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  • 301.
    Bring, Annika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    A Behavioural Medicine Perspective on Acute Whiplash Associated Disorders: Daily Coping, Prognostic Factors and Tailored Treatment2012Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of this thesis was to study the daily process of coping, potential prognostic factors for recovery and evaluating an individually tailored behavioural medicine intervention in the acute stage of Whiplash Associated Disorders (WAD). The studies comprised three samples of patients with acute Whiplash Associated Disorders (WAD). All patients were included within the first month after the whiplash occurrence and were recruited from hospital emergency wards in six Swedish communities.

    Study I and II included 51 participants generating 260 daily coping diaries (WAD-DCA) during seven days in the acute stage of WAD. In Study I daily stressors and primary appraisal were analysed and in Study II patterns between stressors, appraisals, coping strategy profiles, daily activity level and well-being were described. The results showed a large variety of situations that the individuals perceive as stressful, not only pain itself. High self-efficacy was associated with high degree of physical/mental well-being. Threatening stressors and catastrophic thoughts were associated with low degree of physical and mental well-being. In Study III potential prognostic factors for good as well as poor recovery were studied more closely in a mildly affected sample (MIAS) (n=98) from within the first month after the accident up to one year later. Pain-related disability at baseline emerged as the only indicator of prognosis after 12 months in MIAS. Study IV (n=55) was a randomised control study, were current clinical recommendations of standard self-care instructions (SC) for the management of acute WAD was compared to an individually tailored behavioural medicine intervention delivered via Internet or face-to-face. The results showed that SC was not as effective as the behavioural medicine intervention. By early identification of situation-specific factors and potential behavioural (physical, cognitive and affective) determinants of activity performance, it seems possible to tailor a self-management intervention that decreases pain-related disability, fear of movement and catastrophising and increases self-efficacy. The use of innovative methods such as the Internet of distributing treatment interventions showed to be a good alternative to more traditional forms.

    The results of this thesis uncover new insights in understanding the individual’s specific perspective as applied in a behavioural medicine approach in acute WAD.

  • 302.
    Bring, Annika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Bring, Johan
    University of Gävle, Gävle, Sweden.
    Söderlund, Anne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy. Department of Physiotherapy, School of Health, Care and Social wellfare, Vasteras , Sweden .
    Wasteson, Elisabet
    Division of Psychology, Department of Social Sciences, Mid Sweden University, Östersund , Sweden.
    Åsenlöf, Pernilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Coping Patterns and Their Relation to Daily Activity, Worries, Depressed Mood, and Pain Intensity in Acute Whiplash-Associated Disorders2013In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 20, no 2, p. 293-303Article in journal (Refereed)
    Abstract [en]

    BACKGROUND

    There is a lack of knowledge regarding how individuals with acute whiplash-associated disorders (WAD) appraise and cope with situation-specific stressors.

    PURPOSE

    The aim of the study was to describe the daily process of coping reported in a daily coping assessment by individuals with acute WAD within 1 month after the accident. More specifically, profiles of coping strategies were identified and patterns between stressors, primary and secondary appraisals, and coping strategy profiles were described in relation to reported level of activity, worries, depressed mood and pain intensity during the day.

    METHOD

    A descriptive and exploratory design was applied. Two hundred and twenty-nine whiplash-associated disorders-daily coping assessment (WAD-DCA) collected during seven consecutive days from 51 participants with acute WAD in Sweden, were included. Cluster analysis was used to obtain coping strategy profiles and data were graphically visualised as patterns through the coping process.

    RESULTS

    When measuring coping as a daily process relating to the specific stressful situation, different coping pocess patterns appeared. During days with a high degree of physical and mental well-being, high self-efficacy beliefs seemed to be working as an important secondary appraisal, whereas during days with a low degree of physical and mental well-being primary appraisals of the stressor as a threat and catastrophic thoughts were present in the coping process.

    CONCLUSIONS

    Early identification of situational- and individual-specific stressors, appraisals and coping efforts as measured by the WAD-DCA may contribute to the understanding of the coping process in the acute stage of WAD and its possible impact on recovery and adjustment.

  • 303.
    Bring, Annika
    et al.
    Department of Neuroscience, Physiotherapy, Uppsala University, Uppsala, Sweden.
    Bring, Johan
    University of Gävle, Faculty of Engineering and Sustainable Development, Department of Electronics, Mathematics and Natural Sciences, Statistics.
    Söderlund, Anne
    Department of Neuroscience, Physiotherapy, Uppsala University, Uppsala, Sweden, and School of Health, Care and Social Welfare, Physiotherapy, Mälardalen University, Västerås, Sweden.
    Wasteson, Elisabet
    Division of Psychology, Department of Social Sciences, Mid Sweden University, Östersund , Sweden.
    Åsenlöf, Pernilla
    Department of Neuroscience, Physiotherapy, Uppsala University, Uppsala, Sweden.
    Coping Patterns and Their Relation to Daily Activity, Worries, Depressed Mood, and Pain Intensity in Acute Whiplash-Associated Disorders2013In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 20, no 2, p. 293-303Article in journal (Refereed)
    Abstract [en]

    BACKGROUND

    There is a lack of knowledge regarding how individuals with acute whiplash-associated disorders (WAD) appraise and cope with situation-specific stressors.

    PURPOSE

    The aim of the study was to describe the daily process of coping reported in a daily coping assessment by individuals with acute WAD within 1 month after the accident. More specifically, profiles of coping strategies were identified and patterns between stressors, primary and secondary appraisals, and coping strategy profiles were described in relation to reported level of activity, worries, depressed mood and pain intensity during the day.

    METHOD

    A descriptive and exploratory design was applied. Two hundred and twenty-nine whiplash-associated disorders-daily coping assessment (WAD-DCA) collected during seven consecutive days from 51 participants with acute WAD in Sweden, were included. Cluster analysis was used to obtain coping strategy profiles and data were graphically visualised as patterns through the coping process.

    RESULTS

    When measuring coping as a daily process relating to the specific stressful situation, different coping pocess patterns appeared. During days with a high degree of physical and mental well-being, high self-efficacy beliefs seemed to be working as an important secondary appraisal, whereas during days with a low degree of physical and mental well-being primary appraisals of the stressor as a threat and catastrophic thoughts were present in the coping process.

    CONCLUSIONS

    Early identification of situational- and individual-specific stressors, appraisals and coping efforts as measured by the WAD-DCA may contribute to the understanding of the coping process in the acute stage of WAD and its possible impact on recovery and adjustment.

  • 304.
    Bring, Annika
    et al.
    Uppsala University.
    Bring, Johan
    University of Gävle.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Wasteson, Elisabeth
    Mid Sweden University.
    Åsenlöf, Pernilla
    Uppsala University.
    Coping patterns and their relation to daily activity, worries, depressive mood, and pain intensity in acute Whiplash Associated Disorders2013In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 20, no 2, p. 293-303Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    There is a lack of knowledge regarding how individuals with acute whiplash-associated disorders (WAD) appraise and cope with situation-specific stressors.

    PURPOSE:

    The aim of the study was to describe the daily process of coping reported in a daily coping assessment by individuals with acute WAD within 1 month after the accident. More specifically, profiles of coping strategies were identified and patterns between stressors, primary and secondary appraisals, and coping strategy profiles were described in relation to reported level of activity, worries, depressed mood and pain intensity during the day.

    METHOD:

    A descriptive and exploratory design was applied. Two hundred and twenty-nine whiplash-associated disorders-daily coping assessment (WAD-DCA) collected during seven consecutive days from 51 participants with acute WAD in Sweden, were included. Cluster analysis was used to obtain coping strategy profiles and data were graphically visualised as patterns through the coping process.

    RESULTS:

    When measuring coping as a daily process relating to the specific stressful situation, different coping process patterns appeared. During days with a high degree of physical and mental well-being, high self-efficacy beliefs seemed to be working as an important secondary appraisal, whereas during days with a low degree of physical and mental well-being primary appraisals of the stressor as a threat and catastrophic thoughts were present in the coping process.

    CONCLUSIONS:

    Early identification of situational- and individual-specific stressors, appraisals and coping efforts as measured by the WAD-DCA may contribute to the understanding of the coping process in the acute stage of WAD and its possible impact on recovery and adjustment.

  • 305.
    Bring, Annika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Martin, Cathrin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Åsenlöf, Pernilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    A New Core Curriculum For Integration Of Behavioural Medicine And Physiotherapy In Graduate Studies: Planning, Implementation, And Expected Outcomes2016In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 23, p. S18-S18Article in journal (Refereed)
  • 306.
    Bring, Annika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Söderlund, Anne
    Department of Physiotherapy, School of Health, Care and Social wellfare, Vasteras, Sweden .
    Wasteson, Elisabet
    Division of Psychology, Department of Social Sciences, Mid Sweden University, Östersund, Sweden.
    Åsenlöf, Pernilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Daily stressors in patients with acute whiplash associated disorders2012In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 34, no 21, p. 1783-1789Article in journal (Refereed)
    Abstract [en]

    Purpose

    Stressors in acute whiplash associated disorders (WAD), as reported on a daily basis, have hitherto been neglected in research. The primary aim of this study was to describe the most stressful daily situation or event reported by individuals with acute WAD within a month of a whiplash trauma. Another aim was to describe the meaning and significance of these daily stressors, i.e. primary appraisal.

    Method

    A descriptive design with a content analysis approach was used. 260 WAD-daily coping assessments (WAD-DCA) generated during 1 week by 51 participants with acute WAD were included in the study. Stressors were analysed using qualitative content analysis.

     Results

    The reported stressors generated 13 categories covering a wide range of stressful situations in daily life related to (i) work, (ii) physical symptoms, (iii) feelings and cognitions, (iv) family and home responsibilities and (v) recreation. The majority of the stressors were appraised as "expected" as well as "disabling". Most threatening stressors were related to work, driving and feelings/cognitions.

    Conclusions

    The wide variety of stressors indicates that it is not only pain itself that influences daily life in acute WAD. Early identification of individual and situation-specific stressors gives new data regarding what bothers individuals suffering from WAD after a collision and may be helpful in understanding the coping process in relation to specific stressors and stressor appraisals.

  • 307.
    Bring, Annika
    et al.
    Uppsala University, Sweden.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Wasteson, Elisabeth
    Mid Sweden University, Sweden.
    Åsenlöf, Pernilla
    Uppsala University, Sweden.
    Daily stressors in patients with acute Whiplash Associated Disorders2012In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 34, no 21, p. 1783-1789Article in journal (Refereed)
    Abstract [en]

    Purpose: Stressors in acute whiplash associated disorders (WAD), as reported on a daily basis, have hitherto been neglected in research. The primary aim of this study was to describe the most stressful daily situation or event reported by individuals with acute WAD within a month of a whiplash trauma. Another aim was to describe the meaning and significance of these daily stressors, i.e. primary appraisal. Method: A descriptive design with a content analysis approach was used. 260 WAD-daily coping assessments (WAD-DCA) generated during 1 week by 51 participants with acute WAD were included in the study. Stressors were analysed using qualitative content analysis. Results: The reported stressors generated 13 categories covering a wide range of stressful situations in daily life related to (i) work, (ii) physical symptoms, (iii) feelings and cognitions, (iv) family and home responsibilities and (v) recreation. The majority of the stressors were appraised as "expected" as well as "disabling". Most threatening stressors were related to work, driving and feelings/cognitions. Conclusions: The wide variety of stressors indicates that it is not only pain itself that influences daily life in acute WAD. Early identification of individual and situation-specific stressors gives new data regarding what bothers individuals suffering from WAD after a collision and may be helpful in understanding the coping process in relation to specific stressors and stressor appraisals

  • 308.
    Bring, Annika
    et al.
    Uppsala university, Sweden.
    Åsenlöf, Pernilla
    Uppsala university, Sweden.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Comparison of different treatment approaches after acute WAD – Standard-treatment compared to behavioural medicine interventions: A randomized group study2010In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 13, no S1, p. S265-Article in journal (Refereed)
  • 309.
    Bring, Annika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Åsenlöf, Pernilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Söderlund, Anne
    Department of Physiotherapy, School of Health, Care and Social wellfare, Vasteras, Sweden .
    Individually tailored behavioural medicine intervention delivered via Internet or Face to face in acute Whiplash Associated Disorders: A randomized controlled trialArticle in journal (Other academic)
  • 310.
    Bring, Annika
    et al.
    Uppsala University, Uppsala, Sweden.
    Åsenlöf, Pernilla
    Uppsala University, Uppsala, Sweden.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    What is the comparative effectiveness of current standard treatment, against an individually tailored behavioural programme delivered either on the internet or face-to-face for people with acute whiplash associated disorder?: A randomized controlled trial.2016Conference paper (Refereed)
  • 311.
    Bring, Annika
    et al.
    Uppsala Universitet, Sweden.
    Åsenlöf, Pernilla
    Uppsala Universitet, Sweden.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    What is the comparative effectiveness of current standard treatment, against an individually tailored behavioural programme delivered either on the Internet or face-to-face for people with acute whiplash associated disorder?: A randomized controlled trial2016In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 30, no 5, p. 187-188, article id Meeting Abstract: O579Article in journal (Refereed)
  • 312.
    Bring, Annika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Åsenlöf, Pernilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Söderlund, Anne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    What is the comparative effectiveness of current standard treatment, against an individually tailored behavioural programme delivered either on the Internet or face-to-face for people with acute whiplash associated disorder? A randomized controlled trial2016In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 30, no 5, p. 441-453Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate the comparative effectiveness of current standard treatment, against an individually tailored behavioural programme delivered via the Internet or face-to-face for people with acute whiplash associated disorders.

    DESIGN: A multicentre, randomized, three-group design, with concealed allocation.

    SUBJECTS AND SETTINGS: A total of 55 participants (37 female), age 18-65, with acute Whiplash Associated Disorder (Grade I-II), recruited at two emergency clinics in Sweden.

    INTERVENTIONS: Before randomization all participants received standard self-care instructions. The Internet and face-to-face groups followed a seven-week behavioural programme involving individual tailoring, via email (Internet group), or in sessions at a physical therapy unit (face-to-face group). The control group only received the self-care instructions.

    MAIN MEASURES: Pain-related disability, pain intensity, self-efficacy in daily activities, catastrophizing and fear of movement/(re)injury. Assessments were performed at baseline (2-4 weeks postinjury) and at three, six and 12 months postintervention.

    RESULTS: Both the Internet (n = 16) and face-to-face (n = 14) group showed a larger decrease in pain-related disability than the control group (n = 16); -12 and -11, respectively, compared with -5 in the control group at 12-months follow-up. Significant differences between the groups in overall treatment effect were shown in all outcomes except pain intensity. All groups improved significantly over time in all outcomes, except for fear of movement/(re)injury and catastrophizing in the control group.

    CONCLUSION: An individually tailored behavioural programme improved biopsychosocial factors in patients with whiplash associated disorders up to 12 months after treatment. Internet-delivered intervention was as effective as clinic-based face-to-face therapy sessions.

  • 313.
    Bring, Annika
    et al.
    Uppsala Universitet, Sweden.
    Åsenlöf, Pernilla
    Uppsala Universitet, Sweden.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    What is the comparative effectiveness of current standard treatment, against an individually tailored behavioural programme delivered either on the Internet or face-to-face for people with acute whiplash associated disorder?: A randomized controlled trial2016In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 30, no 5, p. 441-453Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate the comparative effectiveness of current standard treatment, against an individually tailored behavioural programme delivered via the Internet or face-to-face for people with acute whiplash associated disorders.

    DESIGN: A multicentre, randomized, three-group design, with concealed allocation.

    SUBJECTS AND SETTINGS: A total of 55 participants (37 female), age 18-65, with acute Whiplash Associated Disorder (Grade I-II), recruited at two emergency clinics in Sweden.

    INTERVENTIONS: Before randomization all participants received standard self-care instructions. The Internet and face-to-face groups followed a seven-week behavioural programme involving individual tailoring, via email (Internet group), or in sessions at a physical therapy unit (face-to-face group). The control group only received the self-care instructions.

    MAIN MEASURES: Pain-related disability, pain intensity, self-efficacy in daily activities, catastrophizing and fear of movement/(re)injury. Assessments were performed at baseline (2-4 weeks postinjury) and at three, six and 12 months postintervention.

    RESULTS: Both the Internet (n = 16) and face-to-face (n = 14) group showed a larger decrease in pain-related disability than the control group (n = 16); -12 and -11, respectively, compared with -5 in the control group at 12-months follow-up. Significant differences between the groups in overall treatment effect were shown in all outcomes except pain intensity. All groups improved significantly over time in all outcomes, except for fear of movement/(re)injury and catastrophizing in the control group.

    CONCLUSION: An individually tailored behavioural programme improved biopsychosocial factors in patients with whiplash associated disorders up to 12 months after treatment. Internet-delivered intervention was as effective as clinic-based face-to-face therapy sessions.

  • 314.
    Bring, Johan
    et al.
    Gävle Univ, Dept Math & Stat, Gävle, Sweden.
    Bring, Annika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Measuring gait – how the choice of measure can affect the statistical results and the clinical interpretation2017In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 19, no 1, p. 8-12Article in journal (Refereed)
    Abstract [en]

    Aims: The aim of this study was to illustrate how the choice of gait measure could affect the statistical analysis of data and the resulting clinical conclusions.

    Methodology: A descriptive design in which the results from different tests from 10 patients with normal pressure hydrocephalus illustrates the potential to generate different clinical conclusions.

    Major findings and principal conclusion: The results illustrate how the choice of measure can affect the statistical results and the clinical interpretation of a study. It is possible to have the paradoxical situation in which one group has a better walking ability if the variable speed is used but the other group has a better walking ability if the variable time is used. An important message is that the choice of measurement and the transformation of data are not primarily statistical issues. If the statistical results are to be useful for clinical decisions, the variables used must be directly related to the utility for the subjects. An understanding of the clinical relevance of different outcomes is required. The distinction between when numbers are purely descriptive and when numbers represent a valuation is subtle and difficult to comprehend.

  • 315.
    Brobäck, Monika
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Samband mellan anterior knälaxitet och funktion vad sport- och fritidsaktiviteter samt knärelaterad livskvalitet efter främre korsbandsrekonstruktion: en jämförelse mellan män och kvinnor2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim

    The purpose of the present study was to find out whether there were any correlations between anterior knee laxity, measured with KT-1000 arthrometer, and the subscales "function in sport and recreation" and "quality of life" according to Knee injury and Osteoarthritis Outcome Score (KOOS) after an anterior cruciate ligament (ACL) reconstruction. Another purpose was to study whether there was a gender difference with respect to these parameters.

    Method

    This study was based on prospectively collected data from the Swedish ACL-register and the Capio Artro Clinic IT-register of patients who have undergone ACL reconstruction with hamstrings graft. The patients (18-35 years) who were operated on by those orthopedic surgeons who had performed the highest number of ACL reconstructions during 2010 and 2011 were consecutively selected. This material was represented by 427 patients. After the inclusion-and exclusion criteria 100 patients finally remained as participants of the study. A power analysis showed a need for a total of 58 patients, 29 men and 29 women. An even distribution between men and women was randomly performed by lottery draw. The patients were evaluated with the KT-1000 as well as with KOOS subscales "function in sports and recreation" and "quality of life" 6-8 months after surgery.

    Results

    The results showed that anterior knee laxity, measured with KT-1000, was reduced in the operated knee and "function in sports and recreation" as well as "quality of life" according to KOOS was improved 6-8 months post-operatively. No significant differences were noted between men and women concerning all studied parameters. No correlations were shown between anterior knee laxity and "function in sports and recreation" as well as "quality of life".

    Conclusion

    No significant differences in terms of gender were found in any of the studied parameters 6-8 months after ACL reconstruction. No correlations were shown between anterior knee laxity and "function in sports and recreation" and "quality of life" according to KOOS.

  • 316.
    Brocki, Barbara Cristina
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Physiotherapy and Occupational Therapy, Aalborg University Hospital, Aalborg, Denmark .
    Andreasen, Jan Jesper
    Aalborg University, Aalborg, Denmark.
    Langer, Daniel
    Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
    Souza, Domingos S. R.
    Faculty of Medicine and Health, Surgery, Örebro University, Örebro, Sweden.
    Westerdahl, Elisabeth
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Postoperative inspiratory muscle training in addition to breathing exercises and early mobilization improves oxygenation in high-risk patients after lung cancer surgery: a randomized controlled trial2016In: European Journal of Cardio-Thoracic Surgery, ISSN 1010-7940, E-ISSN 1873-734X, Vol. 49, no 5, p. 1483-1491, article id 26489835Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES The aim was to investigate whether 2 weeks of inspiratory muscle training (IMT) could preserve respiratory muscle strength in high-risk patients referred for pulmonary resection on the suspicion of or confirmed lung cancer. Secondarily, we investigated the effect of the intervention on the incidence of postoperative pulmonary complications.

    METHODS The study was a single-centre, parallel-group, randomized trial with assessor blinding and intention-to-treat analysis. The intervention group (IG, n = 34) underwent 2 weeks of postoperative IMT twice daily with 2 × 30 breaths on a target intensity of 30% of maximal inspiratory pressure, in addition to standard postoperative physiotherapy. Standard physiotherapy in the control group (CG, n = 34) consisted of breathing exercises, coughing techniques and early mobilization. We measured respiratory muscle strength (maximal inspiratory/expiratory pressure, MIP/MEP), functional performance (6-min walk test), spirometry and peripheral oxygen saturation (SpO2), assessed the day before surgery and again 3–5 days and 2 weeks postoperatively. Postoperative pulmonary complications were evaluated 2 weeks after surgery.

    RESULTS The mean age was 70 ± 8 years and 57.5% were males. Thoracotomy was performed in 48.5% (n = 33) of cases. No effect of the intervention was found regarding MIP, MEP, lung volumes or functional performance at any time point. The overall incidence of pneumonia was 13% (n = 9), with no significant difference between groups [IG 6% (n = 2), CG 21% (n = 7), P = 0.14]. An improved SpO2 was found in the IG on the third and fourth postoperative days (Day 3: IG 93.8 ± 3.4 vs CG 91.9 ± 4.1%, P = 0.058; Day 4: IG 93.5 ± 3.5 vs CG 91 ± 3.9%, P = 0.02). We found no association between surgical procedure (thoracotomy versus thoracoscopy) and respiratory muscle strength, which was recovered in both groups 2 weeks after surgery.

    CONCLUSIONS Two weeks of additional postoperative IMT, compared with standard physiotherapy alone, did not preserve respiratory muscle strength but improved oxygenation in high-risk patients after lung cancer surgery. Respiratory muscle strength recovered in both groups 2 weeks after surgery.

  • 317.
    Brocki, Barbara Cristina
    et al.
    Aalborg University Hospital, Aalborg, Denmark.
    Andreasen, Jan Jesper
    Aalborg University Hospital, Aalborg, Denmark; Aalborg University, Aalborg, Denmark.
    Westerdahl, Elisabeth
    Örebro University, School of Health Sciences. Örebro University Hospital. Uppsala University, Uppsala, Sweden.
    Inspiratory Muscle Training in High-Risk Patients Following Lung Resection May Prevent a Postoperative Decline in Physical Activity Level2018In: Integrative Cancer Therapies, ISSN 1534-7354, E-ISSN 1552-695X, Vol. 17, no 4, p. 1095-1102Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To describe postoperative self-reported physical activity (PA) level and assess the effects of 2 weeks of postoperative inspiratory muscle training (IMT) in patients at high risk for postoperative pulmonary complications following lung resection.

    METHODS: This is a descriptive study reporting supplementary data from a randomized controlled trial that included 68 patients (mean age = 70 ± 8 years), randomized to an intervention group (IG; n = 34) or a control group (CG; n = 34). The IG underwent 2 weeks of postoperative IMT added to a standard postoperative physiotherapy given to both groups. The standard physiotherapy consisted of breathing exercises, coughing techniques, and early mobilization. We evaluated self-reported physical activity (Physical Activity Scale 2.1 questionnaire) and health status (EuroQol EQ-5D-5L questionnaire), assessed the day before surgery and 2 weeks postoperatively.

    RESULTS: A significant percentage of the patients in the IG reported less sedentary activity 2 weeks postoperatively when compared with the CG (sedentary 6% vs 22%, low activity 56% vs 66%, moderate activity 38% vs 12%, respectively; P = .006). The mean difference in EQ-5D-5L between the IG and CG 2 weeks postoperatively was nonsignificant ( P = .80). The overall preoperative EQ-5D-5L index score for the study population was comparable to a reference population.

    CONCLUSION: Postoperative IMT seems to prevent a decline in PA level 2 weeks postoperatively in high-risk patients undergoing lung resection. More research is needed to confirm these findings.

  • 318.
    Brocki, Barbara Cristina
    et al.
    Aalborg Univ Hosp, Aalborg, Denmark.
    Andreasen, Jan Jesper
    Aalborg Univ Hosp, Aalborg, Denmark;Aalborg Univ, Aalborg, Denmark.
    Westerdahl, Elisabeth
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology. Örebro Univ, Örebro, Sweden.
    Inspiratory Muscle Training in High-Risk Patients Following Lung Resection May Prevent a Postoperative Decline in Physical Activity Level2018In: Integrative Cancer Therapies, ISSN 1534-7354, E-ISSN 1552-695X, Vol. 17, no 4, p. 1095-1102Article in journal (Refereed)
    Abstract [en]

    Objectives. To describe postoperative self-reported physical activity (PA) level and assess the effects of 2 weeks of postoperative inspiratory muscle training (IMT) in patients at high risk for postoperative pulmonary complications following lung resection. Methods. This is a descriptive study reporting supplementary data from a randomized controlled trial that included 68 patients (mean age = 70 +/- 8 years), randomized to an intervention group (IG; n = 34) or a control group (CG; n = 34). The IG underwent 2 weeks of postoperative IMT added to a standard postoperative physiotherapy given to both groups. The standard physiotherapy consisted of breathing exercises, coughing techniques, and early mobilization. We evaluated self-reported physical activity (Physical Activity Scale 2.1 questionnaire) and health status (EuroQol EQ-5D-5L questionnaire), assessed the day before surgery and 2 weeks postoperatively. Results. A significant percentage of the patients in the IG reported less sedentary activity 2 weeks postoperatively when compared with the CG (sedentary 6% vs 22%, low activity 56% vs 66%, moderate activity 38% vs 12%, respectively; P = .006). The mean difference in EQ-5D-5L between the IG and CG 2 weeks postoperatively was nonsignificant (P = .80). The overall preoperative EQ-5D-5L index score for the study population was comparable to a reference population. Conclusion. Postoperative IMT seems to prevent a decline in PA level 2 weeks postoperatively in high-risk patients undergoing lung resection. More research is needed to confirm these findings.

  • 319.
    Brocki, Barbara Cristina
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Physiotherapy and Occupational Therapy, Aalborg University Hospital, Aalborg, Denmark.
    Westerdahl, Elisabeth
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Andreasen, Jan Jesper
    Department of Cardiothoracic surgery and Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark.
    Souza, Domingos S. R.
    Faculty of Medicine and Health, Surgery, Örebro University, Örebro, Sweden .
    Improvements in physical performance and health-related quality of life one year after radical operation for lung cancer2015In: Cancer Treatment Communications, ISSN 2213-0896, Vol. 4, p. 65-74Article in journal (Refereed)
    Abstract [en]

    Micro abstract: This study assessed physical performance and health-related quality of life one year after lung cancer surgery and investigated the potential association between both outcomes. We found that the walked distance was associated with the subjective perception of the physical functioning. Patients improved health-related quality of life, reaching values similar to a healthy reference population.

    Background: Resuming an acceptable level of lifestyle and health-related quality of life after lung cancer surgery has become an important issue. We aimed to evaluate the course of recovery of physical performance and health-related quality of life following pulmonary resection for lung cancer, as well as examine the potential association between these outcomes.

    Methods: In an observational design, we assessed 78 individuals radically operated for lungcancer. We measured health-related quality of life (SF-36), six-minute walk test (6MWT) and lung function (spirometry)three weeks (baseline), four and twelve months after surgery. SF-36 values were compared to an age-and gender-matched reference population.

    Results: The mean age was 65 years (SD9), 59% were males. Thoracotomy was performed in 77% of the cases. Compared to baseline values, we found significant improvements after one year in SF-36 physical and mental component summary components of large effect size (0.8 and 0.9 respectively). Values for both SF-36 summary components were comparable to those of the reference population. The improvement in 6MWT was of moderate effect size (0.6). We found a positive association between 6MWT and the SF-36 domain for physical functioning (β=0.05, 95% CI [0.00;0.09], p=0.03) one year after surgery.

    Conclusion: Individuals who were radically operated for lung cancer improved health-related quality of life one year after surgery, reaching values similar to a healthy reference population. The walked distance was positively associated with the subjective perception of physical functioning. The clinical significance of these findings deserves further investigation.

  • 320.
    Brocki, Barbara Cristina
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Aalborg University Hospital, Aalborg, Denmark.
    Westerdahl, Elisabeth
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Souza, Domingos S. R.
    Department of Cardiothoracic Surgery and Anaesthesiology, Örebro University Hospital, Örebro, Sweden.
    Andreasen, Jan Jesper
    University Hospital, Aalborg, Denmark.
    Factors influencing postoperative pulmonary complications following pulmonary resection due to malignant or benign lung tumour: preliminary results2014Conference paper (Refereed)
  • 321.
    Brocki, Barbara
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Physiotherapy and Occupational Therapy, Aalborg University Hospital, Aalborg,.
    Westerdahl, Elisabeth
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Langer, Daniel
    KU Leuven Faculty of Kinesiology and Rehabilitation Sciences, Leuven, Belgium; Respiratory Rehabilitation and Respiratory Division, University Hospital Leuven, Belgium; .
    Souza, Domingos SR
    Faculty of Medicine and Health, Surgery, Örebro University, Örebro, Sweden.
    Andreasen, Jan Jesper
    Departments of Cardiothoracic Surgery and Clinical Medicine, Aalborg University Hospital,.
    Respiratory muscle strength is not affected two weeks and six months following pulmonary resectionManuscript (preprint) (Other academic)
  • 322.
    Brolin, Linda
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Värnqvist, Emma
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Morgonuppvärmning, smärta och livskvalitet hos byggarbetare – en jämförande studie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 323.
    Broman, Karolina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    "Den svåra balansgången": Pedagogers upplevelse av att arbeta med barn med motoriska svårigheter: En kvalitativ studie2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Prevalensen av barn med fördröjd utveckling är nästan ett av var sjätte barn, och eftersom barns första åtta år är en viktig period för tillväxt och utveckling som kan påverka barnets fortsatta liv, bör barnen tidigt erhålla ett gott stöd.

    Syfte: Syftet med uppsatsen är att nå ökad kunskap om hur pedagoger upplever sitt arbete med barn med motoriska svårigheter, och vilket stöd de upplever att de får av en fysioterapeut.

    Metod: Kvalitativ studie grundad på semistrukturerade intervjuer med fem pedagoger som arbetar med barn som har motoriska svårigheter. Barnens ålder är 1-9 år. Intervjuerna analyserades med hjälp av the grounded theory, och för att öka trovärdigheten i datamaterialet genomfördes en triangulering av materialet med totalt tre personer.

    Resultat: En huvudkategori: ”Den svåra balansgången” och fem kategorier: ”Områden som skapar osäkerhet hos pedagogen”,Stöd för pedagogen”, ”Varför en diagnos? ”, ”Målet: ett självständigt barn” och ”Respekt” identifierades. Huvudkategorin, ”Den svåra balansgången”, representerar pedagogernas strävan att nå balans i sitt arbete med barn som har motoriska svårigheter medan kategorierna visar delar som påverkar balansen.

    Slutsats: Pedagogerna upplever att deras arbete är en ständig balansgång där olika delar i arbetet måste avvägas mot varandra i en kontinuerlig strävan efter jämnvikt.

  • 324.
    Brorsson, S.
    et al.
    Health and Welfare, Dala Sports Academy, Dalarna University, Falun, Sweden.
    Thorstensson, C.
    Department of Clinical Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.
    Nilsdotter, A.
    Department of Research and Education, Halmstad County Hospital, Halmstad, Sweden.
    Bremander, Ann
    Department of Clinical Sciences, Lund, Section of Rheumatology, Lund University, Lund, Sweden.
    Two different sets of handexercises improved grip strength after after eight weeks in patients with arthritis2014In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 73, no Suppl. 2, p. 1210-1210Article in journal (Refereed)
    Abstract [en]

    Background Hand function measured as grip force and finger extension force is often impaired in patients with rheumatoid arthritis (RA) and hand osteoarthritis (HOA) affecting performance of daily activities why hand exercises are recommended. A number of hand exercises are often used in the clinic but there is little information about “the effects of a minimal set of hand exercises” and if the choice of exercises is important to improve strength and function in the hand.

    Objectives To study the effect on grip- and finger extension strength and patient reported hand function from two different sets of handexercises performed over 8 weeks using a randomized study design.

    Methods Female patients with arthritis (RA and HOA, n=121) were randomly assigned to two different sets of handexercises (HE) for 8 weeks. The four hand exercises applied in the program were exercises commonly used in traditional hand training programs. The exercises were split into two groups depending on if the muscle activation (measured with EMG) were greater in forearm flexor (HE I, n=62) or in extensor muscles (HE II, n=59) (REF). HE I: isolated finger opposition (digits II-V) and rolling the putty with a flat hand, HE II: squeezing the putty and finger extension with putty resistance. The two HE were performed daily and each set was repeated 15 times, training time per day was maximum 5 minutes 7 days/week.

    Grip strength was measured with Grippit and finger extension strength with EX-it both validated instruments (unit: N). Pain was measured with a Visual Analogue Scale (VAS), 0-10 (best to worst). Hand functions were evaluated with the patient reported questionnaire Quick Disability Arm Shoulder and Hand (QuickDASH), 0-100 (best to worst).

    Results Mean grip strength (p=0.01) and mean finger extension force (p=0.004) increased after the training period in the group using HE I. In HE II the mean finger extension force increased (p=0.044), table 1. Hand function was stable over the training period.

    Table 1.

    Descriptive data of finger extension (EXIT) force and grip strength in the right hand, hand function (QuickDASH) and VAS pain presented as mean ± SD (min–max)

    Conclusions Five daily minutes with two hand exercises resulted increased grip strength and finger extension force after eight weeks. We suggest that hand exercises should be combined and selected to improve both flexor and extensor muscle strength of the forearm.

  • 325.
    Brorsson, Sofia
    et al.
    Halmstad University, School of Business, Engineering and Science, Biological and Environmental Systems (BLESS).
    Nilsdotter, Anna
    Department of Research and Education, Halmstad County Hospital, Halmstad, Sweden.
    Pedersen, Eja
    Halmstad University, School of Business, Engineering and Science, Biological and Environmental Systems (BLESS).
    Bremander, Ann
    Halmstad University, School of Business, Engineering and Science, Biological and Environmental Systems (BLESS).
    Thorstensson, Carina
    Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden.
    Relationship between finger flexion and extension force in healthy women and women with rheumatoid arthritis2012In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 44, no 7, p. 605-608Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Balance between flexor and extensor muscle activity is essential for optimal function. The purpose of this pilot study was to compare the relationship between maximum finger flexion force and maximum finger extension force in women with rheumatoid arthritis and healthy women.

    METHODS: Twenty healthy women (median age 61 years) and 20 women with rheumatoid arthritis (median age 59.5 years, median disease duration 16.5 years) were included in the study. Finger extension force was measured with an electronic device, EX-it, and finger flexion force using Grippit. The Grip Ability Test and the score from the patient-reported outcome Disability Arm Shoulder and Hand were used to evaluate activity limitations.

    RESULTS: Patients with rheumatoid arthritis showed significantly decreased hand function compared with healthy controls. A correlation was found between extension force and flexion force in the healthy group (r = 0.65, p = 0.002),but not in the rheumatoid arthritis group (r = 0.25, p = 0.289).

    CONCLUSION: Impaired hand function appears to influence the relationship between maximum finger flexion and extension force. This study showed a difference in the relationship between maximum finger flexion and extension force in healthy controls and those with rheumatoid arthritis. © 2012 Foundation of Rehabilitation Information.

  • 326.
    Broström, Anders
    et al.
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Clinical Neurophysiology. Jonkoping Univ, Sweden.
    Pakpour, Amir H.
    Jonkoping Univ, Sweden; Qazvin Univ Med Sci, Iran.
    Ulander, Martin
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Clinical Neurophysiology.
    Nilsen, Per
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Development and psychometric evaluation of the Swedish propensity to achieve healthy lifestyle scale in patients with hypertension2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 21-22, p. 4040-4049Article in journal (Refereed)
    Abstract [en]

    PurposeTo develop and validate a Swedish questionnaire to measure propensity for behaviour change regarding food habits, physical activity and weight reduction in patients with hypertension. DesignCross-sectional design. MethodsA total of 270 consecutive patients with hypertension diagnosed at four primary care centres in Sweden were included. The 6-item Swedish version of the Propensity to Achieve Healthy Lifestyle Scale (PAHLS) was developed to measure propensity for behaviour change regarding food habits, physical activity and weight reduction. The PAHLS (i.e., including three items for preparedness and three items for capacity) was developed by three multiprofessional researchers inspired by the transtheoretical model of behaviour change in collaboration with clinically active nurses. Data were collected by questionnaires on food habits (i.e., the Food Frequency Questionnaire), physical activity (the International Physical Activity Questionnaire), propensity for a healthy lifestyle (the PHLQ), as well as during a clinical examination. Exploratory (EFA) and confirmatory factor analyses (CFA), as well as Rasch analysis, were used. ResultsOf the 270 patients (50% women), 27% scored low levels of physical activity on the International Physical Activity Questionnaire, and 34% of the patients were obese (body mass index 30kg/m(2)). The EFA (explaining 54% of the variance) showed unidimensionality for the PAHLS that was supported by both CFA and Rasch analyses. No floor and 1.9% ceiling effects were found. Multiple group CFA (an extension of structural equationmodelling) showed that the PAHLS operated equivalently across both male and female patients. Internal consistency (Cronbachs alpha 0.83) and composite reliability (0.89) were good. ConclusionThe initial testing of PAHLS provided good validity and reliability scores to measure propensity for behaviour change in patients with hypertension. Relevance to Clinical PracticeThe PAHLS can be used by nurses as a tool to simplify shared decision-making in relation to behavioural changes.

  • 327.
    Brännlund, Anton
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sahlström, Robin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Trapezius pain pressure threshold as a predictor for neck muscle functions and cervical range of motion: A comparison of female chronic neck pain patients with or without traumatic background2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Neck pain is one of the most common causes of disability with a lifetime prevalence of approximately 50%. Few previous studies have investigated the correlation between pain and muscle functions and they’ve all used subjective self-estimated pain-rating scales as pain measurements. Pain pressure threshold (PPT) as a pain measurement gives a definite value of the pain which could be clinically useful for therapists.

    Purpose: The primary purpose of this study is to examine if Trapezius PPT can predict muscle functions and cervical range of motion (CROM) in women with chronic neck pain. Other purposes are to examine differences between patients with whiplash associated disorders (WAD) and idiopathic neck pain (INP) as well as if central sensitization affects the examined variables.

    Method: The subjects were devided into three groups; healthy controls (n=29), WAD (n=28) and INP (n=36). PPTs, neck muscle strengths, neuromuscular controll, muscle endurance and CROM were measured and regression analysis as well as difference tests were performed.

    Result: The results show several significant differences between the WAD and INP patients. The regression analysis shows that Trapezius PPT might be used for predicting muscle functions and CROM in the WAD group. The results also show that central sensitization negatively affects the examined variables.

    Conclusion: There are major differences between chronic WAD and INP patients. One might suggest to separate these groups in future studies. The clinical usability of Trapezius PPT as a single predictor for neck muscle functions and CROM needs to be further examined.

  • 328.
    Brännström, Johan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Teamsamarbete i företagshälsovården: En kartläggning i fyra svenska län2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion

    Teamsamarbete mellan professioner inom företagshälsovård kan förbättra arbetets kvalité, resultat och säkerhet.Vidare kan teamsamarbete främja teamets interna hälsa och teamets rehabiliteringsfokus kan vara avgörande för patientens arbetsåtergång.

     

    Syfte

    -Att kartlägga hur teamsamarbetet fungerar inom företagshälsovård.

    -Att undersöka skillnader mellan respondenter som upplevde sällan respektive oftast välfungerande team vad gäller arbetstillfredställelse, självskattad hälsa samt syn på rehabilitering avseende hälsa och arbetsåtergång

     

    Metod

    Enkäten Assessment of Interprofessional Team Collaboration Scale – Svensk version (AITCS-s), med subskalorna partnerskap/delat beslutsfattande, samarbete och koordination användes vid kartläggningen av teamsamarbetet utifrån en femgradig skala. Frågor kring självskattad hälsa, arbetstillfredställelse samt syn på patientrehabilitering avseende hälsa och arbetsåtergång bifogades enkäten.och den tredje 168 personer vid 14 företagshälsovårdsenheter erbjöds deltagande varav 73 personer ingick i studien.

     

    Resultat

    Respondenterna skattade sitt teamsamarbete som välfungerande inom subskalorna partnerskap/delat beslutsfattande (4,11 poäng, SD 0,59) och samarbete (4,13 poäng, SD 0,56). Subskalan koordination skattades lägre (3,88 poäng, SD 0,63). Ingen skillnad mellan respondenter som upplevde sällan respektive oftast välfungerande team noterades för arbetstillfredställelse (p=0,058), självskattad hälsa (p=0,31) eller syn på rehabilitering (hälsa: p=1,00 och arbetsåtergång: p=0,20)

     

    Konklusion

    Teamsamarbetet bedömdes vara välfungerande vilket indikerar effektiv rehabilitering avseende arbetsåtergång. Ingen skillnad mellan sällan respektive oftast välfungerande team noterades för arbetstillfredställelse, självskattad hälsa eller syn på rehabilitering. 

  • 329.
    Buchbinder, Rachelle
    et al.
    Cabrini-Monash Department of Clinical Epidemiology, Cabrini Institute and Monash University, Malvern, VIC, Australia.
    van Tulder, Maurits
    Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
    Öberg, Birgitta
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.
    Costa, Luciola Menezes
    Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil.
    Woolf, Anthony
    Royal Cornwall Hospital and University of Exeter Medical School, Truro, UK.
    Schoene, Mark
    The Back Letter, Newburyport MA, USA.
    Croft, Peter
    Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, UK.
    Low back pain: a call for action2018In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 391, no 10137, p. 2384-2388Article in journal (Other academic)
    Abstract [en]

    n/a

  • 330.
    Buck, Sebastian
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Development of a new functional test targeting proprioceptive ability following anterior cruciate ligament injury2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Movement control is critically dependent on exteroceptive and proprioceptive information. Reduced proprioception of the knee has been demonstrated after injury of the anterior cruciate ligament (ACL). Various test have been proposed in research, but their implementation and evaluation still represent clinical challenges. There is thus a pronounced need for improved clinical discriminative knee function tests related to proprioceptive ability.

    Aim: Our main aim of this pilot study was to develop and evaluate a new functional proprioception test, and secondly evaluate if our test could discriminate ACL injured from controls.

    Method: We developed a test in which participants step repeatedly over an obstacle, with downward vision occluded. Kinematics were collected in 3D motion laboratory from participants with ACL injury (n=8) and healthy controls (n=10). Coefficient of variation were calculated for the following variables: foot clearance, knee flexion angle and step length and compared between legs within group and between groups.

     

    Results: For between-group comparison larger variability of step length on the trailing leg of both legs were found in the ACL group. No other significant differences were found between the groups and within group differences were also nonsignificant.  

    Conclusion: Our test, so far in a small population, did not discriminate between legs within ACL injured persons or between ACL injured persons and healthy controls. This test needs to be further developed to determine whether it can discriminate between ACL injured and controls. If so, obstacle task may provide a valuable functional test of sensorimotor control following an ACL injury.

  • 331.
    Bugge Jakobsen, Knut Erling
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wilén, Catarina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    ”Tejpen ger mig liksom en trygghet”: - tävlingsidrottares upplevelse av att använda Kinesiotape®2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Kinesiotape® är ett populärt verktyg vid både rehabilitering och prevention av idrottsskador inom idrotten, dess påvisade effekt är dock ännu osäker. Ingen kvalitativ studie är tidigare gjord på upplevelsen av att använda Kinesiotape®.

    Syfte: Syftet med studien var att utforska tävlingsidrottares upplevelser av att använda Kinesiotape® vid rehabilitering av idrottsskador eller som prevention.

    Metod: I denna studie användes semistrukturerade intervjuer som analyserades med kvalitativ innehållsanalys enligt Graneheim och Lundman. Totalt fem tävlingsidrottare deltog i intervjuerna; två från Sverige och tre från Norge.

    Resultat: Analysen resulterade i de tre kategorierna Läkande effekt, Trygghetskänsla och Smärtlindring. Informanterna uttryckte bland annat att Kinesiotape® hade påskyndat läkning av inflammation, ökat blodcirkulation verkat smärtlindrande och fungerat som psykiskt stöd. Tejpen användes enskilt eller i kombination med andra metoder. Effekterna kom tydligt fram i flera intervjuer, dock fanns även upplevelser av att tejpen inte hade gett någon effekt alls.

    Konklusion: Resultatet visade att Kinesiotape® hade bidragit till flera positiva effekter. Tolkning av intervjuerna antyder även att det kan vara ett enkelt och säkert verktyg att använda för fysioterapeuter, då möjligtvis som ett komplement till andra behandlingsmetoder.

  • 332. Bui, Kim-Ly
    et al.
    Nyberg, Andre
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Rabinovich, Roberto
    Saey, Didier
    Maltais, François
    The Relevance of Limb Muscle Dysfunction in Chronic Obstructive Pulmonary Disease: A Review For Clinicians2019In: Clinics in Chest Medicine, ISSN 0272-5231, E-ISSN 1557-8216, Vol. 40, no 2, p. 367-383Article in journal (Refereed)
    Abstract [en]

    "Chronic obstructive pulmonary disease (COPD) is often accompanied by extrapulmonary manifestations such as limb muscle dysfunction. This term encompasses several features, including atrophy, weakness, and reduced oxidative capacity. Clinicians should become accustomed with this manifestation of COPD because of its relevance for important outcomes such as exercise tolerance and survival. Measuring muscle strength and mass can be performed with simple and valid tools that could be implemented in clinical practice. One identified, limb muscle dysfunction is amenable to therapy such as exercise training that has been repeatedly shown to improve muscle mass, strength, and oxidative capacity in COPD."

  • 333. Bui, Kim-Ly
    et al.
    Nyberg, André
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Maltais, François
    Saey, Didier
    Functional tests in chronic obstructive pulmonary disease part 1: clinical relevance and links to the International classification of functioning, disability and health2017In: Annals of the American Thoracic Society, ISSN 2329-6933, E-ISSN 2325-6621, Vol. 14, no 5, p. 778-784Article in journal (Refereed)
    Abstract [en]

    Chronic obstructive pulmonary disease is a major cause of morbidity and mortality worldwide and an important cause of disability. A thorough patient-centered outcome assessment, including not only measures of lung function, exercise capacity and health-related quality of life, but also of functional capacity and performance in activities of daily life, is imperative for a comprehensive management of chronic obstructive pulmonary disease. This American Thoracic Society Seminar Series is devoted to help clinicians substantiate their choice of functional outcome measures in this population. In Part 1 of this two-part Seminar Series, we aim to describe the various domains of functional status, to elucidate terms and key concepts intertwined with functioning, and to demonstrate the clinical relevance of assessing functional capacity in the context of activities of daily living, in agreement with the International Classification of Functioning, Disability and Health. We hope that a better understanding of the various defining components of functional status will be instrumental to healthcare providers to optimize chronic obstructive pulmonary disease evaluation and management, ultimately leading to improved quality of life of patients afflicted by this condition. This first paper also serves as an introduction to Part 2 of this Seminar Series, where the main functional tests available to assess upper and lower body functional capacity of these patients will be discussed.

  • 334. Bui, Kim-Ly
    et al.
    Nyberg, André
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Maltais, François
    Saey, Didier
    Functional tests in chronic obstructive pulmonary disease part 2: measurement properties2017In: Annals of the American Thoracic Society, ISSN 2329-6933, E-ISSN 2325-6621, Vol. 14, no 5, p. 785-794Article in journal (Refereed)
    Abstract [en]

    Chronic obstructive pulmonary disease is a major cause of morbidity and mortality worldwide and an important cause of disability and handicap. For a thorough patient-centered outcome assessment and comprehensive management of the disease, measures of lung function, exercise capacity and health-related quality of life, but also of functional capacity in activities of daily life are necessary. In Part 2 of this Seminar Series, we will discuss the main functional tests to assess upper and lower body functional capacity in patients with COPD, to help clinicians substantiate their choice of functional outcome measures in COPD. In agreement with the International Classification of Functioning, Disability and Health to assess functional capacity representative of daily life activities, this review focuses on functional tests that include components such as changing and maintaining body positions, walking, moving and climbing, as well as carrying, moving and handling objects. We will review the validity, reliability and responsiveness of these tests. With 11 links to the International Classification of Functioning, Disability and Health framework addressing several upper and lower body components of functional activities, the Glittre Activities of Daily Life test seems to be the most promising and comprehensive test to evaluate functional capacity in activities of daily life. The links between functional capacity tests and real participation in daily life, as well as with important clinical outcomes such as morbidity and mortality, need further investigation. More studies are also recommended to document minimal detectable changes, minimal clinically important differences and normative values for these functional tests.

  • 335.
    Buksowicz, Monika
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Effekten av högbelastad knäböjs träning vid långvarig flexionsrelaterad ländryggssmärta avseende kontroll av lumbalflexion, smärta och uthållighet i ryggextensorer.2017Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Inledning: Ländryggssmärta är ett vanligt förekommande tillstånd och vanlig orsak till att vi söker vård. Det finns flera sätt att subgruppera långvarig ländryggssmärta, där förmågan att kontrollera rörelse i olika riktningar anses vara ett sätt att klassificera besvären. I denna studie ingår patienter med långvarig flexionsrelaterad ländryggssmärta av nociceptiv mekanisk karaktär. Idag finns ingen konsensus vilken träningsform som är mest effektiv vid detta tillstånd med en påtaglig brist på studier som utvärderar effekten av belastad motorisk kontroll träning vid långvarig ländryggssmärta.

    Syfte: Syftet med denna studie var att utvärdera effekten av högbelastadknäböjsträning (frontböj) vid långvarig flexionsrelaterad ländryggsmärta avseende kontroll av flexion av ländryggen, smärta, och uthållighet i ryggextensorer.

    Metod: Studien genomfördes med singel subject experimental design. Tre individer deltog i högbelastad knäböjsträning, en motorisk kontroll övning som utförs med skivstång. Interventionen genomfördes med två träningspass i veckan under åtta veckor.

    Resultat: Vid studiens slut hade alla deltagare förbättratsavseende kontroll av lumbal flexion, smärta och uthållighet i ryggextensorer.

    Konklusion: Resultatet visar att högbelastad knäböjsträning med kan användas kliniskt i syfte att förbättra kontrollen av flexion i ländryggen, minska smärta samt öka uthållighet i ryggextensorer hos individer med långvarig flexionsrelaterad ländryggssmärta av nociceptiv mekanisk karaktär.

  • 336.
    Bullington, Jennifer
    Ersta Sköndal University College, Department of Health Care Sciences.
    Psykosomatik och meningsskapande: En tillämpning av Maurice Merleau-Pontys fenomenologi2012In: Att förstå kroppens budskap: sjukgymnastiska perspektiv / [ed] Gabriele Biguet, Riitta Keskinen-Rosenqvist, Adrienne Levy Berg, Lund: Studentlitteratur , 2012, 1Chapter in book (Other academic)
  • 337.
    Byfält, Lydia
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Hellerström, Charlotte
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Friskis&Svettis ”Börja träna”-kurs och skillnader på livskvalitet och skattad fysisk aktivitet2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Regelbunden fysisk aktivitet leder till positiva hälsoeffekter och är därmed viktig som primär- och sekundärprevention för flera olika sjukdomar och för tidig död. Primärprevention ges dock begränsat utrymme inom sjukvården och därmed kan ett samarbete med andra hälsofrämjande aktörer i samhället vara motiverat.

    Syfte: Att undersöka om deltagare skattar högre upplevd livskvalitet och fysisk aktivitetsnivå efter Friskis&Svettis (F&S) tio veckor långa ”Börja träna”-kurs samt undersöka om det fanns en korrelation mellan livskvalitet och fysisk aktivitetsnivå.

    Metod: 95 deltagare (81 kvinnor, 14 män) med en medelålder på 50 år fyllde i två enkäter, en före och en efter interventionen. En inomgruppsjämförelse samt en korrelationsanalys gällande livskvalitet och fysisk aktivitetsnivå gjordes.

    Resultat: Medianen för livskvalitet var 7 före interventionen och 8 efter vilket var en signifikant ökning (p=0,022). Även för fysisk aktivitet var ökningen signifikant med en median på 3 före interventionen och 4 efter (p<0,001). I studien sågs ett mycket svagt samband mellan livskvalitet och fysisk aktivitetsnivå före interventionen (r=-0,172, p=0,122).

    Konklusion: Efter deltagande i F&S ”Börja träna”-kurs skattade deltagarna högre livskvalitet och fysisk aktivitetsnivå. På grund av ett stort bortfall och flera metodologiska felkällor bör resultatet användas med försiktighet och vidare studier är därmed nödvändiga.

  • 338.
    Bykachev, Kirsi
    et al.
    University of Eastern Finland.
    Tossavainen, Kerttu
    University of Eastern Finland.
    Kumpulainen, Kirsti
    University of Eastern Finland.
    Kostenius, Catrine
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Lindgren, Eva
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Wilson, Philip
    University of Aberdeen.
    Bjørvig, Siri
    University Hospital of North Norway.
    Borgen, Morten
    University Hospital of North Norway.
    Multi-professional collaboration and consultation: Improving child and adolescent psychiatry with eHealth2016Conference paper (Other academic)
  • 339.
    Bykachev, Kirsi
    et al.
    University of Eastern Finland.
    Tossavainen, Kerttu
    University of Eastern Finland.
    Kumpulainen, Kirsti
    University of Eastern Finland.
    Wilson, Philip
    University of Aberdeen.
    Kostenius, Catrine
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Lindgren, Eva
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Bjørvig, Siri
    University Hospital of North Norway.
    Borgen, Morten
    University Hospital of North Norway.
    Improving psychiatry services for children and adolescents with eHealth in peripheral areas2016Conference paper (Other academic)
  • 340.
    Bylinder Westerberg, Johanna
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy.
    Borén, Elin
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy.
    Knä- och höftartrospatienters erfarenheter av artrosskolan: - En kvalitativ studie2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 341.
    Bylund, Ami
    et al.
    Linnaeus University, Sweden; Karolinska Institute, Sweden; Ersta Hospital, Sweden.
    Årestedt, Kristofer
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Linnaeus University, Sweden.
    Benzein, Eva
    Linnaeus University, Sweden.
    Thorell, Anders
    Karolinska Institute, Sweden; Ersta Hospital, Sweden.
    Persson, Carina
    Linnaeus University, Sweden.
    Assessment of family functioning: evaluation of the General Functioning Scale in a Swedish Bariatric Sample2016In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 30, no 3, p. 614-622Article in journal (Refereed)
    Abstract [en]

    BackgroundThe General Functioning Scale (GFS) was developed to assess self-perceived overall family functioning. The scale has satisfactory psychometric properties, is internationally recognised and has been used in different contexts. However, no validated Swedish version is available. Healthy family functioning can support patients and help them adhere to treatment regimens. Moreover, it maintains the physical and emotional health and that of the family as a unit. Yet, there is limited information regarding family functioning postgastric bypass surgery. Thus, it is important to use validated instruments to understand family functioning in bariatric contexts. AimTo evaluate aspects of reliability and validity in GFS in a Swedish bariatric sample, focusing on factor structure. MethodThe Swedish version of the GFS (S-GFS) was administered on two occasions to 163 participants who had undergone gastric bypass surgery 6-8 weeks prior to testing. Internal consistency, temporal stability and construct validity were assessed. ResultsData were positively skewed. The S-GFS showed good internal consistency (ordinal = 0.92) with a sufficient overall mean interitem correlation (0.500) and adequate temporal stability (intraclass correlation coefficient = 0.833). After modifying response alternatives, confirmatory factor analysis indicated acceptable fit for a one-factor model. ConclusionThe scale is a promising tool for assessing family functioning in bariatric settings. The S-GFS showed satisfactory reliability - consistent with prior research - and acceptable validity in the study sample. This study contributes to the limited research on the scales validity. However, the S-GFS needs to be evaluated in different cultural and clinical contexts, focusing on various aspects of validity and responsiveness (sensitivity to detect significant change over time) in different samples.

  • 342.
    Bylund, Nils
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lundberg, Michael
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Polisstudenters fysiska kapacitet i förhållande till normal fysisk förmåga2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Polisyrket innehåller varierande arbetsuppgifter och är stundvis fysiskt krävande. För att antas till polisutbildningen ska sökanden inneha god hälsa och normal fysisk förmåga. Studier har undersökt polisstudenters fysiska förmågor vid utbildningens början, inga har dock jämfört resultaten med normalvärden.

    Syfte: Syftet med den här studien var att beskriva fysisk kapacitet hos polisstudenter i början av sin utbildning samt eventuella skillnader mellan kvinnor och män. Ytterligare syften var att jämföra resultaten med normalvärden där det är möjligt samt undersöka sambandet mellan explosivitetstester i nedre och övre extremitet.

    Metod: 64 polisstudenter utförde tester som mätte kondition, greppstyrka, bålstabilitet, explosivitet i nedre och övre extremitet. Alla polisstudenter deltog inte i samtliga tester.

    Resultat: Polisstudenterna presterade signifikant högre resultat än normalvärden gällande maximalt syreupptag och greppstyrka. De manliga polisstudenterna hade en signifikant högre kapacitet än de kvinnliga i samtliga test utom bålstabilitetstestet. Ett signifikant samband fanns mellan explosivitet i nedre och övre extremitet.

    Slutsats: I början på sin utbildning är polisstudenterna en grupp med fysiska kapaciteter som överstiger normal fysisk förmåga. Det finns även signifikanta skillnader mellan de manliga och kvinnliga studenternas fysiska kapaciteter. Dessa resultat pekar på att antagningskraven rimligtvis bör justeras för att göra de mer rättvisa. Alternativt att en fysisk kravprofil för polisyrket arbetas fram om antagningskraven ska behållas lika för alla.

  • 343.
    Byman, Emelie
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wahlberg, Jenny
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Tankar kring bemötande och behandling av gravida kvinnors bäcken- och ländryggssmärta: En kvalitativ intervjustudie med fem barnmorskor2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Graviditetsrelaterad bäcken- och ländryggssmärta är en komplikation som drabbar närmare 50 % av alla gravida. Det är dock inte fastställt varför bara vissa kvinnor drabbas. Om de drabbade kvinnorna däremot identifieras redan vid inskrivning på mödravårdscentralen kan symtomen lindras om tidiga åtgärder sätts in.

     

    Syfte: Att undersöka barnmorskors tankar och upplevelser kring graviditetsrelaterad bäcken- och ländryggssmärta utifrån ett interprofessionellt samarbete med fysioterapeuter.

     

    Metod: Studien bygger på semistrukturerade intervjuer med fem barnmorskor. Datamaterialet genomgick en kvalitativ innehållsanalys i enlighet med Graneheim och Lundman.

     

    Resultat: Analysen resulterade i fem kategorier som berör områdena: Bemötande, diagnostisering, behandlingsalternativ, individanpassning och prevention samt interprofessionellt samarbete. Ett antal subkategorier skapades.

     

    Slutsats: Denna studie visar på att barnmorskor har stor erfarenhet och kunskap om hur graviditetsrelaterad bäcken- och ländryggssmärta diagnostiseras, tack vare deras kliniska erfarenhet. Barnmorskorna vittnar även om en viss tveksamhet i sin syn på hur dessa smärtproblem ska behandlas, vilket vittnar om behovet av att utveckla ett bättre samarbete med fysioterapeuter. I framtiden skulle de båda yrkesgrupperna i så fall kunna erbjuda dessa kvinnor bättre och mer effektiv behandling. Ökad information gällande kvinnohälsa och graviditetsrelaterad bäcken- och ländryggssmärta på bådas respektive grundutbildningar borde förbättras enligt författarna och informanterna, för att öka kunskapen och intresset för detta folkhälsoproblem.  

  • 344.
    Bäck, Maria
    et al.
    Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg.
    Jivegård, Lennart
    Department of Vascular Surgery, Sahlgrenska University Hospital/Sahlgrenska.
    Johansson, Anna
    Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg.
    Nordanstig, Joakim
    Department of Vascular Surgery, Sahlgrenska University Hospital/Sahlgrenska.
    Svanberg, Therese
    HTA-Centrum, Region Västra.
    Adania, Ulla Wikberg
    Medical Library, Sahlgrenska University Hospital/Mölndal, Gothenburg, Sweden.
    Sjögren, Petteri
    HTA-Centrum, Region Västra.
    Home-based supervised exercise versus hospital-based supervised exercise or unsupervised walk advice as treatment for intermittent claudication: a systematic review.2015In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 47, no 9, p. 801-808Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate the effects of home-based supervised exercise vs hospital-based supervised exercise, and the effects of home-based supervised exercise vs unsupervised "go home and walk advice" on daily life and corridor-walking capacity, health-related quality of life and patient-reported functional walking capacity in patients with intermittent claudication.

    DATA SOURCES: Systematic literature searches were conducted in PubMed, EMBASE, ProQuest, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Allied and Complementary Medicine Database (AMED), the Cochrane Library, and a number of Health Technology Assessment (HTA)-databases in October 2014.

    STUDY SELECTION: Randomized controlled trials and non-randomized controlled trials (> 100 patients) were considered for inclusion.

    DATA EXTRACTION: Data extraction and risk of bias assessment was performed independently and discussed in meetings.

    DATA SYNTHESIS: Seven randomized controlled trials and 2 non-randomized controlled studies fulfilled the inclusion criteria. The included studies had some, or major, limitations.

    CONCLUSION: Based on a low quality of evidence, home-based supervised exercise may lead to less improvement in maximum and pain-free walking distance, and in more improvement in daily life walking capacity, compared with hospital-based supervised exercise. Home-based supervised exercise may improve maximum and pain-free walking distance compared with "go home and walk advice" and result in little or no difference in health-related quality of life and functional walking capacity compared with hospital-based supervised exercise or "go home and walk advice". Further research is needed to establish the optimal exercise modality for these patients.

  • 345.
    Bäck, Maria
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Sahlgrens Univ Hosp, Sweden; Univ Gothenburg, Sweden.
    Lundberg, Mari
    Karolinska Inst, Sweden.
    Cider, Asa
    Sahlgrens Univ Hosp, Sweden; Univ Gothenburg, Sweden.
    Herlitz, Johan
    Univ Boras, Sweden.
    Jansson, Bengt
    Univ Gothenburg, Sweden.
    Relevance of Kinesiophobia in Relation to Changes Over Time Among Patients After an Acute Coronary Artery Disease Event2018In: JOURNAL OF CARDIOPULMONARY REHABILITATION AND PREVENTION, ISSN 1932-7501, Vol. 38, no 4, p. 224-230Article in journal (Refereed)
    Abstract [en]

    Purpose: To identify levels of kinesiophobia during the first 4 months after an acute episode of coronary artery disease (CAD), while controlling for gender, anxiety, depression, and personality traits. Methods: In all, 106 patients with CAD (25 women), mean age 63.1 11.5 years, were included in the study at the cardiac intensive care unit, Sahlgrenska University Hospital, Sweden. The patients completed questionnaires at 3 time points: in the cardiac intensive care unit (baseline), 2 weeks, and 4 months after baseline. The primary outcome measure was kinesiophobia. Secondary outcome measures were gender, anxiety, depression, harm avoidance, and positive and negative affect. A linear mixed model procedure was used to compare kinesiophobia across time points and gender. Secondary outcome measures were used as covariates. Results: Kinesiophobia decreased over time (P = .005) and there was a significant effect of gender (P = .045; higher values for women). The presence of a high level of kinesiophobia was 25.4% at baseline, 19% after 2 weeks, and 21.1% after 4 months. Inclusion of the covariates showed that positive and negative affect and harm avoidance increased model fit. The effects of time and gender remained significant. Conclusions: This study highlights that kinesiophobia decreased over time after an acute CAD episode. Nonetheless, a substantial part of the patients were identified with a high level of kinesiophobia across time, which emphasizes the need for screening and the design of a treatment intervention.

  • 346.
    Bäck, Philip
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Lindkvist, Sebastian
    Mälardalen University, School of Health, Care and Social Welfare.
    Patienters tolkning av postoperativa restriktioner inför elektiv total höftplastik: En kvalitativ intervjustudie2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 347.
    Bäcklund, Catharina
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Promoting physical activity among overweight and obese children: Effects of a family-based lifestyle intervention on physical activity and metabolic markers2010Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background Overweight and obesity in childhood is associated with physical, psychological and social consequences. Physical inactivity is regarded as one of the main factors that have contributed to the increase in childhood obesity through out the world. Overweight and obesity as well as physical activity level are shown to track from childhood to adolescence and adulthood, thereby influencing not only the current health status but also long-term health. The general purpose of this thesis was to evaluate the effect of a 2-year family-based lifestyle intervention on physical activity and metabolic health among children with overweight and obesity.

    Methods Children with overweight or obesity living in northern Sweden were recruited to the study. In total 105 children, mean age 10.5 years (SD±1.09), were randomized into either an intervention or a control group. The intervention group was offered as a 2-year family-based lifestyle intervention; the 1st year consisted of 14 group sessions and during the 2nd year the intervention was web-based. The control group did not participate in any intervention sessions, but performed all measurements. Physical activity was measured in all children using SenseWear Pro2 Armband (SWA) during 4 consecutive days before, in the middle and after the intervention, data regarding anthropometrics and blood values were collected in the same periods. Twenty-two of the children wore SWA during 14 days before the intervention in order to validate energy expenditure (EE) estimated by SWA against EE measured with double labelled water.

    Results The SWA, together with software version 5.1, proved to be a valid device to accurately estimate EE at group level of overweight and obese children. There were no statistically significant differences between the groups neither before nor after the intervention regarding physical activity and screen-time. All children significantly decreased their time being active ≥3 METs during the study period. After the study period, significantly fewer in the control group achieved the national physical activity recommendation, and they had significantly increased their screen-time. However, these changes were not seen within the intervention group. The intervention group had a significantly lower apolipoprotein B/A1 compared to the control group at 1-year measurement; no other significant differences were found regarding metabolic markers. No statistical difference was found between the groups regarding body mass index after the 2-year study period.

    Conclusion Even though a comprehensive program, the 2-year family-based lifestyle intervention had limited effects on physical activity and metabolic health in overweight and obese children. SWA is a device that can be used in future studies to measure energy expenditure among free-living overweight or obese children.

  • 348.
    Bäcklund, Catharina
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Larsson, Christel
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Effect of a 1-year lifestyle intervention on physical activity in overweight and obese children2011In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 13, no 3, p. 87-96Article in journal (Refereed)
    Abstract [en]

    This study evaluated the effect of a family-based multifactor intervention programme on physical activity among overweight or obese children. Children (n = 105, mean age 10.6 ± 1.07 years) with overweight or obesity were randomized into an intervention or control group. The intervention group participated in a 1-year programme aiming at lifestyle changes regarding food habits and physical activity. All children's physical activity was measured using SenseWear Armband at baseline and after 1 year. The children in both groups had a physical activity level (PAL) of 1.67 (0.27) at baseline. When comparing the intervention and control groups, no significant differences were found in physical activity outcome variables after 1 year of intervention. Contrarily to the hypotheses, both groups decreased their energy expenditure and time spent at >3 MET, and there was no change in steps and screen time after 1 year. Despite extensive efforts, the intervention showed no significant positive effect on overweight and obese children's PAL. Further studies are needed to obtain more knowledge on how to maintain or increase the PAL successfully among overweight and obese children.

    Read More: http://informahealthcare.com/doi/abs/10.3109/14038196.2011.566353

  • 349.
    Bäcklund, Catharina
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Larsson, Christel
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Effects on physical activity of a 2-year lifestyle intervention in overweight and obese children2011In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 13, no 3, p. 97-109Article in journal (Refereed)
    Abstract [en]

    The aim was to examine the effect on physical activity of a 2-year family-based lifestyle intervention among overweight and obese Swedish children 8–12 years of age; 105 children were randomized to either intervention or control group. The intervention group was offered a 2-year lifestyle programme. Physical activity was measured using SenseWear Pro2 Armband during 4 consecutive days before and after the intervention. When comparing the intervention and control groups, no significant differences were found in the physical activity outcome variables after 2 years of intervention. However, the intervention group decreased their number of steps per day by 13%, p = 0.003 but had an unchanged screen time, whereas the control group had an unchanged number of steps but increased their screen time by 15%, p = 0.02, from baseline to 2-year measurement. There were no significant change in the intervention group, whereas significantly fewer children in the control group achieved the physical activity recommendations at 2-year measurement (88%) compared with at baseline (98%), p = 0.007. Future interventions regarding physical activity among overweight and obese children are of great importance even though the present one showed limited effects. In the continuing work, a greater effect may be received with an extended and more intense intervention regarding physical activity, focusing on reducing sedentary time rather than increasing the physical activity level.

    Read More: http://informahealthcare.com/doi/abs/10.3109/14038196.2011.562540

  • 350.
    Bäckman, Pernilla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Validering av självtest för balans och funktionell styrka med mobiltelefon för äldre personer2018Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Att testa balans och styrka med hjälp av en mobiltelefon skulle kunna göra det möjligt för äldre att själva utföra enklare balans- och styrketest i hemmiljö. En prototyp av ett sådant test har tagits fram och som en del i utvecklingen av prototypen ska testresultat jämföras mot kliniskt validerade test. Syfte: Undersöka den samtidiga validiteten mellan kliniska test och rörelsevariabler insamlade samt beräknade med en prototyp av en mobil applikation. Metod: 21 personer (medelålder 78år) inkluderades. Korrelation mellan mobiltelefonens registreringar under 4- stage balance test samt en maximal uppresning och resultatet för sju kliniska test (five times sit to stand, 1 repetitions maximum i benpress, 30 sekunders uppresningstest, MiniBESTest, functional reach, modifierat stepping test och 4-stage balance test) beräknades. Resultat: De variabler som beräknats från mobiltelefonens registreringar under maximalt uppresningstest korrelerade samtliga signifikant med resultatet på 30 sekunders uppresningstest. För balanstesten sågs en korrelation mellan mobiltelefonens registreringar av svaj i den svåraste fotpositionen deltagarna klarat och den totala tiden deltagarna balanserat i 4-stage balance test. I övrigt fanns inga signifikanta korrelationer. Slutsats: Mätningar med en mobiltelefon under en maximal uppresning skulle kunna kvantifiera äldres funktionella benstyrka i likhet med 30 sekunders uppresningstest. En mobiltelefons mätningar verkar inte kunna kvantifiera äldre personers balans på liknande sätt som kliniska balanstest

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