Subjects/Patients: The study was based on 385 patients who participated in a rehabilitation programme. 

    Methods: Patients were divided into 2 groups depending on their ability to work. The groups were compared with each other with regard to sociodemographicfactors, diagnoses, disability pension and number of sick days. The patient's level of exercise habits, ability to undertake activities, physical capacity, pain and quality of life were compared further using logistic regression analysis. 

    Results: Predictive factors for work capacity, such as ability to undertake activities, quality of life and fitness on exercise, were identified as important independent factors. Other well-known factors, i.e. gender, age, education, pain and earlier sickness certification periods, were also identified. Factors that were not significantly different between the groups were employment status, profession, diagnosis and levels of exercise habits. 

    Conclusion: Identifying predictors for ability to return to work is an essential task for deciding on suitable individual rehabilitation. This study identified newpredictive factors, such as ability to undertake activities, quality of life and fitness on exercise.

  • 166.
    Lytsy, Per
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Socialmedicin. Centre for Clinical Research Dalarna, Uppsala University, Falun, Sweden.
    Carlsson, Lars
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin. Centre for Clinical Research Dalarna, Uppsala University, Falun, Sweden.
    Anderzén, Ingrid
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Socialmedicin.
    Effectiveness of two vocational rehabilitation programmes in women with long-term sick leave due to pain syndrome or mental illness: 1-year follow-up of a randomized controlled trial2017Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 49, nr 2, s. 170-177Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: Mental illness and chronic pain are common reasons for long-term sick leave, typically more so for women. This study investigated the effects on return to work of 2 vocational rehabilitation programmes. Methods: In this randomized controlled study, 308 women were allocated to treatment with acceptance and commitment therapy, to multidisciplinary assessment and individualized rehabilitation interventions, or to a control group. Return-to-work at 12 months was assessed as: (i) returning to health insurance; (ii) number of reimbursed health insurance days during follow-up; (iii) self-reported change in working hours; (iv) a composite measure of self-reported change in work-related engagement. Results: The mean age of the Swedish study population was 48.5 years (standard deviation (SD) 6.3 years) and the mean time on sick leave 7.5 years (SD 3.2 years). There were no significant differences in reimbursed days or returning to the health insurance at 12 months. The multidisciplinary assessment and individualized rehabilitation interventions group, compared with control, reported a significant increase in working hours per week, as well as a significant increase in work-related engagement. Conclusion: Multidisciplinary assessments and individual rehabilitation interventions may improve the chance of return-to-work in women with long-term sick leave due to pain condition or mental illness.

  • 167.
    Magnusson, Lina
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Ortopedteknisk plattform. Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering.
    Ahlström, Gerd
    Lunds universitet.
    Ramstrand, Nerrolyn
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Ortopedteknisk plattform. Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering.
    Fransson, Eleonor
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för naturvetenskap och biomedicin. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Malawian prosthetic and orthotic users' mobility and satisfaction with their lower limb assistive device2013Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 45, nr 4, s. 385-391Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To investigate patients’ mobility and satisfaction with their lower limb prosthetic or orthotic device and related service delivery in Malawi and to compare groups of patients regarding type and level of device and demographics.

    METHODS: Questionnaires were used to collect self-report data from 83 patients.

    RESULTS: Ninety percent of prostheses or orthoses were in use by patients, but approximately half of these needed repair. Thirty-nine percent reported pain when using their assistive device. The majority of patients were able to rise from a chair (77%), move around the home (80%), walk on uneven ground (59%) and travel by bus or car (56%). However, patients had difficulties walking up and down hills (78%) and stairs (60%). In general, patients were quite satisfied with their assistive device (mean of 3.9 out of 5) and very satisfied with the service provided (mean of 4.4 out of 5). Access to repairs and servicing were rated as most important, followed by durability and follow-up services. Lack of finances to pay for transport was a barrier to accessing the prosthetic and orthotic centre.

    CONCLUSION: Patients were satisfied with the assistive device and service received, despite reporting pain associated with use of the device and difficulties ambulating on challenging surfaces.

  • 168.
    Magnusson, Lina
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Ortopedteknisk plattform. Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering.
    Ramstrand, Nerrolyn
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. Ortopedteknisk plattform.
    Fransson, Eleonor
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för naturvetenskap och biomedicin. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Ahlström, Gerd
    Lund University.
    Mobility and satisfaction with lower-limb prostheses and orthoses among users in Sierra Leone: A cross-sectional study2014Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 46, nr 5, s. 438-446Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: To investigate patients' mobility and satisfaction with their lower-limb prosthetic or orthotic device and related service delivery in Sierra Leone; to compare groups of patients regarding type and level of assistive device, gender, area of residence, income; and to identify factors associated with satisfaction with the assistive device and service. Methods: A total of 139 patients answered questionnaires, including the Quebec User Evaluation of Satisfaction with Assistive Technology questionnaire (QUEST 2.0). Results: Eighty-six percent of assistive devices were in use, but half needed repair. Thirty-three percent of patients reported pain when using their assistive device. Patients had difficulties or could not walk at all on: uneven ground (65%); hills (75%); and stairs (66%). Patients were quite satisfied with their assistive device and the service (mean 3.7 out of 5 in QUEST), but reported 886 problems. Approximately half of the patients could not access services. In relation to mobility and service delivery, women, orthotic patients and patients using above-knee assistive devices had the poorest results. The general condition of the assistive device and patients' ability to walk on uneven ground were associated with satisfaction with the assistive devices and service. Conclusion: Patients reported high levels of mobility while using their device although they experienced pain and difficulties walking on challenging surfaces. Limitations in the effectiveness of assistive devices and limited access to follow-up services and repairs were issues desired to be addressed.

  • 169.
    Markovic, Gabriela
    et al.
    Karolinska Institute, Sweden.
    Schult, Marie-Louise
    Karolinska Institute, Sweden.
    Bartfai, Aniko
    Karolinska Institute, Sweden.
    Elg, Mattias
    Linköpings universitet, Institutionen för ekonomisk och industriell utveckling, Logistik- och kvalitetsutveckling. Linköpings universitet, Tekniska fakulteten. Linköpings universitet, HELIX Vinn Excellence Centre.
    STATISTICAL PROCESS CONTROL: A FEASIBILITY STUDY OF THE APPLICATION OF TIME-SERIES MEASUREMENT IN EARLY NEUROREHABILITATION AFTER ACQUIRED BRAIN INJURY2017Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 49, nr 2, s. 128-135Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Progress in early cognitive recovery after acquired brain injury is uneven and unpredictable, and thus the evaluation of rehabilitation is complex. The use of time-series measurements is susceptible to statistical change due to process variation. Objective: To evaluate the feasibility of using a time-series method, statistical process control, in early cognitive rehabilitation. Method: Participants were 27 patients with acquired brain injury undergoing interdisciplinary rehabilitation of attention within 4 months post-injury. The outcome measure, the Paced Auditory Serial Addition Test, was analysed using statistical process control. Results: Statistical process control identifies if and when change occurs in the process according to 3 patterns: rapid, steady or stationary performers. The statistical process control method was adjusted, in terms of constructing the baseline and the total number of measurement points, in order to measure a process in change. Conclusion: Statistical process control methodology is feasible for use in early cognitive rehabilitation, since it provides information about change in a process, thus enabling adjustment of the individual treatment response. Together with the results indicating discernible subgroups that respond differently to rehabilitation, statistical process control could be a valid tool in clinical decision-making. This study is a starting-point in understanding the rehabilitation process using a real-time-measurements approach.

  • 170.
    Marnetoft, Sven-Uno
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Selander, J
    Bergroth, Alf
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Ekholm, J
    Factors associated with successful vocational rehabilitation in a Swedish rural area2001Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 33, s. 71-78Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The objective of this study was to identify factors associated with a positive outcome of vocational rehabilitation, and to identify groups that have been successfully rehabilitated in a Swedish rural area. In this study vocational rehabilitation is defined as medical multidisciplinary, psychological, social and occupational activities aiming to re-establish, among sick or injured people with previous work history, their working capacity and prerequisites for returning to the labour market. The study was based on 732 people on registered long-term sick-leave who, in a rural area in northern Sweden during 1992-94, became objects for vocational rehabilitation. Bivariate and stepwise logistic regression analysis was used to identify factors associated with the outcome. By successful vocational rehabilitation is meant reporting well (no economical benefit) at all three Lime-points 6, 12 and 24 months after termination of rehabilitation, or lowered benefit levels. The results indicate that younger, male, employed persons, with an early start on rehabilitation, in a programme entailing education, and partly sick-listed before the start of this programme, had the greatest chance of successful rehabilitation. In contrast, older, female, unemployed people, with a delayed start on rehabilitation, without education, and fully sick-listed before the start, greatly risked being unsuccessful with vocational rehabilitation. The results indicate how to improve the rehabilitation process: several process-related factors shown to be connected with successful vocational rehabilitation include time before the start of rehabilitation, partial instead of full sickness benefit, and education programmes.

  • 171.
    Matuseviciene, Giedre
    et al.
    Karolininska Institutet.
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Karolininska Institutet.
    Nygen DeBoussard, Catharina
    Karolininska Institutet.
    No effect of an early intervention after mild traumatic brain injury on activity and participation: A randomized controlled trial.2016Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 48, nr 1, s. 19-26Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To evaluate measures of activity, participation and quality of life 3 months after mild traumatic brain injury and the effect of an early intervention for patients with an estimated high risk for problems after mild traumatic brain injury.

    PATIENTS: Consecutive patients attending the emergency room with mild traumatic brain injury.

    DESIGN: Randomized controlled trial.

    METHODS: Patients reporting < 3 symptoms after 10 days were considered to have a low risk for prolonged problems. Patients with ≥ 3 symptoms (high-risk patients) were randomized to a visit to a physician or treatment-as-usual. Data on self-reported limitations in activity, restrictions in participation, and quality of life were collected for all patients at 3 months.

    RESULTS: At 3 months post-injury, low-risk patients reported good quality of life and significantly fewer problems in everyday life compared with high-risk patients. The intervention had no effect on activity, participation or quality of life.

    CONCLUSION: Patients who report few symptoms early after mild traumatic brain injury are likely to have a good outcome regarding activity and participation. The intervention offered in this study, focusing on reassurance of a good outcome and treatment of comorbidities, had no effect.

  • 172.
    Matuseviciene, Giedre
    et al.
    Karolininska Institutet.
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Karolininska Institutet.
    Nygen DeBoussard, Catharina
    Karolininska Institutet.
    No effect of an early intervention after mild traumatic brain injury on activity and participation: A randomized controlled trial.2016Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 48, nr 1, s. 19-26Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To evaluate measures of activity, participation and quality of life 3 months after mild traumatic brain injury and the effect of an early intervention for patients with an estimated high risk for problems after mild traumatic brain injury.

    PATIENTS: Consecutive patients attending the emergency room with mild traumatic brain injury.

    DESIGN: Randomized controlled trial.

    METHODS: Patients reporting < 3 symptoms after 10 days were considered to have a low risk for prolonged problems. Patients with ≥ 3 symptoms (high-risk patients) were randomized to a visit to a physician or treatment-as-usual. Data on self-reported limitations in activity, restrictions in participation, and quality of life were collected for all patients at 3 months.

    RESULTS: At 3 months post-injury, low-risk patients reported good quality of life and significantly fewer problems in everyday life compared with high-risk patients. The intervention had no effect on activity, participation or quality of life.

    CONCLUSION: Patients who report few symptoms early after mild traumatic brain injury are likely to have a good outcome regarding activity and participation. The intervention offered in this study, focusing on reassurance of a good outcome and treatment of comorbidities, had no effect.

  • 173.
    Melin, Roland
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin.
    Fugl-Meyer, Axel R
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin.
    On prediction of vocational rehabilitation outcome at a Swedish employability institute2003Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 35, nr 6, s. 284-289Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: The main objective of this investigation was to identify a set of variables usable in early outcome prediction of vocational rehabilitation.

    DESIGN: On commencement of rehabilitation at an employability institute, data were sampled using structured interviews and checklists. Two years later the subjects were followed up by telephone interviews.

    SUBJECTS: The study sample was all unemployed with a somatic disorder as the cause of vocational disability, admitted from October 1995 to December 1996 (n = 149). Of these 109 (73%) agreed to participate.

    METHODS: Initially, data on demography, symptoms, expectations/beliefs about future capacity for gainful employment and sense of coherence (as an indicator of coping resources) were sampled. At follow-up the subjects' vocational situations were recorded.

    RESULTS: At follow-up, 40% were working or employable. Among the about 30 variables included, logistic regression showed that having a relatively high belief in vocational return (odds ratio, OR: 4.6, CI: 1.4-15.4), having a relatively high sense of coherence (OR: 3.5, CI: 1.5-8.4) and having a relatively high educational level (OR: 2.6, CI: 1.1-6.3) were significant predictors of positive outcome.

    CONCLUSION: In this sample, socio-psychological and educational aspects were far more predictive of outcome than were medical circumstances.

  • 174.
    Merrick, Daniel
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    Sundelin, Gunnevi
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Stålnacke, Britt-Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    An observational study of two rehabilitation strategies for patients with chronic pain, focusing on sick leave at one-year follow-up2013Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 45, nr 10, s. 1049-1057Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To follow up 2 rehabilitation strategies for patients with chronic pain: a 2-day interdisciplinary team assessment followed by either (i) a 4-week outpatient multimodal rehabilitation programme, or (ii) a subsequent rehabilitation plan.

    METHODS: After a 2-day interdisciplinary team assessment at our pain rehabilitation clinic, 296 consecutive patients were selected to undergo either multimodal rehabilitation programme (n = 76) or rehabilitation plan (n = 220). They completed questionnaires regarding beliefs about the future (only at assessment), Multidimensional Pain Inventory and sick leave, both at assessment, and at 1-year follow-up.

    RESULTS: Both the rehabilitation plan and multimodal rehabilitation programme groups improved significantly as regards decreased sick leave and the Multidimensional Pain Inventory scales Pain severity, Interference, and Support. The multimodal rehabilitation programme group also improved significantly regarding Life control and Affective distress. For men, low disability level and for women a positive expectation about work was associated with no sick leave at follow-up.

    CONCLUSION: The multimodal rehabilitation programme had long-term positive effects on sick leave and all Multidimensional Pain Inventory scales. However, a less intense intervention (rehabilitation plan) with follow-up in primary care can decrease levels of sick leave and improve some Multidimensional Pain Inventory scales. An interdisciplinary team assessment of patients with chronic pain seems to be useful for selecting which patients should undergo different rehabilitation interventions.

  • 175.
    Merrick, Daniel
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    Sundelin, Gunnevi
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Stålnacke, Britt-Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    One-year follow-up of two different rehabilitation strategies for patients with chronic pain2012Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 44, nr 9, s. 764-773Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To determine outcomes for 2 rehabilitation strategies for patients with chronic pain: a 2-day interdisciplinary team assessment followed by either: (i) a 4-week outpatient multimodal rehabilitation programme, or (ii) a subsequent rehabilitation plan. Methods: After a 2-day interdisciplinary team assessment at our pain rehabilitation clinic 296 consecutive patients were selected to either multimodal rehabilitation (n = 76) or rehabilitation plan (n = 220). They completed questionnaires regarding pain intensity (Visual Analogue Scale), disability (Disability Rating Index), life satisfaction (LiSat-11), anxiety and depression (Hospital Anxiety and Depression Scale) at assessment and again at 1-year follow-up. Results: Both groups showed significant improvements at 1-year follow-up regarding pain intensity. In addition, the multimodal rehabilitation group improved in the disability items ("light work" and "heavy work"), depression and life satisfaction ("leisure", "somatic health", and "psychological health"). In the rehabilitation plan group "somatic health" improved, although not statistically significant. Conclusion: This study indicates that multimodal rehabilitation may have long-term positive effects on pain, disability, depression and domains of life satisfaction. However, a minor intervention, rehabilitation plan with follow-up in primary care, can improve pain and "somatic health". Based on the biopsychosocial approach, an interdisciplinary assessment of patients with chronic pain seems to be of value for selecting patients to different rehabilitation interventions.

  • 176. Michaelson, Peter
    et al.
    Holmberg, David
    Aasa, Björn
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap.
    Aasa, Ulrika
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    High load lifting exercise and low load motor control exercises as interventions for patients with mechanical low back pain: a randomized controlled trial with 24-month follow-up2016Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 48, nr 5, s. 456-463Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: The aim of this study was to compare the effects of a high load lifting exercise with low load motor control exercises on pain intensity, disability and health-related quality of life for patients with mechanical low back pain. Design: A randomized controlled trial. Subjects: Patients with mechanical low back pain as their dominating pain mechanism. Methods: The intervention programme consisted of a high load lifting exercise, while the control group received low load motor control exercises over 8 weeks (12 sessions) with pain education included in both intervention arms. The primary outcome was pain intensity and disability, and the secondary outcome was health-related quality of life. Results: Each intervention arm included 35 participants, analysed following 2-, 12- and 24-month follow-up. There was no significant difference between the high load lifting and low load motor control interventions for the primary or secondary outcome measures. Between 50% and 80% of participants reported a decrease in perceived pain intensity and disability for both short-and long-term follow-up. Conclusion: No difference was observed between the high low load lifting and low load motor control interventions. Both interventions included retraining of movement patterns and pain education, which might explain the positive results over time.

  • 177.
    Michaelson, Peter
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Holmberg, David
    Cederkliniken Primary Health Care Centre.
    Aasa, Björn
    Department of Orthopaedics, Surgical and Perioperative Sciences, Umeå University.
    Aasa, Ulrika
    Umeå University, Department of Community Medicine and Rehabilitation, Division of Physiotherapy.
    High load lifting exercise and low load motor control exercises as interventions for patients with mechanical low back pain: A randomized controlled trial with 24-month follow-up2016Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 48, nr 5, s. 456-463Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: The aim of this study was to compare the effects of a high load lifting exercise with low load motor control exercises on pain intensity, disability and health-related quality of life for patients with mechanical low back pain.DESIGN: A randomized controlled trial.SUBJECTS: Patients with mechanical low back pain as their dominating pain mechanism. METHODS: The intervention programme consisted of a high load lifting exercise, while the control group received low load motor control exercises over 8 weeks (12 sessions) with pain education included in both intervention arms. The primary outcome was pain intensity and disability, and the secondary outcome was health-related quality of life. RESULTS: Each intervention arm included 35 participants, analysed following 2-, 12- and 24-month follow-up. There was no significant difference between the high load lifting and low load motor control interventions for the primary or secondary outcome measures. Between 50% and 80% of participants reported a decrease in perceived pain intensity and disability for both short- and long-term follow-up.CONCLUSION: No difference was observed between the high low load lifting and low load motor control interventions. Both interventions included retraining of movement patterns and pain education, which might explain the positive results over time

  • 178.
    Michaelson, Peter
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Michaelson, M
    Jaric, S
    Latash, ML
    Sjölander, P
    Djupsjöbacka, M
    Vertical posture and head stability in patients with chronic neck pain.2003Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 35, nr 5, s. 229-235Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To evaluate postural performance and head stabilization of patients with chronic neck pain. DESIGN: A single-blind comparative group study. SUBJECTS: Patients with work-related chronic neck pain (n = 9), with chronic whiplash associated disorders (n = 9) and healthy subjects (n = 16). METHODS: During quiet standing in different conditions (e.g. 1 and 2 feet standing, tandem standing, and open and closed eyes) the sway areas and the ability to maintain the postures were measured. The maximal peak-to-peak displacement of the centre of pressure and the head translation were analysed during predictable and unpredictable postural perturbations. RESULTS: Patients with chronic neck pain, in particular those with whiplash-associated disorders, showed larger sway areas and reduced ability to successfully execute more challenging balance tasks. They also displayed larger sway areas and reduced head stability during perturbations. CONCLUSION: The results show that disturbances of postural control in chronic neck pain are dependent on the aetiology, and that it is possible to quantify characteristic postural disturbances in different neck pain conditions. It is suggested that the dissimilarities in postural performance are a reflection of different degrees of disturbances of the proprioceptive input to the central nervous system and/or of the central processing of such input.

  • 179. Michaelson, Peter
    et al.
    Michaelson, Magdalena
    Southern Lapland Research Department, Vilhelmina.
    Jaric, Slobodan
    University of Gävle, Centre of Musculoskeletal Research.
    Latash, Mark L.
    Pennsylvania State University, Department of Kinesiology.
    Sjölander, Per
    Southern Lapland Research Department, Vilhelmina.
    Djupsjöbacka, Mats
    University of Gävle, Centre of Musculoskeletal Research.
    Vertical posture and head stability in patients with chronic neck pain2003Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 35, nr 5, s. 229-35Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To evaluate postural performance and head stabilization of patients with chronic neck pain. DESIGN: A single-blind comparative group study. SUBJECTS: Patients with work-related chronic neck pain (n = 9), with chronic whiplash associated disorders (n = 9) and healthy subjects (n = 16). METHODS: During quiet standing in different conditions (e.g. 1 and 2 feet standing, tandem standing, and open and closed eyes) the sway areas and the ability to maintain the postures were measured. The maximal peak-to-peak displacement of the centre of pressure and the head translation were analysed during predictable and unpredictable postural perturbations. RESULTS: Patients with chronic neck pain, in particular those with whiplash-associated disorders, showed larger sway areas and reduced ability to successfully execute more challenging balance tasks. They also displayed larger sway areas and reduced head stability during perturbations. CONCLUSION: The results show that disturbances of postural control in chronic neck pain are dependent on the aetiology, and that it is possible to quantify characteristic postural disturbances in different neck pain conditions. It is suggested that the dissimilarities in postural performance are a reflection of different degrees of disturbances of the proprioceptive input to the central nervous system and/or of the central processing of such input.

  • 180.
    Nolan, Lee
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Ortopedteknisk plattform.
    A TRAINING PROGRAMME TO IMPROVE HIP STRENGTH IN PERSONS WITH LOWER LIMB AMPUTATION2012Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 44, nr 3, s. 241-248Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To investigate the effect of a 10-week training programme on persons with a lower limb amputation and to determine if this training is sufficient to enable running. Subjects: Seven transtibial, 8 transfemoral and 1 bilateral amputee (all resulting from trauma, tumour or congenital) were randomly assigned to a training (n = 8) or control group (n = 8). Methods: Isokinetic hip flexor and extensor strength at 60 and 120 degrees/s and oxygen consumption while walking at 1.0 m/s were tested pre- and post- a 10-week period. The training group followed a twice weekly hip strengthening programme, while the control group continued with their usual activities. Running ability was determined pretesting, and attempted after post-testing for the training group only. Results: The training group increased hip strength and decreased oxygen consumption. Six amputees who were previously unable to run were able to after training. The control group decreased intact limb hip extensor strength. Conclusion: The training programme is sufficient to improve hip strength and enable running in persons with a lower limb amputation. As hip strength was reduced in those not following the training programme, it is recommended that strength training be undertaken regularly in order to avoid losing limb strength following amputation.

  • 181.
    Nooijen, C. F.
    et al.
    Department of Rehabilitation Medicine, Erasmus MC University Medical Center, Rotterdam.
    Stam, H. J.
    Schoenmakers, I.
    Sluis, T. A.
    Post, M. W.
    Twisk, J. W.
    Group, A. A.
    van den Berg-Emons, R. J.
    Working mechanisms of a behavioural intervention promoting physical activity in persons with subacute spinal cord injury2016Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 48, nr 7, s. 583-8Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: In order to unravel the working mechanisms that underlie the effectiveness of a behavioural intervention promoting physical activity in persons with subacute spinal cord injury, the aim of this study was to assess the mediating effects of physical and psychosocial factors on the intervention effect on physical activity. DESIGN: Randomized controlled trial. SETTING: Four rehabilitation centres in the Netherlands. SUBJECTS: Thirty-nine persons with subacute spinal cord injury. INTERVENTION: Behavioural intervention promoting an active lifestyle, based on motivational interviewing. The intervention involved a total of 13 individual sessions beginning 2 months before and ending 6 months after discharge from initial inpatient rehabilitation. MAIN MEASURES: The potential mediating effects of fatigue, pain, depression, illness cognition, exercise self-efficacy, coping and social support on the effect of the behavioural intervention on objectively measured physical activity (B = 0.35 h, p < 0.01) were studied. Measurements were performed at baseline, discharge, 6 months and 1 year after discharge. RESULTS: No single factor was found that strongly mediated the effect of the behavioural intervention on physical activity; however, multiple factors could partly explain the effect. Mediating effects greater than 10% were found for proactive coping (17.6%), exercise self-efficacy (15.9%), pain disability (15.3%) and helplessness (12.5%). DISCUSSION: Proactive coping (the ability to anticipate and deal with potential threats before they occur), exercise self-efficacy (self-confidence with respect to performing exercise and daily physical activities), pain disability (interference by pain of daily activities) and helplessness (emphasizing the aversive meaning of the disease) are important concepts in interventions promoting physical activity in persons with subacute spinal cord injury.

  • 182.
    Nooijen, Carla F.
    et al.
    Department of Rehabilitation Medicine and Physical Therapy, Rotterdam.
    Post, M. W.
    Spijkerman, D. C.
    Bergen, M. P.
    Stam, H. J.
    van den Berg-Emons, R. J.
    Exercise self-efficacy in persons with spinal cord injury: psychometric properties of the Dutch translation of the Exercise Self-Efficacy Scale2013Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 45, nr 4, s. 347-50Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To assess the reliability and validity of the Dutch version of the exercise self-efficacy scale (ESES) in persons with spinal cord injury. This is the first independent study of ESES psychometric properties, and the first report on ESES test-retest reliability. SUBJECTS/PATIENTS: A total of 53 Dutch persons with spinal cord injury. METHODS: Subjects completed the Dutch ESES twice, with 2 weeks between (ESES_1 and ESES_2). Subjects also completed the General self-efficacy scale (GSE), and a questionnaire regarding demographic characteristics and lesion characteristics. Psychometric properties of the Dutch translation of the ESES were assessed and compared with those of the original English-language version. RESULTS: The Dutch ESES was found to have good internal consistency (Cronbach's alpha for ESES_1 = 0.90, ESES_2 = 0.88). Test-retest reliability was adequate (intra-class correlation coefficient = 0.81, 95% confidence interval 0.70-0.89). For validity, a moderate, statistically significant correlation was found between ESES and the GSE (Spearman's rho ESES_1 = 0.52, ESES_2 = 0.66, p < 0.01). Furthermore, the psychometric properties of the Dutch ESES were found to be similar to those of the original English version. CONCLUSION: The results of this study support the use of the ESES as a reliable and valid measure of exercise self-efficacy.

  • 183.
    Nooijen, Carla
    et al.
    Department of Rehabilitation Medicine and Physical Therapy, Erasmus Medical Center, Rotterdam.
    Slaman, J.
    van der Slot, W.
    Stam, H.
    Roebroeck, M.
    van den Berg-Emons, R.
    Learn2Move Research, Group
    Health-related physical fitness of ambulatory adolescents and young adults with spastic cerebral palsy2014Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 46, nr 7, s. 642-7Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To describe in detail the health-related physical fitness of adolescents and young adults with cerebral palsy, compared with able-bodied references, and to assess differences related to Gross Motor Functioning Classification System (GMFCS) level and distribution of cerebral palsy. DESIGN: Cross-sectional. SUBJECTS: Fifty ambulatory persons with spastic cerebral palsy, GMFCS level I or II, aged 16-24 years. METHODS: Physical fitness measures were: (i) cardiopulmonary fitness by maximal cycle ergometry, (ii) muscle strength, (iii) body mass index and waist circumference, (iv) skin-folds, and (v) lipid profile. RESULTS: Regression analyses, corrected for age and gender, showed that persons with bilateral cerebral palsy had lower cardiopulmonary fitness and lower hip abduction muscle strength than those with unilateral cerebral palsy. Comparisons between persons with GMFCS levels I and II showed a difference only in peak power during cycle ergometry. Cardiopulmonary fitness, hip flexion and knee extension strength were considerably lower (< 75%) in persons with cerebral palsy than reference values. CONCLUSION: The distribution of cerebral palsy affects fitness more than GMFCS level does. Furthermore, adolescents and young adults with cerebral palsy have reduced health-related physical fitness compared with able-bodied persons. This stage of life has a strong influence on adult lifestyle, thus it is an important period for intervention.

  • 184.
    Nordgren, Camilla
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Levi, Richard
    Karolinska Institutet, Stockholm, Sweden.
    Ljunggren, Gunnar
    Karolinska Institutet, Stockholm, Sweden.
    Seiger, Ake
    Karolinska Institutet, Stockholm, Sweden.
    Societal services after traumatic spinal cord injury in Sweden.2003Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 35, nr 3, s. 121-126Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: Societal services after traumatic spinal cord injury in Sweden were investigated, including self-rated levels of satisfaction with the application process and resource allocation.

    DESIGN: Survey of an incidence population.

    SUBJECTS: Thirty-four persons of a total regional incidence population (n = 48) with traumatic spinal cord injury.

    METHODS: Structured interviews using a standardized questionnaire.

    RESULTS: About 25 separate services were identified being available for persons with traumatic spinal cord injury. The average number of applications per person was 5 (range 0-11). The most common service was "transportation service". Of the applications, 17% were partially or totally rejected. Most subjects received information about available services from a social worker. For 13 available services at least 1 subject claimed ignorance about its existence.

    CONCLUSIONS: In Sweden, significant resources are allocated for allowing independence and financial compensation for individuals with traumatic spinal cord injury. However, this support system sometimes also results in frustration and disappointment. Insufficient information and co-ordination are reported as weaknesses. The persons' efforts to acquire knowledge of how the system works take time which could be better used for rehabilitation and full integration into the community.

  • 185.
    Nordgren, Camilla
    et al.
    Neurotec Department, Karolinska Institutet, Stockholm, Sweden and Spinalis SCI Research Unit, Karolinska Institutet, Stockholm, Sweden.
    Richard, Levi
    Neurotec Department, Karolinska Institutet, Stockholm, Sweden and Spinalis SCI Research Unit, Karolinska Institutet, Stockholm, Sweden and Frösunda Center Research Unit, Karolinska Institutet, Stockholm, Sweden.
    Ljunggren, Gunnar
    Neurotec Department, Karolinska Institutet, Stockholm, Sweden.
    Seiger, Åke
    Neurotec Department, Karolinska Institutet, Stockholm, Sweden and Spinalis SCI Research Unit, Karolinska Institutet, Stockholm, Sweden and Frösunda Center Research Unit, Karolinska Institutet, Stockholm, Sweden.
    Societal services after traumatic spinal cord injury in Sweden2003Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 35, nr 3, s. 121-126Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: Societal services after traumatic spinal cord injury in Sweden were investigated, including self-rated levels of satisfaction with the application process and resource allocation.

    DESIGN: Survey of an incidence population.

    SUBJECTS: Thirty-four persons of a total regional incidence population (n = 48) with traumatic spinal cord injury.

    METHODS: Structured interviews using a standardized questionnaire.

    RESULTS: About 25 separate services were identified being available for persons with traumatic spinal cord injury. The average number of applications per person was 5 (range 0-11). The most common service was "transportation service". Of the applications, 17% were partially or totally rejected. Most subjects received information about available services from a social worker. For 13 available services at least 1 subject claimed ignorance about its existence.

    CONCLUSIONS: In Sweden, significant resources are allocated for allowing independence and financial compensation for individuals with traumatic spinal cord injury. However, this support system sometimes also results in frustration and disappointment. Insufficient information and co-ordination are reported as weaknesses. The persons' efforts to acquire knowledge of how the system works take time which could be better used for rehabilitation and full integration into the community.

  • 186. Nordin, Catharina
    et al.
    Gard, Gunvor
    Fjellman-Wiklund, Anncristine
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Being in an exchange process: experiences of patient participation in multimodal pain rehabilitation2013Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 45, nr 6, s. 580-586Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To explore primary healthcare patients' experiences of patients participation in multimodal pain rehabilitation.

    Patients and methods: A total of 17 patients who had completed multimodal rehabilitation for persistent pain were interviewed. The interviews were analysed using qualitative content analysis.

    Results: One theme, Being in an exchange process, and 4 categories emerged. The theme depicted patient participation as a continuous exchange of emotions, thoughts and knowledge. The category Fruitful encounters represented the basic prerequisites for patient participation through dialogue and platforms to meet. Patients' emotional and cognitive resources and restrictions, as well as knowledge gaps, were conditions influencing patient participation in the category Inequality in co-operation. Mutual trust and respect were crucial conditions in patient's personal relationships with the health professionals, forming the category Confidence-inspiring alliance. In the category Competent health professionals, the health professionals' expertise, empathy and personal qualities, were emphasized to favour patient participation.

    Conclusion: Patient participation can be understood as complex and individualized. A confidence-inspiring alliance enables a trusting relationship to be formed between patients and health professionals. Patients emphasized that health professionals need to play an active role in building common ground in the interaction. Understanding each patient's needs in the participation process may favour patient participation.

  • 187.
    Nordin, Catharina
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Fjellman-Wiklund, Anncristine
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University.
    Being in an exchange process: experiences of patient participation in multimodal pain rehabilitation2013Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 45, nr 6, s. 580-586Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To explore primary healthcare patients’ experiences of patients participation in multimodal pain rehabilitation. Patients and methods: A total of 17 patients who had completed multimodal rehabilitation for persistent pain were interviewed. The interviews were analysed using qualitative content analysis. RESULTS: One theme, Being in an exchange process, and 4 categories emerged. The theme depicted patient participation as a continuous exchange of emotions, thoughts and knowledge. The category Fruitful encounters represented the basic prerequisites for patient participation through dialogue and platforms to meet. Patients’ emotional and cognitive resources and restrictions, as well as knowledge gaps, were conditions influencing patient participation in the category Inequality in co-operation. Mutual trust and respect were crucial conditions in patient’s personal relationships with the health professionals, forming the category Confidence-inspiring alliance. In the category Competent health professionals, the health professionals’ expertise, empathy and personal qualities, were emphasized to favour patient participation. CONCLUSION: Patient participation can be understood as complex and individualized. A confidence-inspiring alliance enables a trusting relationship to be formed between patients and health professionals. Patients emphasized that health professionals need to play an active role in building common ground in the interaction. Understanding each patient’s needs in the participation process may favour patient participation.

  • 188.
    Nyberg, André
    et al.
    Heart and Lung Institute, University of Laval, Quebec, Canada.
    Saey, Didier
    Martin, Mickaël
    Maltais, François
    Test-re-test reliability of quadriceps muscle strength measures in people with more severe chronic obstructive pulmonary disease2018Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 50, nr 8, s. 759-764Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To investigate the interday test-retest reliability of volitional and non-volitional measurements of isometric quadriceps strength using a strain-gauge in people with severe to very severe chronic obstructive pulmonary disease.

    DESIGN: Cross-sectional study. Volitional quadriceps measurements consisted of isometric maximal voluntary contractions. Non-volitional measurements were obtained during magnetic potentiated twitch stimulations of the femoral nerve.

    SETTING: Research centre laboratory.

    PARTICIPANTS: Twenty-four individuals with severe to very severe chronic obstructive pulmonary disease (percentage of predicted forced expiratory volume in 1 s, 37% predicted).

    RESULTS: Maximal voluntary contractions and potentiated twitch stimulations measures demonstrated excellent interday test-retest relative reliability (ICC 0.97 and 0.80, respectively), while absolute reliability measures were different between techniques (SEM 1.4 kg, CV 3.2%, MDC 3.9 kg vs SEM 1.5 kg, CV 12.2%, MDC 4.2 kg for maximal voluntary contractions and potentiated twitch stimulations, respectively).

    CONCLUSION: The results supports that maximal voluntary contraction and potentiated twitch stimulation measurements of isometric quadriceps strength are reliable in people with severe to very severe chronic obstructive pulmonary disease as evident excellent relative reliability using both techniques, although the former technique appears to have better absolute reliability.

  • 189.
    Nyberg, Vanja E.
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    Novo, Mehmed
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    Sjölund, Bengt H.
    Changes in multidimensional pain inventory profile after a pain rehabilitation programme indicate the risk of receiving sick leave benefits one year later2014Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 46, nr 10, s. 1006-1013Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: To determine whether coping profile changes after rehabilitation, assessed with the Multidimensional Pain Inventory (MPI), can predict which persons disabled by chronic musculoskeletal pain will be in receipt of sick leave benefits in the long term. Methods: Study of MPI data from 2,784 patients (709 men and 2,075 women) collected from the Swedish Quality Register for Pain Rehabilitation (SQRP) before and at the end of rehabilitation and compared with independent sick leave data for 1 year later. Results: After rehabilitation there was a significantly decreased share of Dysfunctional profiles (DYS) among both men (44% before, 31% after) and women (39% before, 26% after), but an increased share of Adaptive Coper profiles (men 15% before, 24% after, women 14% before, 24% after). The number of patients on full-time sick leave decreased significantly among men (from 57% to 46%) and women (from 57% to 50%). Persons with a DYS profile after rehabilitation had a low probability of having no or part-time sick leave. Conclusion: The number of persons with DYS profiles decreased after rehabilitation. Those with other profiles had less full-time sick leave one year later than those with DYS profiles, indicating that leaving the DYS profile is a positive prognostic sign long-term. Furthermore, the gender differences observed suggest the need to tailor rehabilitative strategies differently for men and women.

  • 190.
    Nyberg, Vanja E
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    Sanne, Harald
    Primary Health Care Service, Occupational Rehab Center, Gothenburg.
    Sjölund, Bengt H
    Dep of Public Health, University of Southern Denmark, Odense.
    Swedish quality registry for pain rehabilitation:: purpose, design, implementation and characteristics of referred patients2011Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 43, nr 1, s. 50-57Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: In order to facilitate comparisons of pain rehabilitationprogrammes in Sweden and to enable audit spirals for single programmes as well as outcome studies, the Swedish Association for Rehabilitation Medicine initiated a national quality registry in 1995.

    Patients: Referred for rehabilitation due to pain-related disability.

    Methods: The registry collects standardized self-reports before assessment, after rehabilitation and one year later, covering demographic, educational and psychometric data, pain intensity, physical disability and life satisfaction. Sick leave data are collected from the National Insurance Board before and up to two years after rehabilitation. At each programme unit self-reports are processed into individual assessment profiles relevant to plan rehabilitation. Data are sent annually to the central registry for analysis and compared with“return to work” data. Each unit can compare its results with national means.

    Results and conclusion: The organization of the registry is described. Data indicating that contextual factors, but not pain characteristics, depression or activity limitations vary between patients referred to different centres, makes comparisons difficult. As of 2007, data from the multidisciplinary assessment of 19,833 patients have been collected. A total of 7289 patients attended a rehabilitation programme, generating two more self-reports. A limitation of the study is a lack of follow-up data from some units.

  • 191. Näslund, Annika
    et al.
    Sundelin, Gunnevi
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Hirschfeld, Helga
    Reach performance and postural adjustments during standing in children with severe spastic diplegia using dynamic ankle-foot orthoses.2007Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 39, nr 9, s. 715-23Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To investigate the co-ordination between reaching, ground reaction forces and muscle activity in standing children with severe spastic diplegia wearing dynamic ankle-foot orthoses compared with typically developing children. DESIGN: Clinical experimental study. SUBJECTS: Six children with spastic diplegia (Gross Motor Function Classification System level III-IV) and 6 controls. METHODS: Ground reaction forces (AMTI force plates), ankle muscle activity (electromyography and displacement of the hand (ELITE systems) were investigated while reaching for an object. RESULTS: For the children with severe spastic diplegia who were wearing dynamic ankle-foot orthoses, co-ordination between upward and forward reach velocity differed regarding the temporal sequencing and amplitude of velocity peaks. During reaching, these children lacked interplay of pushing force beneath the reach leg and braking force beneath the non-reach leg and co-ordinated ankle muscle activity, compared with controls. CONCLUSION: The results suggest differences in reach performance and postural adjustments for balance control during a reaching movement in standing between children with spastic diplegia Gross Motor Function Classification System level III-IV, wearing dynamic ankle-foot orthoses compared with typically developing children.

  • 192.
    Näslund, Annika
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Sundelin, Gunnevi
    Umeå universitet, Institutionen för Samhällsmedicin, Avdelningen för Sjukgymnastik.
    Hirschfeld, Helga
    Karolinska Institutet, Forskningslaboratoriet för motorisk kontroll och sjukgymnastik, Institutionen Neurotec.
    Reach performance and postural adjustments during standing in children with severe spastic diplegia using dynamic ankle-foot orthoses2007Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 39, nr 9, s. 715-23Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To investigate the co-ordination between reaching, ground reaction forces and muscle activity in standing children with severe spastic diplegia wearing dynamic ankle-foot orthoses compared with typically developing children. DESIGN: Clinical experimental study. SUBJECTS: Six children with spastic diplegia (Gross Motor Function Classification System level III-IV) and 6 controls. METHODS: Ground reaction forces (AMTI force plates), ankle muscle activity (electromyography and displacement of the hand (ELITE systems) were investigated while reaching for an object. RESULTS: For the children with severe spastic diplegia who were wearing dynamic ankle-foot orthoses, co-ordination between upward and forward reach velocity differed regarding the temporal sequencing and amplitude of velocity peaks. During reaching, these children lacked interplay of pushing force beneath the reach leg and braking force beneath the non-reach leg and co-ordinated ankle muscle activity, compared with controls. CONCLUSION: The results suggest differences in reach performance and postural adjustments for balance control during a reaching movement in standing between children with spastic diplegia Gross Motor Function Classification System level III-IV, wearing dynamic ankle-foot orthoses compared with typically developing children.

  • 193. Nätterlund, Birgitta
    et al.
    Ahlström, Gerd
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
    Activities of daily living and quality of life in persons with muscular dystrophy.2001Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 33, nr 5, s. 206-211Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The study concerns 77 adults with muscular dystrophy (mean age 49 years) in two counties in Sweden. The purpose was to investigate activities of daily living, quality of life and the relationship between these. Data collection was performed with "the Activity of Daily Living Staircase", "the Self-report Activity of Daily Living" and the Quality of Life Profile. The results indicated that over half of the subjects were dependent on others, chiefly in activities requiring mobility. Muscular dystrophy had mostly negative consequences, and nearly half stated that life would have offered more without it. Few significant diagnosis-related (no gender-related) differences emerged regarding activities of daily living and quality of life. Lower quality of life can only partly be explained by greater disability (r=0.30-0.54). Therefore quality of life as a measurement of rehabilitation outcomes might be based both on physical status, disability and psychosocial factors in terms of positive and negative consequences.

  • 194. Paanalahti, Markku
    et al.
    Lundgren-Nilsson, Asa
    Arndt, Anton
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, Laboratoriet för biomekanik och motorisk kontroll (BMC).
    Sunnerhagen, Katharina S
    Applying the Comprehensive International Classification of Functioning, Disability and Health Core Sets for stroke framework to stroke survivors living in the community.2013Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 45, nr 4, s. 331-40Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: The aims of this study were to explore the perspective of functioning in community-dwelling people with prior stroke and to confirm, if possible, the comprehensive international classification of functioning, disability and health (ICF) Comprehensive Core Set for stroke.

    METHODS: Qualitative interviews were analysed (using the content analysis method and established ICF linking rules) from 22 persons following stroke (age range 59-87 years), as well as their spouses/partners, where relevant.

    RESULTS: Ninety-nine (76%) of 130 second-level ICF categories in the existing Comprehensive ICF Core Set for stroke were confirmed: 31 categories (of 41) in the component of body functions, 38 categories (of 51) in the component of activities and participation, 26 (of 33) in the component of environmental factors and 4 (of 5) in the component of body structures. Eleven additional ICF categories and one personal factor, a coping style of "I take it as it comes" were also identified in the transcribed text.

    CONCLUSION: The Comprehensive ICF Core Set for stroke was largely confirmed.

  • 195.
    Palstam, Annie
    et al.
    Gothenburg University, Sweden; University of Gothenburg Centre Person Centre Care GPCC, Sweden.
    Larsson, Anette
    Gothenburg University, Sweden; University of Gothenburg Centre Person Centre Care GPCC, Sweden.
    Bjersing, Jan
    Gothenburg University, Sweden.
    Lofgren, Monika
    Karolinska Institute, Sweden.
    Ernberg, Malin
    Karolinska Institute, Sweden.
    Bileviciute-Ljungar, Lndre
    Karolinska Institute, Sweden.
    Ghafouri, Bijar
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Arbets- och miljömedicin.
    Sjörs, Anna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet.
    Larsson, Britt
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Gerdle, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Kosek, Eva
    Karolinska Institute, Sweden; Karolinska Institute, Sweden.
    Mannerkorpi, Kaisa
    Gothenburg University, Sweden; University of Gothenburg Centre Person Centre Care GPCC, Sweden .
    PERCEIVED EXERTION AT WORK IN WOMEN WITH FIBROMYALGIA: EXPLANATORY FACTORS AND COMPARISON WITH HEALTHY WOMEN2014Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 46, nr 8, s. 773-780Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To investigate perceived exertion at work in women with fibromyalgia. Design: A controlled cross-sectional multi-centre study. Subjects and methods: Seventy-three women with fibromyalgia and 73 healthy women matched by occupation and physical workload were compared in terms of perceived exertion at work (0-14), muscle strength, 6-min walk test, symptoms rated by Fibromyalgia Impact Questionnaire (FIQ), work status (25-100%), fear avoidance work beliefs (0-42), physical activity at work (7-21) and physical workload (1-5). Spearmans correlation coefficient and linear regression analysis were conducted. Results: Perceived exertion at work was significantly higher in the fibromyalgia group than in the reference group (p=0.002), while physical activity at work did not differ between the groups. Physical capacity was lower and symptom severity higher in fibromyalgia compared with references (pless than0.05). In fibromyalgia, perceived exertion at work showed moderate correlation with physical activity at work, physical workload and fear avoidance work beliefs (r(s) = 0.53 0.65, pless than0.001) and a fair correlation with anxiety (r(s) = 0.26, p=0.027). Regression analysis indicated that the physical activity at work and fear avoidance work beliefs explained 50% of the perceived exertion at work. Conclusion: Women with fibromyalgia perceive an elevated exertion at work, which is associated with physical work-related factors and factors related to fear and anxiety.

  • 196.
    Palstam, Annie
    et al.
    Sahlgrenska Academy, University of Gothenburg.
    Larsson, Anette
    Bjersing, Jan
    Löfgren, Monika
    Ernberg, Malin
    Bileviciute-Ljungar, Indre
    Ghafouri, Bijar
    Sjörs, Anna
    Larsson, Britt
    Mannerkorpi, Kaisa
    Perceived exertion at work in women with fibromyalgia: explanatory factors and comparison with healthy women.2014Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 46, nr 8, s. 773-80Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To investigate perceived exertion at work in women with fibromyalgia.

    DESIGN: A controlled cross-sectional multi-centre study.

    SUBJECTS AND METHODS: Seventy-three women with fibromyalgia and 73 healthy women matched by occupation and physical workload were compared in terms of perceived exertion at work (0-14), muscle strength, 6-min walk test, symptoms rated by Fibromyalgia Impact Questionnaire (FIQ), work status (25-100%), fear avoidance work beliefs (0-42), physical activity at work (7-21) and physical workload (1-5). Spearman's correlation coefficient and linear regression analysis were conducted.

    RESULTS: Perceived exertion at work was significantly higher in the fibromyalgia group than in the reference group (p = 0.002), while physical activity at work did not differ between the groups. Physical capacity was lower and symptom severity higher in fibromyalgia compared with references (p < 0.05). In fibromyalgia, perceived exertion at work showed moderate correlation with physical activity at work, physical workload and fear avoidance work beliefs (rs = 0.53-0.65, p < 0.001) and a fair correlation with anxiety (rs = 0.26, p = 0.027). Regression analysis indicated that the physical activity at work and fear avoidance work beliefs explained 50% of the perceived exertion at work.

    CONCLUSION: Women with fibromyalgia perceive an elevated exertion at work, which is associated with physical work-related factors and factors related to fear and anxiety.

  • 197. Peloso, Paul M
    et al.
    Carroll, Linda J
    Cassidy, J David
    Borg, Jörgen
    von Holst, Hans
    KTH, Skolan för teknik och hälsa (STH), Neuronik.
    Holm, Lena
    Yates, David
    Critical evaluation of the existing guidelines on mild traumatic brain injury.2004Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, nr 43 Suppl, s. 106-12Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The purpose of guidelines is to reduce practice variability, but they need to be evidence-based. We examine current mild traumatic brain injury guidelines, critique their basis in evidence and examine their variability in recommendations. A systematic search of the literature found 38,806 abstracts, with 41 guidelines. There were 18 sports-related guidelines, 13 related to admission policies, 12 related to imaging and 5 related to neuropsychological assessment. Some guidelines addressed several areas. Only 5 guidelines reported a methodology for the assembly of evidence used to develop the guideline. After appraising the guidelines against a validated index, we found that 3 of the 41 guidelines could be categorized as evidence-based. Two of these focused on paediatric patients and 1 on adult patients. Limited methodological quality in the current guidelines results in conflicting recommendations amongst them.

  • 198.
    Peloso, Paul M.
    et al.
    Department of Internal Medicine, University of Iowa Health Center, Iowa City, Iowa, USA.
    von Holst, Hans
    Department of Neurosurgery, Karolinska Institutet, Stockholm, Sweden.
    Borg, Jörgen
    Department of Neuroscience, Rehabilitation Medicine, Uppsala University, Uppsala, Sweden.
    Mild traumatic brain injuries presenting to Swedish hospitals in 1987-20002004Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 36, nr 43, s. 22-27Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To evaluate the incidence and causes of mild traumatic brain injury in Sweden.Design: Retrospective, population-based incidence cohort study.Subjects: All persons presenting to hospitals in Sweden between 1987 and 2000 with a discharge diagnosis of ICD-9 code 850 and ICD-10 code S0.60.Methods: Data source was the Hospital Discharge Register at the National Board of Health and Welfare (Sweden). Incidence rates are stratified by age, gender, mechanism of injury and length of hospital stay.Results: Men had a mean of 209 mild traumatic brain injuries per 100,000 inhabitants and women averaged 148 per 100,000. Men had more mild traumatic brain injury than women at all ages. There were 2 incidence peaks, in the age strata 16-20 years and those over 65 years. Falls were the most common cause of mild traumatic brain injury overall and occurred commonly under the age of 10 years and over the age of 65 years. Motor vehicle and bicycle injuries were the second and third most common causes of mild traumatic brain injury, and had their peak incidence in those aged 16-35 years.Conclusion: Preventative strategies for mild traumatic brain injury should be age and gender specific.

  • 199.
    Peolsson, Anneli
    et al.
    Linköpings universitet, Institutionen för hälsa och samhälle, Sjukgymnastik. Linköpings universitet, Hälsouniversitetet.
    Hedlund, Rund
    Department of Orthopaedics, Huddinge Hospital, Karolinska Institute, Huddinge, Stockholm, Sweden.
    Öberg, Birgitta
    Linköpings universitet, Institutionen för hälsa och samhälle, Sjukgymnastik. Linköpings universitet, Hälsouniversitetet.
    Intra- and inter-tester reliability and reference values for hand strength2001Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 33, nr 1, s. 36-41Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The intra- and inter-tester reliability for measurement of handgrip strength and indexgrip strength using the Jamar dynamometer was investigated in 32 healthy volunteers, and the intra-tester reliability in 13 patients with cervical radiculopathy. The results from the reliability studies showed that handgrip and indexgrip strength measured with the Jamar dynamometer is a reliable method (ICC values 0.85-0.98) and can be recommended for use in clinical practice. Age- and sex-specific reference values for handgrip strength and indexgrip strength were measured with the Jamar dynamometer in 101 randomly selected healthy volunteers, aged 25-64 years. The results from the reference value study showed that sex is a more important determinant of hand strength than age, height and body weight. The reference values for hand strength improve the potential for objective evaluation of patients with arm/hand disorders caused by cervical radiculopathy.

  • 200.
    Peolsson, Anneli
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för sjukgymnastik. Linköpings universitet, Hälsouniversitetet. NHMRC CCRE (Spinal Pain, Injury and Health), The University of Queensland, Brisbane, Australia.
    Peolsson, Michael
    Computational Life Science Cluster and Department of Chemistry, Umeå University, Umeå.
    Jull, Gwendolen
    NHMRC CCRE (Spinal Pain, Injury and Health), The University of Queensland, Brisbane, Australia.
    O Leary, Shaun
    NHMRC CCRE (Spinal Pain, Injury and Health), The University of Queensland, Brisbane, Australia and Physiotherapy Department, Royal Brisbane and Womens Hospital, Queensland Health, Queensland, Australia.
    Is there a difference in the pattern of muscle activity when performing neck exercises with a guild board versus a pulley?2013Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 45, nr 9, s. 900-905Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: Guild boards and pulleys are apparatus commonly used to train cervical muscle function for their purported benefit in facilitating activity of the deeper muscle layers, although this effect has not been substantiated. The objective of this study was to compare the activity of the different layers of cervical muscles when performing exercise with these 2 types of apparatus. Subjects: A total of 19 healthy persons (mean age 28 years, (standard deviation 7 years). Design: Ultrasound measurements of muscle deformation and deformation rate were recorded from the dorsal and ventral neck muscle layers during extension and flexion exercises. Pulley exercises were performed in the upright sitting position against a standardized resistance (men 2 kg, women 1 kg) and guild board exercises at an angle of 45 degrees. Results: The dorsal muscles generally showed greater levels of deformation and deformation rate during exercise with the guild board compared with the pulley system (p<0.05), but with no significant differences in relative activity between the deep and superficial muscle layers (condition x muscle interaction (p>0.05)). No differences were observed for the ventral muscles between exercise methods (p>0.05). Conclusion: While both exercise methods appear to train cervical muscle function, neither appear to be more selective in facilitating deep cervical muscle activity, probably as they involve very similar cervical kinematics.

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