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  • 201.
    Jonsson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Mobility,pain provocative and palpatory tests in patients with neck pain -A systematic review of intra- and inter raterreliability: -A systematic review of intra- and inter rater reliability2013Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
  • 202.
    Jonsson, Jonas
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hagberg, Jennifer
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Valued competencies and attributes in newly graduated physiotherapists: an employer's of view2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 203.
    Jonsvens, Evelina
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Andersson, Malin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Inter- och intra-bedömarreliabilitet för goniometermätnng av passiv höftledsextension hos hund2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 204.
    Kalla, Berndt
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Radierande stötvågsterapi som behandling vid tendinos i Achilessenans mellan portion.: - En studie med Singel Subject Experimental Design2013Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Smärtor från Achillessenan är   vanligt förekommande och drabbbar individer oavsett ålder, kön och   aktivitetsnivå men är vanligare hos löpare. Studier har visat att 6 % - 18 %   av alla skador hos löpare är från Achillessenan. Skadan uppkommer vanligtvis   i 35-55 års ålder.

    Syfte: Syftet med föreliggande studie var att undersöka om behandling med   radierande stötvågsterapi under tre tillfällen hade effekt på smärtan,   funktion och aktivitet vid tendinos i Achilessenans mellanportion.

    Metod: Singel Subject Experimental   Design med A1-B-A2 formation valdes. Fem deltagare med smärta i hälsenan/hälsenorna   under belastning inkluderades i studien. Smärta skulle ha varat mer än tre månader   och diagnosen mellanportion Achillestendions verifierats via ultraljud.  Smärta, funktion och aktivitetsnivå   utvärderades med VAS och VISA-A. Behandlingarna med radierande stötvågsterapi   genomfördes vid tre tillfällen med en veckas intervaller. Uppföljningen   genomfördes tre månader efter sista behandlingen.

    Resultat: Resultatet visade att alla   deltagare uppnådde en signifikant minskad smärta under interventionsperioden   och för tre av deltagarna kvarstod effekten även under uppföljningsfasen. Tre   av deltagarna skattade signifikant bättre funktion på VISA-A under   interventionsperioden och hos två av dessa kvarstod denna signifikanta   förbättring under uppföljningsperioden.

    Konklusion: Föreliggande studie visar   att behandling med radierade stötvågsterapi vid tre tillfällen har effekt på   smärta, funktion och aktivitet vid mellanportion Achillestendinos. Vidare   studier av hög kvalité och större grupper behövs för att säkerhetsställa   evidensstyrkan för behandling av mellanportion Achillestendinos med   stötvågsterapi.

  • 205.
    Kallin, Kristina
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Jensen, Jane
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Olsson, Lillemor Lundin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Nyberg, Lars
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Why the elderly fall in residential care facilities, and suggested remedies.2004In: The Journal of family practice, ISSN 0094-3509, Vol. 53, no 1, p. 41-52Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To study precipitating factors for falls among older people living in residential care facilities. DESIGN: Prospective cohort study. SETTING: Five residential care facilities. PARTICIPANTS: 140 women and 59 men, mean age +/- SD 82.4 +/- 6.8 (range, 65-97). MEASUREMENTS: After baseline assessments, falls in the population were tracked for 1 year. A physician, a nurse, and a physiotherapist investigated each event, and reached a consensus concerning the most probable precipitating factors for the fall. RESULTS: Previous falls and treatment with antidepressants were found to be the most important predisposing factors for falls. Probable precipitating factors could be determined in 331 (68.7%) of the 482 registered falls. Acute disease or symptoms of disease were judged to be precipitating, alone or in combination in 186 (38.6%) of all falls; delirium was a factor in 48 falls (10.0%), and infection, most often urinary tract infection, was a factor in 38 falls (7.9%). Benzodiazepines or neuroleptics were involved in the majority of the 37 falls (7.7%) precipitated by drugs. External factors, such as material defects and obstacles, precipitated 38 (7.9%) of the falls. Other conditions both related to the individual and the environment, such as misinterpretation (eg, overestimation of capacity or forgetfulness), misuse of a roller walker, or mistakes made by the staff were precipitating factors in 83 (17.2%) of falls. CONCLUSION: Among older people in residential care facilities, acute diseases and side effects of drugs are important precipitating factors for falls. Falls should therefore be regarded as a possible symptom of disease or a drug side effect until proven otherwise. Timely correction of precipitating and predisposing factors will help prevent further falls.

  • 206.
    Karin, Wadell
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Fysisk träning vid obstruktiv lungsjukdom (KOL)2004In: Incitament, ISSN 1103-503X, no 6, p. 439-442Article in journal (Refereed)
    Abstract [sv]

    Kronisk obstruktiv lungsjukdom (KOL) är ett samlingsnamn i vilket kronisk bronkit, kronisk bronkiolit och emfysem ingår. Ansträngningsutlöst andfåddhet är ett av de vanligaste symtomen. Fysisk träning har visat sig vara effektivt för att minska symtom och förbättra patienternas livskvalitet.

  • 207.
    Karlsson, Ann-Sofi
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Höglund, Carolin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Astma- en undanskymd sjukdom bland funktionsnedsättningar: Idrottslärares upplevelser kring astma vid idrottsutövande2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion:

    Den fysiska förmågan hos barn och vuxna med astma är ofta nedsatt. Astma är en vanligt förekommande sjukdom, vars prevalens har ökat de senaste åren i Sverige. Ökningen av antalet astmatiker är som störst bland ungdomar. Det har klargjorts att deltagande i fysiska aktiviteter, framförallt i skolan, är en viktig faktor för det psykologiska välbefinnandet.

    Syfte: Syftet med denna studie var att ta reda på idrottslärares upplevelser kring astma vid idrottsutövande.

    Metod: För att kunna förstå idrottslärares upplever kring astma vid idrottsutövande valdes en kvalitativ metod. Materialet samlades in genom halvstrukturerade intervjuer. Deltagarna bestod av åtta personer, fem män och tre kvinnor, som arbetade som idrottslärare.

    Resultat: Efter kodning och kategorisering skapades temat “astma- en undanskymd sjukdom bland funktionsnedsättningar”. De fem underliggande kategorierna blev, “ betydelsen av ett samarbete med skolsköterskan och föräldrarna”, “elever med astma får ta stort egenansvar”, “ elever uppmuntras att delta efter egen förmåga”, “idrottslektioner anpassas inte efter astma” och “ motstridighet gällande kunskap om astma”.

    Konklusion: Astma är en bortglömd del i både utbildning av idrottslärare och i undervisning av idrottsämnet. Mer kunskap behövs om astma i utbildningen av idrottslärare.

  • 208.
    Khatun, Masuma
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Ahlgren, Christina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hammarström, Anne
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    The influence of factors identified in adolescence and early adulthood on social class inequities of musculoskeletal disorders at age 30: A prospective population-based cohort study2004In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 33, no 6, p. 1353-1360Article in journal (Refereed)
    Abstract [en]

    Background Social class inequities have been observed for most measures of health. A greater understanding of the relative importance of different explanations is required. In this prospective population-based cohort study we explored the contribution of factors, ascertained at different stages between adolescence and early adulthood, to social class inequities in musculoskeletal disorders (MSD) at age 30.

    Methods We used data from 547 men and 497 women from a town in north Sweden who were baseline examined at age 16 and followed up to age 30. Using logistic regression models, we estimated the unadjusted odds ratios (OR) for MSD for blue-collar versus white-collar workers in men and women separately. We assessed the contribution of different factors identified between adolescence and early adulthood by comparing the unadjusted OR for social class differences with OR adjusted for these explanatory factors.

    Results We found significant class differences at age 30 with higher MSD among blue-collar workers (OR = 2.03 in men [95% CI: 1.42, 2.90] and 1.98 in women [95% CI: 1.29, 3.02]). After adjustment for explanatory factors, class differences decreased and were no longer significant, with OR of 1.20 in men (95% CI: 0.76, 1.95) and 1.18 in women (95% CI: 0.69, 2.03). School grades at age 16; being single and alcohol consumption at age 21; having children, restricted financial resources, physical activity, alcohol consumption, smoking, and working conditions at age 30 were important for men; parents' social class, school grade, smoking and physical activity at age 16; being single at age 21; and working conditions at age 30 were important for women.

    Conclusion The accumulation of adverse behavioural and social circumstances from adolescence to early adulthood may be an explanation for the class differences in MSD at age 30. Interventions aimed at reducing health inequities need to consider exploratory factors identified at early and later stages in life, also including structural determinants of health.

  • 209. Klein, C S
    et al.
    Häger-Ross, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Thomas, C K
    Fatigue properties of human thenar motor units paralysed by chronic spinal cord injury.2006In: The Journal of physiology, ISSN 0022-3751, Vol. 573, no Pt 1, p. 161-71Article in journal (Refereed)
  • 210.
    Larsson, Annika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Balansträning och dess påverkan på muskelfunktionen friska, vuxna idrottare-en experimentell studie2013Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Balansträning används hos idrottare främst som rehabilitering efter tidigare skador eller som prevention. Några studier har gjorts med syftet att undersöka ifall balansträning kan förbättra den fysiska förmågan hos friska försökspersoner. Dock har ingen konsensus ifall balansträning kan öka styrkan nåtts.Syfte: Syftet med denna studie var att undersöka ifall balansträning kan förbättra muskelfunktion hos friska, vuxna idrottare.

    Metod: 17 stycken (6 män och 11 kvinnor) friska, vuxna idrottare  mellan 21 och 50 år, tränade tre stycken balansövningar 3x30 sekunder per övning per ben en gång dagligen i 6 veckor. Utvärderingsinstrument var squat jump, heelrise SOLEC (där både posturalt svaj och maxtid mättes) samt greppstyrka. Utvärdering skedde före och efter interventionen.

    Resultat: Hopphöjden, maxtid i SOLEC och antal repetetioner i heelrise ökade med statistisk signifikans. Det kunde inte påvisas någon signifikant skillnad i posturalt svaj och greppstyrka.

    Konklusion: Resultaten tyder på att balansträning  kan ge specifik förbättrad muskelfunktion gällande explosivitet och uthållighet hos friska, vuxna idrottare, även om det posturala svajet inte behöver minska.

  • 211.
    Larsson, Ebba
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Test- Retest av den svenska versionen av STarT Back Screening Tool för patienter med ländryggssmärta2013Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund

    Ländryggssmärta är mycket vanligt och orsakar stora kostnader för det svenska samhället. Enligt gällande rekommendationer bör prognostiska faktorer involveras vid bedömning och behandling av ländryggspatienter. STarT Back Screening Tool (SBT) skapades med syftet att upptäcka olika prognostiska faktorer för ländryggspatienter för att underlätta för en riktad behandling. SBT översattes förra året till svenska.

    Syfte

    Syftet med detta projekt var att utvärdera repeterbarheten av SBT genom ett test- retest, med en hypotes om att Kappa värdet skulle vara acceptabelt (>0,60) eller högre.

    Metod

    Deltagare med ländryggssmärta i åldrarna 18-75 rekryterades fån fyra primärvårdskliniker. De fick svara på SBT under det första besöket och sedan återigen efter 5-14 dagar. En oviktad Kappa beräknades för fråga 1-8 och en kvadratisk viktad Kappa användes för fråga nio samt för total- och subskalan.

    Resultat

    Urvalet bestod av 51 personer, 23 män och 28 kvinnor. Kappa statistik för fråga 1-8 resulterade i 0,61 - 0,86, för fråga nio 0,72, totalskalan 0,79 och subskalan 0,84.

    Konklusion

    Kappa värdet för varje enskild fråga, totalskalan och subskalan var av acceptabel nivå. I jämförelse med det engelska SBT var värdena högre. På grund av detta projekts begränsningar och att behandlingen kan ha påverkat resultatet bör fler reliabilitetsstudier göras på den svenska versionen av SBT.

  • 212.
    Larsson, Emma
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Blomé, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Samband mellan alpina skidgymnasieelevers fysiska testresultat och tävlingsprestation2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Fysiska testbatterier används ofta för att utvärdera idrottares prestationsförmåga. Fysprofilens™ testbatteri används idag för att utvärdera alpina skidåkare i Sverige.

    Syfte: Undersöka om det finns något samband mellan testbatteriet i Fysprofilen™ hos alpina skidåkarevid ett alpint skidgymnasium med ranking vid tävling.

     

    Metod: Fysprofilen™ för 15 kvinnor och tio män i åldrarna 16-19 årjämfördesseparat för samband medot FIS-punkter,  som står för Federation International Ski och är ett resultatsystem inom alpin skidåkning, i storslalom (GS) och slalom (SL). I Fysprofilen™ingår följande tester: knäböj, bänkpress, Harres test, gripen, squat jump, Counter Movement Jump (CMJ), Counter Movement Jump arms (CMJ(a)), Coopers test, sprint 20 meter, brutalbänk, frivändning och chins. Pearsons’s korrelationskoefficient användes för att kunna analysera eventuella samband mellan prestation i fysiska testresultattävlingsprestation och FIS-punkterprestation i fysiska test. Signifikansnivån fastställdes till p<0.05. Könen delades upp och räknades ut var för sig i alla analyser av korrelationsanalyser.

     

    Resultat: Kvinnor fick signifikanta samband i åtta av tolv fysiska tester (p = 0.003**-0.044*, r = -0.527 - -0.704) när de jämfördes mot FIS-punkter i GS. När de fysiska testerna jämfördes mot FIS-punkter i SL fick kvinnorna signifikanta samband i fem av tolv fysiska tester (p = 0.001**- 0.028*, r = -0.565 - 0.790). De starkaste sambanden var för CMJ(a) i GS (p = 0.003, r = -0.704) och Harres test i SL (p = 0.001, r = 0.790). För männen fanns inga signifikanta samband för något av testerna gentemot FIS-punkter i GS eller SL.

     

    Slutsats: Trots få deltagare och stor spridning i testprestation mellan kvinnor och män tyder resultaten överlag på att Fysprofilens™ testbatteri för unga alpina skidåkare bör anpassas ytterligare efter sporten, då många av de fysiska testernan inte visade någotn samband till tävlingsprestation. Vertikala hopp och Harres test förefaller som de bästa indikatorerna för tävlingsprestation hos kvinnliga alpina skidåkare.

  • 213.
    Larsson, Gunilla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Motor function over time in Rett syndrome-loss, difficulties and possibilities2008Licentiate thesis, monograph (Other academic)
  • 214.
    Larsson, Gunilla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rett syndrome, motor development, mobility and orthostatic reactions: loss of function, difficulties and possibilities2013Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Rett syndrome (RTT) is a rare, severe neurodevelopmental disorder, which partly develops in a predictable way, and influences many bodily functions. Regression, i.e. loss of earlier achieved abilities, is one of the clinical criteria for RTT. Research on motor function has to some extent focused on this loss, and less on the possibility to keep, regain or develop abilities. RTT is mainly verified in girls/women, and the prevalence of classic RTT in Sweden for girls born between 1965 and 1976 was 1 in 10.000-12.000. Clinical criteria are used for diagnosis, but since 1999 RTT can be confirmed by a genetic test. As there is no cure so far, development of clinical intervention and management is important, and with good treatment it is possible to improve quality of life.

    The main aim was to acquire more knowledge about motor development in RTT, both, early development, and development over time. Another aim was to study if there were deviating orthostatic reactions when rising from sitting to standing, and during standing, compared with normally developed, healthy people, matched by sex and age.

    Clinical experience as well as reports from parents showed that some people with RTT had lost abilities, some had been able to keep abilities, and some had been able to learn new abilities after regression. For good results, the person with RTT had to be motivated, and the intervention jointly planned; it was also important to realize that dyspraxia causes dependence on other people’s initiatives. Information about one person with RTT, collected over several years, showed the possibility to develop in some areas over time and the tendency to deteriorate in other areas. Studying orthostatic reactions when rising to standing, and standing for three minutes, revealed that those with RTT mainly had the same reactions as the healthy controls. The quicker initial drop in systolic blood pressure in people with RTT, when rising, has not been documented earlier. 

     In conclusion, this thesis shows that it is possible for some people with RTT to keep abilities, regain abilities, and also learn new abilities after regression. Since those with RTT recovered their blood pressure in the same way as the healthy controls, there is no reason to recommend limitations in standing, though the quicker initial drop in systolic blood pressure should be noted. The deterioration in walking found in our previous studies does not seem to be due to deviation in orthostatic reactions. Individual analysis, as well as good knowledge about the development of the disorder and variation in its expression, is essential. Since many people with RTT live to adulthood, planning for lifelong intervention and care is most important.

  • 215.
    Larsson, Gunilla
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Swedish Rett Center, Jämtland County Council, Östersund, Sweden.
    Julu, Peter O.O.
    Breakspear Medical Group, Hertfordshire, UnitedKingdom.
    Witt Engerström, Ingegerd
    RettCenter, Jämtland CountyCouncil, Östersund, Sweden.
    Sandlund, Marlene
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lindström, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Normal reactions to orthostatic stress in Rett syndrome2013In: Research in Developmental Disabilities, ISSN 0891-4222, E-ISSN 1873-3379, Vol. 34, no 6, p. 1897-1905Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate orthostatic reactions in females with Rett syndrome (RTT), and also whether the severity of the syndrome had an impact on autonomic reactions. Based on signs of impaired function of the central autonomic system found in RTT, it could be suspected that orthostatic reactions were affected. The orthostatic reactions in 21 females with RTT and 14 normally developed femalesmatched by age were investigated when they rose from a sitting position, and during standing for 3 min. Reactions of the heart, the blood pressure and the time for recovery of systolic blood pressure, were studied in real time, heartbeat by heartbeat, simultaneously. There was no difference between participants with RTT and the normally developed controls regarding general orthostatic reactions (heart rate, systolic and diastolic blood pressure, and mean arterial pressure) when getting up from a sitting position, and when standing erect for 3min. In the specific immediate response by the heart to standing up, the 30:15 ratio, significantly lower values were found for females with RTT. In the RTT group, the maximum fall of systolic blood pressure showed a tendency to a larger decrease, and the initial decrease in systolic blood pressure was significantly faster. The time for recovery of systolic blood pressure from standing erect did not differ between groups. At baseline the females with RTT had significantly lower systolic blood pressure and a tendency to a higher heart rate. The results do not indicate any autonomic limitations for people with RTT in getting up from a sitting position and standing. The participants with RTT had normal orthostatic reactions indicated by the heart and blood pressure responses when standing erect for 3 min. A faster initial drop in systolic blood pressure in people with RTT was notable.

  • 216.
    Larsson, Gunilla
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lindström, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Engerström, IW
    Rett syndrome from a family perspective: the Swedish Rett Center survey2005In: Brain & development (Tokyo. 1979), ISSN 0387-7604, E-ISSN 1872-7131, Vol. 27, no Suppl 1, p. S14-S19Article in journal (Refereed)
  • 217. Larsson, Gunilla
    et al.
    Lindström, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Witt Engerström, I
    General development in females with rett syndrome, focusing on abilities, deformities and managmet: The Swedish rett center survey2007Conference paper (Other academic)
  • 218.
    Leontinsson, Birgitta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Erfarenheter av arbetet bland nyutbildade sjukgymnaster: Analyser gjorda med The Effort-Reward Imbalance questionnaire2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Arbetsrelaterad stress är det näst vanligaste hälsohotet från arbetsmiljön i Europa. Speciellt en hög ansträngningsnivå och låg yrkesmässig belöning har satts i samband med ohälsa. Målet med den här studien är att undersöka nyutbildade sjukgymnasters upplevelser av arbetet med fokus på arbetsrelaterad ansträngning och belöning utifrån The Effort-Reward Imbalance questionnaire (ERI).

    Metod: Jämförelser mellan kön och olika arbetssektorer hos 169 sjukgymnaster studerades utifrån ERI. Även samband mellan ERI och hur sjukgymnasterna trivdes med arbetet, upplevde organisationen/arbetsledningen, ansåg sig ha möjlighet att arbeta självständigt, studerades.

    Resultat: Kvinnorna rapporterade en högre andel reward än männen( p=0,009). Sjukgymnaster inom den privata sektorn upplevde en högre andel reward jämfört med de inom den offentliga sektorn(p=0,029). Andelen upplevd reward var signifikant lägre om sjukgymnasterna gett ett negativt svar på någon av frågorna som rörde upplevelsen av arbetet (p=0,000-0,011). En negativ syn på organisation/arbetsledning kunde också kopplas till en ökad risk för ERI.

    Slutsats: Eftersom sjukgymnasterna som rapporterade en negativ bild av organisationen och arbetsledningen sågs ha en ökad risk för ERI, bör åtgärder som minskar stress därifrån vidtas i första hand. Då även individuella karakteristiska påverkar i sammanhanget behöver också ytterligare faktorer utvärderas för att hitta en optimal arbetsstress minimerande strategi.

  • 219.
    Lewis, Charlotte A.
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Johnson, P. W.
    Whole-body vibration exposure in metropolitan bus drivers2012In: Occupational Medicine, ISSN 0962-7480, E-ISSN 1471-8405, Vol. 62, no 7, p. 519-524Article in journal (Refereed)
    Abstract [en]

    Background Back injuries are common in transit drivers, and can result in substantial direct and indirect cost to the employer and employee. Whole-body vibration (WBV) is one risk factor for drivers. Standards have been adopted (ISO 2631-1) to guide researchers in measuring and analysing WBV levels. Lately, a new standard has been added (ISO 2631-5) that takes impulsive exposures into account. Aims The aims of this study were to determine the levels of vibration for bus drivers using both ISO 2631-1 and 2631-5 standards, and whether there are differences in vibration levels and seat transmissibility between different road types. Methods Thirteen bus drivers drove a 7-year-old bus, instrumented to measure WBV in the seat and floor. The 52 km long test route included freeway, city streets and speed humps. Additionally, for comparison, a subset of five drivers also drove a car over the same route. Results Road type had a significant effect on all the vibration parameters. Based on exposure limit values in the standards, the continuous z-A(w)(8) exposures exceeded the limit value on freeways, and the impulsive z-VDV(8) and S-ed exposures were above limit values in city streets and speed humps. Bus WBV exposures were about twice as high relative to the car and the bus seat amplified rather than attenuated WBV exposures. Conclusions Bus drivers are potentially being exposed to daily vibration levels higher than recommended especially on certain road types. The current seat in this study does not attenuate the vibration.

  • 220.
    Lidberg, Erik
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Krook, Martin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Kan inställningen till fysisk aktivitet samt affektiv respons vid fysisk ansträngning ändras över tid med guidad träning?2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syften med studien var 1) att undersöka om deltagarnas inställning kring träning förändrades av handledd träning under sex veckor, och 2) att undersöka relationen mellan självskattad ansträngning och affektiv respons under två olika träningsmoment under hela träningsperioden. Metod: 5 forskningspersoner med diabetes typ 2 och ett BMI mellan 27- 35 fick under sex veckor genomföra ett ledarlett individuellt träningsprogram på 45- 75 minuter tre gånger per vecka. Vid baslinjen och efter interventionen fick forskningspersonerna svara på ett formulär angående inställning till träning- PRETIE-Q. Vid konditionsträning på crosstrainer och under styrkeövningen ”modifierad burpee” fick deltagarna skatta upplevd ansträng på Borgs RPE-skala och affektiv respons med Feeling scale tre gånger under varje övning en gång per vecka. Resultat: Inställningen till träning enligt PRETIE-Q förändrades till att personerna föredrog mer intensiv träning än vid baslinjen och medianvärdet ökade från 43/80 vid baslinjen till 55/80 efter interventionen dock är inte förändringen signifikant (P= .063). Den affektiva responsen mätt med Feeling scale under ansträngning visade inga entydiga tecken att ha blivit mer positiv efter interventionen. Slutsats: I motsats till andra studier fanns det tecken på att inställning till träning kan förändras, dock var urvalet för litet för att få ett signifikant resultat beträffande förändring i denna studie. Affektiv respons under ansträngning har inte visat sig bli mer positiv med mer träningserfarenhet och guidad träning. Fler forskningspersoner skulle behövas för ett tydligare resultat.

  • 221. Lindberg, Jonatan
    et al.
    Reiz, Johanna
    Lundin Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    En spark i baken för ett aktivare liv2011Report (Other academic)
    Abstract [sv]

    Efter årtionden av inaktivitet fick några patienter i 60-årsåldern fysisk aktivitet på recept (FaR). Vår studie pekar på att det var ett bra sätt att hjälpa dem att finna motivation och att ta ett första steg mot ett aktivare liv.

  • 222.
    Lindelof, Nina
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Littbrand, Håkan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Lindström, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Nyberg, Lars
    Weighted Belt Exercise for Frail Older Women Following Hip Fracture - A Single Subject Design2002In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 4, no 2, p. 54-64Article in journal (Refereed)
  • 223.
    Lindelöf, Nina
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Rosendahl, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gustafsson, S.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Nygaard, J.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Nyberg, L.
    Perceptions of participating in high-intensity functional exercise among older people dependent in activities of daily living (ADL)2013In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 57, no 3, p. 369-376Article in journal (Refereed)
    Abstract [en]

    The purpose of the study was to evaluate how older people, dependent in ADL perceive their participation in a high-intensity, functional exercise program compared to the perceptions of those participating in a control activity. Forty-eight older people living in residential care facilities answered a questionnaire about their perceptions of participating in an activity for three months. They were aged 65-98, had a mean score of 24 on Mini Mental State Examination (MMSE) and 14 on Barthel ADL Index. The participants had been randomized to exercise (n=20) or control activity (n=28). Differences in responses between exercise and control activity were evaluated using logistic and ordinal regression analyses. The results show that a majority of the exercise group perceived positive changes in lower limb strength, balance, and in the ability to move more safely and securely compared to a minority of the control group (p<0.001). Significantly more respondents in the exercise activity answered that they felt less tired due to the activity (p=0.027) and that they prioritized this activity above other activities (p=0.010). More exercise participants reported that meeting for three months was too short, and fewer that it was too long compared to the control group (p=0.038). This study shows that older people living in residential care facilities, dependent in ADL, and with mild or no cognitive impairment had positive perceptions about participating in high-intensity functional exercise. The findings support the use of a high-intensity exercise program in this population of older people.

  • 224. Lindemann, Ulrich
    et al.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hauer, Klaus
    Wengert, Mathias
    Becker, Clemens
    Pfeiffer, Klaus
    Maximum step length as a potential screening tool for falls in non-disabled older adults living in the community.2008In: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 20, no 5, p. 394-9Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND AIMS: Identification of the risk of falls in a cohort of interest is a prerequisite for a targeted fall prevention study. Motor tasks are widely used as baseline assessment in such studies, but there are only a few well-evaluated tests of motor performance to predict falls prospectively. This study was conducted to find out if the potential of the maximum step length (MSL) test can predict future falls in non-disabled older persons. METHODS: A modified version of the MSL test was used for baseline assessment in 56 community-dwelling, non-disabled elderly persons (mean age 67.7 yrs, SD 6 yrs; 57% women). During a follow-up of 1 year, falls were recorded in a daily calendar. RESULTS: During the follow-up, 30 persons (54%) fell, with no gender difference in reporting of falls between men and women. The adjusted mean valid step length and adjusted maximum valid step length were predictive of future falls with a sensitivity/specificity of 77%/62% and 70%/69%, respectively. Combining MSL test results with fall history increased sensitivity to 93% and 90%, respectively, but decreased specificity to 54% and 58%, respectively. CONCLUSIONS: The MSL test is a feasible tool, with low requirements in space, predicting future falls in community-dwelling older persons. In combination with history of falls, the sensitivity of the test increased considerably.

  • 225.
    Lindström, Britta
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Larsson, Barbro
    Positiva effekter av styrketräning vid skador i centrala nervsystemet2006In: Forskning pågår, no 3, p. 48-54Article in journal (Other academic)
  • 226.
    Lindström, Britta
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Röding, Jenny
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    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 survey2009In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 41, p. 714-718Article in journal (Refereed)
  • 227.
    Lindström, Britta
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Waling, Kerstin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Variability of knee extensor force output during the day2007Conference paper (Other academic)
  • 228.
    Lindström, Sanna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Fysisk träning som behandling av upplevd fatigue hos personer med multipel skleros: en systematisk litteraturöversikt2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet med denna systematiska granskning var att fastställa evidensen för fysisk träning som behandling av upplevd fatigue hos personer med multipel skleros genom att granska randomiserade kontrollerade studier (RCT).

    Metod: Databaserna PubMed, CINAHL och PsycINFO genomsöktes januari 2013 för lämpliga studier. Sökord som användes var: multiple sclerosis, fatigue, physical training och physical exercise. För att granska kvalitet användes PEDro granskningsmall och evidensgradering skedde enligt Tulder et al.

    Resultat: Totalt inkluderades nio studier av randomiserad kontrollerad studiedesign med sammanlagt 254 undersökningsdeltagare. Åtta studier bedömdes vara av medelhög och en studie av låg kvalitet. Moderat evidens fanns för att kombinationsträning, styketräning och konditionsträning har en positiv effekt på MS-patienters upplevda fatigue. Begränsad evidens fanns för yogas positiva effekt och för att hemträningsprogram inte har effekt på upplevd fatigue.

    Slutsatser: Kombinationsträning, styrketräning och konditionsträning har potential att reducera upplevd fatigue hos MS-patienter med mild till måttlig nedsättning. Fler högkvalitativa studier behövs som undersöker fatigue som primärt utfallsmått och för att kunna dra några slutsatser kring yogas och hemtränings effekt på upplevd fatigue.

  • 229.
    Lindén, Boel
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sundberg, Susanne
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Risker i arbetsmiljön för personliga assistenter: En observationsstudie med mätinstrumentet Quick Exposure Check (QEC)2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 230.
    Littbrand, Håkan
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Carlsson, Maine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lindelöf, Nina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Håglin, Lena
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Rosendahl, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Effect of a high-intensity functional exercise program on functional balance: preplanned subgroup analyses of a randomized controlled trial in residential care facilities.2011In: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 59, no 7, p. 1274-1282Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To evaluate whether age, sex, depression, dementia disorder, nutritional status, or level of functional balance capacity influences the effect of a high-intensity functional weight-bearing exercise program on functional balance.

    DESIGN: Preplanned subgroup analyses of a randomized controlled trial.

    SETTING: Nine residential care facilities.

    PARTICIPANTS: One hundred ninety-one people aged 65 to 100 dependent in activities of daily living and with Mini-Mental State Examination scores of 10 or greater.

    INTERVENTION: A high-intensity functional weight-bearing exercise program or a control activity, each comprising 29 sessions over 3 months.

    MEASUREMENTS: Functional balance capacity was assessed blindly using the Berg Balance Scale (BBS) at baseline, 3 months, and 6 months. The BBS consists of 14 tasks, common in everyday life, such as standing up from sitting and, while standing, reaching forward or turning 360°. Interactions between allocation to activity group and each subgroup were evaluated according to the intention-to-treat principle.

    RESULTS: The subgroup analyses revealed no statistically significant interaction for age, sex, depression, dementia disorder, nutritional status, or level of functional balance capacity at 3 (P=.65, .65, .51, .78, .09, .67, respectively) or 6 (P=.69, .62, .20, .94, .48, .85, respectively) months. In addition, at 3 and 6 months there was no significant interaction for cognitive level (P=.28, .47, respectively) or number of depressive symptoms (P=.85, .49, respectively).

    CONCLUSION: Older age, female sex, depression, mild to moderate dementia syndrome, malnutrition, and severe physical impairment do not seem to have a negative effect on functional balance from a high-intensity functional weight-bearing exercise program. Consequently, people with these characteristics in residential care facilities should not be excluded from offers of rehabilitation including high-intensity exercises.

  • 231.
    Littbrand, Håkan
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Carlsson, Maine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lindelöf, Nina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Håglin, Lena
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Rosendahl, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    The effect of a high-intensity functional exercise program on functional balance: preplanned subgroup analyses of a randomized controlled trial in residential care facilitiesArticle in journal (Other academic)
  • 232.
    Littbrand, Håkan
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Rosendahl, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    The effect of a high-intensity functional exercise program on activities of daily living: a randomized controlled trial in residential care facilities2009In: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 57, no 10, p. 1741-1749Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To evaluate whether a high-intensity functional weight-bearing exercise program reduces dependency in activities of daily living (ADLs) in older people living in residential care facilities, focusing on people with dementia. DESIGN: Randomized, controlled trial.

    SETTING: Nine residential care facilities.

    PARTICIPANTS: One hundred ninety-one older people dependent in ADLs and with a Mini-Mental State Examination score of 10 or greater. One hundred (52.4%) of the participants had dementia.

    INTERVENTION: A high-intensity functional weight-bearing exercise program or a control activity consisting of 29 sessions over 3 months.

    MEASUREMENTS: The Barthel ADL Index; follow-up at 3 months (directly after the intervention) and 6 months with intention-to-treat analyses.

    RESULTS: There were no statistically significant differences between the groups regarding overall ADL performance. Analyses for each item revealed that a smaller proportion of participants in the exercise group had deteriorated in indoor mobility at 3 months (exercise 3.5% vs control 16.0%, P=.01) and 6 months (7.7% vs 19.8%, P=.03). For people with dementia, there was a significant difference in overall ADL performance in favor of the exercise group at 3 months (mean difference 1.1, P=.03) but not at 6 months.

    CONCLUSION: A high-intensity functional weight-bearing exercise program seems to reduce ADL decline related to indoor mobility for older people living in residential care facilities. The program does not appear to have an overall effect on ADLs. In people with dementia, the exercise program may prevent decline in overall ADL performance, but continuous training may be needed to maintain that effect.

  • 233.
    Littbrand, Håkan
    et al.
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Geriatric Medicine.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Geriatric Medicine.
    Rosendahl, Erik
    The effect on ADL of a high-intensity functional exercise program among older people dependent in ADL: a randomized controlled trial2007Conference paper (Other academic)
  • 234.
    Littbrand, Håkan
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Rosendahl, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Lindelöf, Nina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Nyberg, Lars
    Department of Health Sciences, Physiotherapy Unit, Luleå University of Technology.
    A high-intensity functional weight-bearing exercise program for older people dependent in activities of daily living and living in residential care facilities: evaluation of the applicability with focus on cognitive function2006In: Physical Therapy, ISSN 0031-9023, E-ISSN 1538-6724, Vol. 86, no 4, p. 489-498Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND PURPOSE: Knowledge concerning the applicability and the effect of high-intensity exercise programs is very limited for older people with severe cognitive and physical impairments. The primary aim of this study was to evaluate the applicability of a high-intensity functional weight-bearing exercise program among older people who are dependent in activities of daily living and living in residential care facilities. A second aim was to analyze whether cognitive function was associated with the applicability of the program.

    SUBJECTS: The subjects were 91 older people (mean age=85.3 years, SD=6.1, range=68-100) who were dependent in personal activities of daily living and randomly assigned to participate in an exercise intervention. Their mean score for the Mini-Mental State Examination (MMSE) was 17.5 (SD=5.0, range=10-29).

    METHODS: A high-intensity functional weight-bearing exercise program was performed in groups of 3 to 7 participants who were supervised by physical therapists. There were 29 exercise sessions over 13 weeks. Attendance, intensity of lower-limb strength and balance exercises, and occurrence and seriousness of adverse events were the outcome variables in evaluating the applicability of the program.

    RESULTS: The median attendance rate was 76%. Lower-limb strength exercises with high intensity were performed in a median of 53% of the attended exercise sessions, and balance exercises with high intensity were performed in a median of 73% of the attended exercise sessions. The median rate of sessions with adverse events was 5%. All except 2 adverse events were assessed as minor and temporary, and none led to manifest injury or disease. No significant differences were observed in applicability when comparing participants with dementia and participants without dementia. In addition, there was no significant correlation between applicability and the MMSE score.

    DISCUSSION AND CONCLUSION: The results suggest that a high-intensity functional weight-bearing exercise program is applicable for use, regardless of cognitive function, among older people who are dependent in activities of daily living, living in residential care facilities, and have an MMSE score of 10 or higher.

  • 235.
    Littbrand, Håkan
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Stenvall, Michael
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Rosendahl, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Applicability and effects of physical exercise on physical and cognitive functions and activities of daily living among people with dementia: a systematic review2011In: American Journal of Physical Medicine & Rehabilitation, ISSN 0894-9115, E-ISSN 1537-7385, Vol. 90, no 6, p. 495-518Article, review/survey (Refereed)
    Abstract [en]

    OBJECTIVE: : The aim of this study was to systematically review the applicability (attendance, achieved intensity, adverse events) and effects of physical exercise on physical functions, cognitive functions, and activities of daily living among people with dementia.

    DESIGN: : Randomized controlled trials were identified in PubMed, the Cumulative Index to Nursing and Allied Health, the Allied and Complementary Medicine Database, and the Cochrane Library on August 30 and September 1, 2010, according to predefined inclusion criteria. Two reviewers independently extracted predetermined data and assessed methodologic quality.

    RESULTS: : A qualitative analysis was performed, including ten studies. Most participants were people with Alzheimer disease in residential care facilities. Four studies reached "moderate" methodologic quality, and six reached "low." The studies of moderate quality evaluated the effects of combined functional weight-bearing exercise, combined functional and nonfunctional exercise, and walking exercise.

    CONCLUSIONS: : Among older people with Alzheimer disease in residential care facilities, combined functional weight-bearing exercise seems applicable for use regarding attendance and adverse events, and there is some evidence that exercise improves walking performance and reduces the decline in activities of daily living. Furthermore, there is some evidence that walking exercise performed individually reduces decline in walking performance, but adverse events need to be evaluated. Among older people with various types of dementia disorders who are staying in a hospital, there is some evidence that combined functional and nonfunctional exercise over 2 wks has no effect on mobility. It seems important that the interventions last for at least a few months and that the exercises are task-specific and are intended to challenge the individual's physical capacity. Among older people with unspecified dementia disorders in residential care facilities, there is some evidence that walking exercise performed at a self-selected speed has no effect on cognitive functions. Whether physical exercise can improve cognitive functions among people with dementia remains unclear because studies evaluating this have either been of low methodologic quality or used an intervention of presumably insufficient intensity. There is a need for more studies of high methodologic quality, especially among people with dementia disorders other than Alzheimer disease.

  • 236.
    Lordell, Jenny
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Ger förskrivning av Fysiskaktivitet på recept (FaR) ökad fysisk aktivitet hos hjärtpatienter efteravslutad träningsperiod på hjärtrehabiliteringen?: -En randomiserad kontrollerad studie2013Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: En viktig del av sekundärprevention vid kranskärlssjukdom är fysisk aktivitet och träning. Tidigare forskning har visat att regelbunden träning inom hjärtrehabilitering minskar mortaliteten utan att man sett några risker med träningen. Utmaningen består i att få patienterna att fortsätta träna efter hjärtrehabiliteringen och syftet med studien är att undersöka om tillägg FaR och MI utöver allmän information om vikten av fortsatt träning kan bidra till ökad fysisk aktivitet hos patienter jämfört med endast allmän information om vikten av fortsatt träning efter genomgången poliklinisk träningsperiod på hjärtrehabiliteringen.

    Metod: 19 deltagare randomiserades till interventions- eller kontrollgrupp. Interventionsgruppen fick Fysisk aktivitet på recept (FaR) och ett motiverande samtal (MI) samt ett telefonsamtal utöver den allmänna informationen om träning vid kranskärlssjukdom som alla deltagare fick. Interventionen utvärderades med International Physical Activity Questionnaire short form (IPAQ) och ett submaximalt cykeltest vid studiestart och efter 4 månader. En minskning i patientflödet på hjärtrehabiliteringen gjorde att studien inte kunde nå power i de statistiska beräkningarna.

    Resultat: Inga skillnader i aktivitetsnivå mellan grupperna kunde påvisas. En trend med något mindre försämring i prestationsförmåga vid cykeltestet kunde ses vid uppföljningen hos interventionsgruppen.

    Konklusion: Studien har för få deltagare för att några säkra slutsatser ska kunna dras. Vidare forskning är nödvändig och bättre utvärderingsinstrument önskvärda.

  • 237.
    Lostelius, Petra
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    A family perspective on adolescent sibilings' experiences of pain in children with Cerebral Palsy2013Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
  • 238.
    Lundberg, Veronica
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Health-related quality of life in girls and boys with Juvenile Idiopathic Arthritis: a cross-sectional study2011Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
  • 239.
    Lundgren, Nina
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rönnlund, Sanna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Upplevelser av lokal högrepetitiv muskelträning hos patienter med kroniskt obstruktiv lungsjukdom: En semistrukturerad intervjustudie2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Att undersöka hur patienter med kroniskt obstruktiv lungsjukdom (KOL) upplevde sitt deltagande i lokal högrepetitiv muskel-träning.  

    Metod: Studien utfördes som en semistrukturerad intervjustudie där deltagarna kom från en redan utförd träningsstudie. 19 respondenter, tio kvinnor och nio män, mellan 51 och 78 år intervjuades per telefon med hjälp av ett frågeformulär. Frågorna handlade om deltagarnas egna upplevelser av träningsformen. Svaren analyserades med kvalitativa och kvantitativa metoder.

    Resultat: Analysen resulterade i tre teman; åsikter om träningsinformationen, åsikter om träningsutförandet och generella åsikter om träningen. Överlag var reaktionerna positiva och den positiva trenden sågs tydligare hos de kvinnliga deltagarna. Deltagarna upplevde träningen som givande med enkla redskap, en tuff träning utan andningsbesvär. Många hade gärna fortsatt att träna under en längre tid.

    Slutsats: Lokal högrepetitiv muskelträning uppskattades av deltagarna som tyckte att det var en bra träningsform med enkla redskap, för patienter med KOL. De ansåg att det var en träningsform värd att fortsätta men hellre på kvällar och helger. Att fortsätta träna hemma var dock svårt då motivationen inte räckte till.  

  • 240.
    Lundin Olsson, Lillemor
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Fahlström, Gunilla
    Fallprevention: en central del i god vård för äldre2010In: Hemsjukvård / [ed] Eva Drevenhorn, Lund: Studentlitteratur , 2010, p. 109-132Chapter in book (Other academic)
  • 241.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Att förebygga fall: Fysisk träning och multifaktoriella åtgärder minskar fallrisk2012In: Fysioterapi, ISSN 1653-5804, no 1, p. 7Article in journal (Other (popular science, discussion, etc.))
  • 242.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Balansera rätt: faktaunderlag om fall och fallrelaterade skador2011Report (Other academic)
    Abstract [sv]

    Sjuttio procent av alla som behöver läggas in på sjukhus till följd av olyckshändelser har skadats i fallolyckor. Fallolyckor resulterar i ungefär 600 000 vårddygn per år vilket är nästan tio gånger fler än vad som kommer ut från vägtrafikolyckor. Varje år uppsöker över 300 000 människor en akutmottagning efter att ha skadats i en fallolycka. Samhällets kostnader för fallolyckor har beräknats uppgå till 22 miljarder årligen.   Fallhändelser är den vanligaste orsaken till skador bland äldre personer. Nio av 10 som kommer till en akutmottagning med en måttligt eller mycket allvarlig skada har fallit. Sverige har varit ett föregångsland för att förebygga fallrelaterade skador. I Skaraborgs och Östergötlands län skapades under tidigt 1980-tal en infrastruktur mellan olika sektorer i samhället för att främja säkerhet.

  • 243.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Community-dwelling older adults with balance impairment show a moderate increase in fall risk, although further research is required to refine how balance measurement can be used in clinical practice2010In: Evidence-Based Nursing, ISSN 1367-6539, E-ISSN 1468-9618, Vol. 13, no 3, p. 96-97Article in journal (Refereed)
  • 244.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Prediction and prevention of falls among elderly people in residential care2000Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Among elderly people, falls lead to a considerable amount of immobility, morbidity, and mortality. The purpose of this study was to develop and evaluate methods for predicting falls, and to evaluate a fall prevention program among elderly people living in residential care facilities. A fall was defined as any event in which the resident unintentionally came to rest on the floor or the ground regardless of whether or not an injury was sustained.

    In developing the prediction methods, it was hypothesised that older persons showing difficulties in performing a familiar second task while walking were more likely to fall within six months. For residents who stopped walking when talking, the relative risk of falling was 3.5 (95% CL2.0-6.2) compared to those who continued walking. For residents with a time difference (diffTUG) of at least 4.5 seconds between two performances of the Timed Up&Go test, with and without carrying a glass, the hazard ratio for falls was 4.7 (95% Cl: 1.5-14.2) compared to those with a shorter diffTUG.

    A screening tool, the Mobility Interaction Fall (MIF) chart, was developed and evaluated, then validated in a new sample. This tool included a mobility rating, ‘Stops walking when talking’, ‘diffTUG’, a test of vision, and a concentration rating. In the first sample, the hazard ratio was 12.1 (95% 0:4.6-31.8) for residents classified as ‘high-risk’ compared to ‘low-risk’. The positive predictive value was 78%, and the negative predictive value, the sensitivity, and the specificity were above 80% for falling in six months. In the second sample the prediction accuracy of the MIF chart was lower (hazard ratio 1.7, 95% Cl: 1.1-2.5) and a 6-month fall history or a global rating of fall risk by staff were at least equally valuable. A combination of any two of the methods - the MIF chart, staff judgement, fall history - was more accurate at identifying high risk residents than any method alone. Half of the residents classified by two methods as ‘high risk’ sustained a fall within 6 months.

    In a randomised study a prevention program directed to residents, staff, and environment resulted in a significant reduction in the number of residents falling (44% vs. 56%; odds ratio 0.62, 95% CF0.41-0.92), the incidence of falls (incidence rate ratio IRR 0.80, 95% CF0.69-0.94) and of femoral fractures (IRR 0.25, 95% 0:0.08-0.82) in the intervention compared to the control group.

    In conclusion, a combination of any two of the staff judgement, fall history or MIF chart has the potential to identify a large proportion of residents at particular high fall risk. A multidisciplinary and multifactorial fall prevention program directed to residents, staff, and the environment can reduce the numbnumber of residents falling, of falls and of femoral fractures.

  • 245.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    På säkrare ben: fallförebyggande arbete2012In: Äldres Hälsa: Ett sjukgymnastiskt perspektiv / [ed] Elisabeth Rydwik., Studentlitteratur, 2012, p. 107-125Chapter in book (Other academic)
  • 246.
    Lundin-Olsson, Lillemor
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rosendahl, Erik
    Att förebygga fallolyckor bland äldre personer2008Report (Other academic)
  • 247.
    Lundin-Olsson, Lillemor
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rosendahl, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Fysisk aktivitet ger bättre hälasa för äldre personer2012In: Det goda åldrandet / [ed] Astrid Norberg, Berit Lundman, Regina Santamäki Fischer, Lund: Studentlitteratur, 2012, 1, p. 191-210Chapter in book (Other academic)
  • 248.
    Lundmark, Helén
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Belastningsergonomi och hälsa inom personlig assistans i Umeå Kommun: En kartläggning2012Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 249.
    Lycke, Kristina
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Roubert, Anna Maria
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Skadeförebyggande träning - ett område på frammarsch: Elittränares erfarenheter av utvecklingen de senaste 20 åren2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    SammanfattningFysisk aktivitet germånga fördelar utifrån ett hälsoperspektiv och risken att drabbas av hjärt-/kärlsjukdomar,diabetes samt övervikt minskar. I samband med idrott finns dock risken attdrabbas av skador. Studier visar att skador kan förhindras medskadeförebyggande träning. Syfte: Syftet med studien varatt ur ett tränarperspektiv beskriva utvecklingen av skadeförebyggande träningunder de senaste 20 åren.  Metod: Studien har en kvalitativstudiedesign med halvstrukturerade intervjuer. Fem aktiva tränare som varitverksamma i friidrott och ishockey på elitnivå en längre period intervjuades.Intervjuerna analyserades med kvalitativ innehållsanalys.Resultat: Analysen resulterade i tematSkadeförebyggande träning - ett område påframmarsch och femkategorier, Den naturliga leken harförsvunnit, Från en huvudansvarig till ett helt team, Ett nödvändigt inslag, Frångrenspecifik till fysinriktad träning, Kunskapsluckor hos dagens tränare. Skadeförebyggandeträning har de senaste decennierna utvecklats och blivit vanligare inomelitidrotten. Dagens ungdomar är sämre fysiskt förebredda att kunna satsa påsin idrott. Större team med olika professioner har vuxit fram och träningen harändrat fokus i syfte att undvika skador.Konklusion: Tränarna är överens attskadeförebyggande träning blivit mer aktuell och viktig för att förhindrauppkomst av skador. Sjukgymnaster har med sin kunskap om fysisk aktivitet ochskadeförebyggande träning en given plats i träningsteamet.

  • 250.
    Lämås, Kristina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lindgren, Lenita
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB).
    Wester, Per
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Brulin, Christine
    Umeå University, Faculty of Medicine, Department of Nursing.
    Does touch massage facilitate recovery after stroke?: A study protocol of a randomized controlled trial2016In: BMC Complementary and Alternative Medicine, ISSN 1472-6882, E-ISSN 1472-6882, Vol. 16, article id 50Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Despite high quality stroke care, decreased sensorimotor function, anxiety and pain often remain one year after stroke which can lead to impaired health and dependence, as well as higher healthcare costs. Touch massage (TM) has been proven to decrease anxiety and pain, and improve quality of health in other conditions of reduced health, where reduced anxiety seems to be the most pronounced benefit. Thus there are reasons to believe that TM may also reduce anxiety and pain, and improve quality of life after stroke. Further, several studies indicate that somatosensory stimulation can increase sensorimotor function, and it seems feasible to believe that TM could increase independence after stroke. In this study we will evaluate effects of TM after stroke compared to sham treatment.

    METHODS: This is a prospective randomized open-labelled control trial with blinded evaluation (PROBE-design). Fifty patients with stroke admitted to stroke units will be randomized (1:1) to either a TM intervention or a non-active transcutaneous electrical nerve stimulation (non-TENS) control group. Ten sessions of 30 min treatments (TM or control) will be administered during two weeks. Assessment of status according to the International Classification of Functioning, Disability and Health (ICF), including body function, activity, and participation. Assessment of body function will include anxiety, pain, and stress response (heart rate variability and salivary cortisol), where anxiety is the primary outcome. Activity will be assessed by means of sensorimotor function and disability, and participation by means of health-related quality of life. Assessments will be made at baseline, after one week of treatment, after two weeks of treatment, and finally a follow-up after two months. The trial has been approved by the Regional Ethical Review Board.

    DISCUSSION: TM seems to decrease anxiety and pain, increase health-related quality of life, and improve sensorimotor functions after stroke, but the field is largely unexplored. Considering the documented pleasant effects of massage in general, absence of reported adverse effects, and potential effects in relation to stroke, it is essential to evaluate effects of TM during the sub-acute phase after stroke. The results of this project will hopefully provide important knowledge for evidence-based care.

    TRIAL REGISTRATION: ClinicalTrials.gov: NTC01883947.

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