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  • 301.
    Barka, Anna
    Jönköping University, School of Education and Communication.
    Effective Physical Therapy Methods For Improving Postural Control In Children Diagnosed With Cerebral Palsy: A Systematic Review.2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    AIM: The aim of this study was to investigate which physical therapy methods are most effective for improving the postural control in children and adolescents diagnosed with CP, in order to provide to physical therapists with new evidence on the topic for integrating them in theirs intervention plans.

    METHOD: A systematic literature review was conducted in order to collect all the relevant information according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Five databases (PubMed, ProQuest, CINAHL, Web of science and Scopus) were used to identify relevant studies to include in this review. Keywords included “physical therapy”, “postural control”, “cerebral palsy” and their synonyms. Inclusion and exclusion criteria were settled according to the research question.

    RESULTS: Following the exclusion and inclusion criteria and after the quality assessment of the yielded data 11 articles were included in this review out of 97 of the initial search. PT interventions that were identified in the review included aquatic physical therapy, electrical stimulation therapy, intensive upper- and lower-extremity training (HABIT-ILE), virtual reality therapy and reactive balance exercise and standard PT combined with other methods such as backward walking training, Whole Body Vibration (WBV) training and antigravity treadmill training.

    CONCLUSION: In order to achieve improvements in postural control that are maintained over a period of time, children with cerebral palsy need to have PT included in their everyday routine and to have consistency in their sessions. All the PT interventions showed some positive effects on PC but, as Cerebral Palsy has many classifications and the effects of it varies for each child the PT method needs to be adjusted  to meet each child´s individual characteristics and disability and also to their environmental needs.

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  • 302.
    Barrdahl, Hanna
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Johansson, Sandra
    Mälardalen University, School of Health, Care and Social Welfare.
    FYSIOTERAPEUTERS UPPLEVELSE AV SIN YRKESROLL INOM DEMENSVÅRD2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Befolkningen blir äldre och antalet som lever med en demenssjukdom ökar.

    Fysioterapeuten kan bidra med sin kompetens och vara en del av ett multiprofessionellt team

    i vården av personer med demenssjukdom, en patientgrupp som av andra professioner

    upplevs som utmanande.

    Syfte: Syftet med uppsatsen är att undersöka fysioterapeuters upplevelse av sin yrkesroll

    inom vård av personer med demenssjukdom.

    Metod: En kvalitativ design med induktiv ansats användes. Data samlades in genom

    semistrukturerade intervjuer med sex fysioterapeuter som arbetade med personer med

    demenssjukdom, sedan utfördes en kvalitativ innehållsanalys på materialet.

    Resultat: Den kvalitativa innehållsanalysen resulterande i sex kategorier som sedan

    skapade två olika teman: “problemlösare för rehabiliteringsbeteende mot en ökad

    livskvalitet” och “kompetens, ett öppet sinne och samverkan ligger till grund för arbetet”.

    Slutsats: Fysioterapeuterna upplevde sin yrkesroll som viktig inom vården av personer med

    demenssjukdom samt att arbetet ofta är utmanande, men de upplevde att det behövdes

    större möjlighet till vidareutbildning inom området. Fysioterapeuterna ansåg att det var

    viktigt med bemötandet mot patienterna samt att ha ett samarbete med andra professioner.

    Studieförfattarna anser att fler studier behövs inom området, då med fokus på de hinder som

    finns i samarbetet med andra professioner.

    Nyckelord: Fysioterapi, hälso- och sjukvårdpersonal, kvalitativ forskning,

    neurodegenerativa sjukdomar

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  • 303. Barreto, Philipe de Souto
    et al.
    Morley, John E.
    Chodzko-Zajko, Wojtek
    Pitkala, Kaisu H.
    Weening-Djiksterhuis, Elizabeth
    Rodriguez-Manas, Leocadio
    Barbagallo, Mario
    Rosendahl, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sinclair, Alan
    Landi, Francesco
    Izquierdo, Mikel
    Vellas, Bruno
    Rolland, Yves
    Recommendations on Physical Activity and Exercise for Older Adults Living in Long-Term Care Facilities: A Taskforce Report2016In: Journal of the American Medical Directors Association, ISSN 1525-8610, E-ISSN 1538-9375, Vol. 17, no 5, p. 381-392Article in journal (Refereed)
    Abstract [en]

    A taskforce, under the auspices of The International Association of Gerontology and Geriatrics-Global Aging Research Network (IAGG-GARN) and the IAGG European Region Clinical Section, composed of experts from the fields of exercise science and geriatrics, met in Toulouse, in December 2015, with the aim of establishing recommendations of physical activity and exercise for older adults living in long-term care facilities (LTCFs). Due to the high heterogeneity in terms of functional ability and cognitive function that characterizes older adults living in LTCFs, taskforce members established 2 sets of recommendations: recommendations for reducing sedentary behaviors for all LTCF residents and recommendations for defining specific, evidence-based guidelines for exercise training for subgroups of LTCF residents. To promote a successful implementation of recommendations, taskforce experts highlighted the importance of promoting residents' motivation and pleasure, the key factors that can be increased when taking into account residents' desires, preferences, beliefs, and attitudes toward physical activity and exercise. The importance of organizational factors related to LTCFs and health care systems were recognized by the experts. In conclusion, this taskforce report proposes standards for the elaboration of strategies to increase physical activity as well as to prescribe exercise programs for older adults living in LTCFs. This report should be used as a guide for professionals working in LTCF settings.

  • 304.
    Barth, Cornelia
    et al.
    International Committee of the Red Cross, Geneva, Switzerland.
    Wladis, Andreas
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Regionledningskontoret, Center for Disaster Medicine and Traumatology.
    Blake, Catherine
    School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.
    Bhandarkar, Prashant
    Doctors For You, Mumbai, India.
    O’Sullivan, Cliona
    School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.
    Users of rehabilitation services in 14 countries and territories affected by conflict, 1988–20182020In: Bulletin of the World Health Organization, ISSN 0042-9686, E-ISSN 1564-0604, Vol. 98, p. 599-614Article in journal (Refereed)
    Abstract [en]

    Objective To analyse the demographic and clinical characteristics of people attending physical rehabilitation centres run or supported by the International Committee of the Red Cross in countries and territories affected by conflict.

    Methods Of 150 such rehabilitation centres worldwide, 38 use an electronic patient management system. We invited all 38 centres to participate. We extracted de-identified data from 1988 to 2018 and categorized them by sex, age, country or territory and reason for using rehabilitation services.

    Findings Thirty-one of the 38 rehabilitation centres in 14 countries and territories participated. We included data for 287 274 individuals. Of people using rehabilitation services, 61.6% (176 949/287 274) were in Afghanistan, followed by 15.7% (44 959/287 274) in Cambodia. Seven places had over 9000 service users each (Afghanistan, Cambodia, Gaza Strip, Iraq, Myanmar, Somalia and Sudan). Overall, 72.6% (208 515/287 274) of service users were male. In eight countries, more than half of the users were of working age (18–59 years). Amputation was the most common reason for using rehabilitation services; 33.3% (95 574/287 274) of users were people with amputations, followed by 13.7% (39 446/287 274) with cerebral palsy. The male predominance was greater in the population aged 18–34 years (83.1%; 71 441/85 997) and in people with amputations (88.6%; 84 717/95 574) but was evident across all places, age groups and health conditions.

    Conclusion The considerably lower attendance of females at the rehabilitation centres highlights the need to understand the factors that affect the accessibility and acceptability of rehabilitation for women and girls in conflict settings.

  • 305.
    Basala, Philip
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Borgsgård, Magnus
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Studenters upplevda stress och dess samband med fysisk aktivitet: En enkätstudie på fysioterapeutstudenter vid Uppsala universitet2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background. Mental illness occurs among Swedish physiotherapy students. One symptom is increased stress. Research has shown that physical activity has a resistant effect. However, the correlation is unclear.

    Purpose. To describe the perceived level of stress and the level of physical activity among physiotherapy students at Uppsala University, describe differences between first-, second- and third-year students, what the correlation between the variables was and to what extent the stress is related to studies.

    Method. A cross-sectional study with a web survey, which consisted questions from the surveys GA(2)LEN and Perceived Stress-10, and the rating-scale SNRS-11.

    Results. The students’ perceived level of stress was high among 9,4%, moderate among 50% and low among 40,6%. 55,2% of the students had high physical activity-levels, 27,1% had moderate and 17,7% had low. Significant difference in stress was found between second- and third-year students (p=0,002). The correlation was -0,287 (p=0,006). The students ranked 7 out of 10 that the stress was related to studies. 

    Conclusion. Physiotherapy students at Uppsala University were stressed which was related to studies. A majority met requirements of high physical activity-levels. The correlation was weak between physical activity and stress. There was a difference in stress between second- and third-year students.

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  • 306.
    Basic, Vladimir Tomislav
    et al.
    Department of Clinical Medicine, Örebro University, Örebro, Sweden.
    Tadele, Elsa
    Department of Clinical Medicine, Örebro University, Örebro, Sweden.
    Elmabsout, Ali Ateia
    Department of Clinical Medicine, Örebro University, Örebro, Sweden.
    Yao, Hongwei
    Department of Environmental Medicine, Lung Biology and Disease Program, University of Rochester Medical Center, Rochester NY, USA.
    Rahman, Irfan
    Department of Environmental Medicine, Lung Biology and Disease Program, University of Rochester Medical Center, Rochester NY, USA.
    Sirsjö, Allan
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Abdel-Halim, Samy M.
    Department of Environmental Medicine, Lung Biology and Disease Program, University of Rochester Medical Center, Rochester NY, USA.
    Exposure to cigarette smoke induces overexpression of von Hippel-Lindau tumor suppressor in mouse skeletal muscle2012In: American Journal of Physiology - Lung cellular and Molecular Physiology, ISSN 1040-0605, E-ISSN 1522-1504, Vol. 303, no 6, p. L519-L527Article in journal (Refereed)
    Abstract [en]

    Cigarette smoke (CS) is a well established risk factor in the development of chronic obstructive pulmonary disease (COPD). In contrast, the extent to which CS exposure contributes to the development of the systemic manifestations of COPD, such as skeletal muscle dysfunction and wasting remains largely unknown. Decreased skeletal muscle capillarization has been previously reported in early stages of COPD and might play an important role in the development of COPD-associated skeletal muscle abnormalities. To investigate the effects of chronic CS exposure on skeletal muscle capillarization and exercise tolerance a mouse model of CS exposure was used. The129/SvJ mice were exposed to CS for 6 months, and the expression of putative elements of the hypoxia-angiogenic signaling cascade as well as muscle capillarization were studied. Additionally, functional tests assessing exercise tolerance/endurance were performed in mice. Compared to controls, skeletal muscles from CS-exposed mice exhibited significantly enhanced expression of von Hippel-Lindau tumor suppressor (VHL), ubiquitin-conjugating enzyme E2D1 (UBE2D1) and prolyl hydroxylase-2 (PHD2). In contrast, hypoxia-inducible factor-1 (HIF1-α) and vascular endothelial growth factor (VEGF) expression was reduced. Furthermore, reduced muscle fiber cross-sectional area, decreased skeletal muscle capillarization, and reduced exercise tolerance were also observed in CS-exposed animals. Taken together, the current results provide evidence linking chronic CS exposure and induction of VHL expression in skeletal muscles leading towards impaired hypoxia-angiogenesis signal transduction, reduced muscle fiber cross-sectional area and decreased exercise tolerance.

  • 307.
    Bastås, Josefine
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Åsenlöf: Physiotheraphy.
    Lind, Josefine
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Åsenlöf: Physiotheraphy.
    Det behövs en knuff liksom nu och då för att man ska komma vidare: En kvalitativ intervjustudie om upplevelser och erfarenheter av att få rehabiliterande insatser i ett varmt klimat bland patienter med neurologiska sjukdomar2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background Patients with neurological diseases are often in need of rehabilitative medical care in order to sustain body-function and manage activities in daily life. In some cases, rehabilitation in a warm climate is offered to patients within this group. The rehabilitation period often includes multidisciplinary medical care and will go on for 3-4 weeks. Physiotherapy is commonly a central part of the period. There is limited knowledge in regard to the experiences of receiving physiotherapy during a rehabilitation period in a warm climate and its effects.

    Purpose/Aim of the study The aim of the present study was to explore and describe experiences of receiving physiotherapy during a rehabilitation stay in a warm climate among patients with neurological diseases.

    Design & Method This study had a qualitative and exploratory design were data was collected through five semi-structured interviews. To analyze the data a qualitative, inductive approach was used.

    Result The result of this study suggest that physiotherapy was a central part of the rehabilitation stay and that intensive and individually designed exercise programs were beneficial. Patient-centered care was described as important to the result of the stay. Factors such as the warm climate, social support and being away from one’s daily environment were reported to be crucial in regard to the total rehabilitation experience. An enhanced level of motivation to physical activity was described as an important effect of receiving medical care in a warm climate.

    Conclusion Social support, a warm climate and responsive health care professionals contributed to a positive experience of receiving physiotherapy as a part of a rehabilitation stay. Experiences of enhanced motivation towards physical activity and more positive health outcomes suggest that a rehabilitation stay in a warm climate could be considered as a medical care complement. 

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  • 308.
    Batool, Sana
    et al.
    Faculty of Allied Health Sciences, Department University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan.
    Zafar, Hamayun
    Umeå University, Faculty of Medicine, Department of Odontology. Faculty of Allied Health Sciences, Department University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan; Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia; Rehabilitation Research Chair, King Saud University, Riyadh, Saudi Arabia.
    Gilani, Syed Amir
    Faculty of Allied Health Sciences, Directorate of International Linkages, University of Lahore, Lahore, Pakistan.
    Ahmad, Ashfaq
    Faculty of Allied Health Sciences, Department University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan.
    Hanif, Asif
    Faculty of Allied Health Sciences, Department University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan.
    Effects of visual scanning exercises in addition to task specific approach on balance and activities of daily livings in post stroke patients with eye movement disorders: a randomized controlled trial2022In: BMC Neurology, E-ISSN 1471-2377, Vol. 22, no 1, article id 312Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Impaired vision is one of the commonest and most disabling consequence following stroke. Among all visual impairments, eye movement disorders are found in 70% of stroke patients which include nystagmus, strabismus, gaze palsies, disconjugate eye movements and cranial nerve palsies. They have a wide ranging impact on balance and activities of daily livings by creating difficulties in maintaining normal alignment and appropriate movement of eyes. The purpose of this study was to examine the effects of visual scanning exercises in addition to task specific approach on balance and activities of daily livings in post stroke patients with eye movement disorders.

    METHODS: This study is a randomized controlled trial and was conducted in the University of Lahore Teaching Hospital from May 2019 to October 2020. A sample of 64 patients was recruited and randomly allocated into experimental and control group. 32 patients in experimental group were treated with visual scanning exercises along with task specific approach and 32 patients in control group were treated with task specific approach alone. Pre and post assessment of balance and activities of daily livings was assessed on BERG BALANCE SCALE and BARTHEL INDEX SCALE at baseline and at 4th week.

    RESULTS: Intra-group analysis of BERG BALANCE SCALE in experimental group showed statistically significant result (p < 0.05) in all items except in items 4, 13 and 14 respectively. Intra-group analysis of BERG BALANCE SCALE in control group showed statistically significant result (p < 0.05) in items 3, 5, 8 and 12 respectively, whereas remaining all items showed statistically insignificant result. Intra-group analysis of BARTHEL INDEX SCALE in experimental group showed statistically significant result in all items (p < 0.05) except in items 9 and 10 respectively. Intra-group analysis of BARTHEL INDEX in control group showed statistically significant result (p < 0.05) in items 1, 3, 4 and 8 respectively whereas remaining all items showed statistically insignificant result. Inter-group analysis showed statistically significant result in total scores of BERG BALANCE SCALE (p = 0.000) and BARTHEL INEX SCALE (p = 0.033).

    CONCLUSION: Visual scanning exercises along with task specific approach were found to be more effective in comparison to task specific approach alone.

    TRIAL REGISTRATION: Trial registration number: [IRCT20190717044237N1], trial registration date: 10/11/2019.

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  • 309.
    Battista, Simone
    et al.
    Lund Univ, Sweden; Univ Genoa, Italy.
    Kiadaliri, Ali
    Lund Univ, Sweden.
    Jonsson, Therese
    Lund Univ, Sweden.
    Gustafsson, Kristin
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Ryhov Cty Hosp Jonkoping, Sweden.
    Englund, Martin
    Lund Univ, Sweden.
    Testa, Marco
    Univ Genoa, Italy.
    DellIsola, Andrea
    Lund Univ, Sweden.
    Factors Associated With Adherence to a Supervised Exercise Intervention for Osteoarthritis: Data From the Swedish Osteoarthritis Registry2023In: Arthritis care & research, ISSN 2151-464X, E-ISSN 2151-4658, Vol. 75, no 10, p. 2117-2126Article in journal (Refereed)
    Abstract [en]

    ObjectiveTo explore how lifestyle and demographic, socioeconomic, and disease-related factors are associated with supervised exercise adherence in an osteoarthritis (OA) management program and the ability of these factors to explain exercise adherence. MethodsA cohort register-based study on participants from the Swedish Osteoarthritis Registry who attended the exercise part of a nationwide Swedish OA management program. We ran a multinomial logistic regression to determine the association of exercise adherence with the abovementioned factors. We calculated their ability to explain exercise adherence with the McFadden R-2. ResultsOur sample comprises 19,750 participants (73% female, mean +/- SD age 67 +/- 8.9 years). Among them, 5,862 (30%) reached a low level of adherence, 3,947 (20%) a medium level, and 9,941 (50%) a high level. After a listwise deletion, the analysis was run on 16,685 participants (85%), with low levels of adherence as the reference category. Some factors were positively associated with high levels of adherence, such as older age (relative risk ratio [RRR] 1.01 [95% confidence interval (95% CI) 1.01-1.02] per year), and the arthritis-specific self-efficacy (RRR 1.04 [95% CI 1.02-1.07] per 10-point increase). Others were negatively associated with high levels of adherence, such as female sex (RRR 0.82 [95% CI 0.75-0.89]), having a medium (RRR 0.89 [95% CI 0.81-0.98] or a high level of education (RRR 0.84 [95% CI 0.76-0.94]). Nevertheless, the investigating factors could explain 1% of the variability in exercise adherence (R-2 = 0.012). ConclusionDespite the associations reported above, the poorly explained variability suggests that strategies based on lifestyle and demographic, socioeconomic, and disease-related factors are unlikely to improve exercise adherence significantly.

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  • 310.
    Baunsgaard, Carsten Bach
    et al.
    Univ Copenhagen, Denmark.
    Nissen, Ulla Vig
    Univ Copenhagen, Denmark.
    Brust, Anne Katrin
    SPC, Switzerland.
    Frotzler, Angela
    SPC, Switzerland.
    Ribeill, Cornelia
    Ulm Univ, Germany.
    Kalke, Yorck-Bernhard
    Ulm Univ, Germany.
    Leon, Natacha
    FLM, Spain.
    Gomez, Belen
    FLM, Spain.
    Samuelsson, Kersti
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine.
    Antepohl, Wolfram
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine.
    Holmstrom, Ulrika
    Uppsala Univ Hosp, Sweden.
    Marklund, Niklas
    Uppsala Univ Hosp, Sweden.
    Glott, Thomas
    Sunnaas Rehabil Hosp, Norway.
    Opheim, Arve
    Sunnaas Rehabil Hosp, Norway; Univ Gothenburg, Sweden.
    Benito, Jesus
    Neurorehabil Hosp, Spain.
    Murillo, Narda
    Neurorehabil Hosp, Spain.
    Nachtegaal, Janneke
    Heliomare Rehabil Ctr, Netherlands.
    Faber, Willemijn
    Heliomare Rehabil Ctr, Netherlands.
    Biering-Sorensen, Fin
    Univ Copenhagen, Denmark.
    Gait training after spinal cord injury: safety, feasibility and gait function following 8 weeks of training with the exoskeletons from Ekso Bionics2018In: Spinal Cord, ISSN 1362-4393, E-ISSN 1476-5624, Vol. 56, no 2, p. 106-116Article in journal (Refereed)
    Abstract [en]

    Study design Prospective quasi-experimental study, pre-and post-design. Objectives Assess safety, feasibility, training characteristics and changes in gait function for persons with spinal cord injury (SCI) using the robotic exoskeletons from Ekso Bionics. Setting Nine European rehabilitation centres. Methods Robotic exoskeleton gait training, three times weekly over 8 weeks. Time upright, time walking and steps in the device (training characteristics) were recorded longitudinally. Gait and neurological function were measured by 10 Metre Walk Test (10 MWT), Timed Up and Go (TUG), Berg Balance Scale (BBS), Walking Index for Spinal Cord Injury (WISCI) II and Lower Extremity Motor Score (LEMS). Results Fifty-two participants completed the training protocol. Median age: 35.8 years (IQR 27.5-52.5), men/women: N = 36/16, neurological level of injury: C1-L2 and severity: AIS A-D (American Spinal Injury Association Impairment Scale). Time since injury (TSI) amp;lt; 1 year, N = 25; amp;gt; 1 year, N = 27. No serious adverse events occurred. Three participants dropped out following ankle swelling (overuse injury). Four participants sustained a Category II pressure ulcer at contact points with the device but completed the study and skin normalized. Training characteristics increased significantly for all subgroups. The number of participants with TSI amp;lt; 1 year and gait function increased from 20 to 56% (P=0.004) and 10MWT, TUG, BBS and LEMS results improved (P amp;lt; 0.05). The number of participants with TSI amp;gt; 1 year and gait function, increased from 41 to 44% and TUG and BBS results improved (P amp;lt; 0.05). Conclusions Exoskeleton training was generally safe and feasible in a heterogeneous sample of persons with SCI. Results indicate potential benefits on gait function and balance.

  • 311.
    Baunsgaard, Carsten Bach
    et al.
    Univ Copenhagen, Denmark.
    Nissen, Ulla Vig
    Univ Copenhagen, Denmark.
    Brust, Anne Katrin
    SPC, Switzerland.
    Frotzler, Angela
    SPC, Switzerland.
    Ribeill, Cornelia
    Ulm Univ, Germany.
    Kalke, Yorck-Bernhard
    Ulm Univ, Germany.
    Leon, Natacha
    FLM, Spain.
    Gomez, Belen
    FLM, Spain.
    Samuelsson, Kersti
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine.
    Antepohl, Wolfram
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine.
    Holmstrom, Ulrike
    Uppsala Univ Hosp, Sweden.
    Marklund, Niklas
    Uppsala Univ Hosp, Sweden.
    Glott, Thomas
    Sunnaas Rehabil Hosp, Norway.
    Opheim, Arve
    Sunnaas Rehabil Hosp, Norway; Univ Gothenburg, Sweden; Reg Vastra Gotaland, Sweden.
    Benito Penalva, Jesus
    Neurorehabil Hosp, Spain.
    Murillo, Narda
    Neurorehabil Hosp, Spain.
    Nachtegaal, Janneke
    Heliomare Rehabil Ctr, Netherlands.
    Faber, Willemijn
    Heliomare Rehabil Ctr, Netherlands.
    Biering-Sorensen, Fin
    Univ Copenhagen, Denmark.
    EXOSKELETON GAIT TRAINING AFTER SPINAL CORD INJURY: AN EXPLORATORY STUDY ON SECONDARY HEALTH CONDITIONS2018In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 50, no 9, p. 806-813Article in journal (Refereed)
    Abstract [en]

    Objective: To explore changes in pain, spasticity, range of motion, activities of daily living, bowel and lower urinary tract function and quality of life of individuals with spinal cord injury following robotic exoskeleton gait training. Design: Prospective, observational, open-label multicentre study. Methods: Three training sessions per week for 8 weeks using an Ekso GT robotic exoskeleton (Ekso Bionics). Included were individuals with recent (amp;lt;1 year) or chronic (amp;gt;1 year) injury, paraplegia and tetraplegia, complete and incomplete injury, men and women. Results: Fifty-two participants completed the training protocol. Pain was reported by 52% of participants during the week prior to training and 17% during training, but no change occurred longitudinally. Spasticity decreased after a training session compared with before the training session (pamp;lt; 0.001), but not longitudinally. Chronically injured participants increased Spinal Cord Independence Measure (SCIM III) from 73 to 74 (p= 0.008) and improved life satisfaction (p= 0.036) over 8 weeks of training. Recently injured participants increased SCIM III from 62 to 70 (pamp;lt;0.001), but no significant change occurred in life satisfaction. Range of motion, bowel and lower urinary function did not change over time. Conclusion: Training seemed not to provoke new pain. Spasticity decreased after a single training session. SCIM III and quality of life increased longitudinally for subsets of participants.

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  • 312.
    Baxter, Rebecca
    et al.
    Department of Nursing, Umeå University, Sweden.
    Jemberie, Wossenseged Birhane
    Department of Social Work, Umeå University, Sweden; Centre for Demographic and Ageing Research (CEDAR), Umeå University, Sweden.
    Li, Xia
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden.
    Naseer, Mahwish
    School of Education, Health and Social Studies, Dalarna University, Sweden; Ageing Research Centre, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Sweden.
    Pauelsen, Mascha
    Luleå University of Technology, Department of Health Sciences, Health, Medicine and Rehabilitation.
    Shebehe, Jacques
    Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Sweden.
    Viklund, Emilia W.E.
    Department of Health Sciences, Faculty of Education and Welfare Studies, Åbo Akademi University, Finland.
    Xia, Xin
    Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Sweden.
    Zulka, Linn Elena
    Department of Psychology, Centre for Ageing and Health (AgeCap), University of Gothenburg, Sweden.
    Badache, Andreea
    Department of Disability Sciences, School of Health Sciences, Örebro University, Sweden; Swedish Institute of Disability Research, Örebro University, Sweden.
    COVID-19: Opportunities for interdisciplinary research to improve care for older people in Sweden2021In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 49, no 1, p. 29-32Article in journal (Refereed)
    Abstract [en]

    The emergence of COVID-19 has changed the world as we know it, arguably none more so than for older people. In Sweden, the majority of COVID-19-related fatalities have been among people aged ⩾70 years, many of whom were receiving health and social care services. The pandemic has illuminated aspects within the care continuum requiring evaluative research, such as decision-making processes, the structure and organisation of care, and interventions within the complex public-health system. This short communication highlights several key areas for future interdisciplinary and multi-sectorial collaboration to improve health and social care services in Sweden. It also underlines that a valid, reliable and experiential evidence base is the sine qua non for evaluative research and effective public-health systems.

  • 313.
    Bay, Annika
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Sandberg, Camilla
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Thilen, U.
    Wadell, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Johansson, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Exercise self-efficacy (ESE) in adults with congential heart disease2017In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 38, no Suppl. 1, article id ehx501.P618Article in journal (Refereed)
    Abstract [en]

    Background: Many adults with congenital heart disease (CHD) have reduced aerobic exercise capacity and impaired muscle function. However, it is largely unknown which factors have influence on the confidence to perform exercise training, i.e. Exercise Self-Efficacy (ESE).

    Aims: To identify factors related to low ESE, and thus identify potential targets for rehabilitation and thereby enhance the potential for being physically active.

    Methods: Seventy-nine adults with CHD; simple lesions n=38 (women n=16), complex lesions n=41 (women n=17) (mean age 36.7±14.6 years) and 42 age and sex matched controls were recruited. All participants completed questionnaires on ESE, quality of life (EQ-5D), and physical activity (international physical activity questionnaire, IPAQ), and performed muscle endurance tests.

    Results: ESE was categorised into low (<26 points, n=24) and high (≥26 points, n=55). Patients with low ESE were older (45.2±15.4 vs. 32.6±12.5 years, p=0.002), more often had prescribed medication (67% vs. 44%, p=0.06), higher New York Heart Association functional class (NYHA) (≥ III) (25% vs. 7%, p=0.03) and performed fewer shoulder flexions (30.9±16.1 vs. 45.9±23.9, p=0.01) compared with those with high ESE. In the high ESE group, ESE did not differ from controls (33.8±3.9 vs. 33.4±6.1, p=0.74). In linear multivariate analysis age (B;-0.18, 95% CI -0.28- -0.08), smoking (B;-3.73, 95% CI -7.17- -0.28), EQ-5Dindex <1 (B;-3.33, 95% CI -6.08- -0.57) and number of shoulder flexions (B; 0.09, 95% CI 0.03–0.16) were independently associated with ESE.

    Conclusion: Many adults with CHD have low ESE. Rehabilitation targeting quality of life, smoking cessation and muscle training may improve ESE, and thus enhance the potential for being physically active in this population.

  • 314.
    Becirbegovic, Haris
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Svensson, Niklas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Shining a light on soccer injuries in Africa: A descriptive and comparative Cohort study on soccer injuries in Rwanda and Swaziland2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background/Problem definition

    There are few epidemiological studies on soccer injuries in Africa.The prevalence and variables linked to injuries needs to be recognized. Better mapping and knowledge about injury prevalence/incidence could play an important role in helping players sustain a career in soccer without major injuries. 

    Objective

    To explore prevalence, mechanism, severity of injuries and injured body parts in players from top divisions of Rwanda and Swaziland during season 2012/2013.

    Methods

    The study was of a retrospective, descriptive, comparative design with a quantitative approach on a cohort of n=738 players from Rwanda and Swaziland. Injury frequencies from data sets was analyzed. Data was analyzed using the F-MARC injury-questionnaire.

    Results

    The subpopulations had varying frequencies of injuries. Age 18-24 sustained the most injuries in both countries, n=215. There was a significant difference of injury prevalence, 71,8% of the Swaziland players sustained injuries. In Rwanda 34,8% sustained injuries. However, the severity of injuries was significantly higher in the Rwanda.

    Conclusion

    The results of the findings in this study shows that the players in Swaziland had almost a two-time higher injury prevalence. Although the reason to this can only be speculated in by the authors. Further research is encouraged to increase the mapping of injuries in Africa, and factors associated to them.

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  • 315.
    Begovic, Nino
    Luleå University of Technology, Department of Health Sciences.
    Rehabilitering av arm och handfunktion efter stroke med hjärndatorgränssnittstyrda exoskelett: En explorativ litteraturöversikt2020Independent thesis Basic level (professional degree), 180 HE creditsStudent thesis
    Abstract [en]

    Background: Stroke affects millions of people around the world each year and often results in unilateral motor impairments that severely reduce the ability for independence in everyday life. Physiotherapy after stroke is therefore usually performed through task-oriented training aimed at rehabilitating the motor functional ability of the affected side so that the patient can return to an independent life. But the process places great demands on the patient who cannot always be expected to achieve the best results from their rehabilitation. Therefore, innovative technologies are increasingly being researched with the potential to assist stroke patients as well as physical therapists in the rehabilitation process. Exoskeletons and brain-computer interfaces (BCI) are two such rehabilitative tools that were investigated in this study. Objective: The study aimed to compile the scientific support for the use of BCI-controlled exoskeletons (BCI-Exo) in motor functional arm and hand rehabilitation after stroke in its subacute and chronic phase. Method: Literature searches were conducted in the databases PEDRO, PUBMED, AMED and CINAHL, which resulted in 22 hits which, after review and screening, resulted in four articles being included in the study. Results: All studies reported statistically significant improvements regarding motor function in the hemiplegic hand in the intervention group compared to the control group based on the outcome measures used. Conclusion: The results indicated that BCI-Exo can promote recovery and neuroplasticity after stroke regardless of its phase. However, the technology is still in its early stages and more studies need to be performed to better specify and understand the advantages and disadvantages compared to conventional treatment methods.

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  • 316.
    Beischer, Susanne
    Linnaeus University, Faculty of Social Sciences, Department of Sport Science.
    Lower extremity injuries in young floorball players: A prospective study on overuse injuries2014Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Background: To my knowledge, no previous studies have examined the appearance of injury in young floorball players. Aim: To investigate the occurrence of overuse injuries in lower extremity (LE) in floorball players aged 15 or younger, with respect to frequency, location, and consequence of injury. Method: Fifty-seven players participated (mean age 11±2 years). A modified version of Oslo Sports Trauma Research Center Overuse Injury Questionnaire was submitted every fourth week during four months in order to record the occurrence of overuse injuries in LE. Result: A total of 42 overuse injuries in 42% (24/57) of the cohort were found. The average monthly prevalence for all players, in any anatomical area, was 28% (95% confidence interval 18%-38%). The most common location of injuries was the knee (43%), followed by the foot (40%). A weak positive and significant correlation (rs = 0.276, p = 0.038 ) between overuse injuries and age was found. Conclusion: The present study shows, in accordance with other recent studies on children and adolescents, that overuse injuries seems to be a common problem for young floorball players.

  • 317. Belvederi Murri, Martino
    et al.
    Triolo, Federico
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Coni, Alice
    Nerozzi, Erika
    Maietta Latessa, Pasqualino
    Fantozzi, Silvia
    Padula, Nicola
    Escelsior, Andrea
    Assirelli, Barbara
    Ermini, Giuliano
    Bagnoli, Luigi
    Zocchi, Donato
    Cabassi, Aderville
    Tedeschi, Stefano
    Toni, Giulio
    Chattat, Rabih
    Tripi, Ferdinando
    Neviani, Francesca
    Bertolotti, Marco
    Cremonini, Alessandro
    Bertakis, Klea D.
    Amore, Mario
    Chiari, Lorenzo
    Zanetidou, Stamatula
    The body of evidence of late-life depression: the complex relationship between depressive symptoms, movement, dyspnea and cognition2023In: Experimental Aging Research, ISSN 0361-073X, E-ISSN 1096-4657Article in journal (Refereed)
    Abstract [en]

    Background: Physical symptoms play an important role in late-life depression and may contribute to residual symptomatology after antidepressant treatment. In this exploratory study, we examined the role of specific bodily dimensions including movement, respiratory functions, fear of falling, cognition, and physical weakness in older people with depression.

    Methods: Clinically stable older patients with major depression within a Psychiatric Consultation-Liaison program for Primary Care underwent comprehensive assessment of depressive symptoms, instrumental movement analysis, dyspnea, weakness, activity limitations, cognitive function, and fear of falling. Network analysis was performed to explore the unique adjusted associations between clinical dimensions.

    Results: Sadness was associated with worse turning and walking ability and movement transitions from walking to sitting, as well as with worse general cognitive abilities. Sadness was also connected with dyspnea, while neurovegetative depressive burden was connected with activity limitations.

    Discussion: Limitations of motor and cognitive function, dyspnea, and weakness may contribute to the persistence of residual symptoms of late-life depression.

  • 318.
    Bendelin, Nina
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Internet-Delivered Acceptance and Commitment Therapy for Chronic Pain: Feasibility, patients’ experiences and implementation process2023Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Chronic pain represents a major burden for individuals and society. Internet-delivered psychological interventions are evidence-based treatments that enable patients to access qualified care at a time and place convenient for them. Internet-delivered Acceptance and commitment therapy (IACT) has shown promising treatment effects for chronic pain patients on pain-related outcomes such as disability, pain intensity, and interference, and on psychological outcomes such as catastrophizing, fear-avoidance and acceptance. Interdisciplinary pain rehabilitation programs (IPRP) are multimodal interventions given by synchronized teams of health care professionals from different disciplines. With moderate treatment effects on many outcomes, IPRP is the best evidence treatment for chronic pain to date.   

    IACT may add to IPRP’s effectiveness by providing individual psychological treatment via the internet. However, IACT has not yet been implemented in routine care in a larger scale. In this thesis, the aim was to study if IACT may be acceptable for chronic pain patients and if it is feasible and effective as an addition to IPRP. Three methodological approaches were used: qualitative analysis, implementation science and a controlled trial of effectiveness in a clinical context.   

    Study I showed that an internet-delivered aftercare intervention enabled chronic pain patients to change their perception of their body and pain and their attitude about their future and self. Furthermore, self-motivating goals and acceptance strategies appeared to influence autonomy. The results gave promise to the feasibility of IACT as aftercare following IPRP. Study II showed that chronic pain patients’ experiences of IACT vary, with respect to being in treatment and the consequences of treatment. Specifically, e-therapist feedback and deadlines for homework may have an impact on autonomy and change. Patients’ expectations, motivations, and restraints could explain treatment engagement and experiences. In Study III, IACT added during IPRP enhanced the treatment effects on pain acceptance and affective distress. Furthermore, IACT added as aftercare strengthened the long-term effect of IPRP on psychological flexibility and self-efficacy. However, unsatisfactory completion rates complicated the interpretation of the findings. Study IV showed that implementing IACT in an IPRP setting may be facilitated by contextual alinement and modifications based on patients’ needs. Thorough testing of the application and matching the intervention’s aim with the host’s needs are important not to challenge the process. An implementation framework may ease planning and evaluation of implementation processes.   

    In conclusion, IACT could be feasible as an addition to IPRP. IACT can help chronic pain patients self-manage their pain and improve pain acceptance and self-efficacy. However, chronic pain patients’ varying experiences may need to be considered to improve treatment engagement and help patients benefit from treatment. In addition, implementation of IACT in IPRP settings is likely to depend on both flexibility to changing host needs and continuity of known pivotal components in IACT.   

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  • 319.
    Bendelin, Nina
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Björkdahl, Pär
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Risell, Mimmi
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Zetterqvist Nelson, Karin
    Linköping University, Department of Thematic Studies, Department of Child Studies. Linköping University, Faculty of Arts and Sciences.
    Gerdle, Björn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Inst, Sweden.
    Buhrman, Monica
    Uppsala Univ, Sweden.
    Patients experiences of internet-based Acceptance and commitment therapy for chronic pain: a qualitative study2020In: BMC Musculoskeletal Disorders, E-ISSN 1471-2474, BMC MUSCULOSKELETAL DISORDERS, Vol. 21, no 1, article id 212Article in journal (Refereed)
    Abstract [en]

    Background: Chronic pain is a globally widespread condition with complex clusters of symptoms within a heterogeneous patient group. Internet-delivered Acceptance and Commitment Therapy (IACT) has shown promising results in the treatment of chronic pain. How IACT is experienced by patients is less well known. Qualitative studies of patients experiences are needed to further understand factors behind both engagement and negative effects. The aim of this study was to explore how IACT was experienced by chronic pain patients who had participated in a controlled trial. Methods: Through an open and exploratory approach this study aimed to investigate how IACT was experienced when delivered as a guided self-help program to persons with chronic pain. Eleven participants were interviewed over telephone after completing IACT. Results: Qualitative analysis based on grounded theory resulted in 2 core categories and 8 subcategories. In treatment: Physical and cognitive restraints, Time and deadline, Therapist contact, and Self-confrontation. After treatment: Attitude to pain, Image of pain, Control or Command, and Acting with pain. Individual differences as well as specific conditions of the treatment may explain variations in how the treatment was approached, experienced and what consequences it led to. Therapist guidance and deadlines for homework play complex roles in relation to autonomy and change. Conclusions: Adjusting treatment content and format based on participants characteristics, such as expectations, motivation and restraints, might positively affect engagement, autonomy and change. Further research on attrition and negative effects of treatment might clarify what enables chronic pain patients to benefit from IACT.

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  • 320.
    Bendelin, Nina
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Gerdle, Björn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Inst, Sweden.
    Internet-delivered aftercare following multimodal rehabilitation program for chronic pain: a qualitative feasibility study2018In: Journal of Pain Research, E-ISSN 1178-7090, Vol. 11, p. 1715-1728Article in journal (Refereed)
    Abstract [en]

    Purpose: Methods for delivering aftercare to help chronic pain patients to continue practice self-management skills after rehabilitation are needed. Internet-delivered cognitive behavioral therapy (ICBT) has the potential to partly fill this gap given its accessibility and emphasis on self-care. Methods for engaging and motivating patients to persist throughout the full length of treatment are needed. The aim of this study was to describe how chronic pain patients work in an ICBT program, through their descriptions of what is important when they initiate behavior change in aftercare and their descriptions of what is important for ongoing practice of self-management skills in aftercare. Patients and methods: Following a multimodal rehabilitation program, 29 chronic pain patients participated in a 20-week-long Internet-delivered aftercare program (ACP) based on acceptance-based cognitive behavioral therapy. Latent content analysis was made on 138 chapters of diary-like texts written by participants in aftercare. Results: Attitudes regarding pain and body changed during ACP, as did attitudes toward self and the future for some participants. How participants practiced self-management skills was influenced by how they expressed motivation behind treatment goals. Whether they practiced acceptance strategies influenced their continuous self-management practice. Defusion techniques seemed to be helpful in the process of goal setting. Mindfulness strategies seemed to be helpful when setbacks occurred. Conclusion: Self-motivating goals are described as important both to initiate and in the ongoing practice of self-management skills. Experiencing a helpful effect of acceptance strategies seems to encourage participants to handle obstacles in new ways and to persist throughout treatment. Research on whether tailored therapist guidance might be helpful in stating self-motivating goals and contribute to ongoing practice of self-management skills is needed.

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  • 321.
    Bendelin, Nina
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Gerdle, Björn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Blom, Marie
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Södermark, Martin
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Karolinska Inst, Sweden.
    Internet-Delivered Acceptance and Commitment Therapy Added to Multimodal Pain Rehabilitation: A Cluster Randomized Controlled Trial2021In: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 10, no 24, article id 5872Article in journal (Refereed)
    Abstract [en]

    Internet-delivered interventions hold the possibility to make pain rehabilitation more accessible and adaptable by providing qualified individualized psychological care to chronic pain patients in their homes. Acceptance and commitment therapy (ACT) has shown promising results on psychological functioning and pain acceptance. Internet-delivered ACT (IACT) added to multimodal pain rehabilitation program (MMRP) in primary care has, so far, not shown better results than MMRP alone. The aim of this cluster randomized controlled study was to investigate the effects of adding IACT during and after MMRP in specialist care on psychological outcomes. In total, 122 patients who enrolled in a specialist pain clinic were cluster randomized groupwise to either MMRP (n = 12 groups) or to MMRP with added IACT (n = 12 groups). The IACT addition included 6 weeks of treatment during MMRP and 11 weeks of aftercare following MMRP. Online and paper-and-pencil self-report measures of pain acceptance, psychological inflexibility, self-efficacy, and psychosocial consequences of pain, were collected at four occasions: prior to and post MMRP, post aftercare intervention and at 1 year follow-up. Dropout was extensive with 25% dropping out at post treatment, an additional 35% at post aftercare, and 29% at 1 year follow-up. Medium treatment between-group effects were found on pain acceptance in favor of the group who received IACT added to MMRP, at post treatment and at post aftercare. Large effects were seen on psychological inflexibility and self-efficacy at post aftercare. A medium effect size was seen on affective distress at post aftercare. Moreover, a medium effect on self-efficacy was found at 1 year follow-up. The results indicate that IACT added during MMRP may enhance the treatment effects on pain-related psychological outcomes. Results also suggest that IACT as aftercare may strengthen the long-term effect of MMRP. However, adding a second pain treatment, IACT, to an already extensive pain treatment, MMRP, could be perceived as too comprehensive and might hence influence completion negatively. Further research on adverse events and negative effects could be helpful to improve adherence. Next step of implementation trials could focus on adding IACT before MMRP to improve psychological functioning and after MMRP to prolong its effect.

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  • 322.
    Bendrik, Regina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine. Reg Gavleborg, Gavle, Sweden..
    Kallings, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine. Swedish Sch Sport & Hlth Sci, Stockholm, Sweden..
    Broms, K.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Reg Gavleborg, Gavle, Sweden..
    Emtner, Morgan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Maximal Step-Up Test A New Functional Test In Hip Or Knee Osteoarthritis2016In: Osteoarthritis and Cartilage, ISSN 1063-4584, E-ISSN 1522-9653, Vol. 24, p. S471-S471Article in journal (Other academic)
  • 323.
    Bendrik, Regina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine. Centrum för klinisk forskning, Gävleborg, Centre for Research and Development, Gävleborg.
    Kallings, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Bröms, Kristina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Kunanusornchai, Wanlop
    Faculty of Physical Therapy, Mahidol University, Bangkok, Thailand.
    Emtner, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research.
    Physical activity on prescription in patients with hip or knee osteoarthritis: A randomized controlled trial2021In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 35, no 10, p. 1465-1477Article in journal (Refereed)
    Abstract [en]

    Objective: To evaluate whether physical activity on prescription, comprising five sessions, was more effective in increasing physical activity than a one-hour advice session after six months.

    Design: Randomized, assessor-blinded, controlled trial.

    Setting: Primary care.

    Subjects: Patients with clinically verified osteoarthritis of the hip or knee who undertook less than 150 minute/week of moderate physical activity, and were aged 40-74 years.

    Interventions: The advice group (n = 69) received a one-hour session with individually tailored advice about physical activity. The physical activity on prescription group (n = 72) received individually tailored physical activity recommendations with written prescription, and four follow-ups during six months.

    Main Measures: Patients were assessed at baseline and six months: physical activity (accelerometer, questionnaires); fitness (six-minute walk test, 30-second chair-stand test, maximal step-up test, one-leg rise test); pain after walking (VAS); symptoms (HOOS/KOOS); and health-related quality of life (EQ-5D).

    Results: One hundred four patients had knee osteoarthritis, 102 were women, and mean age was 60.3 ± 8.3 years. Pain after walking decreased significantly more in the prescription group, from VAS 31 ± 22 to 18 ± 23. There was no other between groups difference. Both groups increased self-reported activity minutes significantly, from 105 (95% CI 75-120) to 165 (95% CI 135-218) minute/week in the prescription group versus 75 (95% CI 75-105) to 150 (95% CI 120-225) in the advice group. Also symptoms and quality of life improved significantly in both groups.

    Conclusion: Individually tailored physical activity with written prescription and four follow-ups does not materially improve physical activity level more than advice about osteoarthritis and physical activity.

    Trial Registration: ClinicalTrials.gov (NCT02387034).

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  • 324.
    Bendrik, Regina
    et al.
    Department of Public Health and Caring Sciences, General Practice, Uppsala University, Uppsala, Sweden.; Centre for Research and Development, Uppsala University/ Region Gävleborg, Gävle, Sweden.
    Kallings, Lena V
    Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health. Department of Public Health and Caring Sciences, General Practice, Uppsala University, Uppsala, Sweden..
    Bröms, Kristina
    Department of Public Health and Caring Sciences, General Practice, Uppsala University, Uppsala, Sweden..
    Emtner, Margareta
    Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden..
    Follow-up of individualised physical activity on prescription and individualised advice in patients with hip or knee osteoarthritis: A randomised controlled trial.2024In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, article id 2692155241234666Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Compare the long-term effects of two different individualised physical activity interventions in hip or knee osteoarthritis patients.

    DESIGN: Randomised, assessor-blinded, controlled trial.

    SETTING: Primary care.

    SUBJECTS: Patients with clinically verified hip or knee osteoarthritis, <150 min/week with moderate or vigorous physical activity, aged 40-74.

    INTERVENTION: The advice group (n = 69) received a 1-h information and goalsetting session for individualised physical activity. The prescription group (n = 72) received information, goalsetting, individualised written prescription, self-monitoring, and four follow-ups.

    MAIN MEASURES: Physical activity, physical function, pain and quality of life at baseline, 6, 12 and 24 months.

    RESULTS: There were only minor differences in outcomes between the two groups. For self-reported physical activity, the advice group had improved from a mean of 102 (95% CI 74-130) minutes/week at baseline to 214 (95% CI 183-245) minutes/week at 24 months, while the prescription group had improved from 130 (95% CI 103-157) to 176 (95% CI 145-207) minutes/week (p = 0.01 between groups). Number of steps/day decreased by -514 (95% CI -567-462) steps from baseline to 24 months in the advice group, and the decrease in the prescription group was -852 (95% CI -900-804) steps (p = 0.415 between groups). Pain (HOOS/KOOS) in the advice group had improved by 7.9 points (95% CI 7.5-8.2) and in the prescription group by 14.7 points (95% CI 14.3-15.1) from baseline to 24 months (p = 0.024 between groups).

    CONCLUSIONS: There is no evidence that individualised physical activity on prescription differs from individualised advice in improving long-term effects in patients with hip or knee osteoarthritis.

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  • 325. Bendt, Martina
    et al.
    Forslund, Emelie Butler
    Hagman, Göran
    Hultling, Claes
    Sophiahemmet University.
    Seiger, Åke
    Franzén, Erika
    Gait and dynamic balance in adults with spina bifida2022In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 96, p. 343-350, article id S0966-6362(22)00188-6Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Spina bifida (SB) is a complex congenital malformation, often causing impaired gait performance depending on the level and extent of malformation. Research regarding gait and balance performance in adults with SB, has not been sufficiently described yet.

    RESEARCH QUESTION: What are the characteristics of spatiotemporal gait parameters and balance performance in adults with SB? Further, do persons with muscle function (MF) level 3 differ regarding gait and balance performance from those with MF level 1-2?

    METHODS: Cross-sectional observational study at an outpatient clinic. 41 adults with SB (18-65 years), who walked regularly. Spatiotemporal parameters of gait was assessed with the APDM system and balance performance with the Mini Balance Evaluation Systems Test (Mini-BESTest). Muscle strength in the legs was assessed with 0-5 manual muscle test, and participants were classified according to level of MF into groups MF1, MF2, and MF3. Two-sided t-test was used for parametric independent variables, and Cohen's d was used for effect sizes. The Mann-Whitney U test was used for non-parametric independent data and effect size was calculated by the z value (r = z/√n).

    RESULTS: Mean gait speed was 0.96 (SD 0.20) m/s and mean stride length 1.08 m (SD 0.17), individuals with MF3 showed significantly slower gaitspeed and shorter stride length (p < 0.05). Lumbar rotation was 21° (SD 11), and thoracic lateral sway 15° (IQR 15) with significantley difference (p < 0.001 and p < 0.05) for individuals in MF3. Mini-BESTest showed a mean score of 11.3 (SD 6.9), and individuals with MF3 showed significantly lower scores (p ≤ 0.001).

    SIGNIFICANCE: Gait and balance performance was reduced compared to normative data in almost all parameters, especially in persons with less muscle function. Increased knowledge from advanced gait analysis may help healthcare professionals to design rehabilitation programmes, in order to achieve and maintain a sustainable gait and balance performance.

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  • 326.
    Bendtsen, Marcus
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Garnett, Claire
    UCL, England.
    Toner, Paul
    Queens Univ Belfast, North Ireland.
    Shorter, Gillian W.
    Queens Univ Belfast, North Ireland.
    The Effect of Question Order on Outcomes in the Core Outcome Set for Brief Alcohol Interventions Among Online Help-Seekers: Protocol for a Factorial Randomized Trial2020In: JMIR Research Protocols, E-ISSN 1929-0748, Vol. 9, no 11, article id e24175Article in journal (Refereed)
    Abstract [en]

    Background: A core outcome set (COS) for trials and evaluations of the effectiveness and efficacy of alcohol brief interventions (ABIs) has recently been established through international consensus to address the variability of outcomes evaluated. Objective: This is a protocol for studies to assess if there are order effects among the questions included in the COS. Methods: The 10 items of the COS are organized into 4 clusters. A factorial design will be used with 24 arms, where each arm represents 1 order of the 4 clusters. Individuals searching online for help will be asked to complete a questionnaire, and consenting participants will be randomized to 1 of the 24 arms (double-blind with equal allocation). Participants will be included if they are 18 years or older. The primary analyses will (1) estimate how the order of the clusters of outcomes affects how participants respond and (2) investigate patterns of abandonment of the questionnaire. Results: Data collection is expected to commence in November 2020. A Bayesian group sequential design will be used with interim analyses planned for every 50 participants completing the questionnaire Data collection will end no more than 24 months after commencement, and the results are expected to be published no later than December 2023. Conclusions: Homogenizing the outcomes evaluated in studies of ABIs is important to support synthesis, and the COS is an important step toward this goal. Determining whether there may be issues with the COS question order may improve confidence in using it and speed up its dissemination in the research community We encourage others to adopt the protocol as a study within their trial as they adopt the ORBITAL (Outcome Reporting in Brief Intervention Trials: Alcohol) COS to build a worldwide repository and provide materials to support such analysis.

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  • 327.
    Benedictsson, Clara
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Åsenlöf: Physiotheraphy.
    Carlsson, Jonna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Åsenlöf: Physiotheraphy.
    Kartläggning av utförande av knäkontrollträning hos flickfotbollslag i åldrarna 12-17 år2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Anterior cruciate ligament (ACL) injuries are common in young female soccer players. There is evidence that neuromuscular training can reduce the risk of ACL injury with 64–88 %. Knee control is a neuromuscular training programme that was implemented in the national education for soccer coaches in 2010.

    Aim: The aim of the study was to examine how well girl soccer teams, ages 12–17, follow the existing recommendations regarding knee control training to prevent ACL injuries and if adherence was higher in teams where the coach was educated later than 2010.

    Method: The study design was a quantitative, non experimental cross-sectional study. A self-composed questionnaire was answered through e-mail by 33 coaches for girl soccer teams. Participants were a random sample of a larger population with a geographical spread across Sweden.

    Results: The result of the study was that four (12 %) coaches were placed in the category Following the recommendations fully, 21 (64 %) coaches in the category Following the recommendations partly and eight coaches in the category Do not follow recommendations. A difference in adherence to the programme Knee control could not be seen based on if the coach had completed the national education for soccer coaches later than 2010 or lacked this education.

    Conclusion: The conclusion of the study was that the majority of coaches for girl soccer teams, ages 12–17, followed the recommendations partly for performance of the programme Knee control. No difference could be seen in adherence to the programme Knee control based on the coach’s education.

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  • 328. Bengtsson, Karin
    et al.
    Forsblad-d'Elia, Helena
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology. Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden .
    Lie, Elisabeth
    Klingberg, Eva
    Dehlin, Mats
    Exarchou, Sofia
    Lindstrom, Ulf
    Askling, Johan
    Jacobsson, Lennart T. H.
    Risk of cardiac rhythm disturbances and aortic regurgitation in different spondyloarthritis subtypes in comparison with general population: a register-based study from Sweden2018In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 77, no 4, p. 541-548Article in journal (Refereed)
    Abstract [en]

    Objectives: To describe the incidence of atrioventricular (AV) block II-III, atrial fibrillation (AF), pacemaker implantation (PM) and aortic regurgitation in patients with ankylosing spondylitis (AS), undifferentiated spondyloarthritis (uSpA) and psoriatic arthritis (PsA) compared with the general population (GP) and with each other. Methods: A prospective nationwide study with cohorts of patients with AS (n=6448), PsA (n=16063) and uSpA (n=5190) and a GP (n=266435) cohort, identified in 2001-2009 in the Swedish National Patient and Population registers. Follow-up began on 1 January 2006 and ended at event, death, emigration or 31 December 2012. Age-standardised and sex-standardised incidence rates and hazard ratios (HRs) were calculated. Results: The highest incidence rates were noted for AF (5.5-7.4 events per 1000 person-years), followed by PM (1.0-2.0 events per 1000 person-years). HRs for AV block, AF, PM and aortic regurgitation were significantly increased in AS (HRs 2.3, 1.3, 2.1 and 1.9), uSpA (HRs 2.9, 1.3, 1.9 and 2.0) and PsA (HRs 1.5, 1.5, 1.6 and 1.8) compared with the GP cohort. The highest HRs were seen for AV block in male uSpA (HR 4.2) and AS (HR 2.5) compared with GP. Compared with PsA, significantly increased HRs were noted for PM (HR 1.5) in AS and for AV block (HR 1.8) in uSpA. Conclusions: Patients with SpA are at increased risk of aortic regurgitation, cardiac rhythm disturbances and, as a probable consequence, also PM. Particularly for AF, the most common arrhythmia, increased caution is warranted, whereas AV block should be looked for especially in men with AS or uSpA.

  • 329.
    Bengtsson, Patrik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Postoperativ knäsvullnad efter främre korsbandsrekonstruktion: - en jämförelse mellan standard- och accelererad rehabilitering.2013Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Nu för tiden är det vanligt att använda sig av så kallad accelererad rehabilitering efter främre korsbandsrekonstruktion. Den accelererade rehabiliterings påverkan på uttöjning av det nya korsbandsgraftet och lårmuskelstyrka är väl kända. Däremot är kunskapen om hur accelererad rehabilitering påverkar svullnad i knäleden mer begränsad.

    Syfte: Att undersöka om det finns någon skillnad avseende knäledssvullnad efter främre korsbandsrekonstruktion vid ett standard- och ett accelererat rehabiliteringsprogram.

    Studiedesign: Sekundäranalys av randomiserad kontrollerad studie.

    Material och metod: Etthundra sextioen främre korsbandsrekonstruerade patienter med patellar- eller hamstringssena randomiserades till standard- och ett accelererat rehabiliteringsprogram. Nittio patienter, standard rehabilitering (n=29) och accelererad rehabilitering (n=61) inkluderades för beräkning av svullnad, vid baseline, 1 vecka postoperativt. Svullnad definierades som skillnad i omkrets mätt med måttband av icke opererat knä jämfört med opererat knä. Svullnad beräknades vid vecka 1 och månad 1, 2, 3 och 4 postoperativt.

    Resultat: Det var ingen signifikant skillnad avseende knäsvullnad vid jämförelse  mellan standard- och ett accelererat rehabiliteringsprogram vid något av uppföljningstillfällena.

    Slutsats: Denna studie visar att träning enligt ett accelererat rehabiliteringsprogram efter främre korsbandrekonstruktion inte ökar knäsvullnad signifikant jämfört med ett standard rehabiliteringsprogram. Gruppen som tränat enligt ett accelererat rehabiliteringsprogram uppvisade dock en något större knäsvullnad suprapatellärt.

  • 330.
    Bengtsson, Victor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    The three-dimensional movement patterns in the thoracolumbar and lumbopelvic spine during the deadlift exercise2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Marklyft är en vanlig styrketräningsövning. Det saknas emellertid studier av ryggradens rörelsemönster under utförandet av marklyft. Syftet med den här studien var att kvantifiera ryggradens tredimensionella rörelsemönster under utförandet av marklyft och vid vanehållning i de thorakolumbala och lumbosakrala regionerna samt studera inverkan av kön.

    Tjugofyra tävlande lyftare, 14 män och 10 kvinnor med 1 repetition maximum (1RM) i marklyft på 162.5 ± 55.5 kg, utförde tre repetitioner av tunga marklyft. Ryggens tredimensionella rörelsemönster, rörelseomfång (ROM) och kurvatur i thorakolumbala (T11-L2) och lumbosakrala (L2-S2) regionerna mättes med rörelsesensorer.

    Resultatet visade att rörelser sker i sagittal-, frontal- och horizontalplanet i thorakolumbala (ROM = 11.8 ± 7.6, 4.3 ± 2.8, and 3.4 ± 1.6 degrees) och lumbosakrala regionerna (ROM = 21.7 ± 6.5, 2.8 ± 1.7, och 2.8 ± 1.4 grader) under marklyftsutförandet. I jämförelse med vanehållningen ändrades ryggens kurvatur i start- och stoppläget mot ett mer flekterat läge. Signifikanta skillnader hittades mellan könen avseende vanehållning, startläge och ROM.

    Sammanfattningsvis ändras ryggens kurvatur under utförandet av tunga marklyft i sagittalplanet samt att vanehållningen och rörelsemönster skiljer sig mellan män och kvinnor.

  • 331.
    Bengtsson, Victor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    The three-dimensional thoracolumbar and lumbopelvic spinal alignment during the squat exercise: a comparison between powerlifters and weightlifters2018Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Introduction: The squat is a common strength training exercise used by athletes for injury-reduction, rehabilitation, muscle hypertrophy, and performance-enhancement. Aims: To quantify the three-dimensional spinal alignment in the thoracolumbar and lumbopelvic spine during the squat exercise, compare the alignment during the squat to the alignment during habitual posture, determine whether powerlifters and weightlifters differ in these aspects, and to examine the absolute and relative intrarater test-retest reliability of the spinal alignment during the squat exercise. Methods: Twenty-three competitive lifters: 13 powerlifters and 10 weightlifters were included. They performed the squat exercise with three repetitions at 70% of one-repetition maximum. Three-dimensional thoracolumbar (T11-L2) and lumbopelvic (L2-S2) spinal alignment and range of motion (ROM) were measured using inertial measurement units. Absolute reliability was estimated with minimal detectable change (MDC). Relative reliability was calculated using the intraclass correlation coefficient (ICC). Results: No statistically significant group*time interaction was found for thoracolumbar or lumbopelvic spinal alignment in neither dimension. However, statistically significant interactions for time was found in all three dimensions in thoracolumbar and lumbopelvic spinal alignment. During the squat, adjustments were made in all three dimensions in both the thoracolumbar and lumbopelvic spinal alignment. The MDC ranged between 3.4-27.4° and ICC between 0.91-1.00. Conclusion: These findings suggest that that powerlifters and weightlifters assumes a less lordotic thoracolumbar spinal alignment when the loaded barbell is placed on the upper back and that further adjustments are made in the thoracolumbar and lumbopelvic spinal alignment during the squat. Despite high relative reliability, the MDC was considered high.

  • 332.
    Bengtsson, Victor
    et al.
    Department of Neuroscience, Uppsala University, Sweden.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Öhberg, Fredrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Berglund, Lars
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Thoracolumbar and lumbopelvic spinal alignment during the deadlift exercise: a comparison between men and women2022In: International Journal of Sports Physical Therapy, E-ISSN 2159-2896, Vol. 17, no 6, p. 1063-1074Article in journal (Refereed)
    Abstract [en]

    Background: A neutral spinal alignment is considered important during the execution of the deadlift exercise to decrease the risk of injury. Since male and female powerlifters experience pain in different parts of their backs, it is important to examine whether men and women differ in spinal alignment during the deadlift.

    Objectives: The purpose of this study was to quantify the spinal alignment in the upper (thoracolumbar, T11-L2) and lower (lumbopelvic, L2-S2) lumbar spine during the deadlift exercise in male and female lifters. Secondary aims were to compare lumbar spine alignment during the deadlift to standing habitual posture, and determine whether male and female lifters differ in these aspects.

    Study Design: Observational, Cross-sectional.

    Methods: Twenty-four (14 men, 10 women) lifters performed three repetitions of the deadlift exercise using 70% of their respective one-repetition maximum. Spinal alignment and spinal range of motion were measured using three inertial measurement units placed on the thoracic, lumbar and sacral spine. Data from three different positions were analyzed; habitual posture in standing, and start and stop positions of the deadlift, i.e. bottom and finish position respectively.

    Results: During the deadlift, spinal adjustments were evident in all three planes of movement. From standing habitual posture to the start position the lumbar lordosis decreased 13° in the upper and 20° in the lower lumbar spine. From start position to stop position the total range of motion in the sagittal plane was 11° in the upper and 22° in the lower lumbar spine. The decreased lumbar lordosis from standing habitual posture to the start position was significantly greater among men.

    Conclusions: Men and women adjust their spinal alignment in all three planes of movement when performing a deadlift and men seem to make greater adjustments from their standing habitual posture to start position in the sagittal plane. Level of Evidence 3.

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  • 333.
    Bengtsson, Victor
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Physiotherapy and behavioral medicine.
    Aasa, Ulrika
    Umeå Univ, Community Med & Rehabil, Umeå, Sweden..
    Öhberg, Fredrik
    Umeå Univ, Dept Radiat Sci, Umeå, Sweden..
    Berglund, Lars
    Umeå Univ, Community Med & Rehabil, Umeå, Sweden..
    Thoracolumbar And Lumbopelvic Spinal Alignment During The Deadlift Exercise: A Comparison Between Men And Women2022In: International Journal of Sports Physical Therapy, E-ISSN 2159-2896, Vol. 17, no 6, p. 1063-1074Article in journal (Refereed)
    Abstract [en]

    Background: A neutral spinal alignment is considered important during the execution of the deadlift exercise to decrease the risk of injury. Since male and female powerlifters experience pain in different parts of their backs, it is important to examine whether men and women differ in spinal alignment during the deadlift.

    Objectives: The purpose of this study was to quantify the spinal alignment in the upper (thoracolumbar, T11-L2) and lower (lumbopelvic, L2-S2) lumbar spine during the deadlift exercise in male and female lifters. Secondary aims were to compare lumbar spine alignment during the deadlift to standing habitual posture, and determine whether male and female lifters differ in these aspects.

    Study Design: Observational, Cross-sectional.

    Methods: Twenty-four (14 men, 10 women) lifters performed three repetitions of the deadlift exercise using 70% of their respective one-repetition maximum. Spinal alignment and spinal range of motion were measured using three inertial measurement units placed on the thoracic, lumbar and sacral spine. Data from three different positions were analyzed; habitual posture in standing, and start and stop positions of the deadlift, i.e. bottom and finish position respectively.

    Results: During the deadlift, spinal adjustments were evident in all three planes of movement. From standing habitual posture to the start position the lumbar lordosis decreased 13 degrees in the upper and 20 degrees in the lower lumbar spine. From start position to stop position the total range of motion in the sagittal plane was 11 degrees in the upper and 22 degrees in the lower lumbar spine. The decreased lumbar lordosis from standing habitual posture to the start position was significantly greater among men.

    Conclusions: Men and women adjust their spinal alignment in all three planes of movement when performing a deadlift and men seem to make greater adjustments from their standing habitual posture to start position in the sagittal plane.

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  • 334.
    Bengtsson, Victor
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Berglund, Lars
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Social Sciences, Umeå Sport Sciences Center.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Social Sciences, Umeå Sport Sciences Center. Medfit, Primary Care Rehabilitation and Fitness Centre, Stockholm, Sweden.
    Narrative review of injuries in powerlifting with special reference to their association to the squat, bench press and deadlift2018In: BMJ Open Sport & Exercise Medicine, E-ISSN 2055-7647, Vol. 4, article id e000382Article in journal (Refereed)
    Abstract [en]

    Pain and injuries are considered a common problem among elite athletes and recreational lifters performing the squat, bench press and deadlift. Since all three lifts engage multiple joints and expose the lifters' bodies to high physical demands often several times a week, it has been suggested that their injuries might be related to the excessively heavy loads, the large range of motion during the exercises, insufficient resting times between training sessions and/or faulty lifting technique. However, no previous article has summarised what is known about specific injuries and the injury aetiology associated with the three lifts. Thus, the aim of this narrative review was to summarise what is known about the relationships between the powerlifting exercises and the specific injuries or movement impairments that are common among lifters and recreationally active individuals.

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  • 335.
    Bengtsson, Victor
    et al.
    Department of Women's and Children's Health, Uppsala university.
    Berglund, Lars
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Öhberg, Fredrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Thoracolumbar and Lumbopelvic Spinal Alignment During the Barbell Back Squat: A Comparison Between Men and Women2023In: International Journal of Sports Physical Therapy, E-ISSN 2159-2896, Vol. 18, no 4, p. 820-830Article in journal (Refereed)
    Abstract [en]

    Background:  Maintaining neutral spinal alignment is considered important when performing the barbell back squat exercise. Since male and female lifters may differ in injury location it is important to examine whether they differ in spinal alignment during the back squat.

    Objectives:  The study aimed to quantify the spinal alignment in the upper and lower lumbar spine during the barbell back squat exercise in male and female lifters. Secondary aims were to compare alignment during the back squat to standing habitual lumbar spine alignment and determine whether male and female lifters differ in these aspects.

    Study design:  Observational, Cross-sectional.

    Methods:  Competitive power- and weightlifters were recruited and performed three repetitions of the barbell back squat exercise using a load equivalent to 70% of their one-repetition maximum. Spinal alignment and range of motion were measured using inertial measurement units placed on the thoracic, lumbar and sacral spine. Data was presented descriptively and comparisons between men and women as well as spinal alignment in four different positions were done with a factorial repeated measures analysis of variance.

    Results:  Twenty-three (14 males, 9 females) were included. During execution of the squat, spinal alignment adjustments in the lumbar spine were made in all three planes of movement, compared to the start position, in both male and female lifters. Compared to their standing habitual posture, all lifters adjusted their upper lumbar spine to a less lordotic position when in the start position of the back squat (standing upright with the barbell on their back). Only male lifters assumed a less lordotic alignment in their lower lumbar spine in the start position compared their habitual posture.

    Conclusions:  Adjustments of spinal alignment, predominantly in the sagittal plane, are made during execution of the back squat in both male and female lifters. Further, lifters adopt a less lordotic alignment with a heavy barbell on their upper back, more so in male than female lifters. In conclusion, it seems that spinal alignment changes noticeably during the barbell back squat.

    Level of evidence:  3

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  • 336.
    Benitez, Marcus
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Frantzén, Love
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Förväntat resultat (outcome expectations) av regelbunden fysisk aktivitet hos äldre.2011Independent thesis Basic level (degree of Bachelor), 15 credits / 22,5 HE creditsStudent thesis
    Abstract [en]

    Purpose: The purpose of this study was to examine outcome expectations in terms of physical, self-evaluative and social expectations of regular physical activity/exercise in physically active or physically inactive older adults, and compare the two groups and see if any difference existed.Method: The participants were 32 conveniently selected individuals, representing the population elderly (> 65 years) and healthy individuals who are regularly physically active or inactive. The participants answered a questionnarie regarding their level of physical activity during the last 12 months which divided them into two groups, physically active or physically inactive. The Multidimensional Outcome Expectations for Exercise Scale (MOEES) questionnaire was then used to measure the participant´s level of outcome expectations of regular physical activity/exercise.

    Results: The regularly physically active participants had higher scores on MOEES, in terms of physical expectations than participants who were physically inactive. No significant difference where seen between the two when comparing the total score of MOEES and the subgroups self-evaluative, and social expectations for regular physical activity/exercise.

    Conclusion: This study showed that there in older adults, is a relation between being physically active and having higher physical outcome expectations of physical activity/exercise. Further studies which examines outcome expectations in terms of physical, self-evaluative and social expectations of regular physical activity/exercise, in physically active or physically inactive older adults is warranted.

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  • 337.
    Bentzer, Linda
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hedlund, Linnea
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Functional movement screen, skadeförekomst och träningsmängd hos kvinnliga innebandyspelare2012Student thesis
  • 338.
    Berg, Anette
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Boll, Cristina
    Mälardalen University, School of Health, Care and Social Welfare.
    Omvårdnadspersonalens upplevelser av patientförflyttningar efter förflyttningsutbildning: En kvalitativ intervjustudie2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    SAMMANFATTNING

    Bakgrund:

    Utbildning i förflyttningsteknik och rehabiliterande arbetssätt genomförs för

    personalen i en västsvensk kommun för att förebygga skador och bibehålla patientens

    förmågor. Hur personalen upplever arbetet med patientförflyttningar efter genomgången

    utbildning är okänt.

    Syfte:

    Att ta reda på hur omvårdnadspersonal upplever arbetet med patientförflyttningar

    efter utbildning i förflyttningsteknik och rehabiliterande arbetssätt.

    Metod:

    Studien gjordes som en kvalitativ intervjustudie med en induktiv ansats. Sex

    kvinnor som arbetade inom särskilt boende eller hemtjänst och som genomgått en utbildning

    i förflyttningsteknik och rehabiliterande arbetssätt rekryterades ändamålsenligt och deltog i

    en semistrukturerad intervju. Insamlad data analyserades med kvalitativ innehållsanalys.

    Resultat

    : Analysen resulterade i fem kategorier och åtta underkategorier.

    Omvårdnadspersonalen upplevde att det var viktigt med säkerhet för personal och patient,

    att de var medvetna om patientens medverkan, att arbetet var fysiskt utmanande, att arbetet

    var psykiskt utmanande och att goda förutsättningar fanns i omgivningen.

    Slutsats:

    Omvårdnadspersonalen upplevde att de använder kunskaper från utbildningen i

    den aktuella kommunen och att de upplevde att utbildningar i förflyttningsteknik och

    rehabiliterande arbetssätt har betydelse för arbetet med patientförflyttningar, men att

    återkommande utbildningstillfällen behövs för att hålla kunskaperna aktuella och

    arbetssättet levande.

    Nyckelord

    : förflyttningsteknik, kvalitativ metod, rehabiliterande arbetssätt, utbildning,

    vårdpersonal

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  • 339.
    Berg, Charlotte
    et al.
    Sveriges lantbruksuniversitet.
    Juuso, Päivi
    Luleå Tekniska Universitet.
    Lerner, Henrik
    Marie Cederschiöld University, Department of Health Care Sciences.
    Lidfors, Lena
    Sveriges lantbruksuniversitet.
    One Health: Samspelet mellan human-, djur- och ekosystemhälsa2022In: Vård, omsorg och rehabilitering utomhus: Teori, praktik och nya perspektiv / [ed] Åsa Engström; Päivi Juuso; Madeleine Liljegren; Lotta Lundmark Alfredsson; Anna Bengtsson, Lund: Studentlitteratur AB, 2022, p. 97-112Chapter in book (Other academic)
    Abstract [sv]

    Sambandet mellan människors, djurs och ekosystems hälsa är viktigt för att målet "En gemensam hälsa" skall uppnås. I detta kapitel förklarar vi vad One Health är, vilka teorier som ligger bakom One Health, vilka centrala begrepp och perspektiv som är viktiga för området och forskning om kopplingen mellan människors och djurs hälsa, människors och miljöns hälsa, samt djurens och miljöns hälsa. Vi tar upp olika aspekter rörande lantbruksdjur, sällskapsdjur och vilda djur och hur det sätt vi föder upp och sköter dem på påverkar miljön, och i det långa loppet även människor. Vi beskriver hur djurs sjukdomar kan påverka människors hälsa och omvänt, samt One Health-perspektivets koppling till vård, omsorg och rehabilitering utomhus.

  • 340.
    Berg, Hans ten
    et al.
    Trafikanalys, Sweden.
    Klüft, Carolina
    Generation Pep, Sweden.
    Lindqvist, Anna-Karin
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    Nilsson, Per
    Gymnastik- och idrottshögskolan, Sweden.
    Niska, Anna
    Statens väg- coh transportforskningsinstitut, Sweden.
    Rutberg, Stina
    Luleå University of Technology, Department of Health, Learning and Technology, Health, Medicine and Rehabilitation.
    Pellas, Maria
    Cykelfrämjandet, Sweden.
    Stigell, Erik
    Naturvårdsverket, Sweden.
    DN Debatt: Sluta skjutsa barnen till skolan - hälsa går före rädsla2023In: Dagens Nyheter. (DN), ISSN 1101-2447, no 2023-02-18Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Våra barn blir alltmer stillasittande, vilket får livslånga konsekvenser. En av de enklaste lösningarna står föräldrar i vägen för – på grund av rädsla. Föräldrarnas välvilja är i själva verket ett tydligt hot mot barnens hälsa, både i trafiken och genom livet. Sverige behöver en ny nationell rekommendation för aktiva skolresor, skriver åtta forskare och organisationer.

  • 341.
    Berg, Ida Linnea
    Luleå University of Technology, Department of Health Sciences.
    Att implementera nya arbetssätt i hemrehabiliteringspraxis: Multipel fallstudie2017Independent thesis Advanced level (degree of Master (Two Years)), 80 credits / 120 HE creditsStudent thesis
    Abstract [en]

    Title: To Implement New Strategies in Rehabilitation at Home - Multiple Case Study The aim of this study was to evaluate and describe the implementation process of a Home- rehabilitation-intervention. The new intervention was client-focused, used re-ablement with common goals in order to strengthen the clients’ independence and ability to live at home. Multiple case study was chosen as method and both quantitative and qualitative data was collected and analyzed. Eight clients were included in the study and they took part of a four- week long rehabilitation intervention at home. Interviews with these clients and their care staff were conducted and then analyzed with qualitative content analysis. Measurement before and after the intervention were SPPB, FRAT, Barthel and the Goal Attainment scale, GAS. The adherence, loss of clients to the intervention and the amount of home visits from care staff was also analyzed. As a model for implementation the PDSA- cycle was used. The results show that the clients and the staff felt positive about rehabilitation at home, and that the clients achieved goals and got positive results on function and independence, but that there were weaknesses in the implementation of re- ablement and participation. The care- staff saw that lack of motivation amongst the clients and lack of time were barriers to rehabilitation at home. They also wanted to improve the communication and the cooperation between care-staff and rehabilitation-staff because they saw that the rehabilitation at home was valuable when it worked properly. In the future development of the intervention and implementation of these multiprofessional tasks we will start with these factors. This study can also be seen as a guideline for others that wish to implement new strategies in to clinical practice. The use of development tools and the importance of studying the implementation from a broad perspective is emphasized with this study. Searchwords: Rehabilitation At Home, Implementation, Multiple Case Study, PDSA-cycle 

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  • 342.
    Bergander, Andreas
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Åsenlöf: Physiotheraphy.
    Rask, Jesper
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Åsenlöf: Physiotheraphy.
    Samband mellan spänst och långdistanslöpning hos unga elitaktiva orienterare- en tvärsnittsstudie2020Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Running economy (RE) is known to be a strong indicator for performance on long distance running. RE is improved by plyometric training through an increase in stiffness in the musculotendinous system. Stretch shorten cycle (SSC) is a function in the muscle where a contraction is preceded by a stretch or an eccentric action. Orienteering is an endurance sport where RE is important for performance. Purpose: The purpose of the study was to examine whether or not there is a correlation between jumping performance and performance on long distance running in young elite orienteers 16-19 years old. Methods: 34 young elite orienteers did drop jumps (DJ) and countermovement jumps (CMJ) on an ErgoJump Bosco System contact mat. In conjunction with the jumps time on a 5 or 7 km (for girls and boys respectively) running test was collected. Pearson's correlation test was then used to determine the correlation between jumping height and running velocity. Results: The jumping height of the CMJ was on average 30,46 cm and 28,24 cm for the DJ. The running velocity was on average 14,19 km/h. Pearson's correlation test for the correlation between DJ and running velocity was 0,463 and for the correlation between CMJ and running velocity it was 0,461. In both cases the significance was 0,006. Conclusions: There is a significant, moderate to strong correlation between jump height in DJ and CMJ and performance on long distance running on a running test in young elite orienteers.

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  • 343.
    Bergdahl, Lisa
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Isaksson, Emma
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Äldre personers erfarenheter av fysisk aktivitet under covid-19 pandemin: -En kvalitativ intervjustudie2022Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: För att bibehålla hälsa och kroppslig funktion är det viktigt att äldre inte blir stillasittande utan kan fortsätta med sin fysiska aktivitet. Covid-19 pandemin har genom råd och restriktioner påverkat och begränsat vardagen, speciellt för äldre personer då de tillhör riskgrupp, och i vissa fall försvårat för fysisk aktivitet. Syftet med denna uppsats var att undersöka äldres erfarenheter av fysisk aktivitet under Covid-19 pandemin.

    Metod: Detta är en kvalitativ studie med en induktiv ansats. Kvalitativ innehållsanalys användes för att systematiskt bearbeta 11 individuella intervjuer gjorda på äldre personer med hjälp av en semistrukturerad intervjuguide.

    Resultat: Deltagarnas erfarenhet av fysisk aktivitet under pandemin belyses i fyra kategorier; Begränsas i urval för fysisk aktivitet genom restriktioner för covid-19, Upplever negativa effekter av pandemin, Skapar strategier för fysisk aktivitet samt Nyttjar personliga förmågor för fortsatt fysisk aktivitet. Resultatet visar att samtliga deltagare har fortsatt vara fysiskt aktiva men har som en följd av pandemin tvingats anpassa livet och aktiviteterna utifrån de förutsättningar som varit.

    Slutsats: Deltagarna i denna studie påverkades av pandemin i form av att deras vardag begränsades av restriktioner och utbudet av aktiviteter förändrades. De visade dock på god förmåga att anpassa sig och forma nya strategier för att möjliggöra fortsatt fysisk aktivitet. Individens egen motivationsförmåga samt kunskap om betydelsen av fysisk aktivitet möjliggjorde denna anpassning. Erfarenheterna från denna studie kan vara till hjälp för att i framtiden bättre förstå hur äldre ska kunna bibehålla sin fysiska kapacitet och hälsa under en pandemi.

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  • 344.
    Berger-Estilita, Joana
    et al.
    CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine , University of Porto , Porto , Portugal; b Department of Emergency and Intensive Care Medicine , Algarve University Hospital Centre , Faro , Portugal.
    Granja, Cristina
    CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine , University of Porto , Porto , Portugal; b Department of Emergency and Intensive Care Medicine , Algarve University Hospital Centre , Faro , Portugal; c Department of Biomedical Sciences and Medicine , University of Algarve , Faro , Portugal.
    Gonçalves, Hernâni
    CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine , University of Porto , Porto , Portugal; d Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine , University of Porto , Porto , Portugal.
    Dias, Claudia Camila
    CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine , University of Porto , Porto , Portugal; d Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine , University of Porto , Porto , Portugal.
    Aragão, Irene
    Intensive Care Unit, Hospital Santo Antonio , Porto University Hospital Center , Porto , Portugal.
    Costa-Pereira, Altamiro
    CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine , University of Porto , Porto , Portugal; d Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine , University of Porto , Porto , Portugal.
    Orwelius, Lotti
    Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, ANOPIVA US. Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine , University of Porto , Porto , Portugal.
    A new global health outcome score after trauma (GHOST) for disability, cognitive impairment, and health-related quality of life: data from a prospective cross-sectional observational study2019In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 33, no 7, p. 922-931Article in journal (Refereed)
    Abstract [en]

    Background:Trauma patients experience morbidity related to disability and cognitive impairment that negatively impact their health-related quality of life (HRQoL). We assessed the impact of trauma on disability, cognitive impairment and HRQoL after intensive care in patients with and without traumatic brain injury (TBI) and created a predictive score to identify patients with worse outcome. Methods:We identified 262 patients with severe trauma (ISSamp;gt;15) admitted to the emergency room of a level 1 trauma center. Patients above 13 years were included. After 6 months, patients were assessed for disability, cognitive impairment, and HRQoL. A global health outcome score after trauma (GHOST) was obtained through the combination of these domains. Logistic regression analysis was considered for the effect of demographic, trauma and hospital factors on global outcome. p amp;gt; 0.05. Statistics performed with SPSS 23.0. Results:Patients with the worst outcomes were older and had a longer length of Intensive Care Unit (ICU) stay. The effect of gender was found in all "GHOST dimensions". TBI was not significantly associated with worse outcome. Conclusions:No significant differences were seen on disability, cognitive impairment and decreased HRQoL in patients with or without TBI. Our GHOST score showed that female gender, older age, and longer ICU stay were significantly associated with the worst outcome. Abbreviations: AIS: Abbreviated Injury Scale; EQ-5D: EuroQol 5-dimensions; EQ-5D-3L: EuroQol 5-dimensions 3-levels; GCS: Glasgow Coma Scale; GOSE: Glasgow Outcome Scale Extended; HRQoL: Health-Related Quality of Life; ICU: Intensive Care Unit; ISS: Injury Severity Score; MMS: Mini Mental State; NICE: National Institute for Health and Care Excellence; RTS: Revised Trauma Score; TBI: Traumatic brain injury; TRISS: Trauma Injury Severity Score; VAS: Visual Analogue Scale.

  • 345.
    Berggren, Alvin
    et al.
    Luleå University of Technology, Department of Health Sciences.
    Pettersson, Kristoffer
    Luleå University of Technology, Department of Health Sciences.
    Hur valid är mätning av postural kontroll med Wii Balance Board i jämförelse med en Kistler Force Plate?: How valid is it to measure postural control with  Wii Balance Board in comparison to a Kistler Force Plate?2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Det finns funktionella tester med varierande svårighetsgrad för att utvärdera patienters balans i kliniken. Dessa tester kan dock endast visa på balansförmåga i grova drag, exempelvis om man kan ställa sig upp från en stol eller klarar att stå på ett ben utan att falla. För mer exakta metoder går det att använda sig utav en kraftplatta. Det har det tidigare undersökts huruvida en Wii Balance Board kan fungera som ett valitt substitut för en standardiserad kraftplatta då denna är lättare och mindre kostsam. Det har dock aldrig undersökts med ett testprotokoll där proprioceptionen hos deltagaren försökt påverkas. Syfte: Öka kunskapen om validiteten för Wii Balance Board i jämförelse med Kistler Force Plate vad gäller mätning av postural kontroll i stillastående med och utan nackrotation via bål och underkropp. Metod: Experimentell metod med 15 deltagare som genomförde tre olika test i stillastående, dels med nacken i neutralposition och dels roterad 45 grader genom att rotera bål och underkropp. Posturala svajet mättes med Wii Balance Board och kraftplatta samtidigt. Skillnader i resultaten uträknades och analyserades sedan med Bland-Altman plots metod och presenterades i grafer. Resultat: Generellt framkom mycket god samstämmighet mellan utrustningarna, dock påvisades anmärkningsvärt större avvikelser för tre av deltagarna. Diskussion: Tekniska problem som har påverkat experimentet har upptäckts under studiens gång och har tagits med för framtida kunskap. Även att standardisera de tester som genomfördes med mer detaljerade och strikta instruktioner för deltagaren att stå stilla är viktigt för att inte få onödigt posturalt svaj. Konklusion: Validiteten för Wii Balance Board bedömer vi som god då resultatet mellan plattorna stämde överens i hög grad. Det är dock viktigt att ta hänsyn till upptäckta avvikelser som går att undvika vid framtida upprepade försök tack vare kunskapen från denna studie.

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  • 346.
    Berggren, Emelie
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Larsson, Maria
    Mälardalen University, School of Health, Care and Social Welfare.
    Individuellt anpassat träningsprogram och/ eller gångträning i Syfte att utveckla gångförmågan hos äldre2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:  Since the population is aging the decrease in muscle function and balance impairments leads to increased disable. Which has a negative impact on walking ability, though through functional training, by training muscle strength and balance can enhance walking ability in elderly.

    Aim: The purpose of the study is to investigate how elderly people walking ability, self-efficacy and any anxiety about going, influenced by two different eight-week interventions within municipal operations, and how adherence to exercise is influenced by self-efficacy and anxiety.

    Method: The study design is an experimental variant of the pretest-posttest control group design. Nineteen participants’ ≥65 years recruited consecutively through selection. Test results from TUG, self-selected walking speed, and estimates on anxiety and self-efficacy before going was collected.

    Result: No significant difference (p>0, 05) occurred between or within groups for the test variables. The correlation analysis showed none, low, moderate correlation, both positive and negative but no significant correlations was observed.

    Conclusion: The results of the study can’t be generalized to a larger population, but can be the basis for further studies with a larger sample to be randomized on the basis of population.  More studies are needed to investigate if only walking exercise is effective for developing the walking ability.

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  • 347.
    Berggren, Monica
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Karlsson, Åsa
    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. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Englund, Undis
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Olofsson, Birgitta
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics. Umeå University, Faculty of Medicine, Department of Nursing.
    Nordstöm, Peter
    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.
    Stenvall, Michael
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Effects of geriatric interdisciplinary home rehabilitation on complications and readmissions after hip fracture: a randomized controlled trial2019In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 33, no 1, p. 64-73Article in journal (Refereed)
    Abstract [en]

    Objective: This pre-planned secondary analysis of geriatric interdisciplinary home rehabilitation, which was initially found to shorten the postoperative length of stay in hospital for older individuals following hip fracture, investigated whether such rehabilitation reduced the numbers of complications, readmissions, and total days spent in hospital after discharge during a 12-month follow-up period compared with conventional geriatric care and rehabilitation.

    Design: Randomized controlled trial.

    Setting: Geriatric department, participants' residential care facilities, and ordinary housing.

    Subjects: Individuals aged ⩾70 years with acute hip fracture (n = 205) were included.

    Intervention: Geriatric interdisciplinary home rehabilitation was individually designed and aimed at early discharge with the intention to prevent, detect, and treat complications after discharge.

    Main measures: Complications, readmissions, and days spent in hospital were registered from patients' digital records and interviews conducted during hospitalization and at 3- and 12-month follow-up visits.

    Results: No significant difference in outcomes was observed. Between discharge and the 12-month follow-up, among participants in the geriatric interdisciplinary home rehabilitation group (n = 106) and control group (n = 93), 57 (53.8%) and 44 (47.3%) had complications (P = 0.443), 46 (43.4%) and 38 (40.9%) fell (P = 0.828), and 38 (35.8%) and 27 (29.0%) were readmitted to hospital (P = 0.383); the median total days spent in hospital were 11.5 and 11.0 (P = 0.353), respectively.

    Conclusion: Geriatric interdisciplinary home rehabilitation for older individuals following hip fracture resulted in similar proportions of complications, readmissions, and total days spent in hospital after discharge compared with conventional geriatric care and rehabilitation.

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  • 348.
    Berggren, Tilda
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Åkerström, Pauline
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Effekter av fysisk aktivitet hos gravida kvinnor med ländryggs- och/eller bäckensmärta: En systematisk litteraturstudie2021Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Graviditetsrelaterad ländryggs- och bäckensmärta är ett folkhälsoproblem för större andelen gravida i samhället. Mer än två tredjedelar av gravida kvinnor upplever ländryggssmärta och nästan en femtedel upplever bäckensmärta. 

    Syfte: Att utvärdera evidensen för effekter av fysisk aktivitet som intervention för ländryggs- och/eller bäckensmärta hos gravida kvinnor.

    Metod: Litteratursökningen i denna systematiska litteraturstudie utfördes i tre olika databaser, PubMed, Cinahl samt SPORTDiscus. Studien inkluderade randomiserade kontrollerade studier samt artiklar inom spannet av 15 år. Studier som innefattade ländryggs- och/eller bäckensmärta under graviditet samt fysisk aktivitet inkluderades. Urvalsprocess av relevanta artiklar utfördes enligt PRISMAS flödesschema. Kvalitetsgranskning gjordes enligt PEDro skalan. 

    Resultat: Tretton artiklar inkluderades i litteraturstudien efter litteratursökning samt relevansbedömning. Artiklarna bedömdes ha moderat till bra kvalitet enligt PEDro- skalan. Interventionerna var lika i flera av studierna men överlag skiljde sig flera av studiernas interventioner åt. Tio studier hade variationer av träningsprogram som intervention där tre studier följde American College of Obstetricians and Gynecologists (ACOG) och en studie följde Royal College of Obstetricians and Gynecologists (RCOG). Andra träningsinterventioner var Hatha yoga, pilates samt vattenträning. Resultat visade att fysisk aktivitet gav effekt i 10 av 13 studier sett på ländryggs- och/eller bäckensmärta.

    Konklusion: Resultatet att majoriteten av de granskade randomiserade kontrollerade studierna visade positiva effekter av fysisk aktivitet indikerar att fysisk träning i olika former kan vara positivt och kan rekommenderas till gravida med ländryggs- och/eller bäckensmärta. Då antalet inkluderade studier var lågt och typen av träning och träningsupplägg varierande är det svårt att dra säkra slutsatser om effekt av specifika träningsmetoder. Mer forskning inom området behövs för att kunna säkerhetsställa evidensen för fysisk träning som behandling för graviditetsrelaterad ländryggs- och/eller bäckensmärta.

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  • 349.
    Berggård, Glenn
    et al.
    Luleå University of Technology, Department of Civil, Environmental and Natural Resources Engineering, Architecture and Water.
    Rosander, Peter
    Luleå University of Technology, Department of Civil, Environmental and Natural Resources Engineering, Architecture and Water.
    Larsson, Agneta
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Konsumenttester av vinterskor och halkskydd2015Report (Other academic)
    Abstract [sv]

    Sjukvårdsbaserad skadestatistik från Sverige visar att singelolyckor med fotgängare på is och snö, orsakar höga skadetal. I Sverige beräknas ca 10000 män och 15000 kvinnor uppsöka sjukvård på grund av skada vid fall på snö och is. Personer skadade i fallolyckor på snö och is har svårare skador och längre konvalescenstid jämfört med fotgängare som faller på barmark. Det är därför viktigt att identifiera preventiva metoder och hjälpmedel för fallolyckor vintertid.Syftet med detta arbete har varit att genomföra konsumenttester av vinterskor och halkskydd på olika underlag med avseende på hur väl de fungerar som skydd mot att halka samt hur användarvänliga de upplevs av brukaren. I arbetet har det också varit viktigt att försöka identifiera kriterier som kan anses vara betydelsefulla för att bedöma vinterväglagsegenskaperna. Dessutom fanns ett behov av att ta fram underlag och förslag på en standardiserad metod för halkskydds-/vinterskortester och en märkning som ger konsumenterna möjlighet att bedöma och jämföra halkskyddens respektive vinterskornas egenskaper innan köp.Testmetoden som tagits fram för att undersöka halkskyddens och skornas egenskaper bygger på tidigare erfarenheter från tester av halkskydd. Metoden bygger på att försökspersoner genomför gångtester med halkskydd och skor på olika underlag samtidigt som olika mätmetoder, både objektiva och subjektiva, används för att kategorisera gång. Tester har genomförts av 9 försökspersoner, över 45 år, 4 män och 5 kvinnor, som testat 19 halkskydd och 20 olika skor. Fyra olika underlag har använts för att kategorisera egenskaperna på de undersökta halkskydden och skorna: is, is täckt med snö, packad snö, torr betong.Testmetoden har kompletterats med laboratoriemätningar av halkskyddens och skosulornas friktion på is samt hårdheten hos skornas sulor. Multipel hierarkisk multipel regressionsanalys användes för att identifiera vilka kriterier som kan ha betydelse för fotgängarnas skattade helhetsupplevelse av de testade halkskydden på olika underlag.Resultatet av förmätningarna visar att testgruppen (fem kvinnor och fyra män med medålder 47 år) motsvarar en normalpopulation, avseende variationer i de uppmätta bakgrundsparametrarna.FIOH:s friktionsmätningar på is av samtliga skor och halkskydd visar att halkskydden har genomgående högre friktionsvärden än skorna, dvs. de har bättre fäste på is än de skor som testats men resultaten visar på små skillnader mellan de sämsta halkskydden och de bästa skorna.Resultat från friktionsmätningen, som den utförs idag i fixerat utförande, ger inte överensstämmelse med försökspersonernas upplevelser av gångsäkerhet eller fallrisk. Försökspersonernas gångcykel med hälisättning, överrullning och fotavveckling bygger upp den samlade uppfattningen om egenskaperna och fångas enbart i de subjektiva mätmetoderna.Sex kriterier som bedömts viktiga att ta hänsyn till när det gäller halkfri gång med en vintersko har kunnat identifieras via analys av försökspersonernas fritextsvar avseende fördelar, nackdelar och övrig funktionalitet: gångsäkerhet, möjliggör ett naturligt gångmönster, stabilitet, förutsägbarhet, flexibilitet och passform/komfort. Gångsäkerhet är viktigast och omfattar fäste/grepp, detta är viktigast på is, is/snö vid gång samt vid start och stopp.Sju subjektiva kriterier för halkskydd har också identifierats; gångsäkerhet, tillåter naturligt gångmönster, stabilitet, förutsägbarhet, flexibilitet, passform/komfort, och ljud. Gångsäkerhet är viktigast.Den självskattade hälisättningen på underlagen ren is samt på snö på is framkom som det viktigaste kriteriet för testpersonernas helhetsupplevelse av skyddet. Även skattad fotavveckling på alla underlag med främst på främst på snö på is var av betydelse. Upplevd balans och fallrisk var mest utslagsgivande för helhetsupplevelsen av de halkskydd som inte valdes för eget bruk. Det tyder på att en lägre grad av skattad kontroll av kroppshållning och balans under gång med skyddet är en relevant indikator för att identifiera skydd med bristande funktioner.Variablerna subjektivt skattad fallrisk, balans, hälisättning och fotavveckling kan samtliga relateras till ett skydds halkegenskaper och funktion. Upplevd fallrisk samvarierar med såväl balans, hälisättning och fotavveckling vilket innebär att kriteriet upplevd fallrisk kan antas omfatta de övriga och kan väljas som en enskild variabel i fortsatta analyser.Kvalitetsnivåer i bedömningsskalor kan antas gå att knyta till de subjektiva kriterierna.En standardiserat testmetod för klassindelning av egenskaper för vinterskor respektive halkskydd bör bygga på mätmetoder med försökspersoner enligt ovan.Fortsatta studier med fler testpersoner behövs för att verifiera de resultat som indikeras ovan.

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  • 350. Berglind, Daniel
    et al.
    Nyberg, Gisela
    Karolinska Institutet, Stockholm, Sweden.
    Willmer, Mikaela
    Persson, Margareta
    Wells, Michael
    Forsell, Yvonne
    An eHealth program versus a standard care supervised health program and associated health outcomes in individuals with mobility disability: study protocol for a randomized controlled trial.2018In: Trials, E-ISSN 1745-6215, Vol. 19, no 1, article id 258Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Young adults with mobility disability (MD) are less likely to engage in regular physical activity (PA) compared with their able-bodied peers and inactive adults with a MD are more likely to report one or more chronic diseases compared to those who are physically active. Despite the vast amount of research published in the field of PA interventions over the past decades, little attention has been focused on interventions aiming to increase PA among individuals with MD. Thus, we propose to compare the effects of an eHealth program compared to a usual care supervised health program on levels of PA and other health behaviors.

    METHODS: The current intervention will use a randomized controlled trial (RCT) design with two treatment groups (an eHealth program and a usual care supervised health program) in young adults with newly acquired MD. In total, 110 young adults (aged 18-40 years) with a MD, acquired within the past 3 years, will be recruited to participate in a 12-week intervention. The primary study outcome is accelerometer-measured time spent in moderate to vigorous PA. Secondary outcomes includes health-related quality of life, depression, stress, fitness, body composition, diet, musculoskeletal pain, motivation to exercise and work ability.

    DISCUSSION: There is a lack of RCTs investigating effective ways to increase levels of PA in young adults with MD. Increased levels of PA among this physically inactive population have the potential to substantially improve health-related outcomes, possibly more so than in the general population. The trial will put strong emphasis on optimizing exercise adherence and investigating feasibility in the two treatment programs. The Ethical Review Board (EPN) at Karolinska Institutet has approved the study (2017/1206-31/1).

    TRIAL REGISTRATION: International Standard Randomised Controlled Trial Number (ISRCTN), reference number ISRCTN22387524 . Prospectively registered February 4, 2018.

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