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  • 201.
    Areskoug-Josefsson, Kristina
    Jönköping University, School of Health and Welfare, HHJ, Quality Improvement and Leadership in Health and Welfare.
    HBTQ - Fysioterapeutens roll2015Conference paper (Refereed)
  • 202.
    Areskoug-Josefsson, Kristina
    et al.
    Department of Health Sciences, Division of Physiotherapy, Lund University, Lund, Sweden; Värnamo Hospital, Samrehab, Värnamo Sjukhus, Värnamo, Sweden.
    Ekdahl, Charlotte
    Department of Health Sciences, Division of Physiotherapy, Lund University, Lund, Sweden.
    Jakobsson, Ulf
    Center for Primary Health Care Research, CRC, Lund University, Lund, Sweden.
    Gard, Gunvor
    Department of Health Sciences, Division of Physiotherapy, Lund University, Lund, Sweden.
    Detecting decreased sexual health with MDHAQ-S2013In: Health, ISSN 1949-4998, E-ISSN 1949-5005, Vol. 5, no 6B, p. 38-47Article in journal (Refereed)
    Abstract [en]

    There are instruments that measure sexual function or sexual health for persons with RA, but since sexual health is a sensitive issue, the hypothesis is that it would be easier to have a standard questionnaire that could indicate the need for communication about sexual health issues instead of an extra questionnaire with more detailed questions on sexual health. The aim of the study is to find out whether sexual health difficulties can be screened by factors included in the MDHAQ-S for persons with RA. This study explores the relation between factors included in the MDHAQ-S and the Sexual Health Questionnaire (QSH) using a mixed methods design combining quantitative and qualitative data. The MDHAQ-S covers sexual health issues, not only by using the question on sexual health, but also on other factors included in the questionnaire such as increased pain, fatigue, depression, anxiety, physical capacity, level of physiccal activity and body weight. To explore decreased sexual arousal, decreased sexual satisfaction and decreased sexual well-being, in-depth interviews must be held with persons with RA, either using a sexual health questionnaire or in a clinical interview.

  • 203.
    Areskoug-Josefsson, Kristina
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Gard, Gunvor
    Sexual health – A professional challenge for physiotherapists2016Conference paper (Refereed)
  • 204.
    Areskoug-Josefsson, Kristina
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Quality Improvement and Leadership in Health and Welfare.
    Haraldsson, Patrik
    AME, Region Jönköpings län.
    SMAK - Nyttan av ett strukturerat, validerat multidisciplinärt bedömningsinstrument inom företagshälsovården2015Conference paper (Refereed)
  • 205.
    Areskoug-Josefsson, Kristina
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Luleå University of Technology, Luleå, Sweden.
    Juuso, Päivi
    Luleå University of Technology, Luleå, Sweden.
    Gard, Gunvor
    Luleå University of Technology, Luleå, Sweden.
    Rolander, Bo
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue). Futurum, Academy for Health and Care, Jönköping County Council, Jönköping, Sweden.
    Larsson, Agneta
    Luleå University of Technology, Luleå, Sweden.
    Health care students' attitudes toward addressing sexual health in their future profession: Validity and reliability of a questionnaire2016In: International Journal of Sexual Health, ISSN 1931-7611, E-ISSN 1931-762X, Vol. 28, no 3, p. 243-250Article in journal (Refereed)
    Abstract [en]

    Objectives: To test the reliability and validity of the Students' Attitudes Towards Addressing Sexual Health Questionnaire (SA-SH), measuring students' attitudes toward addressing sexual health in their future professions.

    Method: A cross-sectional online survey (22 items) were distributed to 186 nursing, occupational therapy and physiotherapy students in Sweden, April 2015. Validity and reliability were tested.

    Results: The construct validity analysis led to three major factors: present feelings of comfortableness, future working environment, and fear of negative influence on future patient relations. The construct validity, internal consistency reliability, and intrarater reliability showed good results.

    Conclusion: The SA-SH is valid and reliable.

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    Accepted Manuscript
  • 206.
    Areskoug-Josefsson, Kristina
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Larsson, Agneta
    Department of Health Sciences, Luleå University of Technology, Luleå, Sweden.
    Gard, Gunvor
    Department of Health Sciences, Luleå University of Technology, Luleå, Sweden.
    Rolander, Bo
    Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue). Jönköping University, School of Health and Welfare, HHJ, Dep. of Behavioural Science and Social Work. Futurum, Academy for Health and Care, Jönköping County Council, Jönköping, Sweden.
    Juuso, Päivi
    Department of Health Sciences, Luleå University of Technology, Luleå, Sweden.
    Health care students' attitudes towards working with sexual health in their professional roles: Survey of students at nursing, physiotherapy and occupational therapy programmes2016In: Sexuality and disability, ISSN 0146-1044, E-ISSN 1573-6717, Vol. 34, no 3, p. 289-302Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore differences and similarities in health care students’ attitudes towards working with and communicating with patients about sexual health issues in their future professions. The aim was also to explore whether the students’ gender, age and future professions were influencing factors and whether there was a change in attitude depending on educational levels, gender, age and future professions. The study also aimed to explore the potential development of those differences and similarities in attitudes between health care students having achieved different levels of education and training in their future professions. A cross-sectional quantitative study was performed with an online survey distributed to nursing, occupational therapy and physiotherapy students. The students believed that they needed increased sexual health education and increased communication skills about sexual health. Gender and future profession are factors that significantly affect the attitudes of the students towards working with sexual health. Nursing and occupational therapy students have a more positive attitude towards addressing sexual health in their future professions than do physiotherapy students. Further research is needed in this field to improve competence in sexual health for all student groups, particularly physiotherapy students. Further research is also needed to explore the significance of gender regarding education in sexual health and attitudes towards working with sexual health.

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    Accepted Manuscript
  • 207.
    Ark, Simon
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Åsenlöf: Physiotheraphy.
    Olausson, Filip
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Åsenlöf: Physiotheraphy.
    Sambandsstudie mellan vertikalhopp, marklyft och BMI hos en grupp friska fysioterapeutstudenter2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Deadlift is an exercise that proves to effectively train the hip extensors amongst other muscle groups, which is one of the most important muscle groups for performing a vertical jump. Despite this connection, no studies have been made on the correlation between deadlifts and vertical jumps, contrary to the numerous studies made regarding the correlation between squat and vertical jump. The purpose of this study was to examine the possible correlation between deadlifts, vertical jumps as well as BMI (Body Mass Index) amongst healthy physiotherapy students (n=15) at Uppsala University. This to assess the use of deadlift as an alternative training method to improve a person’s vertical jump ability. Vertical jumps were measured with an electronic jump mat and deadlifts were measured with 1RM-test. BMI was calculated using the person’s height and weight. The variables were then compiled and calculated using Pearson's correlation coefficient.

    The results presented no correlation between vertical jumps and deadlifts (p = 0,773, r = 0,083), and a weak negative correlation between BMI and vertical jumps (p = 0,514, r = -0,188). A very strong positive correlation between BMI and deadlifts (p = 0,013, r = 0,721) was detected, whereas participants with higher BMI lifted more in deadlift. The conclusion of this study dictates that deadlift should not be recommended as an alternative exercise to improve vertical jump ability. However, more studies with larger populations are needed to scrutinize clinical applications.

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  • 208.
    Arkkukangas, Marina
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Evaluation of the Otago Exercise Programme with or without motivational interviewing: Feasibility, experiences, effects and adherence among older community-dwelling people2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Falls and injuries related to falls are one of the most common health problems among older people and are becoming increasingly more frequent. Regular exercise has been identified as one of the most effective fall-prevention activities for older people; however, awareness of the impact of exercise programmes and adherence to recommended exercise among the elderly population is generally low. Research examining how an exercise programme is administered to and experienced by elderly community-dwelling people is needed.

    The overall aim of this thesis was to investigate the feasibility, experiences and effects of and adherence to the fall-preventive Otago Exercise Programme (OEP) with or without motivational interviewing (MI) among community-dwelling people aged 75 years or older.

    Four studies were performed from October 2012 to May 2016 in a sample of 175 people. Both quantitative and qualitative research methods were used. The methods included the feasibility for conducting a randomized controlled trial (RCT) (I), individual face-to-face interviews (II), an RCT (III) and a prospective cohort study (IV). The intervention was given to two groups. The participants who received OEP with or without MI were compared with a control group that received standard care.

    The feasibility of performing an exercise intervention with or without MI was acceptable from the perspective of the participating physiotherapists. From the perspective of the older participants performing the exercise with behavioural change support, the inclusion of monitored exercises in everyday life and daily routines was important. The participants also expressed experiencing more strength, improved physical functioning and greater hope for an extended active life during old age.

    From the short-term perspective, there were significant improvements within the OEP combined with MI group in terms of physical performance, fall self-efficacy, activity level, and handgrip strength. Improved physical performance and fall self-efficacy were also found within the control group; however, corresponding differences did not occur in the OEP group without MI. There were no significant differences between the study groups after 12 weeks of regular exercise. Adherence to the exercises in the pooled exercise group was 81% at the 12-week follow-up.

    At the 52-week follow-up, the behavioural factors being physically active and obtaining behavioural support in terms of MI had a significant association with adherence to the exercise programme.

    These studies provide some support for the combination of OEP with MI as the addition of MI was valuable for achieving adherence to the exercise programme over time in older community-dwelling people.

     

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  • 209.
    Arkkukangas, Marina
    Mälardalens högskola, Hälsa och välfärd.
    Evaluation of the Otago Exercise Programme with or without motivational interviewing: Feasibility, experiences, effects and adherence among older community-dwelling people2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Falls and injuries related to falls are one of the most common health problems among older people and are becoming increasingly more frequent. Regular exercise has been identified as one of the most effective fall-prevention activities for older people; however, awareness of the impact of exercise programmes and adherence to recommended exercise among the elderly population is generally low. Research examining how an exercise programme is administered to and experienced by elderly community-dwelling people is needed.

    The overall aim of this thesis was to investigate the feasibility, experiences and effects of and adherence to the fall-preventive Otago Exercise Programme (OEP) with or without motivational interviewing (MI) among community-dwelling people aged 75 years or older.

    Four studies were performed from October 2012 to May 2016 in a sample of 175 people. Both quantitative and qualitative research methods were used. The methods included the feasibility for conducting a randomized controlled trial (RCT) (I), individual face-to-face interviews (II), an RCT (III) and a prospective cohort study (IV). The intervention was given to two groups. The participants who received OEP with or without MI were compared with a control group that received standard care.

    The feasibility of performing an exercise intervention with or without MI was acceptable from the perspective of the participating physiotherapists. From the perspective of the older participants performing the exercise with behavioural change support, the inclusion of monitored exercises in everyday life and daily routines was important. The participants also expressed experiencing more strength, improved physical functioning and greater hope for an extended active life during old age.

    From the short-term perspective, there were significant improvements within the OEP combined with MI group in terms of physical performance, fall self-efficacy, activity level, and handgrip strength. Improved physical performance and fall self-efficacy were also found within the control group; however, corresponding differences did not occur in the OEP group without MI. There were no significant differences between the study groups after 12 weeks of regular exercise. Adherence to the exercises in the pooled exercise group was 81% at the 12-week follow-up.

    At the 52-week follow-up, the behavioural factors being physically active and obtaining behavioural support in terms of MI had a significant association with adherence to the exercise programme.

    These studies provide some support for the combination of OEP with MI as the addition of MI was valuable for achieving adherence to the exercise programme over time in older community-dwelling people.

     

  • 210. Arkkukangas, Marina
    Keep on and keep up the fall prevention work: older adults need evidence-based fall prevention actions now more than ever!2021In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 23, no 1, p. 1-2Article in journal (Other academic)
  • 211.
    Arkkukangas, Marina
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Res & Dev Sormland, Sormland, Sweden..
    Keep on and keep up the fall prevention work: older adults need evidence-based fall prevention actions now more than ever!2021In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 23, no 1, p. 1-2Article in journal (Other academic)
  • 212.
    Arkkukangas, Marina
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Research and Development in Sörmland, Eskilstuna, Sweden.
    Bååthe, K. S.
    Högskolan Dalarna, Falun, Sweden.
    Ekholm, A.
    Research and Development in Sörmland, Eskilstuna, Sweden.
    Tonkonogi, M.
    Högskolan Dalarna, Falun, Sweden.
    A 10-week judo-based exercise programme improves physical functions such as balance, strength and falling techniques in working age adults2021In: BMC Public Health, E-ISSN 1471-2458, Vol. 21, no 1, article id 744Article in journal (Refereed)
    Abstract [en]

    Background: Falls and fall-related injuries are major threats not only for older adults but also for younger age groups such as working-age adults. It has been shown that it is possible to reduce the risk of falls and fall-related injuries, to some extent. However, interventions aiming at reducing both the risk of falls and mitigating fall-related injuries through teaching safe falling techniques are still sparsely investigated. The aim with this study was to investigate the effect of a 10-week workplace-based judo inspired exercise programme (Judo4Balance). The measures in the study include physical functions, fall-related self-efficacy and safe falling techniques. Methods: A total of 142 working-age adults participated in this non-randomised controlled study. The participants were allocated to the Judo4Balance group (n = 79), or to a waiting list control group (n = 63). The mean age was 47 years (18–68). The recruitment period was from May 2018 to October 2019. A total of 128 participants were included in the analysis. Logistic Regression models were used to analyse the outcomes: physical function, balance and fall-related self-efficacy as well as falling techniques (backwards and forwards). Results: At the 10-week follow-up, the results displayed significant differences between the two groups in all measurements, except for the fall-related self-efficacy with OR = 1.8. Techniques for falling forwards and backwards displayed the highest OR = 124.1 and OR = 98.9. Physical function and balance showed OR = 3.3 and OR = 6.4. Conclusions: This exercise programme under study displayed significant differences in strength, balance and safe falling techniques between the groups. It is suggested that these functions, which were studied here, can effectively be trained in working-age adults by using the Judo4Balace exercise programme. Thus, it may be beneficial to further investigate and include training in proper falling techniques when designing fall prevention exercise programmes. Furthermore, it may be a novel way of addressing fall-related injuries, which are of utmost importance to prevent in near future. Trial registration: NCT04294342. Registered 4 March 2020 - The Impact of Specifically Adapted Judo-based Training Program on Risk Factors for Falls Among Adults.

  • 213.
    Arkkukangas, Marina
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Res & Dev Sormland, Eskilstuna, Sweden.;Dalarna Univ, Sch Educ Hlth & Social Studies, Dept Med Sport & Fitness Sci, Falun, Sweden..
    Cederbom, Sara
    OsloMet Oslo Metropolitan Univ, Fac Hlth Sci, Dept Physiotherapy, Oslo, Norway..
    Movement toward an evidence-Based, digital fall prevention future-Perceptions from a physiotherapy perspective2021In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040Article in journal (Refereed)
    Abstract [en]

    Background Physiotherapy plays an important role in fall prevention, and is a science- and evidence-based profession that is constantly undergoing development. Currently, the possibility of digital fall prevention is being explored; however, the perception of physiotherapists (PTs) toward a digital approach is still a sparsely investigated topic. Purpose This study aimed to explore the PT's experiences with a fall prevention exercise program used in their daily work and their thoughts regarding the use of digital support in this context. Methods Discussions were held in two focus groups with seven PTs (age: 26-48 years). A qualitative content analysis was performed. Results We identified two main categories: 1) The importance of evidence-based fall prevention exercise; and 2) Transition toward a digital fall prevention exercise approach. The participants expressed that they had time- and resource-related limitations affecting evidence-based work and adherence to fall prevention exercise programs. They stated that education and management support were required. Conclusion There is a need for fall prevention exercise to be evidence-based and prioritized in physiotherapy. The study results provide insights into the lack of adherence to fall prevention exercise programs and highlighted the need for a transition toward working digitally in the future.

  • 214.
    Arkkukangas, Marina
    et al.
    Department of Neuroscience, Physiotherapy, Uppsala University, Uppsala, Sweden;Centre for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden;Research and Development in Sörmland, SE-63217, Eskilstuna, Sweden.
    Cederbom, Sara
    Faculty of Health Sciences, Department of Physiotherapy, OsloMet – Oslo Metropolitan University, Oslo, Norway.
    Tonkonogi, Michail
    School of Education, Health and Social Studies, Department of Medicine, Sport and Fitness Sciences, Högskolan Dalarna, Falun, Sweden.
    Umb Carlsson, Õie
    Research and Development in Sörmland, SE-63217, Eskilstuna, Sweden;Department of Health and Caring Sciences, Disability and Habilitation, Uppsala University, Uppsala, Sweden.
    Older adults’ experiences with mHealth for fall prevention exercise: usability and promotion of behavior change strategies2020In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 37, no 12, p. 1346-1352Article in journal (Refereed)
    Abstract [en]

    Background: With the rapidly growing aging population, older adults need to stay healthy and active for a longer time. Mobile health (mHealth) solutions could help support, prevent, or delay functional decline and falls in old age.

    Purpose: The aim was to explore older persons' experiences of a mobile application for fall prevention exercise, and to identify what possible behavior change techniques to include in the further development of the application.

    Methods: Two focus groups were conducted with 12 older adults (seven women and five men) 70 to 83 years of age. A qualitative content analysis was performed.Results: Two main results emerged: 1) external facilitators for using the application; and 2) internal facilitators for using the application and perceived gains, in addition 10 behavior change techniques were identified.

    Conclusion: With support, an application could be adapted for older adults to manage, motivate, and adhere to fall prevention exercise. To achieve long-term adherence to health behavior changes, behavior change strategies and techniques are recommended to be included in further development of the fallprevention application.

  • 215.
    Arkkukangas, Marina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Disciplinary Domain of Medicine and Pharmacy, research centers etc., Centre for Clinical Research Sörmland. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Åsenlöf: Physiotheraphy. Res & Dev Sormland, Eskilstuna, Sweden.;Mälardalen Univ, Sch Hlth Care & Social Welf, Dept Physiotherapy, Västerås, Sweden..
    Eriksson, Hans-Georg
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Disciplinary Domain of Medicine and Pharmacy, research centers etc., Centre for Clinical Research Sörmland.
    Dension, Eva
    Mälardalen Univ, Sch Hlth Care & Social Welf, Dept Physiotherapy, Västerås, Sweden..
    Risk factors for fall-related injuries among community-dwelling men and women over 70 years of age, based on social cognitive theory: results from a population study2021In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 23, no 4, p. 221-226Article in journal (Refereed)
    Abstract [en]

    Introduction: Healthcare professionals', especially physiotherapists' role as promoters, preventers and rehabilitators play a significant role in prevention of falls. The purpose of this study was to gain knowledge on the risk factors which are associated with fall-related injuries among community dwelling men and women, based on Social Cognitive Theory (SCT) concepts. Patients and methods: The study includes 13,151 people who responded to a postal survey questionnaire in 2017. The random sample consisted of men and women aged 70 years and older. Multivariate regression models were used to explore associations between theory-based risk factors and fall-related injuries. Results: A total of 16% (1951 people) reported a fall-related injury during the past 12 months. For men, a total of seven risk factors were associated with fall-related injury: age, pain (neck/shoulder), incontinence, depression, help in daily living, education and sedentary behaviour. For women, a total of nine risk factors were associated with fall-related injury: age, pain (extremities and neck/shoulder), tiredness, incontinence, appetite, economy, accommodation and participation in social activities. Conclusions: This study identified risk factors from all aspects of the SCT, serving as a clinically useful theory in addition to traditional fall preventive actions. Gender differences should be considered when designing fall prevention strategies.

  • 216.
    Arkkukangas, Marina
    et al.
    School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
    Johnson, Susanna Tuvemo
    Department of Neuroscience, Physiotherapy, Uppsala University, BMC, Uppsala, Sweden.
    Hellström, Karin
    Department of Neuroscience, Physiotherapy, Uppsala University, BMC, Uppsala, Sweden.
    Söderlund, Anne
    School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
    Eriksson, Staffan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy. Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden.
    Johansson, Ann-Christin
    School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
    A feasibility study of a randomised controlled trial comparing fall prevention using exercise with or without the support of motivational interviewing2015In: Preventive Medicine Reports, E-ISSN 2211-3355, Vol. 2, p. 134-140Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this investigation was to study the feasibility of a randomised controlled trial (RCT) based on a multicentre fall prevention intervention including exercise with or without motivational interviewing compared to standard care in community-living people 75. years and older.

    Method: The feasibility of a three-armed, randomised controlled trial was evaluated according to the following: process, resources, management by questionnaire, and treatment outcomes. The outcome measures were fall frequency, physical performance and falls self-efficacy evaluated after three months. Twelve physiotherapists conducted the measurements and treatments and responded to the questionnaire. The first 45 participants recruited to the ongoing RCT were included: 16 individuals in the Otago Exercise Program group (OEP), 16 individuals in the OEP combined with motivational interviewing group (MI), and 13 individuals in the control group. The study was conducted from November 2012 to December 2013.

    Results: The feasibility of the study process, resources and management reached the set goals in most aspects; however, the set goal regarding the MI guide and planned exercise for the participating older people was not completely reached. No significant differences were found between the groups regarding the outcome measures.

    Conclusion: This study confirmed the acceptable feasibility for the study protocol in the ongoing RCT.

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  • 217.
    Arkkukangas, Marina
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Dalarna University, Falun, 791 88, Sweden; Research and Development in Sörmland, Region Sörmland, Eskilstuna, 632 17, Sweden.
    Strömqvist Bååthe, K.
    Dalarna University, Falun, 791 88, Sweden.
    Ekholm, A.
    Region Sörmland, Eskilstuna, 632 17, Sweden.
    Tonkonogi, M.
    Dalarna University, Falun, 791 88, Sweden.
    Short Multicomponent Group Exercise Intervention Promotes Long-Term Physical Activity Habits among Community-Dwelling Older Adults during COVID-19 Restrictions: A Cohort Study2022In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, no 22, article id 15140Article in journal (Refereed)
    Abstract [en]

    This study investigated whether strength, balance, body mass index, falls self-efficacy, activity levels, self-rated health, and participation in a multicomponent exercise intervention could predict physical activity levels after 5 months of self-quarantine due to the COVID-19 pandemic. This study included baseline data of 200 community-dwelling older adults (79% women, 21% men) with a mean age of 72 years who participated in a randomized controlled trial investigating a multicomponent exercise program, with 7-month follow-up survey data of their physical activity levels. The results showed significant associations with the activity levels at the 7-month follow-up. The activity levels (odds ratio (OR): 2.83, 95% CI: 1.20–6.71), the self-rated health score (2.80, 1.42–5.53), and being allocated to a specific multicomponent group-based exercise program (2.04, 1.04–4.00) showed a significant association with the activity habits at the 7-month follow-up. As this study suggests, besides the physical activity levels and the self-rated health score, participation in a high challenge multicomponent exercise program was significantly associated with physical activity levels at the 7-month follow-up. This study indicates that a relatively short multicomponent group exercise program (6–9 weeks) can motivate individuals to sustain their own training and activity levels even several months after the program has been paused or terminated. Identifying older adults’ physical activity levels and self-rated health scores and prescribing multicomponent group-based exercise programs to promote sustained physical activity habits may be a successful alternative to provide for older adults in the future. 

  • 218.
    Arkkukangas, Marina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Disciplinary Domain of Medicine and Pharmacy, research centers etc., Centre for Clinical Research Sörmland. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Åsenlöf: Physiotheraphy. Research and Development in Sörmland; Mälardalen University.
    Strömqvist Bååthe, Karin
    Ekholm, Anna
    Tonkonogi, Michail
    Health promotion and prevention: The impact of specifically adapted judo-inspired training program on risk factors for falls among adults2020In: Preventive Medicine Reports, E-ISSN 2211-3355, Vol. 19, article id 101126Article in journal (Refereed)
    Abstract [en]

    Globally, falls and fall-related injuries constitute a severe threat to public health at all ages. New approaches are warranted since existing knowledge and actions have failed to reduce the incidence of falls and fall-related injuries, both at work and during leisure time. The purpose of this quasi-experimental study was to investigate the impact of a 10-week supervised judo-inspired exercise program, Judo4Balance, provided in a workplace setting among men and women targeting: physical functions, activity level, fall-related self-efficacy, and techniques for safe landing when falling. A total of 79 adults from seven different workplaces in Sweden, mean age 45 years (18-68), participated in the program. The study was conducted from May 2018 to June 2019. The 10-week exercise program performed in a workplace setting improved physical and psychological functions, as well as techniques for falling safely, factors of great importance to prevent falls and fall-related injuries among men and women. Therefore, it is suggested that the judo-inspired exercise program may be an effective tool in the quest to promote health and prevention of risk factors for falls and fall-related injuries among those of working age.

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  • 219. Arkkukangas, Marina
    et al.
    Sundler, Annelie J.
    Soderlund, Anne
    Eriksson, Staffan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden; Department of Neuroscience, Physiotherapy, Uppsala University, Uppsala, Sweden.
    Johansson, Ann-Christin
    Older persons' experiences of a home-based exercise program with behavioral change support2017In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 33, no 12, p. 905-913Article in journal (Refereed)
    Abstract [en]

    Background: It is a challenge to promote exercise among older persons. Knowledge is needed regarding the maintenance of exercise aiming at preventing falls and promoting health and well-being in older persons.

    Purpose: This descriptive study used a qualitative inductive approach to describe older persons' experiences of a fall-preventive, home-based exercise program with support for behavioral change.

    Methods: Semi-structured interviews were conducted with 12 elderly persons aged 75years or older, and a qualitative content analysis was performed.

    Results: Four categories emerged: facilitators of performing exercise in everyday life, the importance of support, perceived gains from exercise, and the existential aspects of exercise.

    Conclusion: With support from physiotherapists (PTs), home-based exercise can be adapted to individual circumstances in a meaningful way. Including exercises in everyday life and daily routines could support the experience of being stronger, result in better physical functioning, and give hope for an extended active life in old age.

  • 220.
    Arkkukangas, Marina
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Sundler, Annelie Johansson
    Univ Boras, Fac Caring Sci Work Life & Social Welf, Boras, Sweden.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Eriksson, Staffan
    Uppsala Univ, Ctr Clin Res Sormland, Eskilstuna, Sweden.
    Johansson, Ann Christin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Older persons’ experiences of a home-based exercise programme with behavioural change support2017In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 33, no 12, p. 905-913Article in journal (Refereed)
    Abstract [en]

    Background: It is a challenge to promote exercise among older persons. Knowledge is needed regarding the maintenance of exercise aiming at preventing falls and promoting health and wellbeing in older persons.

    Purpose: This descriptive study used a qualitative inductive approach to describe older persons’ experiences of a fall-preventive, home-based exercise programme with support for behavioural change.

    Methods: Semi-structured interviews were conducted with twelve older persons aged 75 years or older, and a qualitative content analysis was performed.

    Results: Four categories emerged: facilitators of performing exercise in everyday life, the importance of support, perceived gains from exercise, and the existential aspects of exercise.

    Conclusion: With support from physiotherapists, home-based exercise can be adapted to individual circumstances in a meaningful way. By including exercises in everyday life and daily routines could support the experience of being stronger, result in better physical functioning and give hope for an extended active life in old age.

  • 221.
    Arkkukangas, Marina
    et al.
    Dalarna University, School of Education, Health and Social Studies, Medical Science. Mälardalen University.
    Sundler, Annelie Johansson
    Söderlund, Anne
    Eriksson, Staffan
    Johansson, Ann Christin
    Older persons’ experiences of a home-based exercise programme with behavioural change support2017In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 33, no 12, p. 905-913Article in journal (Refereed)
    Abstract [en]

    Background: It is a challenge to promote exercise among older persons. Knowledge is needed regarding the maintenance of exercise aiming at preventing falls and promoting health and wellbeing in older persons.

    Purpose: This descriptive study used a qualitative inductive approach to describe older persons’ experiences of a fall-preventive, home-based exercise programme with support for behavioural change.

    Methods: Semi-structured interviews were conducted with twelve older persons aged 75 years or older, and a qualitative content analysis was performed.

    Results: Four categories emerged: facilitators of performing exercise in everyday life, the importance of support, perceived gains from exercise, and the existential aspects of exercise.

    Conclusion: With support from physiotherapists, home-based exercise can be adapted to individual circumstances in a meaningful way. By including exercises in everyday life and daily routines could support the experience of being stronger, result in better physical functioning and give hope for an extended active life in old age.

  • 222. Arkkukangas, Marina
    et al.
    Söderlund, Anne
    Eriksson, Staffan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation. Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden; Department of Neuroscience, Physiotherapy, Uppsala University, Uppsala, Sweden.
    Johansson, Ann-Christin
    Fall Preventive Exercise With or Without Behavior Change Support for Community-Dwelling Older Adults: A Randomized Controlled Trial With Short-Term Follow-up2019In: Journal of Geriatric Physical Therapy, ISSN 1539-8412, E-ISSN 2152-0895, Vol. 42, no 1, p. 9-17Article in journal (Refereed)
    Abstract [en]

    Background and Purpose: In Western countries, falls and fall-related injuries are a well-known threat to health in the aging population. Studies indicate that regular exercise improves strength and balance and can therefore decrease the incidence of falls and fall-related injuries. The challenge, however, is to provide exercise programs that are safe, effective, and attractive to the older population. The aim of this study was to investigate the short-term effect of a home-based exercise program with or without motivational interviewing (MI) compared with standard care on physical performance, fall self-efficacy, balance, activity level, handgrip strength, adherence to the exercise, and fall frequency.

    Method: A total of 175 older adults participated in this randomized controlled study. They were randomly allocated for the Otago Exercise Program (OEP) (n = 61), OEP combined with MI (n = 58), or a control group (n = 56). The participants' mean age was 83 years. The recruitment period was from October 2012 to May 2015. Measurements of physical performance, fall self-efficacy, balance, activity level, handgrip strength, adherence to the exercise, and fall frequency were done before and 12 weeks after randomization.

    Results and Discussion: A total of 161 participants were followed up, and there were no significant differences between groups after a period of 12 weeks of regular exercise. Within the OEP + MI group, physical performance, fall self-efficacy, physical activity level, and handgrip strength improved significantly; likewise, improved physical performance and fall self-efficacy were found in the control group. A corresponding difference did not occur in the OEP group. Adherence to the exercise was generally high in both exercise groups.

    Conclusion: In the short-term perspective, there were no benefits of an exercise program with or without MI regarding physical performance, fall self-efficacy, activity level, handgrip strength, adherence to the exercise, and fall frequency in comparison to a control group. However, some small effects occurred within the OEP + MI group, indicating that there may be some possible value in behavioral change support combined with exercise in older adults that requires further evaluation in both short- and long-term studies.

  • 223.
    Arkkukangas, Marina
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Eriksson, Staffan
    Johansson, Ann-Christin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    One- year adherence to the Otago Exercise Programme with or without motivational interviewing in older peopleManuscript (preprint) (Other academic)
  • 224. Arkkukangas, Marina
    et al.
    Söderlund, Anne
    Eriksson, Staffan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy. Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden .
    Johansson, Ann-Christin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
    One-Year Adherence to the Otago Exercise Programme with or Without Motivational Interviewing In Community-Dwelling Older People2018In: Journal of Aging and Physical Activity, ISSN 1063-8652, E-ISSN 1543-267X, Vol. 26, no 3, p. 390-395Article in journal (Refereed)
    Abstract [en]

    This study investigated if behavioral factors, treatment with behavioral support, readiness to change, fall self-efficacy and activity habits could predict long-term adherence to an exercise program. Included in this study were 114 community-dwelling older people who had participated in one of two home-based exercise interventions. Behavioral factors associated with adherence to the exercise program over 52 weeks were analyzed. The behavioral factors, specifically activity habits at baseline, significant predicted adherence to the exercise program, with an odds ratio (OR) of 3.39 and 95% CI = 1.38-8.32 for exercise and an OR of 6.11 and 95% CI = 2.34-15.94 for walks. Being allocated to a specific treatment including motivational interviewing (MI) was also significantly predictive: OR = 2.47 and 95% CI = 1.11-5.49 for exercise adherence. In conclusion, activity habits and exercise in combination with MI had a significant association with adherence to the exercise program at a one-year follow up.

  • 225.
    Arkkukangas, Marina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Åsenlöf: Physiotheraphy.
    Tuvemo Johnson, Susanna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Åsenlöf: Physiotheraphy.
    Hellström, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Åsenlöf: Physiotheraphy.
    Anens, Elisabeth
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Åsenlöf: Physiotheraphy.
    Tonkonogi, Michail
    Larsson, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Fall Prevention Exercises With or Without Behavior Change Support for Community-Dwelling Older Adults: A 2-Year Follow-Up of a Randomized Controlled Trial2020In: Journal of Aging and Physical Activity, ISSN 1063-8652, E-ISSN 1543-267X, Vol. 28, no 1, p. 34-41Article in journal (Refereed)
    Abstract [en]

    This study investigates the effectiveness of two fall prevention exercise interventions targeting physical performance, activity level, fall-related self-efficacy, health-related quality of life, and falls: the Otago Exercise Programme (OEP) with and the OEP without behavior change support. In this randomized controlled trial (RCT), 175 participants were randomised into two intervention groups and one control group. A total of 124 community-dwelling older adults over the age of 75 who needed walking aids or home support participated in the two-year follow-up. The OEP with and the OEP without support for behavior change displayed no long-term benefits on physical performance, fall-related self-efficacy, health-related quality of life, and falls compared to a control group. Although no significant differences were detected between the groups, the results implied the control group's physical activity level decreased compared to the intervention groups at two-year follow up.

  • 226.
    Armgren, Evelina
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Olsson, Emma
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Interbedömar- och test-retest reliabilitet av the Foot Posture Index-6 och Navicular Drop Test2022Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Bland en generell vuxen population är fotsmärta vanligt förekommande, där fotställning kan vara en bidragande faktor till fotsmärta. För att bedöma fotställning finns olika tester, där The Foot Posture Index (FPI-6) och Navicular Drop Test (NDT) är bland de vanligaste. Studier som undersöktinterbedömarreliabiliteten har visat på inkonsekventa resultat och få test-retest studier finns beskrivna i litteraturen.

    Syfte: Syftet med studien var att undersöka interbedömarreliabiliteten och test-retest reliabiliteten av de två fot testerna FPI-6 och NDT på en frisk vuxen population.

    Metod: Tjugo individer, i åldrarna 25–63 år, utan smärta, tidigare omfattande eller pågående skada/trauma i foten/fötterna rekryterades genom ett bekvämlighetsurval. Deltagarna testades vid två testtillfällen med 6–7 dagars mellanrum, där fotställningar bedömdes via FPI-6 och NDT av tre olika bedömare. Bedömningen genomfördes av två legitimerade fysioterapeuter och en fysioterapeutstudent, alla utan tidigare erfarenhet av testerna.

    Resultat: Interbedömarreliabiliteten för FPI-6 visade på stor variation från dålig till god reliabilitet och NDT visade på mindre variation men ett generellt sämre resultat med negativa ICC-värden till moderat reliabilitet. Vad gäller test-retest reliabiliteten visade resultaten för FPI-6 på bättre utfall från moderat till excellent reliabilitet och NDT visade även här på sämre resultat från dålig till moderat reliabilitet.

    Slutsats: Resultaten visar på att FPI-6 är ett reliabelt test även bland oerfarna bedömare. Resultaten för NDT påvisar att testet inte är reliabelt, vilket kan bero på olika faktorer i utförandet av testet samt vilken erfarenhet bedömarna har. Vidare reliabilitetsstudier av FPI-6 och NDT behövs med bedömare som besitter olika kliniska erfarenheter och med olika typer av populationer.

  • 227.
    Arnadottir, Solveig
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Physical activity, participation and self-rated health among older community-dwelling Icelanders: a population-based study2010Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: The main objective of this study was to investigate older people’s physical activity, their participation in various life situations, and their perceptions of their own health. This included an exploration of potential influences of urban versus rural residency on these outcomes, an evaluation of the measurement properties of a balance confidence scale, and an examination of the proposed usefulness of the International Classification of Functioning, Disability and Health (ICF) as a conceptual framework to facilitate analysis and understanding of selected outcomes.

    Methods: The study design was cross-sectional, population-based, with random selection from the national register of one urban and two rural municipalities in Northern Iceland. There were 186 participants, all community-dwelling, aged 65 to 88 years (mean = 73.8), and 48% of the group were women. The participation rate was 79%. Data was collected in 2004, in face-to-face interviews and through various standardized assessments. The main outcomes were total physical activity; leisure-time, household, and work-related physical activity; participation frequency and perceived participation restrictions; and self-rated health. Other assessments represented aspects of the ICF body functions, activities, environmental factors and personal factors. Moreover, Rasch analysis methods were applied to examine and modify the Activities-specific Balance Confidence (ABC) scale and the ICF used as a conceptual framework throughout the study.

    Results: The total physical activity score was the same for urban and rural people and the largest proportion of the total physical activity behavior was derived from the household domain. Rural females received the highest scores of all in household physical activity and rural males were more physically active than the others in the work-related domain. However, leisure-time physical activity was more common in urban than rural communities. A physically active lifestyle, urban living, a higher level of cognition, younger age, and fewer depressive symptoms were all associated with more frequent participation. Rural living and depressive symptoms were associated with perceived participation restrictions. Moreover, perceived participation restrictions were associated with not being employed and limitations in advanced lower extremity capacity. Both fewer depressive symptoms and advanced lower extremity capacity also increased the likelihood of better self-rated health, as did capacity in upper extremities, older age, and household physical activity. Rasch rating scale analysis indicated a need to modify the ABC to improve its psychometric properties. The modified ABC was then used to measure balance confidence which, however, was found not to play a major role in explaining participation or self-rated health. Finally, the ICF was useful as a conceptual framework for mapping various components of functioning and health and to facilitate analyses of their relationships.

    Conclusions: The results highlighted the commonalities and differences in factors associated with participation frequency, perceived participation restrictions, and self-rated health in old age. Some of these factors, such as advanced lower extremity capacity, depressive symptoms, and physical activity pattern should be of particular interest for geriatric physical therapy due to their potential for interventions. While the associations between depressive symptoms, participation, and self-rated health are well known, research is needed on the effects of advanced lower extremity capacity on participation and self-rated health in old age. The environment (urban versus rural) also presented itself as an important contextual variable to be aware of when working with older people’s participation and physically active life-style. Greater emphasis should be placed on using Rasch measurement methods for improving the availability of quality scientific measures to evaluate various aspects of functioning and health among older adults. Finally, a coordinated implementation of a conceptual framework such as ICF may further advance interdisciplinary and international studies on aging, functioning, and health.

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  • 228.
    Arnadottir, Solveig A
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gunnarsdottir, Elin D
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Are rural older Icelanders less physically active than those living in urban areas?: a population-based study2009In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 37, no 4, p. 409-417Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Older people in rural areas have been labelled as physically inactive on the basis of leisure-time physical activity research. However, more research is needed to understand the total physical activity pattern in older adults, considering all domains of physical activity, including leisure, work, and domestic life. AIMS: We hypothesised that: (a) total physical activity would be the same for older people in urban and rural areas; and (b) urban and rural residency, along with gender and age, would be associated with differences in domain-specific physical activities. METHODS: Cross-sectional data were collected in Icelandic rural and urban communities from June through to September 2004. Participants were randomly selected, community-dwelling, 65-88 years old, and comprised 68 rural (40% females) and 118 urban (53% females) adults. The Physical Activity Scale for the Elderly (PASE) was used to obtain a total physical activity score and subscores in leisure, during domestic life, and at work. RESULTS: The total PASE score was not associated with rural vs. urban residency, but males were, in total, more physically active than females, and the 65-74-year-olds were more active than the 75-88-year-olds. In the leisure domain, rural people had lower physical activity scores than urban people. Rural males were, however, most likely of all to be physically active in the work domain. In both urban and rural areas, the majority of the physical activity behaviour occurred in relation to housework, with the rural females receiving the highest scores. CONCLUSIONS: Older Icelanders in rural areas should not be labelled as less physically active than those who live in urban areas. Urban vs. rural living may, however, influence the physical activity patterns among older people, even within a fairly socioeconomically and culturally homogeneous country such as Iceland. This reinforces the need to pay closer attention to the living environment when studying and developing strategies to promote physical activity.

  • 229.
    Arnadottir, Solveig A
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. School of Health Sciences, University of Akureyri, Iceland .
    Gunnarsdottir, Elin D
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Determinants of self-rated health in old age: a population-based, cross-sectional study using the international classification of functioning2011In: BMC Public Health, E-ISSN 1471-2458, Vol. 11, p. 670-Article in journal (Refereed)
    Abstract [en]

    Background: Self-rated health (SRH) is a widely used indicator of general health and multiple studies have supported the predictive validity of SRH in older populations concerning future health, functional decline, disability, and mortality. The aim of this study was to use the theoretical framework of the International Classification of Functioning, Disability and Health (ICF) to create a better understanding of factors associated with SRH among community-dwelling older people in urban and rural areas.

    Methods: The study design was population-based and cross-sectional. Participants were 185 Icelanders, randomly selected from a national registry, community-dwelling, 65-88 years old, 63% urban residents, and 52% men. Participants were asked: "In general, would you say your health is excellent, very good, good, fair, or poor?" Associations with SRH were analyzed with ordinal logistic regression. Explanatory variables represented aspects of body functions, activities, participation, environmental factors and personal factors components of the ICF.

    Results: Univariate analysis revealed that SRH was significantly associated with all analyzed ICF components through 16 out of 18 explanatory variables. Multivariate analysis, however, demonstrated that SRH had an independent association with five variables representing ICF body functions, activities, and personal factors components: The likelihood of a better SRH increased with advanced lower extremity capacity (adjusted odds ratio [adjOR] = 1.05, < 0.001), upper extremity capacity (adjOR = 1.13, = 0.040), household physical activity (adjOR = 1.01, = 0.016), and older age (adjOR = 1.09, = 0.006); but decreased with more depressive symptoms (adjOR = 0.79, < 0.001).

    Conclusions: The results highlight a collection of ICF body functions, activities and personal factors associated with higher SRH among community-dwelling older people. Some of these, such as physical capacity, depressive symptoms, and habitual physical activity are of particular interest due to their potential for change through public health interventions. The use of ICF conceptual framework and widely accepted standardized assessments should make these results comparable and relevant in an international context.

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    Determinants of self-rated health in old age: a population-based, cross-sectional study using the international classification of functioning
  • 230.
    Arnadottir, Solveig A
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gunnarsdottir, Elin D
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Participation frequency and perceived participation restrictions at older age: applying the International Classification of Functioning, Disability and Health (ICF) framework2011In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 33, no 23-24, p. 2208-2216Article in journal (Refereed)
    Abstract [en]

    Purpose: To identify variables from different components of International Classification of Functioning, Disability and Health (ICF) associated with older people's participation frequency and perceived participation restrictions. Method: Participants (N = 186) were community-living, 65-88 years old and 52% men. The dependent variables, participation frequency (linear regression) and perceived participation restrictions (logistic regression), were measured using The Late-Life Function and Disability Instrument. Independent variables were selected from various ICF components. Results: Higher participation frequency was associated with living in urban rather than rural community (beta = 2.8, p < 0.001), physically active lifestyle (beta = 4.6, p < 0.001) and higher cognitive function (beta = 0.3, p = 0.009). Lower participation frequency was associated with being older (beta = -0.2, p = 0.002) and depressive symptoms (beta = -0.2, p = 0.029). Older adults living in urban areas, having more advanced lower extremities capacity, or that were employed had higher odds of less perceived participation restrictions (adjusted odds ratio [OR] = 5.5, p = 0.001; OR = 1.09, p < 0.001; OR = 3.7, p = 0.011; respectively). In contrast, the odds of less perceived participation restriction decreased as depressive symptoms increased (OR = 0.8, p = 0.011). Conclusions: Our results highlight the importance of capturing and understanding both frequency and restriction aspects of older persons' participation. ICF may be a helpful reference to map factors associated with participation and to study further potentially modifiable influencing factors such as depressive symptoms and advanced lower extremity capacity.

  • 231.
    Arnadottir, Solveig A
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gunnarsdottir, Elin D
    Fisher, Anne G
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Application of rasch analysis to examine psychometric aspects of the activities-specific balance confidence scale when used in a new cultural context2010In: Archives of Physical Medicine and Rehabilitation, ISSN 0003-9993, E-ISSN 1532-821X, Vol. 91, no 1, p. 156-163Article in journal (Refereed)
    Abstract [en]

    Arnadottir SA, Lundin-Olsson L, Gunnarsdottir ED, Fisher AG. Application of Rasch analysis to examine psychometric aspects of the Activities-Specific Balance Confidence Scale when used in a new cultural context. OBJECTIVE: To investigate by using Rasch analysis the psychometric properties of the Activities-Specific Balance Confidence (ABC) Scale when applied in a new Icelandic context. DESIGN: Cross-sectional, population-based, random selection from the Icelandic National Registry. SETTING: Community-based. PARTICIPANTS: Icelanders (N=183), 65 to 88 years old, and 48% women. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: ABC, an instrument used to evaluate how confident older people are in maintaining balance and remaining steady when moving through the environment. An Icelandic translation of the ABC (ABC-ICE) scale was evaluated by implementing Rasch rating scale analysis to transform ordinal ABC-ICE scores into interval measures and evaluating aspects of validity and reliability of the scale. RESULTS: Participants were not able to differentiate reliably between the 11 rating scale categories of the ABC-ICE. Additionally, 3 items failed to show acceptable goodness of fit to the ABC-ICE rating scale model. By collapsing categories and creating a new 5-category scale, only 1 item misfit. Removing that item resulted in a modified version of ABC-ICE with 5 categories and 15 items. Both item goodness-of-fit statistics and principal components analysis supported unidimensionality of the modified ABC-ICE. The ABC-ICE measures reliably separated the sample into at least 4 statistically distinct strata of balance confidence. Finally, the hierarchical order of item difficulties was consistent with theoretic expectations, and the items were reasonably well targeted to the balance confidence of the persons tested. CONCLUSIONS: Rasch analysis indicated a need to modify the ABC-ICE to improve its psychometric properties. Further studies are needed to determine if similar analyses of other versions of the ABC, including the original one, will yield similar results.

  • 232.
    Arnadottir, Solveig
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gunnarsdottir, E
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Self-rated health: a valid outcome in geriatric physical therapy?Manuscript (preprint) (Other academic)
  • 233.
    Arnell, Susann
    et al.
    Örebro University, School of Health Sciences.
    Jerlinder, Kajsa
    Lundqvist, Lars-Olov
    Örebro University, School of Health Sciences.
    Participation in physical activities among adolescents with an Autism Spectrum Disorder: experiences from a parental perspective2019Conference paper (Other academic)
  • 234.
    Arnvig, Jakob
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Ludvigsson, Adam
    Mälardalen University, School of Health, Care and Social Welfare.
    Fallförebyggande åtgärder för äldre ur ett biopsykosocialt perspektiv: En systematisk litteraturöversikt2022Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Reviews of fall prevention measures are mainly centered around training but inadequate regarding psychological interventions and uncertain around social interventions. The authors see this as an opportunity to compile evidence through a systematic literature review on fall prevention measures from a biopsychosocial perspective. 

    Objective: The objective of this study is to compile research on fall prevention measures in the elderly. Furthermore, the purpose is to review the evidence through the lens of a biopsychosocial perspective and to assess the quality of all included studies. 

    Method: The authors of this literature review conducted a literature search in PubMed and CINAHL Plus. The project-process ended with seven RCT-studies that were included based on the study's questions and purpose and further examined based on SBU's review templates. 

    Results: Physical measures were seen in combined balance and strength in the lower extremity as well as functional training. Psychological measures were seen in the form of MI. Social measures were seen in the form of group training. The quality of the included studies was assessed to be moderate and the strength of evidence to be limited. 

    Conclusions: Physical measures showed positive results on the number of falls. Psychological measures did not show any positive outcomes in the number of falls. Social measures were shown to support adherence to exercise. Functional training in groups can be a relevant measure in preventing falls for older individuals.

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  • 235.
    Aronsson, Elin
    et al.
    Luleå University of Technology, Department of Health, Learning and Technology.
    Eriksson, Faith
    Luleå University of Technology, Department of Health, Learning and Technology.
    Användningen av preventionsprogram för axelskador hos kvinnliga handbollsspelare i Svensk Handbollselit2022Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
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  • 236.
    Aronsson, Gabriella
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Åsenlöf: Physiotheraphy.
    Ågren, Hampus
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Åsenlöf: Physiotheraphy.
    Self-Assessed Anxiety and Physical Fitness in South African University Students: In collaboration with the Department of Physiotherapy, University of the Western Cape2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Background/problem definition: Mental illness, such as anxiety, is a health problem affecting about 10-20% of adolescents worldwide. Studies have found a person’s physical fitness to be associated with their mental health, but most studies have been done in the western world and few have investigated sub-Saharan African (SSA) countries. It has also been found that SSA countries’ guidelines regarding physical activity are few and incomplete, although the importance of it is well known.

     

    Aim: To investigate to what extent physical fitness: grip strength (GS), 20 meter shuttle run test (20MSRT), body mass index (BMI) and waist circumference (WC) correlate to self-assessed anxiety in South African students at the UWC.

     

    Methods: The study had a quantitative, cross-sectional and correlational research design with a non-randomized convenience sampling. The physical fitness data were collected through a hydraulic grip strength dynamometer, 20MSRT and by measuring anthropometric measurements in order to calculate BMI and WC. An electronic version of the GAD-7 form was used for self-assessed anxiety.

     

    Results: The results showed a significant positive correlation between BMI and levels of anxiety in women, but not in men. The correlation of anxiety related to WC, GS and 20MSRT showed no significance for the whole sample or related to gender, respectively.

    Conclusion: No significant correlation could be determined between physical fitness and anxiety. Severe anxiety affected 25% of the population, supporting previous research indicating that students are a group prone to anxiety.

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  • 237.
    Aronsson, Gustav
    Luleå University of Technology, Department of Health, Learning and Technology.
    Ska excentrisk träning prioriteras vid behandling av lateral epikondyalgi?: En systematisk litteraturöversikt2023Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Tennisarmbåge eller lateral epikondylalgi (LE) är ett muskuloskeletalt besvär som drabbar utsidan av armbågen. LE har en prevalens på 1–3 % av hela populationen där majoriteten av fallen är hos individer i åldrarna 35–54 år. Det är en av de vanligaste muskuloskeletala orsakerna till att personer söker primärvården med upp till 7 per 1000 vårdkontakter. Syfte: Undersöka utfall av studier som jämför excentrisk träning mot andra fysioterapeutiska behandlingar vid LE. Metod: En systematisk litteratursökning i databaserna Pubmed, CINAHL och Scopus samt sekundär sökning i referenslistor av relevanta studier. Resultat: Totalt inkluderades åtta studier som randomiserat jämförde excentrisk träning mot töjning (tre studier), koncentrisk och isometrisk träning (tre studier) och cyriax fysioterapi (två studier). Töjning: ingen signifikant skillnad i smärta eller självskattad funktion mellan grupperna. En studie undersökte greppstyrka där excentrisk träning var signifikant bättre efter sex månaders uppföljning. Koncentrisk och isometrisk: varierande resultat från studierna, två studier visade på smärtminskning för excentrisk jämfört med koncentrisk träning samt i en av dem även bättre självskattad funktion för excentrisk träning. I den tredje var det ingen signifikant skillnad mellan excentrisk och koncentrisk träning, dock hade excentrisk och koncentrisk plus isometrisk träning signifikant smärtminskning och ökad självskattad funktion jämfört med de andra. Cyriax fysioterapi: excentrisk träning var signifikant bättre vad gäller smärtminskning och självskattad funktion. Konklusion: Excentrisk träning verkar vara en effektiv behandling mot LE. Det finns dock få studier som jämför enbart excentrisk träning mot andra fysioterapeutiska behandlingar. Dessutom varierar träningsupplägget vad gäller frekvens och intensitet mellan studierna. Fler studier behövs på ovannämnda behandlingar för att säkerställa effekten av excentrisk träning samt studier där man undersöker excentrisk träning mot andra behandlingsmetoder. Jag uppmanar även till studier som jämför olika dosering och intensitet av excentrisk träning för att få ett standardiserat träningsupplägg. 

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  • 238.
    Arrenius, Madeleine
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Löfving, Elin
    Mälardalen University, School of Health, Care and Social Welfare.
    Fysioterapeuters upplevelser av att bemöta patienter med muskuloskeletal smärta och rädsla-undvikande beteende: En kvalitativ intervjustudie2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Muskuloskeletal smärta är den vanligaste orsaken till dysfunktion globalt sett. Detta kan leda till ett rädsla-undvikande beteende hos patienten. Ett sätt att bemöta denna patientgrupp är att integrera det biopsykosociala synsättet. Tidigare forskning har visat att det finns en osäkerhet bland fysioterapeuter i användningen av detta.

    Syfte: Att undersöka fysioterapeuters upplevelser av att bemöta patienter med muskuloskeletal smärta och rädsla-undvikande beteende. 

    Metod: En kvalitativ deskriptiv intervjustudie med ett ändamålsenligt urval av fysioterapeuter med en beteendemedicinsk inriktning verksamma inom primärvården. Datamaterialet analyserades enligt en kvalitativ innehållsanalys med en induktiv ansats.

    Resultat: Ur analysprocessen framkom fyra kategorier gällande bemötande av patienter med muskuloskeletal smärta och rädsla-undvikande beteende: karaktäristiska beteenden hos patienterna, framgångsrika strategier, befintlig kunskap i att hantera denna patientgrupp samt socioekonomiska skillnader. 

    Slutsats: Informanterna i studien upplevde att det var viktigt att se till helheten vid bemötandet av patienter med muskuloskeletal smärta och rädsla-undvikande beteende men på grund av osäkerhet kunde alltför komplexa patientfall bli svårbehandlade som fysioterapeut. Detta pekar på ett behov av fortsatt utbildning gällande integrering av det biopsykosociala synsättet för att fysioterapeuter ska känna sig säkra i hur de ska bemöta denna patientgrupp. 

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  • 239.
    Arumugam, Ashokan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sacral Osteosarcoma Masquerading as Posterior Thigh Pain2018In: Journal of Orthopaedic and Sports Physical Therapy, ISSN 0190-6011, E-ISSN 1938-1344, Vol. 48, no 8, p. 665-665Article in journal (Other academic)
  • 240.
    Arumugam, Ashokan
    et al.
    Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
    Björklund, Martin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy. Centre for Musculoskeletal Research, Department of Occupational Health Sciences and Psychology, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden.
    Mikko, Sanna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Häger, Charlotte K.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Effects of neuromuscular training on knee proprioception in individuals with anterior cruciate ligament injury: A systematic review and GRADE evidence synthesis2021In: BMJ Open, E-ISSN 2044-6055, Vol. 11, no 5, article id e049226Article, review/survey (Refereed)
    Abstract [en]

    Objective: To systematically review and summarise the evidence for the effects of neuromuscular training compared with any other therapy (conventional training/sham) on knee proprioception following anterior cruciate ligament (ACL) injury.

    Design: Systematic Review.

    Data sources: PubMed, CINAHL, SPORTDiscus, AMED, Scopus and Physical Education Index were searched from inception to February 2020.

    Eligibility criteria: Randomised controlled trials (RCTs) and controlled clinical trials investigating the effects of neuromuscular training on knee-specific proprioception tests following a unilateral ACL injury were included.

    Data extraction and synthesis: Two reviewers independently screened and extracted data and assessed risk of bias of the eligible studies using the Cochrane risk of bias 2 tool. Overall certainty in evidence was determined using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) tool.

    Results: Of 2706 articles retrieved, only 9 RCTs, comprising 327 individuals with an ACL reconstruction (ACLR), met the inclusion criteria. Neuromuscular training interventions varied across studies: whole body vibration therapy, Nintendo-Wii-Fit training, balance training, sport-specific exercises, backward walking, etc. Outcome measures included joint position sense (JPS; n=7), thresholds to detect passive motion (TTDPM; n=3) or quadriceps force control (QFC; n=1). Overall, between-group mean differences indicated inconsistent findings with an increase or decrease of errors associated with JPS by ≤2°, TTDPM by ≤1.5° and QFC by ≤6 Nm in the ACLR knee following neuromuscular training. Owing to serious concerns with three or more GRADE domains (risk of bias, inconsistency, indirectness or imprecision associated with the findings) for each outcome of interest across studies, the certainty of evidence was very low.

    Conclusions: The heterogeneity of interventions, methodological limitations, inconsistency of effects (on JPS/TTDPM/QFC) preclude recommendation of one optimal neuromuscular training intervention for improving proprioception following ACL injury in clinical practice. There is a need for methodologically robust RCTs with homogenous populations with ACL injury (managed conservatively or with reconstruction), novel/well-designed neuromuscular training and valid proprioception assessments, which also seem to be lacking.

    PROSPERO registration number CRD42018107349.

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  • 241.
    Arumugam, Ashokan
    et al.
    Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Thigh muscle co-contraction patterns in individuals with anterior cruciate ligament reconstruction, athletes and controls during a novel double-hop test2022In: Scientific Reports, E-ISSN 2045-2322, Vol. 12, article id 8431Article in journal (Refereed)
    Abstract [en]

    Efficient neuromuscular coordination of the thigh muscles is crucial in maintaining dynamic knee stability and thus reducing anterior cruciate ligament (ACL) injury/re-injury risk. This cross-sectional study measured electromyographic (EMG) thigh muscle co-contraction patterns during a novel one-leg double-hop test among individuals with ACL reconstruction (ACLR; n = 34), elite athletes (n = 22) and controls (n = 24). Participants performed a forward hop followed by a 45° unanticipated diagonal hop either in a medial (UMDH) or lateral direction (ULDH). Medial and lateral quadriceps and hamstrings EMG were recorded for one leg (injured/non-dominant). Quadriceps-to-Hamstring (Q:H) ratio, lateral and medial Q:H co-contraction indices (CCIs), and medial-to-lateral Q:H co-contraction ratio (CCR; a ratio of CCIs) were calculated for three phases (100 ms prior to landing, initial contact [IC] and deceleration phases) of landing. We found greater activity of the quadriceps than the hamstrings during the IC and deceleration phases of UMDH/ULDH across groups. However, higher co-contraction of medial rather than lateral thigh muscles during the deceleration phase of landing was found; if such co-contraction patterns cause knee adduction, a putative mechanism to decrease ACL injury risk, during the deceleration phase of landing across groups warrants further investigation.

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  • 242. Arumugam, Ashokan
    et al.
    Markström, Jonas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    A novel test reliably captures hip and knee kinematics and kinetics during unanticipated/anticipated diagonal hops in individuals with anterior cruciate ligament reconstruction2020In: Journal of Biomechanics, ISSN 0021-9290, E-ISSN 1873-2380, Vol. 99, article id 109480Article in journal (Refereed)
    Abstract [en]

    Unanticipated land-and-cut maneuvers might emulate lower limb mechanics associated with anterior cruciate ligament (ACL) injury. Reliability studies on landing mechanics of such maneuvers are however lacking. This study investigated feasibility and within-session reliability of landing mechanics of a novel one-leg double-hop test, mimicking a land-and-cut maneuver, in individuals with ACL reconstruction (ACLR). Our test comprised a forward hop followed by a diagonal hop in either of two directions (medial/lateral) under anticipated and unanticipated conditions. Twenty individuals with a unilateral ACLR (aged 24.2 ± 4.2 years, 0.7-10.8 years post-surgery) performed three successful hops/direction per leg. We determined reliability (intraclass correlation coefficient [ICC]) and agreement (standard error of measurement [SEM]) of 3-dimensional hip and knee angles and moments during the deceleration phase of the land-and-cut maneuver (vulnerable for non-contact ACL injuries). Mean success rate for unanticipated hops was 71-77% and for anticipated hops 91-95%. Both limbs demonstrated moderate-excellent reliability (ICC 95% confidence intervals: 0.50-0.99) for almost all hip and knee peak angles and moments in all planes and conditions, with a few exceptions: poor-good reliability for hip and knee frontal and/or transverse plane variables, especially for lateral diagonal hops. The SEMs were ≤5° and ≤0.23 N·m/kg·m for most peak angles and moments, respectively. Our test seems feasible and showed satisfactory reliability for most hip and knee angles and moments; however, low knee abduction and internal rotation angles and moments, and moderate reliability of these moments deserve consideration. The test appears to challenge dynamic knee control and may prove valuable in evaluation during knee rehabilitation.

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  • 243.
    Arumugam, Ashokan
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Markström, Jonas L.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Häger, Charlotte K.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Introducing a novel test with unanticipated medial/lateral diagonal hops that reliably captures hip and knee kinematics in healthy women2019In: Journal of Biomechanics, ISSN 0021-9290, E-ISSN 1873-2380, Vol. 82, p. 70-79Article in journal (Refereed)
    Abstract [en]

    Despite a vast literature on one-leg hops and cutting maneuvers assessing knee control pre/post-injury of the anterior cruciate ligament (ACL), comprehensive and reliable tests performed under unpredictable conditions are lacking. This study aimed to: (1) assess the feasibility of an innovative, knee-challenging, one-leg double-hop test consisting of a forward hop followed by a diagonal hop (45°) performed medially (UMDH) or laterally (ULDH) in an unanticipated manner; and (2) determine within- and between-session reliability for 3-dimensional hip and knee kinematics and kinetics of these tests. Twenty-two healthy women (22.3 ± 3.3 years) performed three successful UMDH and ULDH, twice 1–4 weeks apart. Hop success rate was 69–84%. Peak hip and knee angles demonstrated moderate to excellent within-session reliability (intraclass correlation coefficient [ICC] 95% confidence interval [CI]: 0.67–0.99, standard error of measurement [SEM] ≤  3°) and poor to excellent between-session reliability (ICC CI: 0.22–0.94, SEM ≤ 3°) for UMDH and ULDH. The smallest real difference (SRD) was low (≤ 5°) for nearly all peak angles. Peak hip and knee moments demonstrated poor to excellent reliability (ICC CI: 0–0.97) and, in general, moments were more reliable within-session (SEM ≤ 0.14 N.m/kg.m, both directions) than between-session (SRD ≤ 0.43 N.m/kg.m). Our novel test was feasible and, in most but not all cases, provided reliable angle estimates (within-session > between-session, both directions) albeit less reliable moments (within-session > between-session, both directions). The relatively large hip and knee movements in the frontal and transverse planes during the unanticipated hops suggest substantial challenge of dynamic knee control. Thus, the test seems appropriate for evaluating knee function during ACL injury rehabilitation.

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  • 244.
    Arumugam, Ashokan
    et al.
    Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; Neuromusculoskeletal Rehabilitation Research Group, RIMHS - Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; Sustainable Engineering Asset Management Research Group, RISE - Research Institute of Sciences and Engineering, University of Sharjah, Sharjah, United Arab Emirates; Adjunct Faculty, Department of Physiotherapy, Manipal College of Health professions, Manipal Academy of Higher Education, Manipal, Karnataka, India.
    Mohammad Zadeh, Shima A.
    Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
    Zabin, Zina Anwar
    Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
    Hawarneh, Tamara Mohammad Emad
    Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
    Ahmed, Hejab Iftikhar
    Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
    Jauhari, Fatema Shabbir
    Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
    Alkalih, Hanan Youssef
    Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
    Shousha, Tamer Mohamed
    Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; Neuromusculoskeletal Rehabilitation Research Group, RIMHS - Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; Adjunct Faculty, Department of Physiotherapy, Manipal College of Health professions, Manipal Academy of Higher Education, Manipal, Karnataka, India.
    Moustafa, Ibrahim M.
    Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; Neuromusculoskeletal Rehabilitation Research Group, RIMHS - Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; Faculty of Physical Therapy, Cairo University, Cairo, Egypt.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Sedentary and physical activity time differs between self-reported ATLS-2 physical activity questionnaire and accelerometer measurements in adolescents and young adults in the United Arab Emirates2023In: BMC Public Health, E-ISSN 1471-2458, Vol. 23, no 1, article id 1045Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Most young adults and adolescents in the United Arab Emirates (UAE) do not meet the established internationally recommended physical activity levels per day. The Arab Teen Lifestyle Study (ATLS) physical activity questionnaire has been recommended for measuring self-reported physical activity of Arab adolescents and young adults (aged 14 years to mid-twenties). The first version of the ATLS has been validated with accelerometers and pedometers (r ≤ 0.30). The revised version of the questionnaire (ATLS-2, 2021) needs further validation. The aim of this study was to validate the self-reported subjective sedentary and physical activity time of the ATLS-2 (revised version) physical activity questionnaire with that of Fibion accelerometer-measured data.

    METHODS: In this cross-sectional study, 131 healthy adolescents and young adults (aged 20.47 ± 2.16 [mean ± SD] years (range 14-25 years), body mass index 23.09 ± 4.45 (kg/m2) completed the ATLS-2 and wore the Fibion accelerometer for a maximum of 7 days. Participants (n = 131; 81% non-UAE Arabs (n = 106), 13% Asians (n = 17) and 6% Emiratis (n = 8)) with valid ATLS-2 data without missing scores and Fibion data of minimum 10 h/day for at least 3 weekdays and 1 weekend day were analyzed. Concurrent validity between the two methods was assessed by the Spearman rho correlation and Bland-Altman plots.

    RESULTS: The questionnaire underestimated sedentary and physical activity time compared to the accelerometer data. Only negligible to weak correlations (r ≤ 0.12; p > 0.05) were found for sitting, walking, cycling, moderate intensity activity, high intensity activity and total activity time. In addition, a proportional/systematic bias was evident in the plots for all but two (walking and moderate intensity activity time) of the outcome measures of interest.

    CONCLUSIONS: Overall, self-reported ATLS-2 sedentary and physical activity time had low correlation and agreement with objective Fibion accelerometer measurements in adolescents and young adults in the UAE. Therefore, sedentary and physical activity assessment for these groups should not be limited to self-reported measures.

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  • 245.
    Arumugam, Ashokan
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Strong, Andrew
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Tengman, Eva
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Röijezon, Ulrik
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Psychometric properties of knee proprioception tests targeting healthy individuals and those with anterior cruciate ligament injury managed with or without reconstruction: a systematic review protocol2019In: BMJ Open, E-ISSN 2044-6055, Vol. 9, no 4, article id e027241Article, review/survey (Refereed)
    Abstract [en]

    Introduction: An anterior cruciate ligament (ACL) injury affects knee proprioception and sensorimotor control and might contribute to an increased risk of a second ACL injury and secondary knee osteoarthritis. Therefore, there is a growing need for valid, reliable and responsive knee proprioception tests. No previous study has comprehensively reviewed all the relevant psychometric properties (PMPs) of these tests together. The aim of this review protocol is to narrate the steps involved in synthesising the evidence for the PMPs of specific knee proprioception tests among individuals with an ACL injury and knee-healthy controls.

    Methods and analysis: The Preferred Reporting Items for Systematic reviews and Meta-Analyses will be followed to report the review. A combination of four conceptual groups of terms-(1) construct (knee proprioception), (2) target population (healthy individuals and those with an ACL injury managed conservatively or with a surgical reconstruction), (3) measurement instrument (specific knee proprioception tests) and (4) PMPs (reliability, validity and responsiveness)-will be used for electronic databases search. PubMed, AMED, CINAHL, SPORTDiscus, Web of Science, Scopus, the Cochrane Central Register of Controlled Trials and ProQuest will be searched from their inception to November 2018. Two reviewers will independently screen titles, abstracts and full text articles, extract data and perform risk of bias assessment using the updated COnsensus-based Standards for the selection of health Measurement INstruments risk of bias checklist for the eligible studies. A narrative synthesis of the findings and a meta-analysis will be attempted as appropriate. Each PMP of knee proprioception tests will be classified as 'sufficient', 'indeterminate' or 'insufficient'. The overall level of evidence will be ascertained using an established set of criteria.

    Ethics and dissemination: Ethical approval or patient consent is not required for a systematic review. The review findings will be submitted as a series of manuscripts for peer-review and publication in scientific journals.

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  • 246.
    Arumugam, Ashokan
    et al.
    Department of Community Medicine and Rehabilitation – Physiotherapy Section, Umeå University, Umeå, Sweden.
    Strong, Andrew
    Department of Community Medicine and Rehabilitation – Physiotherapy Section, Umeå University, Umeå, Sweden.
    Tengman, Eva
    Department of Community Medicine and Rehabilitation – Physiotherapy Section, Umeå University, Umeå, Sweden.
    Röijezon, Ulrik
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Häger, Charlotte K
    Department of Community Medicine and Rehabilitation – Physiotherapy Section, Umeå University, Umeå, Sweden.
    Psychometric properties of knee proprioception tests targeting healthy individuals and those with anterior cruciate ligament injury managed with or without reconstruction: a systematic review protocol2019In: BMJ Open, E-ISSN 2044-6055, Vol. 9, no 4, article id e02741Article in journal (Refereed)
    Abstract [en]

    An anterior cruciate ligament (ACL) injury affects knee proprioception and sensorimotor control and might contribute to an increased risk of a second ACL injury and secondary knee osteoarthritis. Therefore, there is a growing need for valid, reliable and responsive knee proprioception tests. No previous study has comprehensively reviewed all the relevant psychometric properties (PMPs) of these tests together. The aim of this review protocol is to narrate the steps involved in synthesising the evidence for the PMPs of specific knee proprioception tests among individuals with an ACL injury and knee-healthy controls.

  • 247.
    Arundale, Amelia
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.
    Kvist, Joanna
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Hägglund, Martin
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.
    Fältström, Anne
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Region Jönköping County, Rehabilitation Centre, Ryhov County Hospital, Jönköping, Sweden.
    Jumping performance based on duration of rehabilitation in female football players after anterior cruciate ligament reconstruction2019In: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 27, no 2, p. 556-563Article in journal (Refereed)
    Abstract [en]

    Purpose

    To determine if female football players who had longer durations of rehabilitation, measured in months, after anterior cruciate ligament reconstruction would have lower tuck jump scores (fewer technique flaws) and smaller asymmetries during drop vertical jump landing.

    Methods

    One-hundred-and-seventeen female football players, aged 16ᅵ25 years, after primary unilateral ACL reconstruction (median 16 months, range 6ᅵ39) were included. Athletes reported the duration of rehabilitation they performed after anterior cruciate ligament reconstruction. Athletes also performed the tuck jump and drop vertical jump tests. Outcome variables were: tuck jump score, frontal plane knee motion and probability of peak knee abduction moment during drop vertical jump landing.

    Results

    There was no difference in tuck jump score based on duration of rehabilitation (n.s.). No interaction (n.s.), difference between limbs (n.s.), or duration of rehabilitation (n.s.) was found for peak knee abduction moment during drop vertical jump landing. No interaction (n.s.) or difference between limbs (n.s.) was found for frontal plane knee motion, but there was a difference based on duration of rehabilitation (P?=?0.01). Athletes with >?9 months of rehabilitation had more frontal plane knee motion (medial knee displacement) than athletes with <?6 months (P?=?0.01) or 6ᅵ9 months (P?=?0.03).

    Conclusion

    As there was no difference in tuck jump score or peak knee abduction moment based on duration of rehabilitation, the results of this study press upon clinicians the importance of using objective measures to progress rehabilitation and clear athletes for return to sport, rather than time alone.

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    Jumping performance based on duration of rehabilitation in female football players after anterior cruciate ligament reconstruction
  • 248.
    Arvidsson, Christina
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Jaehnke, Katrine
    Mälardalen University, School of Health, Care and Social Welfare.
    FYSIOTERAPEUTISK UNDERSÖKNING OCH BEHANDLING AV FÖRLOSSNINGSSKADA I BÄCKENBOTTEN: En kvalitativ intervjustudie2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Ruptures in the pelvic floor muscles is the most common childbirth injury. It affects 70 – 85 percent of the Swedish women who gives birth every year. Childbirth injuries can cause lack of motor control of the pelvic floor muscles, decreased participation and activity in the womens every day life. It also can affect the qualilty of life. The physiotherapists role in care for these patients is to examine and treat the patients problems in a biopsychosocial way to work for health benefits and provide further injuries.

    Purpose: The purpose is to examine physiotherapists experience of examination and rehabilitation of women with ruptures in the pelvic floor muscles caused by childbirth injuries.

    Method: In a qualitative descriptive interview study with a appropriate selection, interviews was done with six physiotherapists who is operative in womens health. A semi structured interview guide was used and then a manifest qualitative analysis was done with an inductive approach.

    Result: The analysis process showed five main categories in terms of the physiotherapists experience of examine and treat women with muscle ruptures in the pevic floor caused by childbirth injuries: ’Examination and treatment in body structure and body function level’, ’to build trust between therapist and patient’, ’work with the patients fear-avoidance behaviour’, ’work in team with other professionals’ and ’inform the patient about the injury in early state’. Two of the five main categories were divided into under categories associated to the main categories. Conclusion: The informants in the study experienced that there is a necessity to examine and rehabilitate patients out of their individual needs. They experienced that it was important to talk about the worry a lot of the patients with injuries in the pelvic floor feel and to build trust to avoid catastrophizing and fear-avoidance behaviour.

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  • 249.
    Arvidsson, Hanna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Åsenlöf: Physiotheraphy.
    Norberg, Felicia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Åsenlöf: Physiotheraphy.
    Nervmobilisering som fysioterapeutisk behandling vid karpaltunnelsyndrom2021Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Carpal tunnel syndrome is the most common type of peripheral neuropathy caused by compression of the median nerve in the carpal tunnel. The condition is characterized by night time tingling and pain in the hand and fingers. 

    Objective: The purpose of this study was to investigate the effects and evidence of neural mobilization as a treatment for carpal tunnel syndrome. 

    Methods: Searches were made in the databases PubMed, PEDro, CINAHL, AMED and Scopus to try and find randomized controlled trials that investigated neural mobilization as treatment for carpal tunnel syndrome. All of the included articles were appraised by the PEDro-scale and the level of evidence was graded using GRADEstud. 

    Results: Nine studies were included in this review. In all of the included studies a positive effect could be seen by neural mobilization on symptoms and/or function with a significant difference between groups in seven out of the nine studies. Six out of the nine studies had high quality and three had low quality according to the PEDro-scale. The grading of evidence showed that neural mobilization as treatment for carpal tunnel syndrome has a moderately high level of evidence (+++). Few studies with few participants resulted in one point deduction for lack of precision.

    Conclusion: Neural mobilization could have positive effects on symptoms and function in patients with carpal tunnel syndrome and has a moderately high level of evidence according to GRADEstud. Neural mobilization may have positive effects long term and could reduce need for surgery but more high quality research is needed to confirm this.

    Key words: Carpal tunnel syndrome, CTS, neural mobilization, nerve gliding.

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  • 250.
    Arvidsson Lindvall, Mialinn
    et al.
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Appelros, Peter
    Örebro University, Faculty of Medicine and Health, Örebro, Sweden.
    Forsberg, Anette
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Anderzen-Carlsson, Agneta
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Experiences of living with balance limitations after first-ever stroke2023Conference paper (Refereed)
    Abstract [en]

    Background:  

    Stroke is the leading cause of serious, long-term disability among adults. Balance control after stroke may be affected due to motor impairment such as muscle weakness, spasticity and impaired sensory function and also cognitive deficits may affect balance control. The balance limitations affect walking and independence in activities of daily living. Having good balance has been described as an important factor in outdoor walking and for participation in exercises. Studies in which persons with stroke describe their experience of balance in everyday life are scarce.

    Purpose:  

    The aim of the present presentation is to describe experiences of living with balance limitations in everyday life after first-ever stroke.

    Methods:  

    Twenty persons initially agreed to participate; however, one person later declined further participation, thus giving a sample size of 19 participants (10 females and 9 men), aged between 42-92 years. The inclusion criteria were: having had a first-ever stroke and having self-reported impaired balance, unaffected speech, independence in toileting and dressing, and walking ability indoors and outdoors with or without a walking aid. A qualitative data collection through individual interviews was conducted. Data was analysed by means of an inductive content analysis covering both the manifest and the latent content of the transcribed interviews.

    Results:  

    The participants' experiences of balance and its influence in everyday life, are presented in two themes. The first theme “Feeling dizzy and unstable is a continuous challenge”, revolves around participants' descriptions of balance as a constant feeling of dizziness and unsteadiness. The second theme “Feeling trust and confidence despite dizziness and unsteadiness” is about perceived abilities and feelings of confidence about still being able to do things oneself, despite the dizziness and unsteadiness.

    Conclusion(s):  

    All participants experienced the balance limitations as a continuous challenge in everyday life, yet they also felt trust and confidence and experienced that they still managed their everyday life. In future research it would be of interest to establish which strategies can make persons with stroke feel in balance in relation to fear of falling.

    Implications:

    In physical therapy practice, the experiences of balance limitations after stroke from the person with stroke add valuable information to various assessments. By asking the person about their abilities and challenges in daily living, rehabilitation interventions can be more individualized and based on the person's actual condition and their wishes and needs.

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