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  • 251.
    Lönnberg, Lisa
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Postural balance and muscle performance for young athletes with intellectual disability: a comparisson between groups with differernt physical activity levels2012Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
  • 252.
    Madison, Guy
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Paulin, Johan
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Musikens positiva kraft2011In: Svensk Idrottsforskning: Organ för Centrum för Idrottsforskning, ISSN 1103-4629, Vol. 20, no 1, p. 46-49Article in journal (Other academic)
  • 253.
    Madison, Guy
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Paulin, Johan
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Physical and psychological effects from supervised aerobic music exercise2013In: American Journal of Health Behavior, ISSN 1087-3244, E-ISSN 1945-7359, Vol. 37, no 6, p. 780-793Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To assess the physical and psychological effects across 11 weeks of music-exercise sessions, the participants' training experience, and attitudes towards physical activity. The effect of different music information was also investigated.

    METHODS: Overall, 146 sedentary volunteers were randomized into 4 exercise groups and each group received different music information. Physical capacity and psychological measures were obtained.

    RESULTS: Increased performance in oxygen uptake and flexibility and decreased blood pressure was found. Participants reported increased wellbeing and body-awareness, and an intention to remain physically active. No differences between groups were found.

    CONCLUSION: Music-exercise can be recommended to promote physical activity among sedentary individuals. The amount of musical information in synchronous music seems not to have any effects on self-selected intensity or physiological benefits.

  • 254.
    Magnusson, Moa
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Walfridsson, Sanna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Synen på träning vid infektion bland idrottande barn, deras målsmän och tränare: En enkätstudie med svårtolkat resultat2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Att barn är aktiva inom olika idrotter i föreningar är främjande för deras hälsa. Om träning sker i samband med infektion kan dock negativa hälsoeffekter uppstå. Studier visar att träning vid infektion ej ska bedrivas.

    Syfte: Syftet med studien var att undersöka synen på träning vid infektion bland idrottande barn, deras målsmän samt tränare. Metod: Studien gjordes genom utskick av eget utformade enkäter via programmet Google Docs till idrottande barn, deras målsmän samt tränare i idrottsföreningen KFUM i Umeå. Resultat: Bortfallet i de tre grupperna idrottande barn, deras målsmän samt tränare var så pass stort att ingen statistisk analys av svaren kunde göras. Resultatet beskrivs därför endast deskriptivt. Konklusion: Att undersöka synen på träning vid infektion bland idrottande barn, deras målsmän samt tränare genom en enkätstudie har inneburit flera svårigheter. Enkätstudier som berör ämnen som kan anses vara känsliga kräver en väl genomförd planering av metod och upplägg för att kunna undersökas på bästa sätt. Om dessa metodologiska aspekter kan uppnås finns möjligheten att undersöka synen på träning vid infektion vidare.

  • 255.
    Malmgren Olsson, Eva-Britt
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Armelius, Bengt-Åke
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Non-specific musculoskeletal disorders in patients in primary care: subgroups with different outcome patterns2003In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 19, no 3, p. 161-173Article in journal (Refereed)
    Abstract [en]

    Patients with non-specific musculoskeletal disorders are considered to be a heterogeneous group with multifactorial problems. Appropriate and effective treatments for these patients have been hard to find. The purpose of this study was to identify subgroups of patients with different patterns of treatment outcome and to find possible predictors of outcome. A total of 78 patients, 64 females and 14 males, with non-specific musculoskeletal disorders were recruited consecutively to three different treatment approaches, Body Awareness Therapy, Feldenkrais, and conventional, individual physiotherapy in primary care. The outcome variables were calculated as effect-size values and consisted of dynamic balance; pain measurements according to pain drawing and MPI; psychological variables such as psychological distress and self-image; and health related factors with regard to quality of life, self-efficacy and sense of coherence. A cluster analysis revealed three subgroups of patients with significantly different treatment outcomes, which were systematically related to the treatment approach. With Body Awareness Therapy and Feldenkrais, the possibility to achieve positive treatment effects increased significantly in comparison to individual physiotherapy.

  • 256.
    Malmgren-Olsson, Eva-Britt
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Armelius, B A
    Physical and psychological health and social relations in patients with prolonged musculoskeletal disorders2001In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 15, no 2, p. 181-189Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to describe and analyse the relationship between physical and psychological health and social relations in patients with prolonged musculoskeletal disorders in primary care. Seventy-eight patients 64 women and 14 men - were included in the study. Data from a semi-structured interview called addiction severity index (ASI), frequently used in psychiatric and drug abuse research and a visual analogue scale (VAS) symptom list as well were analysed using principal component analysis (PCA). The analysis gave a two-dimensional model with four poles of related variables characterizing the whole group. The first dimension consisted of one pole characterized by present psychiatric symptoms and many somatic symptoms. The second pole on this dimension was characterized by well-being, having work and feeling satisfaction with life. One pole on the second dimension was characterized by severe physical problems, related to sick leave and disability pension. The opposite pole on this dimension was characterized by severe psychiatric symptoms earlier in life and present relationship problems with family and other people. The ASI-instrument was considered to be relevant for describing important problem areas in patients with prolonged musculoskeletal disorders.

  • 257.
    Malmgren-Olsson, Eva-Britt
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Bergdahl, Jan
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Temperament and character personality dimensions in patients with nonspecific musculoskeletal disorders2006In: The Clinical Journal of Pain, ISSN 0749-8047, E-ISSN 1536-5409, Vol. 22, no 7, p. 625-Article in journal (Refereed)
  • 258.
    Malmgren-Olsson, Eva-Britt
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Bränholm, Inga-Britt
    A comparison between three physiotherapy approaches with regard to health-related factors in patients with non-specific musculoskeletal disorders.2002In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 24, no 6, p. 308-17Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The main aim of this study was to compare the effects of Body Awareness Therapy (BAT), the Feldenkrais (FK) method and conventional physiotherapy on changes of health-related quality of life (HRQL), self-efficacy and sense of coherence (SOC) in patients with non-specific musculoskeletal disorders. A second aim was to explore the relationships between SOC, HRQL and self-efficacy and to examine whether SOC could be a predictor of the treatment outcome.

    METHOD: A total of 78 patients, 64 women and 14 men, were recruited consecutively to the three treatment groups. The instrument used were the Swedish version of SF-36, the 20 items Arthritis Self-efficacy Scale and the 29-item questionnaire by Antonovsky.

    RESULTS: The results showed that there were significant improvements on all subscales of SF-36 except for one. By using effect-size values it was found that the BAT and FK groups reached larger effect-size than did the conventional therapy group. These two groups also improved in self-efficacy of pain and stayed stable while the third group deteriorated at the one-year follow-up. There were significant correlations between the mental dimensions of SF-36 and SOC indicating that the instruments may measure aspects of the same global construct.

    CONCLUSIONS: Although few significant differences between the three treatment groups the BAT and FK seemed to improve health-related quality of life and self-efficacy of pain to a somewhat higher degree than the conventional physiotherapy. SOC seemed to be a stable trait measure over time.

  • 259.
    Marklund, Ingela
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Intensivträning av nedre extremitet för personer med stroke: effekter och upplevelser2009Licentiate thesis, comprehensive summary (Other academic)
  • 260.
    Merrick, Daniel
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Stålnacke, Britt-Marie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    A follow-up of two different rehabiliation strategies for patients with chronic pain, focusing on sick leaveManuscript (preprint) (Other academic)
  • 261.
    Merrick, Daniel
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Stålnacke, Britt-Marie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    An observational study of two rehabilitation strategies for patients with chronic pain, focusing on sick leave at one-year follow-up2013In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 45, no 10, p. 1049-1057Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 262.
    Merrick, Daniel
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Stålnacke, Britt-Marie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    One-year follow-up of two different rehabilitation strategies for patients with chronic pain2012In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 44, no 9, p. 764-773Article in journal (Refereed)
    Abstract [en]

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

  • 263.
    Mikkelsen, Fredrik
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hellgren, Joel
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Styrkeförhållandet mellan specifika rörelser i övre och nedre extremiteten vid maximal dynamisk isokinetisk kraftutveckling hos patienter med KOL2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Enligt vår vetskap finns inga tidigare studier som undersökt styrkeförhållandet mellan olika rörelser hos patienter med KOL. Syfte: Fastställa styrkeförhållandet mellan specifika rörelser vid maximal dynamisk isokinetisk kraftutveckling hos patienter med KOL. Illustrera slutpositionen för involverade rörelser vid träning med elastiska band. Undersöka eventuella skillnader i kraftutveckling, andfåddhet och muskeltrötthet mellan rörelserna. Metod: Sju personer med moderat till svår (steg II-IV) KOL utförde åtta maximala styrketester i en isokinetisk dynamometer. Från testerna analyserades peakvärdet samt skattning för muskeltrötthet och andfåddhet enligt Borgs Cr-10 skala för varje rörelse. Resultat: Rörelsernas förhållanden låg inom 20-90 % av knäextensionens kraftutveckling. Alla utvecklade störst kraft i knäextension. Deltagarna var signifikant starkare i extensionsrörelser än i flexionrörelser (p<0,05). På gruppnivå skattade deltagarna totalt signifikant högre på andfåddhet än muskeltrötthet (p=0,019). Vid jämförelse av enskilda rörelser kunde vi inte se någon signifikant skillnad (p>0,05). Konklusion: Rörelsernas förhållande låg inom 20-90 % av knäextensionens kraftutveckling. Störst kraft utvecklades i knäextension. Utifrån vårt resultat och tidigare studier om elastiska band vet vi hur mycket bandet bör förlängas för att få rätt belastning för varje rörelse. Studien visar att personer med moderat till svår KOL är starkare i extensionsrörelser än i flexionrörelser. Totalt sett skattades andfåddhet högre än muskeltrötthet.

  • 264. Milosavljevic, Stephan
    et al.
    Bagheri, Nasser
    Vasiljev, Radivoj M
    McBride, David I
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Does daily exposure to whole-body vibration and mechanical shock relate to the prevalence of low back and neck pain in a rural workforce?2012In: Annals of Occupational Hygiene, ISSN 0003-4878, E-ISSN 1475-3162, Vol. 56, no 1, p. 10-17Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To determine whether whole-body vibration (WBV) and mechanical shock exposure from quad bike use are associated with the prevalence of neck and low back pain (LBP) in New Zealand farmers and rural workers.

    METHODS: Full-day WBV and mechanical shock exposures were gathered from 130 farmers and rural workers. Participants were surveyed for a history of neck or LBP in the past 7 days and in the past 12 months. Anthropometric, personal, and workplace data were also gathered.

    RESULTS: Physical exposures (mechanical shocks), employee status, and low levels of workplace satisfaction are all significantly associated with the 12-month prevalence of LBP in this rural workforce that regularly use quad bikes. Both vibration and mechanical shock exposure were strongly associated with 12-month prevalence of neck pain. The 7-day prevalence of neck pain showed a non-significant association with mechanical shock and vibration.

    CONCLUSIONS: Knowledge of these findings will be valuable information for those who teach and advise on safe driving techniques for such vehicles in the rural workplace where reduction of physical exposures and injury rates is of high importance.

  • 265. Milosavljevic, Stephan
    et al.
    Bergman, Frida
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Carman, Allan B
    All-terrain vehicle use in agriculture: Exposure to whole body vibration and mechanical shock2010In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 41, no 4, p. 530-535Article in journal (Refereed)
    Abstract [en]

    Whole body vibration (WBV) and mechanical shock were measured in 12 New Zealand farmers during their daily use of all-terrain vehicles (ATVs). As per the International Organization for Standardization (ISO) guidelines for WBV exposure, frequencies between 0 and 100Hz were recorded via a seat-pad tri-axial accelerometer during 20min of ATV use. The farmers were also surveyed to estimate seasonal variation in daily ATV usage as well as 7-day and 12-month prevalence of spinal pain. Frequency-weighted vibration exposure and total riding time were calculated to determine the daily vibration dose value (VDV). The daily VDV of 16.6m/s(1.75) was in excess of the 9.1m/s(1.75) action limit set by ISO guidelines suggesting an increased risk of low back injury from such exposure. However, the mean shock factor R, representing cumulative adverse health effects, was 0.31 indicating that these farmers were not exposed to excessive doses of mechanical shock. Extrapolation of daily VDV data to estimated seasonal variations of farmers in ATV riding time demonstrated that all participants would exceed the ISO recommended maximum permissible limits during the spring lambing season, as compared to lower exposures calculated for summer, autumn and winter. Low back pain was the most commonly reported complaint for both 7 day (50%) and 12 month prevalence (67%), followed by the neck (17% and 42%) and the upper back (17% and 25%) respectively. The results demonstrate high levels of vibration exposure within New Zealand farmers and practical recommendations are needed to reduce their exposure to WBV.

  • 266. Milosavljevic, Stephan
    et al.
    Mani, Ramakrishnan
    Ribeiro, Daniel Cury
    Vasiljev, Radivoj
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Exploring how anthropometric, vehicle and workplace factors influence whole-body vibration exposures during on-farm use of a quad bike2012In: International Journal of Industrial Ergonomics, ISSN 0169-8141, E-ISSN 1872-8219, Vol. 42, no 4, p. 392-396Article in journal (Refereed)
    Abstract [en]

    The primary aim of this study is to determine whether a combination of body height, terrain and vehicle mechanical factors confound for the effect of body mass on WBV exposure while using a quad bike under normal rural working conditions. A seat pad mounted triaxial accelerometer and data logger recorded full work day vibration and shock data from 130 New Zealand rural workers. Personal, vehicle and workplace characteristics were gathered using a modified version of the Whole Body Vibration Health Surveillance Questionnaire. Whole-body vibrations were analysed in accordance with the ISO 2631-1 and ISO 2631-5 standards and it is presented as one hour vibration dose value in the Z-direction (1 h VDVZ). Body mass did not demonstrate any significant bivariate association (P > 0.20) with I h VDVZ. However BMI, body height, vehicle weight, sheep farm, dairy farm, 2 shock absorber solid axle rear suspension, flat farmland and engine capacity (cc) all demonstrated threshold bivariate associations (P <= 0.20) with 1 h VDVZ. Body mass, body height, 2 shock absorber solid rear axle suspension, and working on a sheep farm created the strongest multiple regression model explaining 16% of variance in VDVZ. Relevance to industry: The influence of driver's body mass on vibration exposure is strongly influenced by work environment and vehicle mechanical factors and this should be taken in to consideration for research that explores exposures and/or designing seating and suspension systems to attenuate vibration exposures in small on-farm vehicles. (C) 2012 Elsevier B.V. All rights reserved.

  • 267. Milosavljevic, Stephan
    et al.
    McBride, David I.
    Bagheri, Nasser
    Vasiljev, Radivoj M.
    Carman, Allan B.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Moore, Dave
    Factors associated with quad bike loss of control events in agriculture2011In: International Journal of Industrial Ergonomics, ISSN 0169-8141, E-ISSN 1872-8219, Vol. 41, no 3, p. 317-321Article in journal (Refereed)
    Abstract [en]

    Objective: To determine personal and workplace factors associated with quad bike loss of control events (LCEs) on New Zealand farms. Methods: Rural community databases were used to sample 130 farmers and farm employees (workers). Fieldwork and survey investigated for prevalence of LCEs; farm type; farm terrain; personal measures; and vehicle driving exposures. Results: Seventy nine workers (61%) described a total of 200 LCEs. Increased driver height, increased body mass, non-flat farm terrain, increased driving speed and distance, and greater whole body vibration exposure were significantly associated with LCEs. Conclusions: Taller and heavier drivers of quad bikes should be particularly vigilant for risk of an ICE. Vehicle speed, distance driven and choice of driving routes over difficult terrain are potentially modifiable factors which have behavioural components and should be considered as management strategies for reducing risk of on-farm quad bike LCEs. Relevance to industry: Quad bike accidents are a considerable problem in agriculture. This research has identified a number of physical and driving factors that should be considered in the management strategies for reducing risk of on-farm quad bike accidents. (C) 2011 Elsevier B.V. All rights reserved.

  • 268. Milosavljevic, Stephan
    et al.
    McBride, David I
    Bagheri, Nasser
    Vasiljev, Radivoj M
    Mani, Ramakrishnan
    Carman, Allan B
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Exposure to whole-body vibration and mechanical shock: a field study of quad bike use in agriculture2011In: Annals of Occupational Hygiene, ISSN 0003-4878, E-ISSN 1475-3162, Vol. 55, no 3, p. 286-295Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The purpose of this study was to determine exposure to whole-body vibration (WBV) and mechanical shock in rural workers who use quad bikes and to explore how personal, physical, and workplace characteristics influence exposure.

    METHODS: A seat pad mounted triaxial accelerometer and data logger recorded full workday vibration and shock data from 130 New Zealand rural workers. Personal, physical, and workplace characteristics were gathered using a modified version of the Whole Body Vibration Health Surveillance Questionnaire. WBVs and mechanical shocks were analysed in accordance with the International Standardization for Organization (ISO 2631-1 and ISO 2631-5) standards and are presented as vibration dose value (VDV) and mechanical shock (S(ed)) exposures.

    RESULTS: VDV(Z) consistently exceeded European Union (Guide to good practice on whole body vibration. Directive 2002/44/EC on minimum health and safety, European Commission Directorate General Employment, Social Affairs and Equal Opportunities. 2006) guideline exposure action thresholds with some workers exceeding exposure limit thresholds. Exposure to mechanical shock was also evident. Increasing age had the strongest (negative) association with vibration and shock exposure with body mass index (BMI) having a similar but weaker effect. Age, daily driving duration, dairy farming, and use of two rear shock absorbers created the strongest multivariate model explaining 33% of variance in VDV(Z). Only age and dairy farming combined to explain 17% of the variance for daily mechanical shock. Twelve-month prevalence for low back pain was highest at 57.7% and lowest for upper back pain (13.8%).

    CONCLUSIONS: Personal (age and BMI), physical (shock absorbers and velocity), and workplace characteristics (driving duration and dairy farming) suggest that a mix of engineered workplace and behavioural interventions is required to reduce this level of exposure to vibration and shock.

  • 269. Moe-Nilssen, R
    et al.
    Nordin, Ellinor
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Criteria for evaluation of measurement properties of clinical balance measures for use in fall prevention studies2007In: Journal of Evaluation in Clinical Practice, ISSN 1356-1294Article in journal (Refereed)
  • 270. Moorhead, A
    et al.
    Liddle, D
    Hurley-Osing, D
    Häger-Ross, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Baxter, D
    McDonough, S
    Physical activity monitoring in healthy adults2007Conference paper (Other academic)
  • 271.
    Mosell, Johanna
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gunnarsson, Sofia
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Personliga assistenters fysiska kapacitet relatertat till yrkets fysiska krav samt hälsoaspekter: En deskriptiv studie2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Studier har visat att det är vanligt att personer med fysiskt krävande arbeten har bristande fysisk kapacitet samt en inaktiv livsstil. Det finns indikationer från en tidigare studie på att personlig assistent är ett fysiskt krävande arbete. Syftet med den här studien var därför att undersöka personliga assistenters fysiska kapacitet med avseende på   kondition, bålstryka samt greppkraft, och diskutera det gentemot arbetets krav samt i relation till hälsoaspekter.

    Metod: Studiens testgrupp bestod av åtta deltagare (24-61år). Fyra olika tester i kondition, bålstyrka och greppkraft användes för att utvärdera den fysiska kapaciteten. Samtliga fyllde  dessutom i ett frågeformulär ångåeende deras livsstil.

    Resultat: Sammanställningen av studiens data visade stora variationer, både i testresultat och frågeformulärssvar. Det framkom inget specifikt problemområde för gruppen generellt men hos vissa individer fanns det tendens till  mycket stillasittande (>9timmar/dag),   obalans mellan uppskattad funktion och upplevda krav samt en inaktiv livsstil.

     Slutsats: Studien tyder på att det finns en viss obalans mellan yrkets fysiska krav och den upplevda   förmågan hos vissa individer inom yrkesgruppen, samt att preventiva insatser   inom hälsa skulle kunna gynna arbetsgruppen. Eventuella åtgärder bör individanpassas eftersom problematiken är heterogen.

  • 272. Mulligan, Hilda
    et al.
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hale, Leigh
    Thomas, David
    Häger-Ross, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Promoting physical activity for people with neurological disability: perspectives and experiences of physiotherapists2011In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 27, no 6, p. 399-410Article in journal (Refereed)
    Abstract [en]

    Both New Zealand and Sweden have health and disability policies that promote recreational exercise within society for people with disability. Despite these policies, levels of physical activity by people with disability in these countries are low. Physiotherapists are equipped to assist people with disabling conditions into physical activity. This qualitative study explored the perspectives and experiences of physiotherapists in New Zealand and Sweden toward promoting physically active recreation for adults with chronic neurological conditions. Nine physiotherapists who worked with adults with neurological disability in a range of long-term rehabilitation and community (home) health services were interviewed and the data analysed for themes. The physiotherapists described innovative and resourceful expertise to assist patients to be physically active. However, they perceived a lack of support for their work from within the health system and a lack of knowledge of disability issues within the recreational arena, both of which they perceived hindered their promotion of physical activity for people with neurological disability. Physiotherapists feel unable to fully support health and disability policies for the promotion of physically active recreation for people with neurological conditions, because of perceived constraints from within the recreational arena and their own health systems. If these constraints were addressed, then physiotherapists could be better agents to promote physical activity for people with neurological conditions.

  • 273. Naili, J E
    et al.
    Esbjörnsson, A C
    Hedström, M
    Wretenberg, P
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Broström, E W
    Utvärdering av funktion före och efter total höftledsplastik hos personer med höftledsartros2014Conference paper (Other academic)
  • 274. Naili, J E
    et al.
    Esbjörnsson, A C
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Quantifying function before and after total joint replacement surgery in patients with hip osteoarthritis2014Conference paper (Other academic)
  • 275. Naili, J E
    et al.
    Esbjörnsson, A C
    Iversen, M D
    Schwartz, M H
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Broström, E W
    Quantifying function before and after total joint replacement surgery in patients with hip osteoarthritis.2014Conference paper (Other academic)
  • 276.
    Nehlin, Emmy
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Linde, Malin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Skadeförekomst bland svenska beachvolleyspelare: En retrospektiv enkätstudie2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 277.
    Ng, Nawi
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Centre for Population Studies (CPS).
    Söderman, Kerstin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Norberg, Margareta
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Centre for Population Studies (CPS).
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Increasing physical activity, but persisting social gaps among middle-aged people: trends in Northern Sweden from 1990 to 20072011In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 4, p. 6347-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Physical activity is identified as one important protective factor for chronic diseases. Physical activity surveillance is important in assessing healthy population behaviour over time. Many countries lack population trends on physical activity.

    OBJECTIVE: To present trends in physical activity levels in Västerbotten County, Sweden and to evaluate physical activity among women and men with various educational levels.

    METHODS: opulation-based cross-sectional and panel data from the Västerbotten Intervention Programme (VIP) during 1990-2007 were used. All individuals in Västerbotten County who turned 40, 50, or 60 years old were invited to their local primary health care for a health screening. Physical activity during commuting, recreational activities, physical exercise, and socio-demographic data were collected using a self-administered questionnaire. Respondents were categorised as sedentary, moderate physically active, or physically active.

    RESULTS: The prevalences of physically active behaviours increased from 16 to 24.2% among men and from 12.6 to 30.4% among women. Increases are observed in all educational groups, but gaps between educational groups widened recently. The level of sedentary behaviour was stable over the time period studied. The 10-year follow-up data show that the prevalences of physically active behaviours increased from 15.8 to 21.4% among men and 12.7 to 23.3% among women. However, 10.2% of men and 3.8% of women remained sedentary.

    CONCLUSION: Despite the promising evidence of increasing physical activity levels among the population in Västerbotten County, challenges remain for how to reduce the stable levels of sedentary behaviours in some subgroups. Persisting social gaps in physical activity levels should be addressed further. An exploration of people's views on engaging in physical activity and barriers to doing so will allow better formulation of targeted interventions within this population.

  • 278.
    Niklas, Ivarsson
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Emanuel, Vall
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Samband mellan sprintprestation och enbensknäböj respektive tvåbensknäböj: En tvärsnittsstudie av innebandyspelare på elitnivå2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Det finns flera studier som belyser frågeställningen om hur individers bilaterala benstyrka korrelerar med sprintkapacitet. Huruvida den unilaterala benstyrkan korrelerar med sprintprestation är däremot inte lika beforskat. Syftet med den här studien var att undersöka sambandet mellan sprintprestation och enbensknäböj respektive tvåbensknäböj hos kvinnliga innebandyspelare på elitnivå. 

     

    Den unilaterala- respektive bilaterala benstyrkan, för åtta kvinnliga innebandyspelare aktiva i den Svenska Superligan, utvärderades genom knäböj med fria vikter. Dessa resultat jämfördes sedan gentemot tidigare insamlade testvärden gällande sprintprestation.

     

    Resultaten visade en hög (r=0.764)  signifikant korrelation mellan enbensknäböj och linjär sprint 20 m. Mellan enbensknäböj och linjär sprint 10 m samt change of direction speed (CODS) uppvisades en moderat icke signifikant korrelation. Tvåbensknäböj visade ingen statistiskt signifikans, med en moderat icke signifikant korrelation med linjär sprint 10-  och 20 m samt en låg icke signifikant korrelation med CODS.

     

    Den unilaterala benstyrkan tycks ha ett starkare samband med sprintprestation i jämförelse med den bilaterala benstyrkan hos kvinnliga elitinnebandyspelare. Detta resultat antyder att enbensknäböj är ett bättre föutsägande styrketest i förhållande till tvåbensknäböj gällande sprintprestation.

  • 279.
    Niklewski, Linnea
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sanderberg, John
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Förutsättningar, utmaningar och möjligheter i utbildning och yrke: Svenska och tanzaniska sjukgymnaststudenters yrkesval - En intervjustudie2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Anledningen till varför man väljer att studera till sjukgymnast samt yrkets status skiljer sig åt i olika länder. Hur länge yrket funnits i länderna kan bidra till detta.

    Syfte: Syftet med studien var att utforska sjukgymnaststudenters tankar och erfarenheter kring sitt yrkesval i Sverige och Tanzania.

    Metod: I denna studie användes halvstrukturerade intervjuer som analyserades med Kvalitativ innehållsanalys enligt Graneheim och Lundman. Sex sjukgymnaststudenter från Sverige och Tanzania deltog i studien, tre från vardera land.

    Resultat: Intervjuerna resulterade i fem kategorier, Intressen ledde vägen till utbildning och yrkesval, Ett yrke med framtid, Konkurrens eller samarbete - olika upplevelser, Unik roll i sjukvården och Sjukgymnasten i vården. Resultatet visade både skillnader och likheter mellan sjukgymnaststudenternas erfarenheter i de båda länderna. Det fanns en stor omedvetenhet kring sjukgymnastik i Tanzania jämfört med i Sverige. Studenterna från båda länderna delade uppfattning om att sjukgymnaster har en unik roll i sjukvården och kommer att behövas mer i framtiden liksom att sjukgymnaster förtjänar en större roll inom sjukvården än vad de har idag.

    Slutsats: Sjukgymnastik är viktigt i dagens sjukvård men utmanas av en låg medvetenhet inom andra vårdyrken. Sjukgymnaster bör i många olika sammanhang nyttja sina möjligheter att öka medvetenheten om vikten av sjukgymnastik bland annan vårdpersonal.

  • 280.
    Nilsson Fredriksson, Marie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    En självskattningsskala för patienter med artros i nedre extremitetbaserad på ICF:s klassifikation, översatt till svenska och initialt validerad:Ab-IAPSE2013Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Självskattningsskalan Aberdeen Impairment, Activity Limitation and Participation Restriction measures (Ab-IAP) beskriver hälsa och hälsorelaterade problem hos patienter med knä- och/eller höftartros baserad på ICF:s klassifikation. Användandet av ICF anpassade mätinstrument kan ge en bredare och mer täckande bild av patientens upplevda hälsa och hälsorelaterade problem då det medicinska perspektivet kompletteras med ett psykologiskt och socialt samt tar hänsyn till den miljö individen lever i.

    Syfte: Studiens syfte var att översätta och kulturellt anpassa Ab-IAP till svenska och bedöma innehållsvaliditet.

    Metod: Översättningen gjordes enligt forward och back metoden av två svenska sjukgymnaster och en USA-född sjukgymnast. Den kulturella anpassningen gjordes med hjälp av två fokusgrupper. För att bedöma innehållsvaliditeten användes en expertpanel som besvarade en enkät gällande enskilda frågors relevans och tydlighet. För kvantifiering av innehållsvaliditet beräknades Content Validity Index (CVI).

    Resultat: Bedömning av innehållsvaliditet resulterade i att 6 frågor föreslås strykas ur Ab-IAPSE. Innehållsvaliditet för den föreslagna Ab-IAPSE gällande relevans och tydlighet är hög respektive god. Ab-IAPSE når dock inte upp i rekommenderat värde ≥ .90.

    Konklusion: Den preliminära svenska versionen av Ab-IAPSE behöver vidare diskuteras med original författarna innan den kan användas i Sverige.

  • 281.
    Nordin, C
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Enberg, Birgit
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Psychosocial work enviroment for novice occupational and physical therapists in public employment2007In: World Physical Therapy 2007 - Abstracts, 2007, p. S655-Conference paper (Other academic)
  • 282. Nordin, Catharina
    et al.
    Gard, Gunvor
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Being in an exchange process: experiences of patient participation in multimodal pain rehabilitation2013In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 45, no 6, p. 580-586Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 283.
    Nordin, Ellinor
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Moe-Nilssen, R
    Ramnemark, Anna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Changes in step-width during dual-task walking predicts falls2010In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 32, no 1, p. 92-97Article in journal (Refereed)
    Abstract [en]

    The aim was to evaluate whether gait pattern changes between single- and dual-task conditions were associated with risk of falling in older people. Dual-task cost (DTC) of 230 community living, physically independent people, 75 years or older, was determined with an electronic walkway. Participants were followed up each month for 1 year to record falls. Mean and variability measures of gait characteristics for 5 dual-task conditions were compared to single-task walking for each participant. Almost half (48%) of the participants fell at least once during follow-up. Risk of falling increased in individuals where DTC for performing a subtraction task demonstrated change in mean step-width compared to single-task walking. Risk of falling decreased in individuals where DTC for carrying a cup and saucer demonstrated change compared to single-task walking in mean step-width, mean step-time, and step-length variability. Degree of change in gait characteristics related to a change in risk of falling differed between measures. Prognostic guidance for fall risk was found for the above DTCs in mean step-width with a negative likelihood ratio of 0.5 and a positive likelihood ratio of 2.3, respectively. Findings suggest that changes in step-width, step-time, and step-length with dual tasking may be related to future risk of falling. Depending on the nature of the second task, DTC may indicate either an increased risk of falling, or a protective strategy to avoid falling.

  • 284.
    Nordin, Ellinor
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rosendahl, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Lindelöf, Nina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Jensen, Jane
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Prognostic validity of the Timed Up-and-Go test, a modified Get Up-and-Go test, staff's global judgement and fall history in evaluating fall risk in residential care facilities2008In: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 37, no 4, p. 442-448Article in journal (Refereed)
  • 285.
    Nordin, Ellinor
    et al.
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Rosendahl, Erik
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Timed "Up & Go" test: reliability in older people dependent in activities of daily living - focus on cognitive state.2006In: Physical Therapy, ISSN 0031-9023, E-ISSN 1538-6724, Vol. 86, no 5, p. 646-655Article in journal (Refereed)
  • 286.
    Nordlund, Sofia
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Julia, Edman
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Variability in the clinical measurement of tandem gait: a systematic review of timed protocols2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 287.
    Nordström, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Grysell, Tomas
    The effect of a role-playing exercise on clerkshipstudents’ views of death notification: the Swedish experience2011In: International Journal of Medical Education, ISSN 2042-6372, Vol. 2, p. 24-29Article in journal (Refereed)
    Abstract [en]

    Objectives The purpose of this study was to examine clerkship students' perspective towards delivering death notifications. An additional purpose of the study was to identify the learning needs of students following a role play exercise in delivering death notifications.

    Methods Participants in this study were fourth-year medical students (N=86) ranging in age from 22-43 years with a mean age of 27.1 years. There were 28 women and 58 men. Questionnaires, consisting of open-ended questions and a visual analogue scale (VAS), were administered before and after the "Marathon Death" role play exercise.

    Results Six categories emerged from the analysis of the questionnaire: communication, emotions, self-development, exercise-related, learning opportunities and tools and strategies. Results from the visual analogue scale showed that the majority of students (60%) needed to practice how to deliver difficult messages in death notifications. After taking part in the role-playing activity with video playback, where the students had an opportunity to view, discuss and reenact scenarios, seventy-six out of 78 (97.4%) stated that they had received training in communication skills. The responding students rated the exercise as highly relevant, scoring it a mean of 91 on a VAS scale of 0 to 100 mm.

    Conclusions Students are not competent in the communication skills required for delivering death notifications. A majority of students expressed a need for training in communication skills. The "Marathon Death" role play exercise provides initial training and emotional support for delivering a death notification. However, further empirical studies are required about the effect of the exercise on delivering the notification of death.

  • 288.
    Nordvall, Helena
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Surgical and Perioperative Sciences, Orthopaedics.
    Factors in secondary prevention subsequent to distal radius fracture: Focus on physical function, co-morbidity, bone mineral density and health-related quality of life2009Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    In Sweden approximately 25000 distal radius fractures occur annually, which is 37 % of all fractures related to osteoporosis. In this thesis, risk factors for osteoporosis, bone mineral density (BMD) and health-related quality of life (the SF-36) were compared in patients who suffered a distal radius fracture after low energy trauma with a control group matched on the basis of age, gender, and municipality of residence. The aim was also to analyse, among these patients, whether a risk factor questionnaire, tests on dynamic and static balance and a one-leg rise test could identify those, who have osteopenia or osteoporosis, and run a risk of new falls. Moreover, in a three-year follow-up, mortality, the need for in- and outpatient care, and health-related quality of life after radius fracture were investigated and compared between the patients and matched controls. Finally, the effect of a preventive intervention program including patient education and self-training was evaluated. Falls were reported in a risk factor questionnaire and in a fall diary.

    The patients aged 45-64 years showed lower, although not statistically significant, BMD, compared with the controls of the same age, but there was no difference concerning their history of falls. In contrast, the patients aged 64 years or older had a history of falling more often than the corresponding controls, but no difference in BMD was found. For all other risk factors, except falls, no differences were found between the patients and the controls. The results of the one-leg rise test were associated with those of dynamic and static balance, but none of the functional tests were associated with the number of falls. Decreased height and cigarette smoking were the only risk factors, which predicted osteopenia and osteoporosis.

    Five patients, although none of the controls, died during the study time. The patients needed statistically significantly more episodes as inpatients than the controls. The patients also had lower SF-36, Role Physical scores, than the controls at three months. This difference disappeared by the time of the follow-up.

    Both the patients, who participated in a four-week intervention program, “the osteoporosis school” followed by a one-year home-based exercise program, and the controls showed statistically significantly improved dynamic and static balance, ability to walk backwards and to stand on one leg with eyes open and closed at the end of the study. However, no significant differences were found between the patients and the controls in any of the tests, in BMD or in the number of the falls.

    The thesis shows that, except for the falls in patients aged over 64 years, there were no significant differences between patients and controls with respect to BMD and other risk factors related to osteoporosis. Consequently, in patients aged 45-64 years and older, the underlying cause of a distal radius fracture is more related to falls than to osteoporosis. Furthermore, the thesis shows that the functional tests and the risk factor questionnaire seem to be of limited value for identifying 8 people with a radius fracture, who are at risk of falling or have osteopenia or osteoporosis. If, in spite of this, functional tests on musculoskeletal function are considered for testing of functional ability in patients with a recent radius fracture, the one leg-rise test may be sufficient. There seems to be an increased mortality and morbidity necessitating inpatient care among patients with a recent radius fracture. The osteoporosis school had no significant effect on BMD, balance, muscle strength or falls in this thesis. Therefore, the lack of proven efficacy of the osteoporosis school for the secondary prevention of distal radius fractures highlights the need for more and long-term randomised controlled follow-up studies in this specific population.

  • 289.
    Nordvall, Helena
    et al.
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Lysholm, Jack
    Umeå University, Faculty of Medicine, Surgical and Perioperative Sciences, Orthopaedics.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Secondary prevention after distal radius fracture: a prospective observational study of the effect of an exercise interventionManuscript (Other academic)
    Abstract [en]

    This prospective observational study evaluated the effect of a four-week educational and exercise program, entitled the osteoporosis school. Two hundred and thirteen women with a distal radius fracture (mean age 66 years) were invited and 41 of them (mean age 64 years) accepted to join an exercise group (exercisers), 172 (mean age 66 years) declined and became a control group (non-exercisers). The intervention was followed by a one-year self-administrated exercise program. Bone mineral density (BMD), functional tests of dynamic and static balance, and leg strength were evaluated before and after the one-year intervention period and falls were registered in a fall diary. No statistically significant mean difference was found in dynamic or static balance between the exercisers and the non-exercisers. However, both groups showed improved balance (walking backwards and standing on one leg with eyes open over the study time (p<0.01). After the intervention, no significant difference was found between the groups in the one-leg rise test (p=0.494). The mean T-score was -1.859 at the baseline and -1.951 after intervention for the exercisers, and -2.0 and -2.064 for the non-exercises. There was no statistically significant difference in prospective falls between the exercisers and the non-exercisers (p= 0.272). Twelve of 41 exercisers (29.3%) and 37 of 172 non-exercisers (21.5%) reported one or more falls. Conclusion: Only 19% of the patients with a recent radius fracture accepted to participate in the osteoporosis school. The osteoporosis school with a 12-month home-based exercise program had no established effect on BMD, balance, leg strength or falls. This lack of proven efficacy for the secondary prevention of distal radius fractures, highlights the need for further research on better and more controlled interventions and for long-term randomised controlled follow-up studies.

  • 290.
    Nordvall, Helena
    et al.
    The Department of Physiotherapy,Department of Orthopaedics, Sunderby Hospital, Luleå, Sweden.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lysholm, Jack
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Can a risk factor questionnaire for osteoporosis and functional tests predict low bone mineral density or falls in patients with a distal radius fracture?2009In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 11, no 2, p. 71-80Article in journal (Refereed)
    Abstract [en]

    In a prospective cohort study, 141 patients with a recent radius fracture [135 women (66±9.2 years) and six men (72±6.3 years)] were studied using bone mineral density (BMD) measurements, a risk factor questionnaire, a fall diary, functional tests of dynamic and static balance, and a one-leg rise from a chair test. The mean BMD T-score was -1.97. The results of the one-leg rise test were significantly associated with dynamic and static balance, but none of the functional tests was associated with the number of falls. Forty of 117 patients fell prospectively, 77 of them did not. Decreased height and cigarette smoking were the only risk factors, which significantly predicted low BMD. All risk factors were estimated to explain osteopenia and osteoporosis to an extent of 27%. The functional tests and the risk factor questionnaire seem to be of limited value for identifying people with a radius fracture who are at risk of falling or to have early osteoporosis. If functional tests on musculoskeletal function are considered for older and more frail, the one-leg rise test may be sufficient. Keywords: Bone mineral density (BMD); functional tests; one-leg rise test; radius fracture; risk factors for osteoporosis

  • 291.
    Nordvall, Helena
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lysholm, Jack
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Pay attention to co-morbidity after a recent radius fracture: a longitudinal case-control studyArticle in journal (Refereed)
    Abstract [en]

    Material and methods: Mortality and co-morbidity, as in the number of visits to in- or outpatient care facilities, were studied in 73 patients during the first three years after a radius fracture compared to controls, and health-related quality of life, using the SF-36 initially and three years later.

    Results: Four patients died but none among the controls, during the study period. There were statistically significantly more in-patient visits among the patients, due to other reasons than the radius fracture, but fewer out-patients visits at the hospital.  The patients had a significantly lower Role Physical score in the SF-36 about three months after the fracture. This difference disappeared three years later.

    Conclusions: A higher need for in-patient care, indicating a worse general health, has to be taken into consideration when secondary prevention programs for patients with a radius fracture are designed and implemented.

  • 292.
    Nordvall Strömberg, Petronella
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Exercise training - An unknown territory. An interview study in patients with chronic obstructive pulmonary disease, COPD2013Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
  • 293. Norlin, S
    et al.
    Rösblad, Birgit
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Postural control in children with myelomeninigocele2008In: Postural control.: A key isssue in developmental disorders. Clinics in Developmental Medicine / [ed] Hadders Algra M, Brogren Carlberg, London: Mac Keith Press , 2008Chapter in book (Other academic)
  • 294.
    Norlund, Sofia
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Nordin, Maria
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Stenlund, Therese
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Ahlgren, Christina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Personal Resources and Support When Regaining the Ability to Work: An Interview Study with Exhaustion Disorder Patients2013In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 23, no 2, p. 270-279Article in journal (Refereed)
    Abstract [en]

    Purpose The aim of the study was to explore experiences and thoughts in the process of returning to work in employed patients with Exhaustion Disorder. Methods Twelve patients with Exhaustion Disorder (burnout) who had been referred to a Stress Rehabilitation Clinic were interviewed. All patients were employed but a majority was on full or part-time sick leave. Grounded Theory was used as the qualitative method. Results A core category, regaining the ability to work, was developed. Alongside, two categories, internal resources and the external support system, were experienced as being important to the process. The internal resources were expressed through three key features (sub-categories), perceived validation, insights and adaptive coping abilities. The external support system was diverse and described by the sub-categories practical/structural and/or emotional support. Four external support actors were identified; the workplace, health care, the Social Insurance Agency, and the union. The supervisor was described as the most important external actor. Conclusions Internal and external resources are intertwined in the process of regaining the ability to work. The internal resources and external support can directly increase the probability to regain the ability to work. Moreover, these resources can affect each other and thus indirectly have an effect on the process.

  • 295.
    Norman, Anton
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Appelgren, Caroline
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rörelsemönster hos kvinnliga fotbollsspelare: Sambandet mellan prestation i The Functional Movement Screen och höftledsrörlighet2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion

    The Functional Movement Screen (FMS) är en metod som undersöker rörelsemönster och

    asymmetrier mellan kroppssidor. Tidigare studier har visat att ett lägre testresultat, ≤14

    poäng av 21 möjliga, i FMS är förenat med ökad skaderisk. Andra studier har visat ett

    samband mellan höftledsrörlighet och prestation i några av delmomenten i FMS.

    Syfte

    Syftet med studien var att undersöka hur kvinnliga fotbollsspelare på elitnivå presterar i

    FMS, om det fanns samband mellan aktiv och passiv höftledsrörlighet och prestation i FMS,

    samt om det fanns några samband mellan aktiv och passiv höftledsrörlighet och två av

    delmomenten (djupt knäböj och hindersteg) i FMS.

    Metod och material

    I studien ingick 12 kvinnliga fotbollsspelare (medelålder 21,7±2,6) från ett elitlag i Umeå.

    Samtliga blev bedömda i FMS, samt uppmättes deras höftledsrörlighet med goniometer.

    Resultat

    Medelvärdet för deltagarna i FMS var 13,2 (±1,75). Inga samband kunde återfinnas mellan

    vare sig prestation i FMS eller de två delmomenten i FMS och höftledsrörlighet.

    Konklusion

    Studiens resultat visar att deltagarna skulle kunna ha högre risk för att skada sig baserat på

    deras prestation i FMS.

  • 296. Norrlin, S
    et al.
    Rösblad, Birgit
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Adaptation of reaching movements in children and young adults with myelomeningocele.2004In: Acta pædiatrica, ISSN 0803-5253, Vol. 93, no 7, p. 922-8Article in journal (Refereed)
  • 297. Norrlin, Simone
    et al.
    Dahl, Margareta
    Rösblad, Birgit
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Control of reaching movements in children and young adults with myelomeningocele.2004In: Developmental medicine and child neurology, ISSN 0012-1622, Vol. 46, no 1, p. 28-33Article in journal (Refereed)
  • 298.
    Norén, Emma-Maria
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Larsson, Daniel
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Inomhuscykling i grupp förpatienter med utmattningssyndrom: En genomförbarhetsstudie2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: För patienter med utmattningssyndrom saknas konsensus gällande vilken rehabilitering som är effektiv. Denna studie syftar till att utvärdera genomförbarheten av inomhuscykling i grupp tre gånger per vecka under en 12 veckors intervention för patienter med utmattningssyndrom.

    Metod: Urvalet bestod av 38 deltagare  (29 kvinnor, 9 män, medelålder 42,8 år) med utmattningssyndrom som deltog i en randomiserad kontrollerad studie med inomhuscykling som intervention. Under interventionen använde deltagarna pulsklocka och tränade inom pulsintervallet 70-85 % av sin maximala hjärtfrekvens. Efter interventionen besvarades ett frågeformulär som undersökte upplevelsen av inomhuscykling i grupp, feedback på träning och pulsnivåer, hindrande och stödjande faktorer för deltagande, betydelse av att erbjuda träning vid rehabiliteringsprogram  för utmattningssyndrom, stöd i målsättning av fysisk aktivitet samt  fysisk kapacitet och minne.

     Resultat: Femtio procent av deltagarna (15 kvinnor, 4 män) påbörjade interventionen och 38 % (12 kvinnor, 2 män) fullföljde. Inga signifikanta skillnader gällande ålder, utmattningssymtom, ångest, depression,maximal syreupptagningsförmåga eller body mass index påvisades vid start mellan de som påbörjade eller ej. Interventionens duration (12 veckor) upplevdes som lagom medan frekvensen (3 gånger/vecka) ansågs för hög. Användandet av pulsklocka under träning, att träna i grupp samt att få feedback från sjukgymnast angående pulsfiler och träning upplevdes som positivt. Deltagarna ville i framtiden att konditionsträning ska ingå som en behandlingsform för patienter med utmattningssyndrom.

     Konklusion: Inomhuscykling i grupp kan vara ett behandlingsalternativ för patienter med utmattningssyndrom. Följsamheten kan öka om flera olika former av konditionsträning finns att välja mellan samt om frekvensen ökas stegvis. Att träna inom en pulszon på 70-85% av maximal hjärtfrekvens under en period av 12 veckor visade sig fungera väl. Faktorer som underlättar följsamheten är gruppträning, använda pulsklocka, stöd samt regelbunden feedback från sjukgymnast.

  • 299.
    Novak, Masuma
    et al.
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine. Umeå University, Faculty of Medicine, Public Health and Clinical Medicine.
    Ahlgren, Christina
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation. Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Hammarström, Anne
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Family Medicine. Umeå University, Faculty of Medicine, Public Health and Clinical Medicine.
    A life-course approach in explaining social inequity in obesity among young adult men and women.2006In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 30, no 1, p. 191-200Article in journal (Refereed)
    Abstract [en]

    Objective: To examine the cumulative influence of adverse behavioural, social, and psychosocial circumstances from adolescence to young adulthood in explaining social differences in overweight and obesity at age 30 years and if explanations differ by gender.

    Design: A 14-year longitudinal study with 96.4% response rate.

    Subject: Data from 547 men and 497 women from a town in north Sweden who were baseline examined at age 16 years and prospectively followed up to age 30 years.

    Measurements: Overweight and obesity were ascertained at ages 16 and 30 years. Occupation and education were used to measure socioeconomic status. The explanatory measurements were: age at menarche, smoking, physical activity, alcohol consumption, TV viewing, home and school environment, social support, social network, and work environment.

    Results: No gender or social difference in overweight was observed at age 16 years. At age 30 years, significantly more men than women (odds ratio (OR)¼2.81, 95% confidence interval (CI) 2.14–3.68) were overweight or obese. Educational level was associated with overweight at age 30 years, but not occupational class. Both men (OR¼1.55, 95% CI 1.10–2.19) and women (OR¼1.78, 95% CI 1.16–2.73) with low education (p11 years) were at risk of overweight. The factors that explained the educational gradient in overweight among men were low parental support in education during adolescence, and physical inactivity, alcohol consumption, and nonparticipation in any association during young adulthood. The educational gradient in overweight in women was explained mostly by adolescence factors, which include early age at menarche, physical inactivity, parental divorce, not being popular in school, and low school control. Restricted financial resource during young adulthood was an additional explanatory factor for women. All these factors were significantly more common among men and women with low education than with high education.

    Conclusion: Social inequities in overweight reflect the cumulative influence of multiple adverse circumstances experienced from adolescence to young adulthood. Underlying pathways to social inequity in overweight differ between men and women. Policy implications to reduce social inequity in overweight include reduction of social differences in health behaviours and social circumstances that take place at different life stages, particularly psychosocial circumstances during adolescence.

  • 300.
    Novak, Masuma
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Ahlgren, Christina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hammarström, Anne
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Inequalities in smoking: influence of social chain of risks from adolescence to young adulthood: a prospective population-based cohort study.2007In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 14, no 3, p. 181-7Article in journal (Refereed)
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