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  • 301.
    Nyberg, Andre
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Effekter av lokal, högrepetitiv träning vid KOL: studieprotokoll för en randomiserad kontrollerad multicenterstudie2013In: BestPractise: lungmedicin, Vol. 1, p. 18-21Article in journal (Other (popular science, discussion, etc.))
  • 302.
    Nyberg, Andre
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hedlund, Mattias
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Kolberg, Albin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Alm, Lisa
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lindström, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wadell, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    The accuracy of using elastic resistance bands to evaluate muscular strength2014In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, European Journal of Physiotherapy, Vol. 16, no 2, p. 104-112Article in journal (Refereed)
    Abstract [en]

    Elastic resistance as a tool for evaluation of muscular strength has rarely been addressed even though it is commonly used in exercise and rehabilitation regimens involving the shoulder muscles. The aim was therefore to investigate the relationship and potential difference between development of force during maximal isokinetic (maximum peak force, maximum mean force and peak mean force) and elastic (one-repetition maximum (1 RM)) concentric shoulder fl exion in healthy older adults. A total of 30 voluntary adults over the age of 50 (15 women, 15 men) were included. Intraclass correlation coefficient absolute agreement was 0.85, 0.43 and 0.48 for the isokinetic values respectively, when all subjects were analysed together. No difference was found between the isokinetic maximum peak force value and the elastic 1 RM for all participants (0.15 kg, p 0.791), for men (0.80 kg, p 0.121) or women ( 0.49 kg, p 0.135). Variations at an individual level, i.e. 95% limits of agreement, were 3.3 kg for all participants, 2.8 kg for women and 3.2 kg for men. These results imply that elastic resistance could be used to evaluate shoulder fl exion strength in both older men and women. However, thevariation on an individual level and the lower agreement among women is important to consider.

  • 303.
    Nyberg, Andre
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Jonsson, Per
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Limited scientific evidence supports the use of conservative treatment interventions for pain and function in patients with subacromial impingement syndrome: randomized control trials2010In: Physical Therapy Reviews, ISSN 1083-3196, E-ISSN 1743-288X, Vol. 15, no 6, p. 436-452Article in journal (Refereed)
    Abstract [en]

    Background: Different conservative treatment interventions are often used to decrease pain and improve function in patients with subacromial impingement syndrome (SAIS). However, the current evidence to support the use of these interventions has not been established.

    Objectives: To determine the evidence for conservative treatment interventions regarding pain and function compared to any intervention for SAIS patients.

    Methods: A systematic review of randomized controlled trials, published in English between 1 January 1999 and 31 May 2010, was performed using PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library and manual searching. The methodological quality (PEDro scale) and evidence grade (SBU) were rated. Eight studies were of high quality, four were medium quality, and eight were low quality. Various conservative treatment interventions were evaluated: acupuncture, electrotherapy modalities, exercises, mixed modalities, changing posture, and use of a functional brace.

    Results: Limited scientific evidence (LSE) indicates positive effects of exercise and mixed modalities regarding pain and function and high-intensity laser therapy (HILT) regarding pain in SAIS patients. LSE also indicate no effect of electrotherapy modalities, apart from HILT, as treatment for SAIS.

    Conclusions: The lack of high quality interventions limits the ability to draw conclusions regarding efficacy from several of the included studies. However, exercise may be as efficient as surgery, manual therapy in combination with exercise seems to be more effective than exercise alone and high-dose exercises seem to be more effective than low-dose exercises. Furthermore, there is contradictory evidence to support the use of acupuncture.

  • 304.
    Nyberg, Andre
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lindström, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rickenlund, Anette
    Institutionen för klinisk fysiologi, Karolinska universitetssjukhuset, Stockholm; Institutionen för molekylär medicin och kirurgi, Karolinska Institutet, Stockholm.
    Wadell, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Low-load/high-repetition elastic band resistance training in patients with COPD: a randomized, controlled, multicenter trial2015In: Clinical Respiratory Journal, ISSN 1752-6981, E-ISSN 1752-699X, Vol. 9, no 3, p. 278-288Article in journal (Refereed)
    Abstract [en]

    Background: High-repetitive resistance training is recommended to increase peripheral muscular endurance in healthy adults, however the effects of resistance training with this design on exercise capacity and health-related quality of life (HRQOL) in patients with chronic obstructive pulmonary disease (COPD) is unknown.

    Objective: Investigate if low load / high repetition elastic band resistance training (RT) could improve functional capacity, muscular function, endurance cycle capacity or HRQOL in patients with COPD.

    Methods: A prospective, randomized controlled multicentre trial was constructed with concealed allocation, blinded outcome assessment, and intention-to-treat analysis. A total of 44 patients with moderate to very severe COPD (FEV1 44.6% predicted) were included. Patients were randomized to either the experimental group receiving eight weeks of RT (3 sessions/week) in combination with patient education (four occasions) or the control group receiving the patient education alone.

    Results: At post-tests, the between-group differences were in favor of the experimental group on the 6 minute walk test (mean difference (95% confidence interval)): 34 meters (14 to 54) and the 6 minute pegboard and ring test (20 rings (3 to 37). No difference between groups was found on the chronic respiratory disease questionnaire (0.1 (-0.2 to 0.4). On secondary outcomes, results were in favor of the experimental group regarding upper extremity endurance capacity, muscular function and depression but no difference was seen between groups on endurance cycle capacity and HRQOL.

    Conclusion: RT can increase functional capacity and muscular function but not cycle endurance capacity and HRQOL in patients with moderate to severe COPD.

  • 305.
    Nyberg, Andre
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lindström, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wadell, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    A Cohort Study to Evaluate the Feasibility of Low Load/High Repetition Elastic Band Resistance Training for People with Chronic Obstructive Pulmonary Disease2014In: Journal of Novel Physiotherapies, ISSN 2165-7025, Vol. 4, article id 190Article in journal (Refereed)
    Abstract [en]

    Background: Resistance training is an important component of pulmonary rehabilitation in people with Chronic Obstructive Pulmonary Disease (COPD). A vast majority or resistance training studies in COPD have focused on increasing muscular strength with use of weight machines and has been found to be a feasible approach in COPD. However, regarding feasibility of resistance training equipment other than weight machines, such as elastic resistance equipment, information is scarce. In addition, little is known regarding other trainable muscle characteristics, such as peripheral muscular endurance in COPD. We therefore aim to evaluate the feasibility of a low load/high repetition elastic band Resistance Training (RT) regimen in people with moderate to severe COPD. We also aim to evaluate if the RT regimen is feasible for the physiotherapists, conducting the intervention.

    Methods: Twenty-two participants with moderate to severe COPD (mean forced expiratory volume in one second, FEV1 58.7% predicted) and five physiotherapists participated in the study. Measurements of attendance, assessment and progression of exercise intensity, adverse events, participant and compliance (participant and physiotherapist) were collected for assessment of feasibility.

    Results: The mean (95% confidence interval) attendance rate was 94% (91-97) and mean exercise intensity was 79% (74-83) of the predicted maximum intensity. Furthermore, the median (interquartile range) compliance was 96% (94-96) and 100% (94-100) for the people with COPD and the physiotherapists respectively. Exercise intensity increased on all exercises and any recorded adverse events were considered minor and temporary.

    Conclusions: Low load/high repetition elastic band resistance training appears to be feasible for both people with COPD and the physiotherapists performing the intervention. These results indicate that elastic bands could be a feasible alternative to weight machines in resistance training for people with COPD.

  • 306.
    Nyberg, Andre
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lindström, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wadell, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Assessing the effect of high-repetitive single limb exercises (HRSLE) on exercise capacity and quality of life in patients with chronic obstructive pulmonary disease (COPD): study protocol for randomized controlled trial2012In: TRIALS, ISSN 1745-6215, Vol. 13, p. 114-Article in journal (Refereed)
    Abstract [en]

    Background: Single-limb knee extension exercises have been found to be effective at improving lower extremity exercise capacity in patients with chronic obstructive pulmonary disease (COPD). Since the positive local physiological effects of exercise training only occur in the engaged muscle(s), should upper extremity muscles also be included to determine the effect of single limb exercises in COPD patients. Methods/design: Trial design: a prospective, assessor-blind, block randomized controlled, parallel-group multicenter trial. Participants: stage II-IV COPD patients, > 40 years of age, ex-smokers, with stable medical treatment will be included starting May 2011. Recruitment at three locations in Sweden. Interventions: 1) high-repetitive single limb exercise (HRSLE) training with elastic bands, 60 minutes, three times/week for 8 weeks combined with four sessions of 60 minutes patient education, or 2) the same patient education alone. Outcomes: Primary: determine the effects of HRSLE on local muscle endurance capacity (measured as meters walked during 6-minute walk test and rings moved on 6-minute ring and pegboard test) and quality of life (measured as change on the Swedish version of the Chronic Respiratory Disease Questionnaire). Secondary: effects on maximal strength, muscular endurance, dyspnea, self-efficacy, anxiety and depression. The relationship between changes in health-related variables and changes in exercise capacity, sex-related differences in training effects, feasibility of the program, strategies to determine adequate starting resistance and provide accurate resistance for each involved movement and the relationship between muscle fatigue and dyspnea in the different exercise tests will also be analyzed. Randomization: performed by a person independent of the recruitment process and using a computer random number generator. Stratification by center and gender with a 1: 1 allocation to the intervention or control using random block sizes. Blinding: all outcome assessors will be blinded to group assignment. Discussion: The results of this project will contribute to increase the body of knowledge regarding COPD and HRSLE.

  • 307.
    Nyberg, Andre
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Törnberg, Anna
    Department of Neurobiology, Care Sciences and Society, Karolinska Instiitutet, Stockholm, Sweden.
    Wadell, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Correlation between limb muscle endurance, strength and functional capacity in people with chronic obstructive pulmonary disease2016In: Physiotherapy Canada, ISSN 0300-0508, E-ISSN 1708-8313, Vol. 68, no 1, p. 46-53Article in journal (Refereed)
    Abstract [en]

    Purpose: To examine the correlation between limb muscle function (endurance and strength) and functional capacity in upper limbs (ULs) and lower limbs (LLs) of people with chronic obstructive pulmonary disease (COPD). Method: This article describes a secondary analysis of data from a randomized controlled trial. A stationary dynamometer was used to measure isokinetic muscle strength and endurance; the 6-minute walk test, the 6-minute pegboard and ring test, and the unsupported UL exercise test were used to measure functional capacity. Results: Participants were 44 adults with COPD. Muscle strength and endurance in ULs and LLs demonstrated a moderate to strong correlation with functional capacity. When controlling for muscle strength, muscle endurance was moderately correlated with functional capacity in ULs and LLs, but when controlling for muscle endurance, there was no positive and significant correlation between muscle strength and functional capacity for the ULs or LLs. Conclusions: Functional capacity seems to be more closely related to limb muscle endurance than to limb muscle strength in people with COPD.

  • 308.
    Nyberg, André
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lindström, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wadell, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Evidence for single-limb exercises on exercise capacity, quality of life, and dyspnea in patients with chronic obstructive pulmonary disease or chronic heart failure2013In: Physical Therapy Reviews, ISSN 1083-3196, E-ISSN 1743-288X, Vol. 18, no 3, p. 157-172Article in journal (Refereed)
    Abstract [en]

    Background: Although single-limb exercise (SLE) has been used for patients with chronic obstructive pulmonary disease (COPD) and for patients with chronic heart failure (CHF), the evidence for SLE has not been evaluated systematically and remains unclear.

    Objectives: Determine the evidence for the effect of SLE compared to any comparator on outcome measurements for exercise capacity, quality of life (QoL) or dyspnea in patients with COPD or CHF.

    Methods: PubMed, PEDro, and CENTRAL databases were searched from inception until 31 May 2011. Searches started 1 April 2011. English language randomized controlled trials (RCTs) were included. Extraction of data was performed by two review authors. Data and evidence for SLE were summarized in accordance with grading of recommendations assessment, development and evaluation (GRADE) guidelines. Authors of included studies were contacted for missing data.

    Results: Six RCTs (two COPD and four CHF) were included. Low to very low-quality evidence indicates that SLE significantly improved exercise capacity, but not dyspnea, in patients with COPD, and significantly improved exercise capacity outcomes compared to a control in patients with CHF. However, when SLE was compared to non-SLE regimes in patients with CHF, positive effects were found irrespective of training regime regarding exercise capacity and QoL.

    Conclusions: SLE appears to be effective in both conditions especially regarding exercise capacity, and might be included in exercise programs in patients with COPD or CHF. However, the evidence is low to very low according to GRADE and more clinical studies of high quality are required.

  • 309. Nyberg, Lars
    et al.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Sondell, Björn
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Geriatric Medicine.
    Backman, Anders
    Holmlund, Kenneth
    Eriksson, Staffan
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Stenvall, Michael
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Geriatric Medicine.
    Rosendahl, Erik
    Maxhall, Marcus
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Geriatric Medicine.
    Bucht, Gustaf
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Geriatric Medicine.
    Using a virtual reality system to study balance and walking in a virtual outdoor environment: a pilot study.2006In: Cyberpsychology & behavior, ISSN 1094-9313, Vol. 9, no 4, p. 388-95Article in journal (Refereed)
  • 310.
    Nyberg, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sondell, Björn
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Backman, Anders
    Holmlund, Kenneth
    Eriksson, Sture
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Stenvall, Michael
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Rosendahl, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Maxhall, Marcus
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Bucht, Gösta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Development of a virtual reality system to study tendency of falling among older people2004In: Proc 5th International Conference Series on Disability Virtual Reality and Associated Technologies, p. 315-320Article in journal (Other academic)
  • 311. Näslund, Annika
    et al.
    Jesinkey, K
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    von Wendt, L
    Hirschfeldt, Helga
    Effects of dynamic ankle-foot orthoses on standing in children with severe spastic diplegia2005In: International Journal of Therapy & Rehabilitation, ISSN 1741-1645, Vol. 12, no 5, p. 200-207Article in journal (Refereed)
  • 312. Näslund, Annika
    et al.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Hirschfeld, H
    Postural adjustments during reaching in chhildren with severe spastic diplegia wearing dafos2007Conference paper (Other academic)
  • 313. Näslund, Annika
    et al.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hirschfeld, Helga
    Reach performance and postural adjustments during standing in children with severe spastic diplegia using dynamic ankle-foot orthoses.2007In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 39, no 9, p. 715-23Article in journal (Refereed)
    Abstract [en]

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

  • 314. Ohlson, Charlotte
    et al.
    Lindström, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Basal Kroppskännedom påverkade balansen hos personer med diagnosen MS2006In: Nordisk Fysioterapi, Vol. 10, no 1, p. 12-20Article in journal (Other academic)
  • 315.
    Olofsson, Helen
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Olsson, Elin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Functional Gait Assessment: Svensk översättning och pilottestning av ett mätinstrument för gång- och balansförmåga2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Sammanfattning: Functional Gait Assessment (FGA) är ett mätinstrument som avser att testa balans- och gångförmåga. Studier har visat att FGA har god reliabilitet och validitet, samt mindre risk för takeffekt än exempelvis Bergs balansskala. Förutom ursprungsspråket, som är engelska, finns FGA även översatt till tyska.Syfte: Syftet med denna studie var att översätta FGA till en svensk version, samt undersöka dess förståelse i en pilotstudie.Metod: ”Forward-and-back-translation” användes vid översättningen av FGA. Först gjordes tre översättningar oberoende av varandra, som sedan sammanställdes till en svensk version. Den versionen granskades av en panel med erfarna sjukgymnaster. Därefter testades förståelsen av den svenska versionen i en pilotstudie. Pilotstudien genomfördes av fyra kliniskt erfarna sjukgymnaster, två sjukgymnaststudenter samt sex testpersoner med olika fysisk förmåga. Den svenska versionen reviderades efter både panelgranskning och pilotstudie.Resultat: Första pilottestet visade tydligt på behov av en manual, en sådan utvecklades. Manualen förtydligade mätinstrumentet och gjorde den svenska versionen av FGA lätt att förstå och använda.Slutsats: Resultatet från pilotstudien tyder på att den svenska versionen av FGA är tydlig och lätt att förstå för sjukgymnaster.

  • 316.
    Olofsson, Lena
    et al.
    Department of Occupational Therapy and Physiotherapy, Östersund Hospital, Östersund, Sweden.
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sö derman, Kerstin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    From loss towards restoration: Experiences from anterior cruciate ligament injury2010In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 12, no 1, p. 50-57Article in journal (Refereed)
    Abstract [en]

    The objective of this study was to illuminate anterior cruciate ligament (ACL)-reconstructed athletes’ experience of their injury, rehabilitation and recovery. Seven persons, aged 19–57 years, were interviewed on one occasion in autumn 2004, between 10 and 31 months after the ACL reconstruction. They were selected to reach a maximum variation sample according to gender, age, activity level, time between injury and ACL reconstruction and time between surgery and the interview. The analyses were carried out using the Grounded Theory method of constant comparison. One core category “From loss towards restored belief in one's ability” and three categories emerged. The core category represents the process starting when the informants were injured. The process contained phases that interacted with each other but more importantly were drawn out over a long period, especially the mental recovery. The informants used different procedures to manage situations that arose and strived towards restored belief in their ability. This study illuminates the complexity of the recovery process. The patients’ belief in their own ability took a long time to restore. It is important for physiotherapists to understand what patients with ACL injuries need while waiting for surgery. The process of rehabilitation can further equip people with the means to manage problems that can arise and help to strengthen their belief in their ability, as well as helping them with physical training.

  • 317.
    Olsson, Carl-Johan
    et al.
    Umeå University, Faculty of Social Sciences, Centre for Population Studies (CPS). Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI).
    Hedlund, Mattias
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sojka, Peter
    Department of Health Sciences, Mid-Sweden University, Östersund, Sweden.
    Lundström, Ronnie
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Lindström, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Increased prefrontal activity and reduced motor cortex activity during imagined eccentric compared to concentric muscle actions2012In: Frontiers in Human Neuroscience, ISSN 1662-5161, E-ISSN 1662-5161, Vol. 6, no 255Article in journal (Refereed)
    Abstract [en]

    In this study we used functional magnetic resonance imaging (fMRI) to examine differences in recruited brain regions during the concentric and the eccentric phase of an imagined maximum resistance training task of the elbow flexors in healthy young subjects. The results showed that during the eccentric phase, pre-frontal cortex (BA44) bilaterally was recruited when contrasted to the concentric phase. During the concentric phase, however, the motor and pre-motor cortex (BA 4/6) was recruited when contrasted to the eccentric phase. Interestingly, the brain activity of this region was reduced, when compared to the mean activity of the session, during the eccentric phase. Thus, the neural mechanisms governing imagined concentric and eccentric contractions appear to differ. We propose that the recruitment of the pre-frontal cortex is due to an increased demand of regulating force during the eccentric phase. Moreover, it is possible that the inability to fully activate a muscle during eccentric contractions may partly be explained by a reduction of activity in the motor and pre-motor cortex.

  • 318.
    Olsson, Eva
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Löfgren, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Nyberg, Lars
    Validation of a fall risk index in stroke rehabilitation2005In: Journal of stroke and cerebrovascular diseases, ISSN 1052-3057, Vol. 14, no 1, p. 23-28Article in journal (Refereed)
  • 319.
    Olsson, Josefine
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wallin, Louise
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Comparison of postural balance and muscle performance in the trunk and lower limbs between adolescent men and women with and without intellectual disability2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 320. Ora, Josuel
    et al.
    Laveneziana, Pierantonio
    Wadell, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Preston, Megan
    Webb, Katherine A
    O'Donnell, Denis E
    Effect of obesity on respiratory mechanics during rest and exercise in COPD2011In: Journal of applied physiology, ISSN 8750-7587, E-ISSN 1522-1601, Vol. 111, no 1, p. 10-19Article in journal (Refereed)
    Abstract [en]

    The presence of obesity in COPD appears not to be a disadvantage with respect to dyspnea and weight-supported cycle exercise performance. We hypothesized that one explanation for this might be that the volume-reducing effects of obesity convey mechanical and respiratory muscle function advantages. Twelve obese chronic obstructive pulmonary disease (COPD) (OB) [forced expiratory volume in 1 s (FEV(1)) = 60%predicted; body mass index (BMI) = 32 ± 1 kg/m(2); mean ± SD] and 12 age-matched, normal-weight COPD (NW) (FEV(1) = 59%predicted; BMI = 23 ± 2 kg/m(2)) subjects were compared at rest and during symptom-limited constant-work-rate exercise at 75% of their maximum. Measurements included pulmonary function tests, operating lung volumes, esophageal pressure, and gastric pressure. OB vs. NW had a reduced total lung capacity (109 vs. 124%predicted; P < 0.05) and resting end-expiratory lung volume (130 vs. 158%predicted; P < 0.05). At rest, there was no difference in respiratory muscle strength but OB had greater (P < 0.05) static recoil and intra-abdominal pressures than NW. Peak ventilation, oxygen consumption, and exercise endurance times were similar in OB and NW. Pulmonary resistance fell (P < 0.05) at the onset of exercise in OB but not in NW. Resting inspiratory capacity, dyspnea/ventilation plots, and the ratio of respiratory muscle effort to tidal volume displacement were similar, as was the dynamic performance of the respiratory muscles including the diaphragm. In conclusion, the lack of increase in dyspnea and exercise intolerance in OB vs. NW could not be attributed to improvement in respiratory muscle function. Potential contributory factors included alterations in the elastic properties of the lungs, raised intra-abdominal pressures, reduced lung hyperinflation, and preserved inspiratory capacity.

  • 321.
    Palmborg, Tommy
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Persson, Andreas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Cirkulatorisk belastning vid balanstester för äldre och yngre: En pilotstudie2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Inledning: Med stigande ålder så förändras ett flertal funktioner i kroppen som försämrar den muskulära kontrollen av postural balans. Med kunskap om dessa förändringar hos äldre så skulle man kunna anta att cirkulationsorganen måste arbeta hårdare för att upprätthålla balansen. 

    Syfte: Syftet med denna studie var att undersöka om balanskontroll kräver att cirkulationsorganen arbetar hårdare hos äldre jämfört med yngre personer. Detta kan ha betydelse för äldre som på grund av åldersförändringar har en mindre hjärtfrekvensreserv. 

    Metod: I studien ingick totalt 18 personer i en äldre(65-82år) och en yngre grupp(20-34år) med både kvinnor och män. Samtliga deltagare genomförde ett antal statiska (3 st) och dynamiska (1-2 st) balanstester med olika grad av sensorisk information och i en randomiserad ordning. Arbetspulsen under dessa aktiviteter registrerades med pulsklocka och analyserades.   

    Resultat: De äldre hade som grupp signifikanta ökningar i arbetspuls för de svåraste balanstesterna. Det var en signifikant skillnad mellan yngre och äldre gällande vilopuls. Nyttjandegraden av hjärtfrekvensreserven var genomgående högre i den äldre gruppen och i vissa fall över 50%.  

    Slutsats: Det verkar vara svårare för äldre att hålla balansen då sensorisk information minskar och den cirkulatoriska belastningen kan för vissa personer då bli relativt hög. Den kardiovaskulära förmågan kan därför vara en funktion som behöver undersökas och förstärkas vid nedsatt balans hos äldre.

  • 322.
    Persson, Christofer
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Jonsson, Samuel
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Balansmätning med hjälp av ett enkelt system för rörelseanalys: - En metodstudie2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion:

    Äldre personer har ökad risk för fall. Åtgärder som balans- och styrketräning kan minska fallrisk och förebygga följder med långdragna besvär för individen samt bespara samhället stora kostnader.  Balansförmåga kan mätas på flera sätt och är ett viktigt verktyg för att bedöma fallrisk eller utvärdera en träningsperiod. Det finns behov av enkla och kliniskt användbara system för rörelseanalys och Krimag är ett exempel på det.

    Syfte:

    Att undersöka huruvida KriMags rörelseanalyssystem går att använda för att utvärdera balansförmåga i enkla balanstester, fånga skillnader mellan balanstester av olika svårighetsgrad samt se skillnader i balansförmåga mellan två åldersgrupper.

    Metod:

    Tio personer, varav sex kvinnor och fyra män delades in i två grupper, en yngre och en äldre.  Medelåldern för de yngre var 26,6 (21-36) och för de äldre 70,6 (64-80). Tre olika balanstester genomfördes: Romberg, Tandemstående och Enbensstående och dessa hade två svårighetsnivåer: Med ögonen öppna respektive slutna.

    Resultat:

    De äldre testdeltagarna klarade inte alla tester fullt ut, framförallt när smal understödsyta kombinerades med att de blundade. Generellt sågs att ju svårare test, desto mer ökade individens svaj mätt i medelavvikelse. I det test som bägge åldersgrupper klarade (Romberg) fanns inga signifikanta skillnader i svaj mellan grupperna.

    Konklusion:

    KriMags rörelseanalyssystem visade sig kunna uppfatta skillnader mellan balanstest av olika svårighetsnivå när måttet medelavvikelse används men för att kunna mäta svaj hos äldre personer behöver balanstester med lämplig svårighetsgrad användas.

  • 323.
    Persson, Elin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sundkvist Lindelöf, Hillevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Physical activity, aerobic capacity, postural balance and health – a comparison between adolescents with intellectual disabilities and normally developed adolescents2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Previous studies show that persons with intellectual disability (ID) have a lower level of physical activity, lower aerobic capacity, and an impaired balance, compared to persons without ID. The main aim of the present study was to investigate associations between level of physical activity, aerobic capacity and static postural balance, in a group of adolescents with ID and normally developed peers. A secondary aim was to study if there were any differences in aerobic capacity between the groups. A third aim was to investigate how the participants rated their own health. A cross-sectional study design was implemented. In total, there were 106 high school students who joined the study, 57 of them had an ID that was mild to moderate and the control group consisted of 49 students that were normally developed. Tests were performed for level of physical activity, aerobic capacity and static postural balance. The participants also answered an adapted questionnaire about their perceived health. Analysis of associations between level of physical activity, aerobic capacity and the static balance tests were made using the Pearson’s correlation coefficient, no significant correlations could be seen. The participants in the ID group had significantly lower estimated maximum oxygen uptake (l O2/min) compared to non-ID groups (p< 0.001 for females, p=0.004 for males).  Even if adolescents with ID have reduced aerobic capacity, there seem to be no strong associations with static postural balance and aerobic activity level. The answers from the health questionnaire did in many ways not correspond to the measured outcomes from the physical tests. Further it appears as if perception of health is not associated with physical status.

  • 324.
    Persson, Martin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Knee muscle strength about 20 years after ACL reconstruction: A long term follow-up2012Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
  • 325.
    Persson, Stefan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Analys av hälsenans belastning och längd- och tjockleksförändring vid koncentrisk respektive excentrisk dynamisk tåhävning: en pilotstudie2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 326.
    Pettersson, Anders
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gren, Mikael
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Förändring av fysisk aktivitet och VO2max hos män och kvinnor mellan 34 och 52 år2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 327.
    Pettersson, Jessica
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Aktivitets- ochlivsrollsinriktadarbetsrehabilitering (ALAR: -En randomiserad kontrollerad studie utförd iprimärvården i Landstinget Dalarna2013Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund och syfte Långvariga muskuloskeletala smärttillstånd är vanligt förekommande besvär i den svenska befolkningen, vilket gör det till ett stort samhällsekonomiskt problem. ALAR är ett nytt rehabiliteringsprogram avsett för primärvården som syftar till att minska smärtrelaterad disability och öka arbetsförmågan.Syftet med studien var att utvärdera effekten av ALAR för patienter med långvariga muskuloskeletala smärttillstånd med avseende på den primära utfallsvariabeln faktisk arbetsförmåga

    Metod En randomiserad kontrollerad studie utfördes vid 6 primärvårdsmottaggningar i Landstinget Dalarna under åren 2011-2013. Personer mellan 18-60 år som sökte vård på grund av långvarig muskuloskeletal smärta (≥3 månader) vid någon av de ingående mottaggningarna tillfrågades om deltagande. Deltagarna randomiserades till interventionsbehandlingen ALAR eller kontrollbehandlingen ”sedvanlig behandling”. Den primära utfallsvariabeln  faktisk arbetsförmåga undersöktes genom telefonintervju med deltagaren, information från journalen samt självskattningsformulär vid baslinjen och 9 veckor efter inklusion.

    Resultat 60 personer inkluderades i studien. Vid jämförande analyser av data kan ingen statistiskt säkerställd skillnad ses mellan grupperna avseende den primära utfallsvariabeln.

    SlutsatsYtterligare forskning krävs för att utvärdera effekten av ALAR. Studien är finansierad av REHSAM, Sverige.

  • 328.
    Pettersson, Linda
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Using Electrical Stimulation to Detect Muscle Fatigue in the Extensor Caarpi Ulnaris Muscle2012Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
  • 329. Pini, Alessa
    et al.
    Abramowicz, Konrad
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hébert-Losier, Kim
    Schelin, Lina
    Strandberg, Johan
    Vantini, Simone
    Anterior Cruciate Ligament Rupture: Functional Data Analysis of Knee Motion2014In: 47-th Scientific Meeting of the Italian Statistical Society: Proceedings / [ed] S. Cabras, T. Di Battista, W. Racugno, Caligari: CUEC , 2014Conference paper (Other academic)
  • 330.
    Pohl, Petra
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Does the Ronnie Gardiner Rhythm and Music (RGRM) Method improve motor function and cognition in patients with Parkinson's disease? A pilot study2011Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
  • 331.
    Pohl, Petra
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    The Ronnie Gardiner rhythm and music method: a way to stimulate cognitive and motor function in the elderly2012In: Journal of Aging and Physical Activity, ISSN 1063-8652, E-ISSN 1543-267X, Vol. 20, p. S47-S48Article in journal (Other academic)
  • 332.
    Pohl, Petra
    et al.
    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.
    Nordin, Ellinor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lundquist, Anders
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gender perspective on fear of falling using the classification of functioning as the model2015In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, no 3, p. 214-222Article in journal (Refereed)
    Abstract [en]

    Abstract Purpose: To investigate associations between fear of falling (FOF) and recurrent falls among women and men, and gender differences in FOF with respect to International Classification of Functioning (ICF). Methods: Community-dwelling people (n = 230, 75-93 years, 72% women) were included and followed 1 year regarding falls. Data collection included self-reported demographics, questionnaires, and physical performance-based tests. FOF was assessed with the question "Are you afraid of falling?". Results were discussed with a gender relational approach. Results: At baseline 55% women (n = 92) and 22% men (n = 14) reported FOF. During the follow-up 21% women (n = 35) and 30% men (n = 19) experienced recurrent falls. There was an association between gender and FOF (p = 0.001), but not between FOF and recurrent falls (p = 0.79), or between gender and recurrent falls (p = 0.32). FOF was related to Personal factors and Activity and Participation. The relationship between FOF and Personal factors was in opposite directions for women and men. Conclusions: Results did not support the prevailing paradigm that FOF increases rate of recurrent falls in community-dwelling people, and indicated that the answer to "Are you afraid of falling?" might be highly influenced by gendered patterns.

    Implications for Rehabilitation

    The question "Are you afraid of falling?" has no predictive value when screening for the risk of falling in independent community-dwelling women or men over 75 years of age.

    Gendered patterns might influence the answer to the question "Are you afraid of falling?" Healthcare personnel are recommended to be aware of this when asking older women and men about fear of falling.

  • 333.
    Pohl, Petra
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Department of Neurology, University Hospital, Linköping, Sweden.
    Dizdar, Nil
    Hallert, Eva
    The Ronnie Gardiner Rhythm and Music Method: a feasibility study in Parkinson's disease2013In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 35, no 26, p. 2197-2204Article in journal (Refereed)
    Abstract [en]

    Purpose: To assess the feasibility of the novel intervention, Ronnie Gardiner Rhythm and Music (RGRM™) Method compared to a control group for patients with Parkinson's disease (PD).

    Method: Eighteen patients, mean age 68, participating in a disability study within a neurological rehabilitation centre, were randomly allocated to intervention group (n = 12) or control group (n = 6). Feasibility was assessed by comparing effects of the intervention on clinical outcome measures (primary outcome: mobility as assessed by two-dimensional motion analysis, secondary outcomes: mobility, cognition, quality of life, adherence, adverse events and eligibility).

    Results: Univariable analyses showed no significant differences between groups following intervention. However, analyses suggested that patients in the intervention group improved more on mobility (p = 0.006), cognition and quality of life than patients in the control group. There were no adverse events and a high level of adherence to therapy was observed.

    Conclusions: In this disability study, the use of the RGRM™ Method showed promising results in the intervention group and the adherence level was high. Our results suggest that most assessments chosen are eligible to use in a larger randomized controlled study for patients with PD.

  • 334.
    Pohl, Petra
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Nordin, Ellinor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lundquist, Anders
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics.
    Bergström, Ulrica
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Community-dwelling older people with an injurious fall are likely to sustain new injurious falls within 5 years: a prospective long-term follow-up study2014In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 14, no 1, p. 120-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Fall-related injuries in older people are a leading cause of morbidity and mortality. Self-reported fall events in the last year is often used to estimate fall risk in older people. However, it remains to be investigated if the fall frequency and the consequences of the falls have an impact on the risk for subsequent injurious falls in the long term. The objective of this study was to investigate if a history of one single non-injurious fall, at least two non-injurious falls, or at least one injurious fall within 12 months increases the risk of sustaining future injurious falls.

    METHODS: Community-dwelling individuals 75-93 years of age (n = 230) were initially followed prospectively with monthly calendars reporting falls over a period of 12 months. The participants were classified into four groups based on the number and type of falls (0, 1, ≥2 non-injurious falls, and ≥1 injurious fall severe enough to cause a visit to a hospital emergency department). The participants were then followed for several years (mean time 5.0 years ±1.1) regarding injurious falls requiring a visit to the emergency department. The Andersen-Gill method of Cox regression for multiple events was used to estimate the risk of injurious falls.

    RESULTS: During the long-term follow-up period, thirty per cent of the participants suffered from at least one injurious fall. Those with a self-reported history of at least one injurious fall during the initial 12 months follow-up period showed a significantly higher risk for sustaining subsequent injurious falls in the long term (hazard ratio 2.78; 95% CI, 1.40-5.50) compared to those with no falls. No other group showed an increased risk.

    CONCLUSIONS: In community-dwelling people over 75 years of age, a history of at least one self-reported injurious fall severe enough to cause a visit to the emergency department within a period of 12 months implies an increased risk of sustaining future injurious falls. Our results support the recommendations to offer a multifactorial fall-risk assessment coupled with adequate interventions to community-dwelling people over 75 years who present to the ED due to an injurious fall.

  • 335.
    Reeds Lundqvist, Sandra
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sambandet mellan förekomst av främre korsbandsskada hos alpina tävlingsskidåkare och deras föräldrar2013Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund och syfte:Främre korsbandsskada är en av idrottstraumatologins allvarligaste knäskador. Syftet med denna studie var att undersöka om det föreligger något  samband mellan förekomsten av främre korsbandsskador hos alpina tävlingsskidåkare, som gått på ett svenskt skidgymnasium och främre korsbandsskador hos deras föräldrar.

    Metod:Samtliga 593 (293 manliga, 300 kvinnliga) alpina tävlingsskidåkare som studerat på Sveriges skidgymnasier under åren 2006-2012 tillfrågades om de själva eller deras föräldrar hade drabbats av en främre korsbandsskada. Frågan besvarades av 418 (187 manliga, 231 kvinnliga) skidåkare.

    Resultat:Tjugo-nio procent (n=19) av de 65 främre korsbandsskadade skidåkarna hade en förälder som hade haft en främre korsbandsskada jämfört med 18 % (n=64) av de 353 skidåkare som ej hade drabbats av  en främre korsbandsskada. Resultatet visade oddskvot 1,95 att drabbas av en främre korsbandsskada om man har en förälder som haft en främre korsbandsskada jämfört med om man har en förälder som ej hade haft en främre korsbandsskada (p= 0,04).

    Konklusion:Resultatet av denna studie påvisade ett samband mellan förekomsten av främre korsbandsskada hos alpina skidåkare i åldrarna 16-27 år, som gått på ett svenskt skidgymnasium och förekomsten av främre korsbandsskadahos deras föräldrar.

  • 336.
    Rehn, B
    et al.
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Nilsson, T
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Occupational and Enviromental Medicine.
    Lundström, R
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Occupational and Enviromental Medicine.
    Hagberg, M
    Burström, L
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Occupational and Enviromental Medicine.
    Neck pain combined with arm pain among professional drivers of forest machines and the association with whole-body vibration exposure.2009In: Ergonomics, ISSN 1366-5847, Vol. 52, no 10, p. 1240-7Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to investigate the existence of neck pain and arm pain among professional forest machine drivers and to find out if pain were related to their whole-body vibration (WBV) exposure. A self-administered questionnaire was sent to 529 forest machine drivers in northern Sweden and the response was 63%. Two pain groups were formed; 1) neck pain; 2) neck pain combined with arm pain. From WBV exposure data (recent measurements made according to ISO 2631-1, available information from reports) and from the self-administered questionnaire, 14 various WBV exposure/dose measures were calculated for each driver. The prevalence of neck pain reported both for the previous 12 months and for the previous 7 d was 34% and more than half of them reported neck pain combined with pain in one or both arms. Analysis showed no significant association between neck pain and high WBV exposure; however, cases with neck pain more often experienced shocks and jolts in the vehicle as uncomfortable. There was no significant association between the 14 WBV measures and type of neck pain (neck pain vs. neck pain combined with arm pain). It seems as if characteristics of WBV exposure can explain neither existence nor the type of neck pain amongst professional drivers of forest machines. The logging industry is important for several industrialised countries. Drivers of forest machines frequently report neuromusculoskeletal pain from the neck. The type of neck pain is important for the decision of treatment modality and may be associated with exposure characteristics at work.

  • 337.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Occurence and type of neck pain among drivers of forest machines and the sociation with whole-body vibration exposere2007Conference paper (Other academic)
  • 338.
    Rehn, Börje
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lidström, J
    Skoglund, J
    Lindström, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Effects on leg muscular performance from whole-body vibration exercise: a systematic review.2007In: Scandinavian journal of medicine & science in sports, ISSN 0905-7188, Vol. 17, no 1, p. 2-11Article in journal (Refereed)
  • 339.
    Rehn, Börje
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lundström, Ronny
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Nilsson, Tor
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Bergdahl, Ingvar
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Ahlgren, Christin
    From, C
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Järvholm, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Symptoms of musculoskeletal disorders among drivers of all-terrain vehicles in northern Sweden2005In: Noise and Vibration Worldwide, ISSN 0957-4565, Vol. 36, no 1, p. 13-18Article in journal (Refereed)
  • 340.
    Rehn, Börje
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Nilsson, Peter
    Norgren, Martin
    Effects of whole-body vibration exercise on human bone density - systematic review2008In: Physical Therapy Reviews, ISSN 1083-3196, E-ISSN 1743-288X, ISSN 10833196, Vol. 13, no 6, p. 427-433Article in journal (Refereed)
  • 341.
    Renström, Barbro
    et al.
    Kolbäcken Child Rehabilitation Centre, Umeå.
    Söderman, Kerstin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Domellöf, Erik
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Emanuelson, Ingrid
    Univ Gothenburg, Dept Pediat, Inst Clin Sci, Gothenburg, Sweden.
    Self-reported health and influence on  life  situation 5–8 years after paediatric traumatic brain injury2012In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 26, no 12, p. 1405-1414Article in journal (Refereed)
    Abstract [en]

    Primary objective : During childhood, the central nervous system is in a state of rapid development which can be interrupted by a traumatic brain injury (TBI). This study aimed to describe if and how TBI during childhood influences health and life situation, 5–8 years later.

    Research design : A case-control retrospective design was employed for the assessment of 61 adolescents and young adults with a mild, moderate or severe TBI and 229 matched controls from a normative group (16–24 years).

    Methods and procedures : SF-36 (Short Form 36 health survey) and a self-reported questionnaire measuring life situation were distributed to youths suffering TBI 5–8 years ago. Forty-five youths (74%) completed the questionnaires.

    Main outcomes and results : Participants with a TBI stated lower self-estimated health compared with the normative group.

    Remaining self-reported symptoms were physical and cognitive. Negative effects of TBI influencing school results, leisure activities and thoughts about future life situation were also described.

    Conclusion : Young individuals experience sustained negative effects of childhood TBI on health and life situation. More research is necessary to detect, understand and properly support these youths.

  • 342.
    Ringsell, Heidi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Muskulär respons i nacke och rygg under sidledsförskjutningar i sittande: -en pilotstudie2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund:Tidigare studier av posturala responser har i huvudsak gjorts på personer i stående. Samtidigt kan konstateras en högre grad av användning av snabba transportmedel som leder till att förare, såväl inom yrkes- som privatlivet, utsätts för höga nivåer av belastande stötar.

    Syfte: Studiens syfte var att analysera den muskulära aktiviteten i m. trapezius och m. erector spinae hos personer som i sittande utsattes för upprepade sidledsförskjutningar av samma karaktär. Analysen innefattar aktiveringstid, aktiveringsnivå och rekryteringsordning.

    Metod: Tre manliga försökspersoner med en medianålder på 31år, medianlängd 183 cm och

    medianvikt 75 kg, utsattes för upprepade sidledsförskjutningar av samma karaktär, samtidigt som den muskulära responsen registrerades genom elektromyografisk mätning.

    Resultat: Rörelsemönstret  som registrerades vid balansstörningarna  följde ett kaudo-kraniellt mönster. Vid upprepade störningar återfanns en tendens till lägre registrerade toppvärden på muskelns elektriska aktivitet. Vidare sågs generellt en sänkning i aktiveringstid i muskulaturen. Rekryteringsordningen varierade mellan individer.

    Slutsats: Generellt ses en tillvänjning avseende aktivitetsnivå och aktiveringstid. Belastningen på den undersökta muskulaturen betraktades vara förhållandevis låg. Belastningsskador till följd av upprepade sidledsförskjutningar av dylik karaktär skulle därför kunna bero på statisk belastning, muskeltrötthet alternativt belastning av andra muskler eller passiva strukturer.

  • 343.
    Rosendahl, Erik
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Nordin, Ellinor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Nyberg, Lars
    A randomised controlled trial of fall prevention by a high-intensity functional exercise program for older people in residential care facilities2008In: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 20, no 1, p. 67-75Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND AIMS: Falls are particularly common among older people living in residential care facilities. The aim of this randomized controlled trial was to evaluate the effectiveness of a high-intensity functional exercise program in reducing falls in residential care facilities.

    METHODS: Participants comprised 191 older people, 139 women and 52 men, who were dependent in activities of daily living. Their mean+/-SD score on the Mini-Mental State Examination was 17.8+/-5.1 (range 10-30). Participants were randomized to a high-intensity functional exercise program or a control activity, consisting of 29 sessions over 3 months. The fall rate and proportion of participants sustaining a fall were the outcome measures, subsequently analysed using negative binominal analysis and logistic regression analysis, respectively.

    RESULTS: During the 6-month follow-up period, when all participants were compared, no statistically significant differences between groups were found for fall rate (exercise group 3.6 falls per person years [PY], control group 4.6 falls per PY), incidence rate ratio (95% CI) 0.82 (0.49-1.39), p=0.46, or the proportion of participants sustaining a fall (exercise 53%, control 51%), odds ratio (95% CI) 0.95 (0.52-1.74), p=0.86. A subgroup interaction analysis revealed that, among participants who improved their balance during the intervention period, the exercise group had a lower fall rate than the control group (exercise 2.7 falls per PY, control 5.9 falls per PY), incidence rate ratio (95% CI) 0.44 (0.21-0.91), p=0.03.

    CONCLUSIONS: In older people living in residential care facilities, a high-intensity functional exercise program may prevent falls among those who improve their balance.

  • 344.
    Rosendahl, Erik
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Lindelöf, Nina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Littbrand, Håkan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Yifter-Lindgren, E
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Nordin, Ellinor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lundin olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Håglin, L
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Nyberg, Lars
    High-intensity functional exercise program for older people dependent in ADL: an RCT evaluating the effects on physical functions and falls2007Conference paper (Other academic)
  • 345.
    Rosendahl, Erik
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Lindelöf, Nina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Littbrand, Håkan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Yifter-Lindgren, Elinor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Håglin, Lena
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Nyberg, Lars
    High-intensity functional exercise program and protein-enriched energy supplement for older persons dependent in activities of daily living: a randomised controlled trial2006In: Australian Journal of Physiotherapy, ISSN 0004-9514, Vol. 52, no 2, p. 105-113Article in journal (Refereed)
    Abstract [en]

    The aims of this randomised controlled trial were to determine if a high-intensity functional exercise program improves balance, gait ability, and lower-limb strength in older persons dependent in activities of daily living and if an intake of protein-enriched energy supplement immediately after the exercises increases the effects of the training. One hundred and ninety-one older persons dependent in activities of daily living, living in residential care facilities, and with a Mini-Mental State Examination (MMSE) score of ? 10 participated. They were randomised to a high-intensity functional exercise program or a control activity, which included 29 sessions over 3 months, as well as to protein-enriched energy supplement or placebo. Berg Balance Scale, self-paced and maximum gait speed, and one-repetition maximum in lower-limb strength were followed-up at three and six months and analysed by 2 x 2 factorial ANCOVA, using the intention-to-treat principle. At three months, the exercise group had improved significantly in self-paced gait speed compared with the control group (mean difference 0.04 m/s, p = 0.02). At six months, there were significant improvements favouring the exercise group for Berg Balance Scale (1.9 points, p = 0.05), self-paced gait speed (0.05 m/s, p = 0.009), and lower-limb strength (10.8 kg, p = 0.03). No interaction effects were seen between the exercise and nutrition interventions. In conclusion, a high-intensity functional exercise program has positive long-term effects in balance, gait ability, and lower-limb strength for older persons dependent in activities of daily living. An intake of protein-enriched energy supplement immediately after the exercises does not appear to increase the effects of the training.

  • 346.
    Rosendahl, Erik
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Littbrand, Håkan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Demenssjukdomar: motorik, fysisk aktivitet och fysisk träning2012In: Äldres hälsa: ett sjukgymnastiskt perspektiv / [ed] Elisabeth Rydwik, Lund: Studentlitteratur, 2012, 1, p. 235-247Chapter in book (Other (popular science, discussion, etc.))
  • 347.
    Rova, Ann-Christin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Medveten närvaro, trötthet och stress efter en mindfulness-kurs2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Studien syftar till att undersöka långtidseffekten av ett mindfulnessbaserat stresshanteringsprogram utifrån frågeställningarna: -Finns det något samband mellan upplevd hälsa, stress och trötthet och mindfulnessnivå? Har deltagarna gjort några förändringar i arbetsliv och privatliv efter kursen som man kan relatera till mindfulness?

    Metod: Trettio personer som genomgått en mindfulnesskurs under 10 veckor, 1,5 tim/vecka mellan åren 2008-2011 besvarade en enkät. Den bestod av instrumenten Mindful Attention Awarness Scale och Checklist Individual Strength Questionnaire samt frågor om upplevd stress, hälsa och förändringar de gjort inom arbetsliv och privatliv kopplat till mindfulness. De svarande var 19 kvinnor och tre män i åldern 29-68 med en medelålder av 53 år.

    Resultat: Det fanns ett svagt samband mellan mindfulness och trötthet vilket antyder att en ökad grad av mental närvaro var kopplad till minskad trötthet. Vid jämförelse mellan mindfulnessnivå, skattad trötthet, stress och hälsa fanns inga samband. Deltagarna hade gjort livsstilsförändringar kopplade till mindfulness inom arbetsliv och privatliv som vidmakthållits sedan kursen avslutats exempelvis använder de övningen ”andningsankaret” för att reducera stress.

    Implikation: Fortsatta studier behövs för att få svar om mindfulness kan fungera som stressreducering. För att få ett mer tillförlitligt svar på långtidseffekten av en mindfulnesskurs hade det även behövts baslinjemätningar i samband med start och slut på kursen.

  • 348.
    Rudolfsson, Thomas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, Sweden.
    Sensorimotor control and cervical range of motion in women with chronic neck pain: Kinematic assessments and effects of neck coordination exercise2014Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Introduction: Neck pain is a common problem in society and is more prevalent among women. The consequences of neck pain for the individual often include activity and participation limitations, thus affecting many dimensions of life. There is still a lack of understanding of the underlying mechanisms of the disorder and likewise of efficient rehabilitation for people with neck pain. However, coordination exercises have shown promising short-term effects. To carry this line of research forward, there is a need to improve methods for objective characterization of impairments and to investigate novel methods of rehabilitation.

    Aims: To characterize impairments of active cervical range of motion of the upper and lower cervical levels in women with chronic neck pain with a novel method (Study I and II) and identify the influence of head posture and movement strategies (Study II). Further, to investigate the effects of a novel method for neck coordination exercise on sensorimotor function and neck pain (study III) and the consistencies of motor variability metrics in a goal directed arm movement task to aid the design of future clinical research (Study IV).

    Methods: All studies were laboratory based with kinematic assessments of neck movements (Study I-III), balance (Study III) and goal directed arm movements (Study III, IV). The studies had designs that were: cross-sectional (I and II), randomized controlled trial (III) or test-retest reliability study (IV). Participants in Study I (n=135) and II (n=160) were women with chronic non-specific neck pain and healthy controls. In Study III, women with chronic non-specific neck pain (n=108) were randomized into three different individually supervised 11 week interventions. Study IV included healthy women (n=14).

    Results: It was found that cervical range of motion impairments in women with non-specific neck pain were direction- and level-specific; impairments were greater in extension in the upper and flexion in the lower levels of the cervical spine. The magnitude of impairments in range of motion was associated to self-ratings of functioning and health. Possible group differences in natural head posture were rejected as a cause for the direction specific effects. Neither could the effects be explained by a strategy to minimize torque in the cervical spine during movement execution. The neck coordination training was not superior to strength training (best-available) and massage treatment (sham) in improving sensorimotor functions or pain according to short-term and 6 months follow ups. The results from the study of the goal directed movement task showed that between and within-subject sizes of most motor variability metrics were too large to make the test suitable for application in clinical research.

    Conclusions: Women with chronic non-specific neck pain have direction- and level-specific impairments in cervical sagittal range of motion. The underlying causes of these specific impairments remains unresolved, but the direction specific impairments are not related to natural head posture. The clinical validity of the method of characterization of cervical range of motion was supported and it can be useful in future clinical research. The novel method of neck coordination exercise showed no advantages on sensorimotor functions or pain compared with best-available treatment in women with chronic non-specific neck pain.

  • 349.
    Rudolfsson, Thomas
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Björklund, Martin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Djupsjöbacka, Mats
    Centrum för belastningsskadeforskning, Högskolan i Gävle.
    Range of motion in the upper and lower cervical spine in people with chronic neck pain2012In: Manual Therapy, ISSN 1356-689X, E-ISSN 1532-2769, Vol. 17, no 1, p. 53-59Article in journal (Refereed)
    Abstract [en]

    Reduced cervical range of motion (ROM) is a common finding in people with neck pain. With few exceptions, only the angle between head and thorax has been measured. Our aim was to use an extended model to compare active cervical flexion and extension, separate for upper and lower cervical levels, between people with chronic non-traumatic neck pain and controls. We also investigated associations between ROM measures, symptoms and self-rated functioning. In this cross-sectional study, 102 subjects with neck pain and 33 healthy controls participated. An electromagnetic tracker system was used to measure the kinematics to construct a three-segment model including the thorax, cervical spine and head. Neutral flexion/extension were defined at subjects’ self-selected seated posture. We found that in the neck pain group, extension in the upper cervical levels and predominately flexion for the lower levels were reduced. The ratio between ROM for the upper and lower levels was altered in the neck pain group so that the lower levels contributed to a lesser extent to the total sagittal ROM compared to controls. These findings could not be explained by a greater forward head posture but must have other origins. For the neck pain group, ROM measures were weakly associated to pain and self-rated functioning. Altogether, this implies that using a three-segment model for assessment of ROM can be a valuable improvement for characterisation of patients and treatment evaluation.

  • 350.
    Rudolfsson, Thomas
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Djupsjöbacka, Mats
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Björklund, Martin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Effects of neck coordination exercise on sensorimotor function in chronic neck pain: A randomized controlled trial.2014In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 46, no 9, p. 908-914Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate the effect of neck coordination exercise on sensorimotor function in women with neck pain compared with best-available treatment and sham treatment.

    DESIGN: Observer-blinded randomized controlled trial with short-term and 6-month follow-ups.

    SUBJECTS: Women with chronic non-specific neck pain were randomized to 3 groups: neck coordination exercise with a novel training device; strength training for the neck and shoulders; or massage. Each group had 36 participants.

    METHODS: The intervention period was 11 weeks with 22 individually supervised sessions. Primary outcomes were postural sway measures and precision of goal-directed arm movements. Secondary outcomes were range of motion for the neck, peak speed of axial rotation, and neck pain. A repeated measures multivariate analysis of variance (MANOVA) was conducted separately on the primary outcomes for the short-term and 6-month evaluations and on the sensorimotor secondary outcomes for the 6-month effect. The 6-month effect on pain was analysed with a repeated measures analysis of variance (ANOVA).

    RESULTS: No significant treatment effects in favour of neck coordination exercise were found for short-term or 6-month evaluations.

    CONCLUSION: Neck coordination exercise is no better than strength training and massage in improving sensorimotor function. Further research should investigate the use of cut-offs for sensorimotor dysfunctions prior to proprioceptive or coordinative training.

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