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  • 201.
    Bergström, Aileen L.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin.
    von Koch, Lena
    Andersson, Magnus
    Tham, Kerstin
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin.
    Participation in everyday life and life satisfaction in persons with stroke and their caregivers 3–6 months after onset2015Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 47, nr 6, s. 508-515Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To explore and describe persons with stroke and their caregivers' restrictions in participation in everyday occupations, i.e. occupational gaps, 3-6 months post-stroke, in relation to life satisfaction, combined life satisfaction, caregiver burden, perceived impact of stroke, and activities of daily living. Design: Cross-sectional study. Subjects: Persons with stroke and their caregivers (105 dyads). Methods: The Occupational Gaps Questionnaire, Life Satisfaction Checklist, Caregiver Burden Scale, Stroke Impact Scale and Barthel Index were used. Correlations were analysed with Spearman's rank, and regression analyses used life satisfaction as the dependent variable. Results: At least one person in 86% of the dyads perceived restrictions in participation, with the most common gap in travelling for pleasure. Correlations were low between the numbers of occupational gaps and life satisfaction (R=-0.33, R=-0.31); however, life satisfaction accounted for occupational gaps both for persons with stroke and for caregivers. A greater number of occupational gaps were perceived in the dyads with combined low levels of life satisfaction compared with those with combined high levels of life satisfaction. Conclusion: Participation in everyday occupations is related to life satisfaction even for caregivers of persons with stroke. The results of this study add to our knowledge about the stroke-caregiver dyad and will help to inform family-centred approaches within stroke rehabilitation.

  • 202.
    Bergström, Christoffer
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Eliasson, Martin
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Äldre personers inställning till fallpreventiv träning: - en enkätstudie2014Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    BAKGRUND: Fallolyckor är vanliga bland äldre och medför lidande och kostnader för individ och samhälle. Trots att tidigare studier visat att träning i fallpreventivt syfte har goda effekter är det få äldre som påbörjar eller fullföljer ett sådant träningsprogram.

    SYFTE: Huvudsyftet med studien var att undersöka och jämföra äldre kvinnors och mäns inställning till träningsprogram i fallpreventivt syfte samt vad de uppfattade vara motiverande faktorer i ett sådant träningsprogram.

    METOD: En enkät med frågor om inställning till fallpreventiv träning, baserat på Theory of Planned Behavior, samt frågor om motiverande faktorer vid en sådan träning delades ut till två grupper av äldre. I studien inkluderades 58 personer över 65 år.

    RESULTAT: Resultaten visade att det inte fanns någon större skillnad i hur männen och kvinnorna ville träna i fallpreventivt syfte, däremot ansåg sig kvinnorna mer än männen vara den typ av person som borde göra övningar i fallpreventivt syfte (p=0,047). Kvinnorna var mer positivt inställda till fallpreventiv träning (p=0,030).

    KONKLUSION: Resultaten kan vara till hjälp för att lättare skapa fallpreventiva träningsprogram som kvinnor och män vill delta i och på så vis öka deltagandet. Vid skapandet av fallpreventivt träningsprogram behöver ingen eller liten hänsyn tas till vilket kön personen har.

  • 203.
    Bergström, Johan
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Fysioterapi.
    Linnér, Marcus
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Fysioterapi.
    Kan en målad trappa förändra beteenden?: En interventionsstudie om människors beteende när miljön de interagerar med förändras.2018Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund: Infrastruktur och hur vi väljer att bygga våra städer styr befolkningens aktivitetsmönster. Infrastrukturen och tekniken har utvecklats i samhället och gett alternativa tillvägagångssätt att ta sig upp och ner mellan olika våningsplan. Fler människor väljer rulltrapporna och hissen före trapporna och går miste om de positiva effekterna som är kopplade till vardaglig trappgång.

    Syfte: Syftet med studien var att undersöka om det gick att påverka människors beteende att ta trappan istället för rulltrappan, genom att förändra miljön med en trappmålning.

    Metod: Studien var en prospektiv, kvasiexperimentell, deskriptiv interventionsstudie med ett konsekutivt urval. De personer som passerade trapporna/rulltrapporna under en förutbestämd tidsperiod studerades. Mätningarna gjordes med hjälp av ett system för trafikmätningar(OTUS3D) och pågick under tre veckor. Först mättes en baseline under vecka ett, målning av trappan under vecka två samt mätning för interventionen vecka tre.

    Resultatsammanfattning: Denna studie visade ingen förbättring gällande beteendeförändring hos fotgängare. Den statistiska signifikanta minskningen av fotgängare i trappan kan ha sin förklaring i de stora antalet deltagare i studien.

    Slutsats: Det finns många olösta frågor om vad som påverkar människors beteende i deras dagliga liv. Antalet faktorer är större än den här studien har testat. Andra interventioner i form av annat motiv eller arkitekturell utformning kan ge andra resultat.

  • 204.
    Bergström, Malin
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap.
    Skulderstabiliserande träningsövningar registrerade med EMG: en jämförelse mellan slyngbaserade övningar och övningar på stabilt underlag2014Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Sammanfattning

    Syfte och frågeställningar

    Studiens syfte var att undersöka muskelaktiveringen i tre muskler (övre trapezius (ÖT), serratur anterior (SA) och nedre trapezius (NT)) under sex olika skulderstabiliserande övningar samt undersöka eventuella sidoskillnader. Syftet var även att undersöka om specifika skulderstabiliserande övningar i slyngor kunde öka aktiveringen i främst SA samtidigt som aktiveringen i ÖT minskar, hos friska individer, jämfört med nuvarande rekommenderade övningar på stabilit underlag. Aktiveras SA och NT mer vid slyngbaserade övningar än vid övningar på stabilt underlag? Visar studiens slyngövningar mindre aktivering i ÖT än övningar på fast underlag? Ses någon sidoskillnad mellan höger och vänster kroppshalva under utförandet av samtliga skulderstabiliserande övningar?

    Metod

    Tio friska kvinnor (medelålder 36år) deltog i studien. Aktiviteten i tre muskler (ÖT, SA, NT) registerades billateralt under sex olika skulderstabiliserande övningar med elektromyografi (EMG). Tre av övningarna genomfördes i redcord slyngor och tre övningar på fast underlag, dvs på golv eller mot en vägg. Två övningar gjordes i stående, två övningar i fyrfotaposition och en i ryggliggande. För att jämföra aktiveringsgraden i muskulaturen under de olika övningarna normaliserades EMG-data till % av maximal viljemässig kontraktion (MVC) för respektive muskel.

    Resultat

    Slyngövningarna UF och UA visade signifikant lägre aktiveringsgrad i SA jämfört med de övningarna PuP (p<0.001 och p<0.001) och WS (p<0.001 och p<0.001) som utfördes på fast underlag. Slyngövningen PuPR visade ingen signifikant skillnad i SA aktiveringsgrad jämfört med PuP (p=0.30). ÖT aktiviteten var signifikant lägre under slyngövningen utfall med abduktion (UA) jämfört med ryggliggande protraktion (PRO) (p<0.001) och push up plus (PuP) (p<0.001). Av de utvärderade övningarna var ÖT som minst aktiverad vid UF (0.3 % av MVC) och mest aktiverad vid PuPR (4.0 % av MVC). SA var som minst aktiverad vid UF (3.7%) och mest vid PuP (43.9%). NT var minst aktiverad vid Pup (-1.5%) och mest vid UF (9.7%). Ingen sidoskillnad sågs.

    Slutsats

    Utifrån resultaten från denna studie rekommenderas att friska personer som specifikt vill träna SA, utför skulderstabiliserande övningarna PuP, WS eller PuPR. Om personen dessutom vill genomföra en övning med låg aktivitet i ÖT samtidigt som aktiveringsgraden i SA är hög kan övningen PuP rekommenderas.

  • 205.
    Bergström, Maria
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för arbetsterapi. Linköpings universitet, Medicinska fakulteten.
    Ahlstrand, Inger
    Jönköping University, Sweden.
    Thyberg, Ingrid
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Falkmer, Torbjörn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum. Jonköping University, Sweden; Curtin University, Australia.
    Börsbo, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten.
    Björk, Mathilda
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för arbetsterapi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Like the worst toothache you've had - How people with rheumatoid arthritis describe and manage pain2017Inngår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 24, nr 6, s. 468-476Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease often associated with disability. Despite new treatments, pain and activity limitations are still present. Objectives: To describe how persons with RA experience and manage pain in their daily life. Methods: Seven semi-structured focus groups (FGs) were conducted and analyzed using content analysis. Results: The analysis revealed four categories: 1) Pain expresses itself in different ways referred to pain as overwhelming, aching or as a feeling of stiffness. 2) Mitigating pain referred to the use of heat, cold, medications and activities as distractions from the pain. 3) Adapting to pain referred to strategies employed as coping mechanisms for the pain, e.g. planning and adjustment of daily activities, and use of assistive devices. 4) Pain in a social context referred to the participants social environment as being both supportive and uncomprehending, the latter causing patients to hide their pain. Conclusions: Pain in RA is experienced in different ways. This emphasizes the multi-professional team to address this spectrum of experiences and to find pain management directed to the individual experience that also include the persons social environment.

  • 206.
    Bergström, Matilda
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Larsson, Helena
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Konditionsträning i intervallform som behandling vid hjärntrötthet efter stroke: en single-subject-studie2017Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Introduktion: Hjärntrötthet efter stroke är ett vanligt men ofta förbisett tillstånd. Det upplevs i många fall som det värsta symtomet efter stroke och kan vara en stor begränsning i vardagen. Orsak såväl som behandling är för närvarande okänt. En tänkbar orsak är att försämrad fysisk kapacitet leder till en negativ spiral där vardagliga aktiviteter kräver mer ansträngning vilket förvärrar hjärntröttheten och bidrar till en mer inaktiv livsstil. Konditionsträning i intervallform kan därför vara en möjlig behandlingsform då intervallträning har visat sig vara effektivt i syfte att uppnå konditionsförbättring i olika patientgrupper, inklusive stroke.

    Syfte: Undersöka om konditionsträning i intervallform på cykel påverkar hjärntrötthet efter stroke.

    Metod: Två män, 77 och 83 år, deltog i denna upprepade single-subject-studie. Interventionsfasen bestod av ett fyra veckor långt intervallträningsprogram. Träningspassen utfördes under övervakning tre gånger i veckan på cykel i testpersonernas hem. Genomförbarhet av interventionen registrerades. Hjärntrötthet mättes två gånger i veckan under baslinjefas och interventionsfas med Swedish fatigue assessment scale (S-FAS). Konditionstester genomfördes före och efter interventionen.

    Resultat: Samtliga träningspass genomfördes utan farliga händelser. En minskning av hjärntrötthet gick att observera, dock kunde en sann skillnad ej fastställas. Kondition förbättrades med 7 % respektive 17 % på sex minuters gångtest (6MWT) samt med 7 % respektive 35 % på Åstrands cykelergometertest.

    Konklusion: Resultaten antyder att hjärntrötthet kan minska samt att kondition kan förbättras efter intervallträning på cykel hos personer som drabbats av stroke. Längre interventionstid krävs för att påvisa en eventuell sann skillnad i hjärntrötthet.

  • 207.
    Bergström, Sara
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Patienters syn på personcentrerad vård: - En kvalitativ studie med personer som genomgått reumatisk rehabilitering2017Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund: Personcentrerad vård är en vårdmodell där patienten ses som   expert på sig själv och sin situation. I en personcentrerad vård anpassas   vården efter varje individ och patienten är aktiv i sin egen vård.

    Syfte:   Syftet med uppsatsen var att undersöka erfarenheter av och synen   på personcentrerad vård hos personer som genomgått reumatisk rehabilitering.

    Metod:   Kvalitativ metod användes och uppsatsen baserades på fem   semistrukturerade intervjuer som analyserades med kvalitativ innehållsanalys.   Inklusionskriterierna var att ha genomgått rehabilitering på reumatologens   dagvård någon gång under senaste halvåret.

    Resultat: Analysen utmynnade i tre kategorier som var Patientens   självkännedom, Vårdpersonalens kunskap och Interaktion mellan patient,   vårdpersonal och grupp. Kategorierna bildade temat Personcentrerad vård- när   patient och vård möts genom förmågor och gemensamt engagemang. Intervjupersonerna   beskrev att de hade betydelsefull självkännedom och att vårdpersonalen hade   betydelsefull kunskap för rehabiliteringen. För att självkännedomen/kunskapen   skulle kunna nyttjas i rehabiliteringen krävdes, enligt intervjupersonerna,   ett gott samarbete mellan patient och vårdpersonal där båda parter var   engagerade. Intervjupersonernas acceptans av sin funktionsnedsättning samt   förväntningar på en personcentrerad vård både från patient och vårdpersonal   gynnade, enligt intervjupersonerna, en personcentrerad vård.

    Slutsats: Resultatet visade att både patient och vårdpersonal hade en aktiv roll i att uppnå en personcentrerad vård vilket skulle kunna betyda att vården blir personcentrerad i olika utsträckning beroende på patienten. Mer forskning krävs för att undersöka patientens påverkan på att uppnå en personcentrerad vård och för att undersöka ämnet utifrån vårdpersonalens perspektiv.

  • 208.
    Bergvall-Kåreborn, Birgitta
    et al.
    Luleå tekniska universitet, Institutionen för ekonomi, teknik och samhälle, Innovation och Design.
    Howcroft, Debra
    Luleå tekniska universitet, Institutionen för ekonomi, teknik och samhälle, Innovation och Design.
    Ståhlbröst, Anna
    Luleå tekniska universitet, Institutionen för ekonomi, teknik och samhälle, Innovation och Design.
    Melander-Wikman, Anita
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Participation in living lab: designing systems with users2010Inngår i: Human Benefit through the Diffusion of Information Systems Design Science Research: IFIP WG 8.2/8.6 International Working Conference, Perth, Australia, March 30 - April 1, 2010, Proceedings / [ed] Jan Pries-Heje; John J. Veneble; Deborah Bunker; Nancy L. Russo; Janice I. DeGross, Encyclopedia of Global Archaeology/Springer Verlag, 2010, s. 317-326Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Drawing on a case study of a living lab, this paper considers the process of participation during the design stages of a health care project for the elderly in Sweden. While participation has an established history, more recently it has been described as an "old, tired concept" that is in need of revitalization in order to cater for changing IS practices. In this paper, we reflect on how participation materializes in a context that is quite dissimilar from more traditional development settings and report on the kinds of practices that may be used to assist design with users

  • 209.
    Bergvall-Kåreborn, Birgitta
    et al.
    Luleå tekniska universitet, Institutionen för system- och rymdteknik, Datavetenskap.
    Melander-Wikman, Anita
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Eriksson, Carina Ihlström
    Halmstad University.
    Ståhlbröst, Anna
    Luleå tekniska universitet, Institutionen för system- och rymdteknik, Datavetenskap.
    A Model for Reflective Participatory Design: The Role of Participation, Voice and Space2015Inngår i: 21st Americas Conference on Information Systems: AMCIS 2015, Puerto Rico, 13 - 15 August 2015, Americas Conference on Information Systems , 2015Konferansepaper (Fagfellevurdert)
    Abstract [en]

    This paper aims to contribute to the participatory tradition in health informatics by presenting a model for reflective participatory design emerging from qualitative fieldwork in a participatory project aimed to improve the health and wellbeing of older people in the northern periphery regions of Europe, through new mobile services. The model brings together two established processes in novel ways: systems development and user participation. Within each process three concepts are presented to facilitate discussion and reflection at the concept level, the process level and the integrated process level.

  • 210.
    Bernhardsson, Susanne
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Advancing evidence-based practice in primary care physiotherapy: Guideline implementation, clinical practice, and patient preferences2015Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Research on physiotherapy treatment interventions has increased dramatically in the past 25 years and it is a challenge to transfer research findings into clinical practice, so that patients benefit from effective treatment. Development of clinical practice guidelines is a potentially useful strategy to implement research evidence into practice. However, the impact of guideline implementation in Swedish primary care physiotherapy is unknown. To achieve evidence-based practice (EBP), research evidence should be integrated with clinical expertise and patient preferences, but knowledge is limited about these factors in Swedish primary care physiotherapy.

    The overall aim of this thesis was to increase understanding of factors of importance for the implementation of EBP in Swedish primary care physiotherapy. Specific aims were: to translate and adapt a questionnaire for the measurement of EBP and guidelines; to investigate physiotherapists’ attitudes, knowledge and behaviour related to EBP and guidelines; to examine clinical practice patterns; to evaluate the effects of a tailored guideline implementation strategy; and to explore patients’ preferences for physiotherapy.

    The thesis comprises four studies (A-D), reported in five papers. In Study A, a questionnaire for the measurement of EBP and guidelines was translated, cross-culturally adapted, and tested for validity (n=10) and reliability (n=42). Study B was a cross-sectional study in which this questionnaire was used to survey primary care physiotherapists in the county council Region Västra Götaland (n=271). In Study C, a strategy for the implementation of guidelines was developed and evaluated, using the same questionnaire (n=271 at baseline, n=256 at follow-up), in a prospective controlled trial. The strategy was based on an implementation model, was tailored to address the determinants of guideline use identified in Study B, and comprised several components including an educational seminar. Study D was an exploratory qualitative study of patients with musculoskeletal disorders (n=20), using qualitative content analysis.

    The validity and reliability of the questionnaire was found to be satisfactory. Most physiotherapists have a positive regard for EBP and guidelines, although these attitudes are not fully reflected in the reported use of guidelines. The most important determinants of  guideline use were considering guidelines important to facilitate practice and knowing how to integrate patient preferences with guidelines. The tailored, multi-component guideline implementation significantly affected awareness of, knowledge of, and access to guidelines. Use of guidelines was significantly affected among those who attended an implementation seminar. Clinical practice for common musculoskeletal conditions included interventions supported by evidence of various strengths as well as interventions with insufficient research evidence. The most frequently reported interventions were advice and exercise therapy. The interviewed patients expressed trust and confidence in the professionalism of physiotherapists and in the therapists’ ability to choose appropriate treatment, rendering treatment preferences subordinate. This trust seemed to foster active engagement in their physiotherapy.

    In conclusion: The adapted questionnaire can be used to reliably measure EBP in physiotherapy. The positive attitudes found do not necessarily translate to guideline use, due to several perceived barriers. The tailored guideline implementation strategy used can be effective to reduce barriers and contribute to increased use of guidelines. The clinical practice patterns identified suggest that physiotherapists rely both on research evidence and their clinical expertise when choosing treatment methods. Patients’ trust in their physiotherapist’s competence and preference for active engagement in their therapy need to be embraced by the clinician and, together with the therapist’s clinical expertise, integrated with guideline use in the clinical decision making. Further research is needed on how the EBP components and different knowledge sources can be integrated in physiotherapy practice, as well as on implementation effects on patient outcomes.

  • 211.
    Bernhardsson, Susanne
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Larsson, Maria E. H.
    Research and Development Primary Health Care, Region Västra Götaland, Gothenburg, Sweden / The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
    Johansson, Kajsa
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Öberg, Birgitta
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    “In the physio we trust”: A qualitative study on patients’ preferences for physiotherapy2017Inngår i: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 33, nr 7, s. 535-549Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Patient preferences are suggested to be incorporated in clinical decision making, but little is known about preferences for physiotherapy treatment of patients with musculoskeletal pain. This study aimed to explore preferences regarding physiotherapy treatment and participation in decision making, of patients who seek primary care physiotherapy for pain in the back, neck or shoulder.

    Methods: A qualitative study set in an urban physiotherapy clinic in Sweden. Individual, semi-structured interviews were conducted with a purposeful sample of 20 individuals who sought physiotherapy for back, neck or shoulder pain. The interviews were digitally recorded, transcribed verbatim and analysed with qualitative content analysis.

    Results: An overarching theme, embracing six categories, was conceptualised: Trust in the physiotherapist fosters active engagement in therapy. Most informants preferred active treatment strategies such as exercise and advice for self-management, allowing them to actively engage in their therapy. Some preferred passive treatments, primarily acupuncture (because they had heard that it works well) or massage therapy (because “it feels good”). Preferences were consistent across the three musculoskeletal conditions. Key influencers on treatment preferences were previous experiences and media. All informants wanted to be involved in the clinical decision making, but to varying extents. Some expressed a preference for an active role and wanting to share decisions while others were content with a passive role. Expectations for a professional management were reflected in trust and confidence in physiotherapists’ skills and competence, expectations for good outcomes, and believing that treatment methods should be evidence-based.

    Conclusions: Trust in the physiotherapist’s ability to choose appropriate treatment and confidence in the professional skills and competence of physiotherapists, as well as a desire to participate in clinical decision making, fostered active engagement in physiotherapy. Preferences for particular interventions were subordinate, although a preference for active treatments dominated. Preferences for active engagement need to be embraced by the physiotherapist. Awareness of these preferences can facilitate clinical decision making and contribute to increased quality of care for patients with musculoskeletal pain.

  • 212.
    Bernhardsson, Susanne
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för sjukgymnastik. Linköpings universitet, Hälsouniversitetet. Region Västra Götaland.
    Larsson, Maria
    Region Västra Götaland, Göteborgs universitet.
    Eggertsen, Robert
    Region Västra Götaland, Göteborgs universitet.
    Fagevik Olsén, Monika
    Göteborgs universitet.
    Johansson, Kajsa
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för sjukgymnastik. Linköpings universitet, Hälsouniversitetet.
    Nilsen, Per
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för hälso- och sjukvårdsanalys. Linköpings universitet, Hälsouniversitetet.
    Nordeman, Lena
    Region Västra Götaland.
    van Tulder, Maurits
    VU University, Amsterdam, The Netherlands.
    Öberg, Birgitta
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för sjukgymnastik. Linköpings universitet, Hälsouniversitetet.
    Evaluation of a tailored, multi-component intervention for implementation of evidence-based clinical practice guidelines in primary care physical therapy: a non-randomized controlled trial.2014Inngår i: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 14, nr 1, s. 105-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND:

    Clinical practice guidelines are important for transmitting research findings into practice and facilitating the application of evidence-based practice (EBP). There is a paucity of knowledge about the impact of guideline implementation strategies in primary care physical therapy. The aim of this study was to evaluate the effect of a guideline implementation intervention in primary care physical therapy in western Sweden.

    METHODS:

    An implementation strategy based on theory and current evidence was developed. A tailored, multi-component implementation intervention, addressing earlier identified determinants, was carried out in three areas comprising 28 physical therapy practices including 277 physical therapists (PTs) (intervention group). In two adjacent areas, 171 PTs at 32 practices received no intervention (control group). The core component of the intervention was an implementation seminar with group discussions. Among other components were a website and email reminders. Data were collected at baseline and follow-up with a web-based questionnaire. Primary outcomes were the self-reported awareness of, knowledge of, access to, and use of guidelines. Secondary outcomes were self-reported attitudes toward EBP and guidelines. Analyses were performed using Pearson's χ2 test and approximative z-test.

    RESULTS:

    168 PTs (60.6%) in the intervention group and 88 PTs (51.5%) in the control group responded to the follow-up questionnaire. 186/277 PTs (67.1%) participated in the implementation seminars, of which 97 (52.2%) responded. The proportions of PTs reporting awareness of (absolute difference in change 20.6%, p = 0.023), knowledge where to find (20.4%, p = 0.007), access to (21.7%, p < 0.001), and frequent use of (9.5%, NS) guidelines increased more in the intervention group than in the control group. The proportion of PTs reporting frequent guideline use after participation in the implementation seminar was 15.2% (p = 0.043) higher than the proportion in the control group. A higher proportion considered EBP helpful in decision making (p = 0.018). There were no other significant differences in secondary outcomes.

    CONCLUSIONS:

    A tailored, theory- and evidence-informed, multi-component intervention for the implementation of clinical practice guidelines had a modest, positive effect on awareness of, knowledge of, access to, and use of guidelines, among PTs in primary care in western Sweden. In general, attitudes to EBP and guidelines were not affected.

  • 213.
    Bernhoff, Gabriella
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Landén Ludvigsson, Maria
    Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i västra Östergötland, Rehab Väst. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi.
    Peterson, Gunnel
    Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Uppsala University, Sweden.
    Bertilson, Bo Christer
    Karolinska Institute, Sweden; Stockholm County Council, Sweden.
    Elf, Madeleine
    Kista Rygg and Idrottsklin, Sweden.
    Peolsson, Anneli
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    The pain drawing as an instrument for identifying cervical spine nerve involvement in chronic whiplash-associated disorders2016Inngår i: Journal of Pain Research, ISSN 1178-7090, E-ISSN 1178-7090, Vol. 9, s. 397-404Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: The aim of the study was to investigate the psychometric properties of a standardized assessment of pain drawing with regard to clinical signs of cervical spine nerve root involvement. Design: This cross-sectional study included data collected in a randomized controlled study. Patients: Two hundred and sixteen patients with chronic (amp;gt;= 6 months) whiplash-associated disorders, grade 2 or 3, were included in this study. Methods: The validity, sensitivity, and specificity of a standardized pain drawing assessment for determining nerve root involvement were analyzed, compared to the clinical assessment. In addition, we analyzed the interrater reliability with 50 pain drawings. Results: Agreement was poor between the standardized pain drawing assessment and the clinical assessment (kappa = 0.11, 95% CI: -0.03 to 0.20). Sensitivity was high (93%), but specificity was low (19%). Interrater reliability was good (kappa = 0.64, 95% CI: 0.53 to 0.76). Conclusion: The standardized pain drawing assessment of nerve root involvement in chronic whiplash-associated disorders was not in agreement with the clinical assessment. Further research is warranted to optimize the utilization of a pain/discomfort drawing as a supportive instrument for identifying nerve involvement in cervical spinal injuries.

  • 214.
    Beskow, Hanna
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Larsson, Elinor
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Undersköterskors erfarenhet av delaktighet i rehabilitering inom slutenvård2014Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund: Rehabilitering inom slutenvården innefattar ett samarbete mellan undersköterska och sjukgymnast. Undersköterskor har en viktig roll i rehabiliteringen men det saknas forskning om deras uppfattningar kring sin roll.

    Syfte: Att undersöka undersköterskors erfarenheter av delaktighet i sjukgymnastisk rehabilitering av patienter på en vårdavdelning inom slutenvården.

    Metod: En kvalitativ design med induktiv ansats användes. Datainsamlingen gjordes i form av semistrukturerade gruppintervjuer med undersköterskor. Materialet analyserades sedan med hjälp av kvalitativ innehållsanalys.

    Resultat: Analysen resulterade i fem kategorier som blev två teman, Känsla av att vara viktiga och god egen tilltro till sin förmåga at utföra rehabiliterande insatser samt Samarbetet kring rehabiliteringen påverkas av individerna och omgivningen.

    Diskussion: Resultatet visar att undersköterskornas känsla av delaktighet påverkas av konsekvenser, individer, beteende och omgivning vilket kan ses i förhållande till den operanta inlärningsteorin och den socialkognitiva teorin.

    Slutsats: Undersköterskorna känner sig delaktiga i rehabilitering då de är engagerade, aktivt medverkande och känner att de är till nytta. En svaghet i delaktigheten är att kommunikationen kring rehabiliteringen upplevs vara bristfällig och därmed minskar undersköterskornas medinflytande. Vidare anser författarna att en upprepning av studien behövs samt att det saknas forskning om effekten av undersköterskors arbete och deras uppfattningar kring detta.

    Nyckelord: fysioterapi, kvalitativ forskning, sjukgymnastik, socialkognitiv teori, vårdpersonal

  • 215.
    Betten, Carola
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi. Skånevård Kryh, Division Primärvård Skurup, Sweden.
    Sandell, Christofer
    Hill, Jonathan C.
    Gutke, Annelie
    Cross-cultural adaptation and validation of the Swedish STarT Back Screening Tool2015Inngår i: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 17, nr 1, s. 29-36Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives : The STarT Back Screening Tool (SBT) is a newly validated questionnaire that identifies modifiable risk factors of poor prognosis in patients with low back pain (LBP). The aim of this study was to cross-culturally adapt the SBT into Swedish and to test its concurrent validity in patients with LBP in primary healthcare.

    Methods: The SBT was translated according to established guidelines. Concurrent validity was tested on 62 patients by comparing the SBT with the Orebro Musculoskeletal Pain Screening Questionnaire, short form (OMPSQ-short). Analysis of correlations between the instruments' total scores and between psychosocial sub-score of SBT and OMPSQ-short was performed using Spearman's rank correlation.

    Results: A translation of the SBT into Swedish required minor semantic adaptation until the final version was acceptable. Correlation between the SBT and the OMPSQ-short was large with r = 0.61 (SBT total with OMPSQ-short total score) and r = 0.60 (SBT psychosocial subscale with OMPSQ-short total score).

    Conclusion: The original SBT was successfully translated into Swedish. Correlation between the Swedish SBT and OMPSQ- short was large. The present study supports the use of the Swedish SBT for further clinical practice and research.

  • 216.
    Binisi, Sara
    Linnéuniversitetet, Fakulteten för samhällsvetenskap (FSV), Institutionen för idrottsvetenskap (ID).
    Korrelation mellan höftstyrka och maximal skridskoåkningsförmåga på is hos manliga ishockeyspelare.2017Independent thesis Advanced level (degree of Master (One Year)), 20 poäng / 30 hpOppgave
  • 217.
    Bjerke, Joakim
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Gait and postural control after total knee arthroplasty2014Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    The aim of the thesis was to investigate deficits and compensatory strategies after total knee arthroplasty (TKA) in different conditions during gait and quiet standing. Although TKA is considered the gold standard treatment for end-stage knee osteoarthritis, it is associated with a number of implications. Reduced physical function after osteoarthritis is partly, but apparently not fully, remedied by surgery. The two most common deficits are reduced knee muscle strength and limited range of knee joint motion (ROM), partly due to prosthesis mechanics. Reduced postural control has also been shown shortly after surgery. In spite of sufficient passive knee joint ROM for normal ambulation, gait patterns are characterized by reduced knee flexion. Several factors such as reduced knee muscle strength, reduced proprioception, habitual strategies or fear of movement may be suggested as explanations for difficulties in gait and posture. As an effect, compensatory strategies may result. In order to focus on the implications of TKA, participants had to be less than 65 years of age and healthy, TKA being the only factor different form controls. The same 23 individuals with unilateral TKA ~ 19 months post-operative and 23 controls participated in all studies.

     

    3D whole body kinematics was used to assess gait and posture and electromyography was used to record muscle activity. Isokinetic measurements were used to determine dynamic knee muscle strength. Gait in the frontal and sagittal planes were assessed. The tasks included in the test protocol were negotiation up and down stairs, gait on hard and soft surface, quiet standing with sensory modulation (with and without vision and on soft surface), and single limb stance.  Primary outcome variables addressed were: knee and hip joint kinematics in frontal and sagittal planes, upper body inclination, postural sway and relative knee muscle activity as an indicator of relative effort. Background factors used to explain group differences in the primary outcomes were derived from demographics, clinical examination, and questionnaires. Demographic factors were age, body mass index (BMI), and time since surgery. Clinical examinations were conducted for passive knee joint ROM, joint position sense, knee muscle strength, anterior knee joint laxity, and leg length. Questionnaires assessed fear of movement, pain, and knee related function and quality of life. The results showed that knee flexion was reduced during stair descent in both the prosthetic and the contralateral knee in the TKA group compared to controls. Although reduced passive knee joint flexion in the TKA group was sufficient for normal stair descent, it was the only factor identified that explained reduced knee flexion in stair descent. As knee muscle strength was significantly reduced in the TKA group, it is reasonable to suggest that as a contributing factor. Furthermore, the TKA group also displayed increased hip adduction during stair descent, which may indicate both a compensatory strategy as well as reduced hip muscle strength. In stair ascent, no significant group differences were found in relative knee muscle activity as expected due to knee muscle weakness. Nor were there any indications of compensatory forward inclination of the trunk to reduce knee joint moments. Instead, probably compensating for muscle weakness, the TKA group ascended stairs at a significantly slower speed. Surface modulation during level gait showed that reduced knee flexion in the prosthetic knee during the stance phase when walking on a hard surface was further decreased during gait on a soft surface. Knee and hip adduction at the stance phase were not affected by surface conditions. Nevertheless, the TKA group displayed increased knee adduction and hip adduction compared to controls, particularly in the prosthetic side. In addition, the TKA group displayed increased step width on the soft compared to hard surface. Single-limb stance for 20 seconds failed in 30 % of the TKA group and in 4 % of the control group. Those in the TKA group who were able to perform single-limb stance performed equally well as controls. During bilateral quiet standing, postural sway was similar in both groups, and inability to stand on one leg did not affect bilateral stance. Older age, higher BMI and reduced quadriceps strength determined the failure to maintain single-limb stance in the TKA group.

     

    In conclusion, this thesis indicates that reduced knee muscle strength is a common denominator as part of the explanatory factors for reduced performance and compensatory strategies in individuals with TKA. Reduced speed during stair ascent as well as reduced knee flexion during stair descent may be compensations for reduced lower extremity strength. Increased hip adduction may compensate for reduced knee flexion in stair descent, but may also represent hip muscle weakness or reduced motor control as increased hip adduction is found also in level gait. The failure to maintain single-limb stance in the TKA group is also partly explained by reduced knee muscle strength. Muscle weakness may be and indicator for reduced physical capacity in general.

  • 218.
    Bjerke, Joakim
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik. Department of Physiotherapy, School of Health Education & Social Work, Sør-Trøndelag University College, Trondheim, Norway.
    Öhberg, Fredrik
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Radiofysik.
    Nilsson, Kjell G
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Ortopedi.
    Foss, Olav A
    Orthopaedic Research Centre, Trondheim University Hospital, Trondheim, Norway.
    Stensdotter, Ann-Katrin
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik. Department of Physiotherapy, School of Health Education & Social Work, Sør-Trøndelag University College, Trondheim, Norway.
    Peak knee flexion angles during stair descent in TKA patients2014Inngår i: The Journal of Arthroplasty, ISSN 0883-5403, E-ISSN 1532-8406, Vol. 29, nr 4, s. 707-711Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Reduced peak knee flexion during stair descent (PKSD) is demonstrated in subjects with total knee arthroplasty (TKA), but the underlying factors are not well studied. 3D gait patterns during stair descent, peak passive knee flexion (PPKF), quadriceps strength, pain, proprioception, demographics, and anthropometrics were assessed in 23 unilateral TKA-subjects ~ 19 months post-operatively, and in 23 controls. PKSD, PPKF and quadriceps strength were reduced in the TKA-side, but also in the contralateral side. A multiple regression analysis identified PPKF as the only predictor (57%) to explain the relationship with PKSD. PPKF was, however sufficient for normal PKSD. Deficits in quadriceps strength in TKA-group suggest that strength is also contributing to smaller PKSD. Increased hip adduction at PKSD may indicate both compensatory strategy and reduced hip strength.

  • 219.
    Bjerke, Joakim
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi. Department of Physiotherapy, School of Health Education & Social Work, Sør-Trøndelag University College, Trondheim, Norway.
    Öhberg, Fredrik
    Department of Biomedical Engineering & Informatics, Umeå University Hospital, Umeå, Sweden.
    Nilsson, Kjell G
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Ortopedi.
    Stensdotter, Ann-Katrin
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi. Department of Physiotherapy, School of Health Education & Social Work, Sør-Trøndelag University College, Trondheim, Norway.
    Compensatory strategies for muscle weakness during stair ascent in subjects with total knee arthroplasty2014Inngår i: The Journal of Arthroplasty, ISSN 0883-5403, E-ISSN 1532-8406, Vol. 29, nr 7, s. 1499-1502Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Subjects with total knee arthroplasty (TKA) exhibit decreased quadriceps and hamstring strength. This may bring about greater relative effort or compensatory strategies to reduce knee joint moments in daily activities. To study gait and map out the resource capacity, knee muscle strength was assessed by maximal voluntary concentric contractions, and whole body kinematics and root mean square (RMS) electromyography (EMG) of vastus lateralis and semitendinosus were recorded during stair ascent in 23 unilateral TKA-subjects ~19months post-operation, and in 23 healthy controls. Muscle strength and gait velocity were lower in the TKA group, but no significant group differences were found in RMS EMG or forward trunk lean. The results suggest that reduced walking velocity sufficiently compensated for reduced knee muscle strength.

  • 220.
    Bjerke, Joakim
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi. Department of Physiotherapy, School of Health Education & Social Work, Sør-Trøndelag University College, Trondheim, Norway.
    Öhberg, Fredrik
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper.
    Nilsson, Kjell G
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap.
    Stensdotter, Ann-Katrin
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi. Department of Physiotherapy, School of Health Education & Social Work, Sør-Trøndelag University College, Trondheim, Norway.
    Gait on soft versus hard surface after total knee arthroplastyManuskript (preprint) (Annet vitenskapelig)
    Abstract [en]

    Asymmetric gait patterns are common following total knee arthroplasty (TKA). Gait on even and hard surface is primarily characterized by reduced peak knee flexion in the prosthetic knee, increased contralateral knee adduction angle, and decreased walking speed compared to controls. Natural conditions may however lead to different strategies. Therefore, the objective of the present study was to explore how gait patterns may differ when walking on a soft surface. Methods: 3D kinematics during gait on hard and soft surface were assessed in 23 unilateral TKA-subjects ~19 months post-operative, and in 23 controls. Results: Gait characteristics in TKA-subjects that differed from controls observed on hard surface were amplified on soft surface. Flexion in the prosthetic knee was further decreased and a tendency towards reduced flexion in the contralateral knee was observed. Knee and hip adduction were not affected by surface conditions nevertheless there was a difference between groups, in particular with regard to the prosthetic side. In addition, step width increased on soft surface in TKA-subjects. Conclusion: Gait on an even and soft surface did not amplify asymmetries in TKA-subjects, but decreased knee flexion and increased step-width, albeit with similar gait speed as the control group suggests that the soft surface provided a small but significant challenge making the TKA-subjects precautious.

  • 221. Bjerke, Ulrika
    et al.
    Frändin, Kerstin
    Högskolan i Borås, Institutionen för Vårdvetenskap.
    Formkontroll för äldre. En randomiserad, kontrollerad studie2013Rapport (Annet vitenskapelig)
  • 222.
    Bjernulf, Alfred
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Fysioterapi.
    Oscar, Kolbe
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Fysioterapi.
    Fysisk kapacitet hos personer med obstruktiv sömnapné, övervikt och låg fysisk aktivitetsnivå: - En jämförande & sambandstudie2019Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund

    Obstruktiv sömnapné (OSA) karakteriseras av upprepade episoder av helt eller delvis avstängda luftvägar under sömn. Det saknas studier som undersöker samband mellan fysisk kapacitet och graden av OSA, Body Mass Index (BMI), dagtrötthet, mängden tid med lågintensiv fysisk aktivitet (LFA) och ålder hos personer med OSA.

     

    Syfte

    Syftet var att se hur fysisk kapacitet skiljer sig hos personer med OSA beroende på graden av OSA, BMI, dagtrötthet, mängden LFA och ålder samt studera sambandet mellan dessa variabler.

     

    Metod

    Studien var en tvärsnittsstudie med en jämförande och korrelerande design. Data kommer från baslinjemätningar av en randomiserad kontrollerad studie på 86 deltagare med diagnosen OSA (AHI >15), BMI >25, samt en självskattad måttligt intensiv fysisk aktivitet på mindre än 150 minuter/vecka. Dagtrötthet mättes med Epworth sleepiness scale och LFA mättes med accelerometer. 

     

    Resultat

    Det fanns ett signifikant samband mellan prestation på 6 MWT och ålder respektive mängden tid i LFA. Hög ålder och få minuter av LFA korrelerar med kortare gångsträcka. Personer med övervikt hade längre gångsträcka än personer med fetma. Det var inga skillnader i gångsträcka beroende på graden av OSA eller om det förekom dagtrötthet.

     

    Slutsats

    Ålder och BMI bör tas i beaktande vid utförandet och utvärdering av gångtest för personer med OSA. Personer med OSA som utför mer LFA hade en högre kapacitet vilket möjligen kan förklaras av att de är mindre stillasittande. Mer forskning behövs på ämnet för att ta reda på bakomliggande orsaker och se kausala samband.

  • 223.
    Bjersing, Jan L.
    et al.
    University of Gothenburg, Sweden; Sahlgrens University Hospital, Sweden.
    Larsson, Anette
    University of Gothenburg, Sweden.
    Palstam, Annie
    University of Gothenburg, Sweden.
    Ernberg, Malin
    Karolinska Institute, Sweden.
    Bileviciute-Ljungar, Indre
    Karolinska Institute, Sweden.
    Löfgren, Monika
    Karolinska Institute, Sweden.
    Gerdle, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Kosek, Eva
    Karolinska Institute, Sweden; Stockholm Spine Centre, Sweden.
    Mannerkorpi, Kaisa
    University of Gothenburg, Sweden; Sahlgrenska University Hospital, Sweden.
    Benefits of resistance exercise in lean women with fibromyalgia: involvement of IGF-1 and leptin2017Inngår i: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 18, artikkel-id 106Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Chronic pain and fatigue improves by exercise in fibromyalgia (FM) but underlying mechanisms are not known. Obesity is increased among FM patients and associates with higher levels of pain. Symptom improvement after aerobic exercise is affected by body mass index (BMI) in FM. Metabolic factors such as insulin-like growth factor 1 (IGF1) and leptin may be involved. In this study, the aim was to evaluate the role of metabolic factors in lean, overweight and obese women during resistance exercise, in relation to symptom severity and muscle strength in women with FM. Methods: Forty-three women participated in supervised progressive resistance exercise, twice weekly for 15-weeks. Serum free and total IGF-1, IGF-binding protein 3 (IGFBP3), adiponectin, leptin and resistin were determined at baseline and after 15-weeks. Level of current pain was rated on a visual analogue scale (0-100 mm). Level of fatigue was rated by multidimensional fatigue inventory (MFI-20) subscale general fatigue (MFIGF). Knee extension force, elbow flexion force and handgrip force were assessed by dynamometers. Results: Free IGF-1 (p = 0.047), IGFBP3 (p = 0.025) and leptin (p = 0.008) were significantly decreased in lean women (n = 18), but not in the overweight (n = 17) and the obese (n = 8). Lean women with FM benefited from resistance exercise with improvements in current pain (p= 0.039, n = 18), general fatigue (MFIGF, p = 0.022, n = 18) and improved elbow-flexion force (p = 0.017, n = 18). In overweight and obese women with FM there was no significant improvement in pain or fatigue but an improvement in elbow flexion (p = 0.049; p = 0.012) after 15 weeks of resistance exercise. Conclusion: The clearest clinical response to resistance exercise was found in lean patients with FM. In these individuals, individualized resistance exercise was followed by changes in IGF-1 and leptin, reduced pain, fatigue and improved muscular strength. In overweight and obese women FM markers of metabolic signaling and clinical symptoms were unchanged, but strength was improved in the upper limb. Resistance exercise combined with dietary interventions might benefit patients with FM and overweight.

  • 224.
    Bjurehed, Linda
    et al.
    Linköpings universitet.
    Brodin, Nina
    Karolinska Institutet, Huddinge, Sweden; Danderyd Hospital, Stockholm, Sweden.
    Nordenskiold, Ulla
    Gothenburg University, Gothenburg, Sweden.
    Björk, Mathilda
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för arbetsterapi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Improved Hand Function, Self-Rated Health, and Decreased Activity Limitations: Results After a Two-Month Hand Osteoarthritis Group Intervention2018Inngår i: Arthritis care & research, ISSN 2151-464X, E-ISSN 2151-4658, Vol. 70, nr 7, s. 1039-1045Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective

    To evaluate the effects on hand function, activity limitations, and self‐rated health of a primary care hand osteoarthritis (OA) group intervention. Hand OA causes pain, impaired mobility, and reduced grip force, which cause activity limitations. OA group interventions in primary care settings are sparsely reported.

    Methods

    Sixty‐four individuals with hand OA agreed to participate; 15 were excluded due to not fulfilling the inclusion criteria. The 49 remaining (90% female) participated in an OA group intervention at a primary care unit with education, paraffin wax bath, and hand exercise over a 6‐week period. Data were collected at baseline, end of intervention, and after 1 year. Instruments used were the Grip Ability Test (GAT), the Signals of Functional Impairment (SOFI), dynamometry (grip force), hand pain at rest using a visual analog scale (VAS), the Patient‐Specific Functional Scale (PSFS), the Quick Disabilities of the Arm, Shoulder, and Hand (Quick‐DASH), and the EuroQol VAS (EQ VAS). Data were analyzed using nonparametric statistics.

    Results

    Hand function, activity limitation, and self‐rated health significantly improved from baseline to end of intervention, grip force (right hand: P < 0.001; left hand: P = 0.008), SOFI (P = 0.011), GAT (P < 0.001), hand pain at rest (P < 0.001), PSFS (1: P = 0.008, 2: P < 0.001, and 3: P = 0.004), Quick‐DASH (P = 0.001), and EQ VAS (P = 0.039), and the effects were sustained after 1 year.

    Conclusion

    The hand OA group intervention in primary care improves hand function, activity limitation, and self‐rated health. The benefits are sustained 1 year after completion of the intervention.

  • 225.
    Björkbacka, Sofia
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Holmberg, Elin
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Polisstudents träningsvanor och uppfattning om polisyrkets fysiska krav2013Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Introduktion: Polisyrket är ett stillasittande arbete som stundtals ställer höga krav på polisers fysiska kapacitet.

    Syfte: Syftet med denna studie var att undersöka nyrekryterade polisstudenters tidigare och nuvarande träningsvanor. Syftet var också att undersöka studenternas uppfattning om träning och motivation för att klara de fysiska kraven på det framtida yrket.

    Metod: Totalt deltog 69 studenter från en polisutbildning i Sverige i denna frågeformulärsbaserade studie.

    Resultat: Polisstudenterna tränade i genomsnitt 7,6 timmar i veckan vid tiden för studien och 97 % angav att de tränat regelbundet under det senaste halvåret. De främsta anledningarna till att de tränade var för psykiskt och fysiskt välmående och för att klara det framtida yrket som polis. 90% av studenterna hade tränat regelbundet under ungdomsåren. De flesta polisstudenterna var positiva till införandet av regelbundna fystester för yrkesverksamma poliser.

    Slutsats: Polisstudenterna i denna studie hade flera års erfarenhet av träning och alla studenterna uppgav att de var motiverade att fortsätta träna. Eftersom tidigare studier visat att personer med lång träningsvana lättare upprätthåller en god fysisk kapacitet högre upp i åldern tydde resultatet i denna studie på att denna grupp studenter har goda förutsättningar att fortsätta vara fysiskt aktiva även efter avslutade studier.

  • 226.
    Björkgren, Camilla
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Walles, Stina
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Bergshög motivation: Motivationsfaktorer för fysisk aktivitet hos universitetsstuderande2017Independent thesis Basic level (professional degree), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund: Det finns många kartlagda hälsoeffekter av fysisk aktivitet, bland annat minskar risken för hjärt- och kärlsjukdomar, högt blodtryck, cancer och metabola sjukdomar. Motivation kan beskrivas genom self-determination theory (SDT) som delar upp motivation i inre och yttre faktorer. En individ rör sig mellan ett kontinuum av motivationsfaktorer. Den inre motivationen är associerad med ett längre bibehållande av en aktivitet. En skillnad i motivationsfaktorer mellan idrottsutövare och motionärer har setts i tidigare studier. Det är intressant ur ett hälsopromotivt perspektiv att kunna identifiera vad som motiverar studenter till fysisk aktivitet. Syfte: Syftet med studien var att beskriva motivationsfaktorer för vardagsmotion respektive bergsbestigning hos studenter. Metod: Kvalitativa semistrukturerade intervjuer genomfördes med fyra studenter som bestigit Kebnekaises västra led någon gång de senaste tre åren. Materialet analyserades genom kvalitativ innehållsanalys. Resultat: Materialet från intervjuerna resulterade i fem kategorier: Välbefinnande för hela kroppen, Lust till aktivitet, Vänners uppmuntran, Få en gemensam upplevelse samt Testa sina gränser. Varje kategori representerade en viktig motivationsfaktor. Två av motivationsfaktorerna var gemensamma för såväl vardagsmotion som bergsbestigning. Konklusion: Motivationsfaktorerna skiljde sig åt beroende på aktivitet. Välbefinnande för hela kroppen representerar en motivationsfaktor för vardagsmotion. Motivationsfaktorerna Lust till aktivitet och Vänners uppmuntran var någotsom representerade både vardagsmotion och bergsbestigning. Faktorer som enbart sågs hos bergsbestigning hos informanterna var Få en gemensam upplevelse och Testa sina gränser. Det fanns även skillnad i motivationsfaktorer beroende på erfarenhet; mindre erfarna motiverades av att testa sina gränser och mer erfarna av att dela upplevelsen med andra.

  • 227.
    Björkholm, Annika
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Wahlström, Olivia
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Är yt-EMG ett reliabelt instrument i kombination med Biodex vid mätning av bukmuskelaktivitet?: En pilotstudie med friska kontrollpersoner och personer med abdominal rektusdiastas.2018Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Introduktion: Abdominal rektusdiastas (ARD) är ett tillstånd då de raka magmusklerna delar på sig för att linea alba blir slapp. Detta kan drabba kvinnor under graviditet och kraftigt överviktiga. Personer med ARD kan uppleva nedsatt styrka och obehagskänsla.

    Metod: Totalt fem deltagare medverkade i bukmuskelmätningar, tre friska kontrollpersoner och två personer med ARD. Elektroder för yt-elektromyografi (yt-EMG) placerades på sex olika ställen över deltagarnas m. rectus abdominis och m. obliquus externus abdominis. Muskelaktivitet och muskelstyrka mättes genom isometriska kontraktioner i Biodex dynamometer. Deltagarna fick utföra fem kontraktioner om fem sekunder med fem sekunder vila mellan varje kontraktion. Detta upprepades två gånger för varje deltagare med en veckas mellanrum. Relativ och absolut test-retest relabilitet beräknades med intraclass correlation coefficient (ICC) och minimal detectable change i % (MDC %) på timing, amplitud och fatigue uppmätt med yt-EMG och muskelstyrka uppmätt med Biodex.

    Resultat: Den relativa och absoluta reliabiliteten visade sig vara varierad avseende samtliga variabler. Relativ reliabilitet gick från låg till utmärkt (ICC: 0,36—0,92) och absolut reliabilitet visade MDC % 42—362

    Konklusion: Denna pilotstudie kan ge en grund för vidare studier om hur muskelfunktionen är påverkad hos personer med ARD med hjälp av yt-EMG, dock krävs fortsatta studier med fler deltagare för att resultat ska kunna generaliseras.

  • 228.
    Björkkvist, Johan
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Interplay in deformation between dorsal neck muscles: an observational ultrasound study2018Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
    Abstract [sv]

    Introduktion: Nacksmärta är ett ökande problem i dagens samhälle och nedsatt muskelfunktion kan leda till funktionsnedsättning. Nackspecifik träning kan minska smärta och öka funktion men hur musklerna aktiveras i övningarna är okänt. Ultraljud med speckle tracking analys kan användas för att mäta deformation och deformationshastighet i muskulatur. Syfte: Att med ultraljud undersöka skillnader i deformation mellan dorsala nackmuskler samt musklernas samspel vid fyrfotastående rotationsträning. Metod: Deformation och deformationshastighet i dorsala nackmuskler hos tjugo nackfriska individer mäts med hjälp av ultraljud och analyseras med speckle tracking. Repeated measure ANOVA används för att undersöka skillnader i deformation och deformationshastighet och Kendall’s tau correlation används för att undersöka sampel mellan musklerna.  Resultat: Semispinalis capitis påvisar den högsta deformationen (F(1.23, 24.26) =6.90, p=0.01) i vänsterrotation jämfört med multifider (p=0.05) och trapezius (p=0.03). Semispinalis capitis visar också signifikant korrelation angående samspel med trapezius i rotation vänster (r=0.42) och höger (r=0.34) gällande deformation. Högst deformationshastighet har också semispinalis capitis i både rotation vänster (F(1.43, 27.25)=9.05, p=< 0.01) och höger (F(2, 38)=14.26, p=< 0.01) jämfört med trapezius och multifider. Semispinalis capitis har ett samspel med trapezius i rotation höger (r=0.47) och med multifider i både rotation vänster (r=0.58) och höger (r=0.62).  Slutsats: Ultraljudsundersökning visar att i fyrfotastående rotationsträning samverkar semispinalis capitis med både trapezius och multifider men hade en högre grad av deformation än dessa muskler. Detta bör ses som en pilotstudie för att mäta nackmuskelfunktion i en rehabiliteringsövning. Kompletterande studier behövs för att kunna avgöra om deformationen var aktiv eller passiv.

  • 229.
    Björklund, Cecilia
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Erlandsson, Lena-Karin
    Department of Health Sciences, Lund University.
    Lilja, Margareta
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Temporal Patterns of Daily Occupations Related to Older Adults' Health in Northern Sweden2015Inngår i: Journal of Occupational Science, ISSN 1442-7591, E-ISSN 2158-1576, Vol. 22, nr 2, s. 127-145Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to identify characteristics of temporal patterns of daily occupations that could be related to high and low subjective health among older adults in Northern Sweden. A cross-sectional design imprinted by time-geographic methodology was used and participants 70 years and older were purposively selected and divided into groups of high and low health using the SoC-29 and SF-36 questionnaires. Daily occupations data were registered and analysed using VISUAL Time-PAcTS and related to health conditions using SPSS. The results showed that the participants in the high- and low-health groups showed similar patterns of participation in occupations during the 24-hour sequences describing their daily routines. Some differences in patterns of frequency and duration of occupations were shown between health groups during the 24-hour sequences as well as within six intervals. The low-health group showed higher frequencies and longer durations for “care for oneself” and “reflection and recreation” occupations and lower for “house-keeping” and “procure and prepare food” occupations compared to the high-health groups. There were few significant differences between the high- and low-health groups' mean durations for occupations. The results of this study could contribute to the support and assistance of occupations of older adults in society.

  • 230.
    Björklund, Cecilia
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Lilja, Margareta
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute.
    Erlandsson, Lena-Karin
    Department of Health Sciences, Lund University.
    Temporal Patterns of Daily Occupations among Older Adults in Northern Sweden2014Inngår i: Journal of Occupational Science, ISSN 1442-7591, E-ISSN 2158-1576, Vol. 21, nr 2, s. 143-160Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study sought to expand knowledge regarding patterns of daily occupations and, specifically, to explore and describe the daily occupations of Swedish people aged over 70 years by investigating sequences, contexts and time-use. A cross-sectional design with a time-geographic approach was used. Open time diaries from 151 participants were collected and analysed using the software VISUAL-TimePAcTS. The results were illustrated as a routine of six pooled intervals during 24-hour sequences. The intervals comprised different lengths of time and each interval was dominated by different occupations. Night was dominated by ‘care for oneself’; morning by ‘house-keeping’ and ‘reflection and recreation’; lunch-time by care for oneself; afternoon by ‘reflection and recreation’; dinner/tea-time by ‘care for oneself’, and evening by ‘reflection and recreation’. The results were also illustrated as characteristic profiles of occupations visualised by the number of participants in each occupation during 24-hour sequences. Occupations were mainly supported by the home environment. Summed time-use showed the highest proportions in ‘care for oneself’ and ‘reflection and recreation’ occupations. To what extent health and well-being experiences of patterns of daily occupations might be related to challenges and fulfilment of basic occupational needs requires further investigation

  • 231.
    Björklund, Martin
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning. Institutionen för samhällsmedicin och rehabilitering, fysioterapi, Umeå universitet.
    What works for whom:challenges in personalising physical therapy: Discussion panel2015Konferansepaper (Annet vitenskapelig)
  • 232.
    Björklund, Martin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik. Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, Gävle, Sweden.
    Djupsjöbacka, Mats
    Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, Gävle, Sweden.
    Svedmark, Åsa
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik. Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, Gävle, Sweden.
    Häger, Charlotte
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Effects of tailored neck-shoulder pain treatment based on a decision model guided by clinical assessments and standardized functional tests: a study protocol of a randomized controlled trial2012Inngår i: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 13, artikkel-id 75Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: A major problem with rehabilitation interventions for neck pain is that the condition may have multiple causes, thus a single treatment approach is seldom efficient. The present study protocol outlines a single blinded randomised controlled trial evaluating the effect of tailored treatment for neck-shoulder pain. The treatment is based on a decision model guided by standardized clinical assessment and functional tests with cut-off values. Our main hypothesis is that the tailored treatment has better short, intermediate and long-term effects than either non-tailored treatment or treatment-as-usual (TAU) on pain and function. We sub-sequentially hypothesize that tailored and non-tailored treatment both have better effect than TAU.

    METHODS: 120 working women with minimum six weeks of nonspecific neck-shoulder pain aged 20-65, are allocated by minimisation with the factors age, duration of pain, pain intensity and disability in to the groups tailored treatment (T), non-tailored treatment (NT) or treatment-as-usual (TAU). Treatment is given to the groups T and NT for 11 weeks (27 sessions evenly distributed). An extensive presentation of the tests and treatment decision model is provided. The main treatment components are manual therapy, cranio-cervical flexion exercise and strength training, EMG-biofeedback training, treatment for cervicogenic headache, neck motor control training. A decision algorithm based on the baseline assessment determines the treatment components given to the each participant of T- and NT-groups. Primary outcome measures are physical functioning (Neck Disability Index) and average pain intensity last week (Numeric Rating Scale). Secondary outcomes are general improvement (Patient Global Impression of Change scale), symptoms (Profile Fitness Mapping neck questionnaire), capacity to work in the last 6 weeks (quality and quantity) and pressure pain threshold of m. trapezius. Primary and secondary outcomes will be reported for each group with effect size and its precision.

    DISCUSSION: We have chosen not to include women with psychological ill-health and focus on biomedical aspects of neck pain. Future studies should aim at including psychosocial aspects in a widened treatment decision model. No important adverse events or side-effects are expected.

    Trial registration: Current Controlled Trials registration ISRCTN49348025.

  • 233.
    Björklund, Martin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Djupsjöbacka, Mats
    Svedmark, Åsa
    Häger, Charlotte
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Effects of tailored versus non-tailored treatment on pain and pressure pain threshold in women with non-specific neck pain: A randomized controlled trial2014Konferansepaper (Fagfellevurdert)
  • 234.
    Björklund, Martin
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning. Dept. of Community Med. and Rehabilitation, Physiotherapy, Umeå Univ., Umeå, Sweden.
    Djupsjöbacka, Mats
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Svedmark, Åsa
    Dept. of Community Med. and Rehabilitation, Physiotherapy, Umeå Univ., Umeå, Sweden.
    Häger, Charlotte
    Dept. of Community Med. and Rehabilitation, Physiotherapy, Umeå Univ., Umeå, Sweden.
    Effects of tailored versus non-tailored treatment on pain and pressure pain threshold in women with nonspecific neck pain: a randomized controlled trial2014Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Aim of the investigation: The evidence for physiotherapy treatments of nonspecific neck pain is modest despite a large increase of intervention studies the last decade. One reason could be different underlying causes for pain in individuals with nonspecific neck pain, and that identification of sub-groups or individual needs is seldom accounted for in studies. In the absence of causal treatment options, a tailored treatment approach based on an explicit clinical decision model guided by assessment of function, clinical signs and symptoms, should be considered. Our aim was to evaluate tailored treatment based on such a decision model, targeting women with nonspecific neck pain. Our main hypothesis was that the tailored treatment (T) would have better short, intermediate and long-term effects on pain intensity and pressure pain threshold for the trapezius muscles than either non-tailored treatment (NT) (same treatment components but applied quasi-randomly) or treatment-as-usual (TAU) (no treatment from the study, no restrictions). We further hypothesized that T or NT has better effect than TAU. For details, cf. Current Controlled Trials registration ISRCTN49348025 and published study protocol.

    Methods: 120 working women with minimum six weeks duration of neck pain were randomized to the T, NT or TAU groups. All participants had more than “no disability” but less than “complete disability” according to the Neck Disability Index, and reported impaired capacity on the quality or quantity to work the preceding month. Main exclusion criteria were trauma-related neck pain, specific diagnoses and generalized pain or concomitant low back pain. The decision model for tailored treatment was based on tests and symptoms with defined cut-off levels comprising the following main categories: reduced cervical mobility, impaired neck-shoulder strength and motor control, trapezius myalgia, cervicogenic headache and impaired eye-head-neck control (cf. published study protocol). Assessment was performed one week before and after the 11-weeks intervention, with follow-ups 6-months (intermediate-term) and 12-months (long-term) after the intervention. Outcome variables were pain intensity (Numeric Rating Scale, NRS, 0 – 10) and pressure pain threshold (PPT) of the upper trapezius muscles (kPa). PPT was not measured at long-term follow-up.  Preliminary statistical analyses for the predefined hypotheses were performed with analysis of covariance (ANCOVA) with baseline outcome values as covariates. This was supplemented with pairwise Bonferroni-compensated comparisons in case of significance of factor group.

    Results: 86% of the participants completed the intervention, and the attrition was similar across groups. Preliminary results for the short term evaluation showed a reduction in NRS from an average of 4.4 and 4.5 to 2.5 in the T and NT groups, respectively, which was significantly greater compared to the TAU group (p=0.024 and p=0.014 for T and NT). For the PPT, there was no difference between T and NT groups at the short term evaluation, but close to a significantly increased threshold for the T compared to the TAU group (p=0,058). No differences were found between treatment groups on the intermediate and long-term evaluations for neither of the two outcome variables.

    Conclusions: The results indicate that tailored treatment for women with nonspecific neck pain may not be more effective, with respect to pain reduction, compared to non-tailored treatment. The hypothesis of superiority of tailored or non-tailored treatment over treatment-as-usual was partly supported for the short-term evaluation. However, the short-term results should be interpreted with caution since the impact of higher attention given to the participants in T and NT groups is not known. Reference:1. Björklund M, Djupsjöbacka M, Svedmark Å, Häger C. (2012) Effects of tailored neck-shoulder pain treatment based on a decision model guided by clinical assessments and standardized functional tests. A study protocol of a randomized controlled trial. BMC Musculoskeletal Disorders. May 20;13(1):75

  • 235.
    Björklund, Martin
    et al.
    Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Hamberg, Jern
    Alfta Research Foundation, Alfta, Sweden.
    Heiden, Marina
    Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Barnekow-Bergkvist, Margareta
    Högskolan i Gävle, Centrum för belastningsskadeforskning.
    The profile fitness mapping scales, validity of a new back-specific questionnaire2009Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Background: Disability questionnaires for LBP-patients mostlyemanate from health professionals and have a content of differentdomains of disability presented as a single sum score, makingit difficult to derive changes within a specific domain. Thisstudy introduces a new back-specific questionnaire, the ProfileFitness Mapping questionnaire (PFM), which was based on patient’sself-reported characteristics of the LBP. The PFM incorporatesboth a functional limitation and a symptom scale, with furthersubdivision of the symptom scale in separate indices for severityand temporal aspects. The aim of the study was to assess theoverall validity of the PFM.

    Methods and Results: Chronic LBP-patients (n=193) answered thePFM and four validated back-specific criterion questionnaires.The correlation coefficients between the PFM and the criterionquestionnaires showed good concurrent criterion validity (0.61– 0.83). The best discriminative ability between patientswith different pain severity was demonstrated by the functionallimitation scale of the PFM. Classification according to theICF revealed a high degree of homogeneous item content of thesymptom scale to the domain of impairments, and of the functionallimitation scale to the domain of activity limitations. Wellcentered score distribution indicates that the PFM has the potentialto detect improvement or worsening of symptoms and functionallimitations in chronic LBP-patients.

    Conclusion: The results of the study signify that the PFM isa valid indicator of symptoms and functional limitations ofLBP-patients. It provides the combination of a composite totalscore and the possibility of evaluations within specific domainsof disability.

  • 236.
    Björklund, Martin
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning. Department of Community Medicine and Rehabilitation, Physiotherapy, Umea University, Umeå Sweden.
    Wiitavaara, Birgitta
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Heiden, Marina
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
    Responsiveness and minimal important change for the ProFitMap-neck questionnaire and the Neck Disability Index in women with neck-shoulder pain2017Inngår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 26, nr 1, s. 161-170Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose

    The aim was to determine the responsiveness and minimal important change (MIC) of the questionnaire ProFitMap-neck that measures symptoms and functional limitations in people with neck pain. The same measurement properties were determined for Neck Disability Index (NDI) for comparison purposes.

    Methods

    Longitudinal data were derived from two randomized controlled trials, including 103 and 120 women with non-specific neck pain, with questionnaire measurements performed before and after interventions. Sensitivity and specificity to discriminate between improved and non-improved participants, based on categorization of a global rating of change scale (GRCS), were determined for the ProFitMap-neck indices and NDI by using area under receiver operator curves (AUC). Correlations between the GRCS anchor and change scores of the questionnaires were also used to assess responsiveness. The change score that showed the highest combination of sensitivity and specificity was set for MIC.

    Results

    The ProFitMap-neck indices showed similar responsiveness as NDI with AUC exceeding 0.70 (Range: ProFitMap-neck, 0.74 – 0.83; NDI, 0.75 – 0.86). The MIC in the two samples ranged between 6.6 – 13.6% for ProFitMap-neck indices and 5.2 and 6.3% for NDI. Both questionnaires had significant correlations with GRCS (Spearman’s rho 0.47 – 0.72).

    Conclusions

    Validity of change scores was demonstrated for the ProFitMap-neck indices with adequate ability to discriminate between improved and non-improved participants. Values of minimal important change were presented.

  • 237.
    Björnsdóttir, Sigrún Vala
    et al.
    Univ Iceland, Fac Med, Dept Phys Therapy, Reykjavik, Iceland.;Univ Iceland, Fac Med, Ctr Publ Hlth Sci, Reykjavik, Iceland..
    Arnljotsdottir, Margret
    HNLFI Rehabil Clin, Hverageroi, Iceland..
    Tomasson, Gunnar
    Univ Iceland, Fac Med, Ctr Publ Hlth Sci, Reykjavik, Iceland..
    Triebel, Jan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Ortopedi. HNLFI Rehabil Clin, Hverageroi, Iceland..
    Valdimarsdottir, Unnur Anna
    Univ Iceland, Fac Med, Ctr Publ Hlth Sci, Reykjavik, Iceland.;Harvard Univ, Sch Publ Hlth, Dept Epidemiol, 665 Huntington Ave, Boston, MA 02115 USA..
    Health-related quality of life improvements among women with chronic pain: comparison of two multidisciplinary interventions2016Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 38, nr 9, s. 828-836Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: To measure the effect of 4 weeks traditional multidisciplinary pain management program (TMP) versus neuroscience education and mindfulness-based cognitive therapy (NEM) on quality of life (HRQL) among women with chronic pain. Method: This observational longitudinal cohort study conducted in an Icelandic rehabilitation centre included 122 women who received TMP, 90 receiving NEM, and 57 waiting list controls. Pain intensity (visual analogue scale) and HRQL (Icelandic Quality of Life scale) were measured before and after interventions. ANOVA and linear regression were used for comparisons. Results: Compared with controls we observed statistically significant changes in pain intensity (p < 0.001) and HRQL (p < 0.001) among women receiving both interventions, while NEM participants reported significant improvements in sleep (8.0 versus 4.4 in TMP; p = 0.008). Head to head comparison between study groups revealed that pain intensity improved more among TMP participants (21.8 versus 17.2 mm; p = 0.013 adjusted). Women with low HRQL at baseline improved more than those with higher HRQL (mean TMP = 13.4; NEM = 12.9 if HRQL <= 35 versus mean TMP = 6.6 and NEM = 7.8 if HQRL > 35). Conclusions: Our non-randomized study suggests that both NEM and TMP programs improve pain and HRQL among women with chronic pain. Sleep quality showed more improvements in NEM while pain intensity in TMP. Longer-term follow-ups are needed to address whether improvements sustain. Implications for Rehabilitation Chronic pain is a debilitating condition affecting quality of life and restricting societal participation. Intensive multidisciplinary bio-psycho-social rehabilitation is essential for this patient group. This study shows improvement in health-related quality of life and pain intensity following such rehabilitation. Emphasizing mindfulness based cognitive therapy and neuroscience patient education improves sleep to more extend than more traditional approach.

  • 238. Blain, H.
    et al.
    Masud, T.
    Dargent-Molina, P.
    Martin, F. C.
    Rosendahl, Erik
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    van der Velde, N.
    Bousquet, J.
    Benetos, A.
    Cooper, C.
    Kanis, J. A.
    Reginster, J. Y.
    Rizzoli, R.
    Cortet, B.
    Barbagallo, M.
    Dreinhoefer, K. E.
    Vellas, B.
    Maggi, S.
    Strandberg, T.
    A comprehensive fracture prevention strategy in older adults: the European Union Geriatric Medicine Society (EUGMS) statement2016Inngår i: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 28, nr 4, s. 797-803Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Prevention of fragility fractures in older people has become a public health priority, although the most appropriate and cost-effective strategy remains unclear. In the present statement, the Interest Group on Falls and Fracture Prevention of the European Union Geriatric Medicine Society, in collaboration with the International Association of Gerontology and Geriatrics for the European Region, the European Union of Medical Specialists, and the International Osteoporosis Foundation-European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, outlines its views on the main points in the current debate in relation to the primary and secondary prevention of falls, the diagnosis and treatment of bone fragility, and the place of combined falls and fracture liaison services for fracture prevention in older people.

  • 239.
    Blane, Alison
    et al.
    Curtin Univ, Australia.
    Falkmer, Torbjörn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum. Curtin Univ, Australia; Jonkoping Univ, Sweden; La Trobe Univ, Australia.
    Lee, Hoe C.
    Curtin Univ, Australia.
    Dukic Willstrand, Tania
    Swedish Natl Rd and Transport Res Inst VTI, Sweden.
    Investigating cognitive ability and self-reported driving performance of post-stroke adults in a driving simulator2018Inngår i: Topics in Stroke Rehabilitation, ISSN 1074-9357, E-ISSN 1945-5119, Vol. 25, nr 1, s. 44-53Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Safe driving is a complex activity that requires calibration. This means the driver can accurately assess the level of task demand required for task completion and can accurately evaluate their driving capability. There is much debate on the calibration ability of post-stroke drivers. Objectives: The aim of this study was to assess the cognition, self-rated performance, and estimation of task demand in a driving simulator with post-stroke drivers and controls. Methods: A between-groups study design was employed, which included a post-stroke driver group and a group of similarly aged older control drivers. Both groups were observed driving in two simulator-based driving scenarios and asked to complete the NASA Task Load Index (TLX) to assess their perceived task demand and self-rate their driving performance. Participants also completed a battery of psychometric tasks to assess attention and executive function, which was used to determine whether post-stroke cognitive impairment impacted on calibration. Results: There was no difference in the amount of perceived task demand required to complete the driving task. Despite impairments in cognition, the post-stroke drivers were not more likely to over-estimate their driving abilities than controls. On average, the post-stroke drivers self-rated themselves more poorly than the controls and this rating was related to cognitive ability. Conclusion: This study suggests that post-stroke drivers may be aware of their deficits and adjust their driving behavior. Furthermore, using self-performance measures alongside a driving simulator and cognitive assessments may provide complementary fitness-to-drive assessments, as well as rehabilitation tools during post-stroke recovery.

  • 240.
    Blane, Alison
    et al.
    Curtin University.
    Falkmer, Torbjörn
    Curtin University.
    Lee, Hoe C.
    Curtin University.
    Dukic Willstrand, Tania
    Statens väg- och transportforskningsinstitut, Trafik och trafikant,TRAF, Trafikanttillstånd, TIL.
    Investigating cognitive ability and self-reported driving performance of post-stroke adults in a driving simulator2018Inngår i: Topics in Stroke Rehabilitation, ISSN 1074-9357, E-ISSN 1945-5119, Vol. 25, nr 1, s. 44-53Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Safe driving is a complex activity that requires calibration. This means the driver can accurately assess the level of task demand required for task completion and can accurately evaluate their driving capability. There is much debate on the calibration ability of post-stroke drivers.

    Objectives: The aim of this study was to assess the cognition, self-rated performance, and estimation of task demand in a driving simulator with post-stroke drivers and controls.

    Methods: A between-groups study design was employed, which included a post-stroke driver group and a group of similarly aged older control drivers. Both groups were observed driving in two simulator-based driving scenarios and asked to complete the NASA Task Load Index (TLX) to assess their perceived task demand and self-rate their driving performance. Participants also completed a battery of psychometric tasks to assess attention and executive function, which was used to determine whether post-stroke cognitive impairment impacted on calibration.

    Results: There was no difference in the amount of perceived task demand required to complete the driving task. Despite impairments in cognition, the post-stroke drivers were not more likely to over-estimate their driving abilities than controls. On average, the post-stroke drivers self-rated themselves more poorly than the controls and this rating was related to cognitive ability.

    Conclusion: This study suggests that post-stroke drivers may be aware of their deficits and adjust their driving behavior. Furthermore, using self-performance measures alongside a driving simulator and cognitive assessments may provide complementary fitness-to-drive assessments, as well as rehabilitation tools during post-stroke recovery.

  • 241.
    Blom, Anna-Klara
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Andersson, Charlotta
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Akuta responser vid högintensiv uppvärmning hos idrottare2017Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Syfte: Att undersöka förändringar i autonom balans och forcerad expiratorisk volym (FEV1) före jämfört med efter specifik intervalluppvärmning hos idrottare utan någon form av astma eller ansträngningsutlöst bronkokonstriktion (EIB). Detta för att se vilken belastning som är bäst lämpad att använda i vidare studie av akuta responser vid högintensiv uppvärmning hos individer med EIB, samt om en förskjutning i autonom balans mot en förhöjd sympatikusaktivitet parallellt med ett ökat FEV1 kan ses hos friska idrottare. 

    Metod: Fyra deltagare utförde ett Maximal Aerobic Power output test (MAP) för att beräkna maximal aerob effekt. Cykelintervaller utfördes sedan på fyra olika nivåer av intensitet (75–150% av MAP) där hjärtfrekvensvariabilitet och FEV1 mättes före och efter.

    Resultat: Endast vid cykelintervaller på 150% av MAP sågs en förändring i autonom balans med ett ökat sympatikuspåslag och ett minskat parasympatikuspåslag hos alla deltagare före jämfört med efter intervallerna. Ingen tydlig ökning sågs i FEV1 före jämfört med efter cykelintervaller på de fyra olika nivåerna av belastning (75–150% av MAP).

    Slutsats: En belastning på minst 150% av MAP kan leda till en förskjutning i autonom balans mot en förhöjd sympatikusaktivitet skall ske hos friska idrottare. FEV1 tycks ej följa kurvan för autonom balans vid samma belastning hos idrottare utan astma.

  • 242.
    Blom, Kerstin
    et al.
    Karolinska Institute, Sweden.
    Tarkian Tillgren, Hanna
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten.
    Wiklund, Tobias
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Danlycke, Ewa
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten.
    Forssen, Mattias
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten.
    Söderström, Alexandra
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten.
    Johansson, Robert
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Hesser, Hugo
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Jernelov, Susanna
    Karolinska Institute, Sweden.
    Lindefors, Nils
    Karolinska Institute, Sweden.
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Karolinska Institute, Sweden.
    Kaldo, Viktor
    Karolinska Institute, Sweden.
    Internet-vs. group-delivered cognitive behavior therapy for insomnia: A randomized controlled non-inferiority trial2015Inngår i: Behaviour Research and Therapy, ISSN 0005-7967, E-ISSN 1873-622X, Vol. 70, s. 47-55Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to compare guided Internet-delivered to group-delivered cognitive behavioral therapy (CBT) for insomnia. We conducted an 8-week randomized controlled non-inferiority trial with 6-months follow-up. Participants were forty-eight adults with insomnia, recruited via media. Interventions were guided Internet-delivered CBT (ICBT) and group-delivered CBT (GCBT) for insomnia. Primary outcome measure was the Insomnia Severity Index (ISI), secondary outcome measures were sleep diary data, depressive symptoms, response- and remission rates. Both treatment groups showed significant improvements and large effect sizes for ISI (Within Cohens d: ICBT post = 1.8, 6-months follow-up = 2.1; GCBT post = 2.1, 6-months follow-up = 2.2). Confidence interval of the difference between groups posttreatment and at FU6 indicated non-inferiority of ICBT compared to GCBT. At post-treatment, two thirds of patients in both groups were considered responders (ISI-reduction greater than 7p). Using diagnostic criteria, 63% (ICBT) and 75% (GCBT) were in remission. Sleep diary data showed moderate to large effect sizes. We conclude that both guided Internet-CBT and group-CBT in this study were efficacious with regard to insomnia severity, sleep parameters and depressive symptoms. The results are in line with previous research, and strengthen the evidence for guided Internet-CBT for insomnia. Trial registration: The study protocol was approved by, and registered with, the regional ethics review board in Linkoping, Sweden, registration number 2010/385-31.

  • 243. Blomgren, Johannes
    et al.
    Strandell, Erika
    Jull, Gwendolen
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering. Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, Australia..
    Vikman, Irene
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Röijezon, Ulrik
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Effects of deep cervical flexor training on impaired physiological functions associated with chronic neck pain: a systematic review2018Inngår i: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 19, artikkel-id 415Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background:Neck pain is a major health issue with high rates of recurrence. It presents with a variety ofaltered sensorimotor functions. Exercise is a cornerstone of rehabilitation and many training methods areused. Exercise is evaluated in most randomized controlled trials on its pain relieving effects. No review hasassessed the effect of exercise on the altered physiological functions or determined if there are differentialeffects of particular training methods. This review investigated the effects of deep cervical flexor (DCF)training, a training method commonly used for patients with neck pain, and compared it to other trainingmethodsornotrainingonoutcomesofcervicalneuromuscular function, muscle size, kinematics and kinetics.Methods:Web of Science, Scopus, CINAHL, PubMed were searched from inception until January 2018. Twelverandomized controlled trials were included that compared DCF training as sole intervention to other trainingor no interventions in persons with neck pain. The Cochrane Risk of Bias tool was used to assess the methodquality. All outcome measures were analysed descriptively and meta-analyses were performed for measuresevaluated in three or more studies.Results:DCF training was compared to cervical endurance, strength, proprioception and mobility training,muscle stretching, and no intervention control groups. Physiological outcome measures includedneuromuscular co-ordination (craniocervical flexion test), functional tasks, muscle fatigability, muscle size,kinematics (joint position sense, posture and range of motion) and kinetics (strength, endurance andcontraction accuracy). Strong evidence was found for effectiveness of DCF training on neuromuscularcoordination, but it had no or small effects on strength and endurance at higher loads. DCF trainingimproved head and cervical posture, while evidence was limited or contradictory for other measures.Conclusions:DCF training can successfully address impaired neuromuscular coordination, but not cervicalflexor strength and endurance at higher contraction intensities. A multimodal training regime is proposedwhen the aim is to specifically address various impaired physiological functions associated with neck pain

  • 244.
    Blomkvist, Anna-Christina
    et al.
    University of Lulea, Department of Human Work Science.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Computer use in cold environments2000Inngår i: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 31, nr 3, s. 239-245Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study addresses computer work in cold environments with the two-fold aim to explore conditions for such work, and to add knowledge about the use of fingers at data entry in the cold. Five workplaces were visited and work contents and use of computers are briefly described. Effects of work in the cold were in line with those mentioned in the literature, and manual lifting of heavy goods the most impairing activity. Subjects contended with strenuous working postures--holding the computers in their hands or arms--and with cold fingers. Individual fingering for data input was noted. Forefinger or a pen were used, and a pen is recommendable for input, either as a touch pen or, simply to press the keys. A supportive rack could be recommended for portable workstations.

  • 245.
    Blomkvist, Anna-Christina
    et al.
    Luleå tekniska universitet.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Datoranvändning i kyla1997Rapport (Annet vitenskapelig)
  • 246.
    Blomqvist, Linnea
    Linnéuniversitetet, Fakultetsnämnden för hälsa, socialt arbete och beteendevetenskap, Institutionen för hälso- och vårdvetenskap, HV.
    Sambandet mellan undersökningsinstrument för fysisk aktivitet som används för barn med övervikt2012Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
    Abstract [sv]

    Sammanfattning

    Att undersöka en befolknings fysiska aktivitet ger beskrivande data utav

    dagsläget samt att resultatet fungerar som mätinstrument för hur en framtida

    intervention ska utformas. Syftet med denna studie var att se om något

    samband förelåg mellan tre olika undersökningsinstrument för fysisk

    aktivitet, som används för med barn med övervikt. Metod: Deltagarna

    mättes, vägdes, skattade sin fysiska aktivitetsnivå (frågeformulär), testade sin

    fysiska prestationsförmåga (sex minuters gångtest) och deras fysiska aktivitet

    mättes (accelerometer). Resultat: Åtta flickor, 7-13 år, med ett Body Mass

    Index (BMI) på 26 ± 3,7 kg/m2deltog. Majoriteten skattade sig vara fysiskt

    aktiva 30-60 min/dag under vardag och helg, men som grupp var skattningen

    signifikant lägre på helgen. Deltagarnas fysiska prestationsförmåga var

    signifikant lägre än det beräknade normalvärde. Barnen utförde i snitt 67 ±24

    min/dag aktivitet under vardagarna och signifikant mindre aktivitet (31 ±

    29,7min/dag) på helgerna. Ett signifikant samband förelåg mellan

    undersökningsinstrumenten för utförd fysisk aktivet under vardagarna och

    prestationsförmågan, där även en formel för hur sambandet kunde kalkyleras

    framtogs. Slutsats: Trots litet deltagarantal skulle studiens resultat tyda på att

    6MGT kan användas inte bara för att bedöma prestationsförmåga utan även

    för beräknad utförd fysisk aktivitet under vardagarna.

  • 247.
    Blomqvist, Sven
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Postural balance, physical activity and capacity among young people with intellectual disability2013Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    The overall aim of this thesis was to investigate postural balance, physical activity, physical capacity and their associations in young people (16-20 years) with intellectual disability (ID), mild to moderate. The aim was also to study the reliability and concurrent validity of postural balance tests.

    To evaluate postural balance, one assessor used five common postural balance tests and one new test. The tests were performed twice for 89 young people with ID (one to twelve days apart). Intraclass correlation coefficients greater than 0.80 were achieved for four of the common balance tests: Extended Timed Up and Go Test (ETUGT), Modified Forward Reach Test (MFRT), One-Leg Stance Test (OLS), and a Force Platform Test (FPT). The smallest real difference ranged from 12% to 40%; less than 20% is considered to be low. For the six balance tests, the concurrent validity varied between none to low.

    Falls are more common for young people with ID compared to young people without ID. One reason could be impaired postural balance. The postural balance for young people with ID has not been thoroughly investigated. Therefore, five balance tests and three muscle strength tests were used to compare young people with ID with an age-matched control group without ID (n=255). The young people with ID had significantly lower scores on most of the postural balance tests and muscle strength tests of the trunk and lower limbs. Muscle strength, height, and body mass index had no strong association with postural balance. The results also illustrated that young people with ID did not rely more on vision for their balance ability compared to peers without ID.

    It seems that postural balance is impaired for young people with ID when evaluated with common tests. An everyday situation is to react to unexpected balance disturbances to avoid falls by using different postural responses. Since young people with ID seem to fall more often than peers without ID, it is valuable to investigate if those postural responses are different between the groups. Therefore, young people with and without ID (n=99) were exposed to six backward surface translations and several postural muscle responses were evaluated: muscle synergies and strategies, muscle onset latency, time-to-peak amplitude, and adaptation. The responses of the investigated muscles – the gastrocnemius, the biceps femoris, and the erector spinae L4 level – were measured using electromyography. The results showed that there were no differences between the two groups with respect to synergies or strategies, muscle onset latency, and time-to-peak amplitude. An overall pattern was seen, that young people with ID adapted their muscle response slower in all three muscles than peers without ID, but this pattern was not statistically significant.

    Studies have shown that people with ID have impaired postural balance, a lower level of physical activity, and lower aerobic capacity compared to people without ID. The association is however not investigated. Therefore, postural balance (postural sway indirectly measured with the subjects standing on a force platform), physical activity (measured with a pedometer), and aerobic capacity (measured with a sub-maximal ergometer cycle test) were used to assess young people with and without ID (n=106). To investigate the subjects’ view of their own health, the subjects completed an adapted questionnaire that addressed their perceived health. The analysis showed no significant associations between postural balance, level of physical activity, and aerobic capacity. The subjects in the ID group, both men and women, had significantly lower aerobic capacity compared to subjects without ID. The answers from the health questionnaire did not correspond to the measured outcomes from the physical tests for young people with ID.

    In conclusion, ETUGT and MFRT can be used to evaluate change in postural balance over time in young people with mild to moderate ID. The low concurrent validity suggests that the postural balance tests probably challenge various subsystems. Young people with ID have impaired postural balance and perform lower on muscle strength tests than age-matched controls. Postural muscle responses after external perturbations seem to be similar for young people with and without ID, but the ability to adapt muscle responses after repeated perturbations appears to be slower for young people with ID. The studies in the thesis also indicate that young people with ID have reduced level of physical activity and lower aerobic capacity. The lack of association between the different physical functions indicates that they should be evaluated and exercised separately. Young persons with ID might have more difficulty realising the health advantage of being physically active, as they do not seem to make this connection. Because of this, it is important that parents/guardians, school staff, physiotherapists, and others encourage them to participate in physical activity.

  • 248.
    Blomqvist, Sven
    et al.
    Gävle Högskola.
    Lönnberg, Lisa
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Sundelin, Gunnevi
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Wester, Anita
    Skolverket.
    Rehn, Börje
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Physical Exercise Frequency Seem not to Influence Postural Balance but Trunk Muscle Endurance in Young Persons with Intellectual Disability2017Inngår i: Journal of Physical Education and Sports Management, ISSN 2373-2156, E-ISSN 2373-2164, Vol. 4, nr 2, s. 38-47Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The influence of various physical exercise frequencies on postural balance and muscle performance among young persons with intellectual disability (ID) is not well understood.

    Method: Cross-sectional data from 26 elite athletes were compared with 37 students at a sports school and to 57 students at a special school, all diagnosed with mild to moderate ID and with different exercise frequencies. Data were also compared with a group of 149 age-matched participants without ID.

    Results: There were no significant differences in postural balance between young ID groups regardless of physical exercise frequency, all of them had however impaired postural balance compared to the non-ID group. The group with high exercise performed better than the other ID groups in the trunk muscle endurance test.

    Conclusions: It appears as if physical exercise frequency don’t improve postural balance but endurance in the trunk muscles for young persons with ID.

  • 249.
    Blomqvist, Sven
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Olsson, Josefine
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Wallin, Louise
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Wester, Anita
    Rehn, Börje
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Adolescents with intellectual disability have reduced postural balance and muscle performance in trunk and lower limbs compared to peers without intellectual disability2013Inngår i: Research in Developmental Disabilities, ISSN 0891-4222, E-ISSN 1873-3379, Vol. 34, nr 1, s. 198-206Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    For adolescent people with ID, falls are more common compared to peers without ID. However, postural balance among this group is not thoroughly investigated. The aim of this study was to compare balance and muscle performance among adolescents aged between 16 and 20 years with a mild to moderate intellectual disability (ID) to age-matched adolescents without ID. A secondary purpose was to investigate the influence of vision, strength, height and Body Mass Index (BMI) on balance. A group of 100 adolescents with ID and a control group of 155 adolescents without ID were investigated with five balance tests and three strength tests: timed up and go test, one leg stance, dynamic one leg stance, modified functional reach test, force platform test, counter movement jump, sit-ups, and Biering-Sorensen trunk extensor endurance test. The results showed that adolescents with an ID in general had significantly lower scores in the balance and muscle performance tests. The group with ID did not have a more visually dominated postural control compared to the group without ID. Height, BMI or muscle performance had no strong correlations with balance performance. It appears as if measures to improve balance and strength are required already at a young age for people with an ID. 

  • 250.
    Blomqvist, Sven
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Idrottsvetenskap.
    Rehn, Börje
    Institutionen för Samhällsmedicin och Rehabilitering, Fysioterapi, Umeå universitet.
    Fysisk aktivitet och hälsa för personer med utvecklingsstörning2015Inngår i: Fysioterapi, ISSN 1653-5804, nr 1, s. 26-31Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [sv]

    Hälsa är en förutsättning för att kunna förverkliga sina mål i livet. Personer med utvecklingsstörning, cirka 90 000 i Sverige, har nedsatt hälsa jämfört med personer utan utvecklingsstörning och det leder till att denna grupp har svårare att uppfylla sina mål. Personer med utvecklingsstörning drabbas i större utsträckning av övervikt, typ 2-diabetes, hjärt- och kärlsjukdomar, högt blodtryck, benskörhet och depression. Undersökningar visar också på nedsatt fysisk aktivitet, motorik, syreupptagningsförmåga, muskelstyrka och postural balans hos denna grupp. Dessa sjukdomar och nedsatta förmågor går att påverkai positiv riktning med fysisk aktivitet. Fysioterapeuter som har bred kunskap om hälsa och anpassning av fysisk aktivitet kan vara till stor hjälp vid prevention, bedömning och träning.

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