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  • 351.
    Rydhé, Alexander
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Bidebo, Rasmus
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Effekter av hög - och lågbelastande träning av motorisk kontroll på mm. multifidus tjocklek och förmågan till aktivering2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 352.
    Rystedt, Emma
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Svensson, Lina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Fysisk aktivitet, syreupptagningsförmåga och balans hos män och kvinnir vid 34 och 50 års ålder2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 353.
    Röding, Jenny
    et al.
    Department of Health Sciences, Luleå University of Technology, Luleå, Sweden.
    Glader, Eva-Lotta
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Malm, Jan
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurology.
    Eriksson, Marie
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Lindström, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Perceived impaired physical and cognitive functions after stroke in men and women between 18 and 55 years of age: a national survey2009In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 31, no 13, p. 1092-9Article in journal (Refereed)
    Abstract [en]

    PURPOSE: We describe self-reported consequences for physical and cognitive functions, detect possible gender differences, and find factors that were associated with deteriorated physical function in younger stroke patients, independent in their personal activities of daily life. METHODS: This study involved all first ever stroke patients, aged 18-55 years, registered in the Swedish national quality register for stroke. A questionnaire was answered by 1068 patients 8-36 months after the stroke. Changes were sought in physical and cognitive functions as compared with the pre-stroke condition. RESULTS: Eight hundred and sixty-seven patients (83%) were independent in personal activities of daily life. Significant differences between men and women were found: deteriorated physical ability was reported by 56-71% of the men and 65-79% of the women; deteriorated cognitive function was reported by 48-57% of the men and 57-68% of the women. Many patients (70% men, 77% women) reported that they had received insufficient information about physical exertion. Significant associations were found between deteriorated physical function and deteriorated cognitive function as well as fear of physical exertion. CONCLUSIONS: Deterioration was found in physical and cognitive functions greater in women then in men. Insecurity regarding physical exertion existed indicating that younger stroke patients might need information directly aimed at physical functioning and more gender specific than today. This study has raised the awareness that there also might be gender differences in other fields, which needs further studies.

  • 354.
    Röding, Jenny
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Glader, Eva-Lotta
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Malm, Jan
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurology.
    Lindström, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Life satisfaction in younger individuals after stroke: different predisposing factors among men and women2010In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 42, no 2, p. 155-161Article in journal (Refereed)
    Abstract [en]

    There were different factors for being satisfied with life as a whole between men and women, indicating a need for a more gender-specific rehabilitation than is currently used. The impact that deteriorated ability to concentrate has on life satisfaction is an important finding that needs to be considered in the rehabilitation process of younger patients after stroke.

  • 355.
    Röijezon, Ulrik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sensorimotor function in chronic neck pain: objective assessments and a novel method for neck coordination exercise2009Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Chronic neck pain is a widespread problem that causes individual suffering as well as large costs for the society. The knowledge about the pathophysiology is poor and therefore specific diagnosis and causal treatment are rare. Important knowledge for characterization of the disorders has been gained from research on sensorimotor functions in people with neck pain. Moreover, rehabilitation regimes including sensorimotor exercises indicate promising results.

    The main objectives of this thesis were to extend the knowledge on sensorimotor dysfunctions in chronic neck pain, and to develop a new exercise method for improving sensorimotor functions of the neck. The studies focused on aspects of postural control and movements of the arm and neck. These are vital functions for many activities of daily living. People with chronic (>3 months) neck pain were compared to healthy controls (CON). Neck pain related to trauma was referred to as whiplash associated disorders (WAD), while neck pain without association to trauma was referred to as non-specific (NS).

    Arm-functioning was assessed in a pointing task. WAD and NS had reduced pointing precision compared to CON. The reduced precision was associated with self-rated difficulties performing neck movements, physical functioning, and in WAD, also pain and balance disturbances.

    Postural control was assessed in quiet standing on a force platform without vision. The center of pressure signal was decomposed into it’s slow and fast components. WAD and NS were compared to CON. The results revealed an effect of age on the magnitude of the fast sway component, but no effect of group. The magnitude of the slow component was elevated in both WAD and NS. This increase was associated with self-rated balance disturbance, arm-functioning, difficulties to run and sensory alterations in WAD, while in NS, the increase in the slow sway component was associated with concurrent low back pain.

    Neck movements were assessed in a cervical axial rotation test with maximal speed. In total 8 variables representing basic kinematics, including variables reflecting movement smoothness and conjunct motions were calculated. NS were compared to CON. Linear discriminant modelling indicated Peak Speed and conjunct motions as significant classification variables that together had a sensitivity of 76.3% and specificity of 77.6%. Retest reliability was good for Peak Speed but poor for the measure of conjunct motions. Peak Speed was slower in NS compared to CON, and even slower in a sub-group of NS with concurrent low back pain. Reduced Peak Speed was associated with self-rated difficulties performing neck movements, car driving, running, sleeping disturbances and pain.

    The clinical applicability of a novel method for neck coordination exercise was assessed in a pilot study on persons with NS. The results supported the applicability and indicated positive effects of the exercise: reduced postural sway in quiet standing and increased smoothness in cervical rotations. Indications on improvement in self-rated disability and fear of movement were seen at six months follow up.

    In conclusion, sensorimotor functions can be altered in chronic neck pain, particularly in neck disorders with concurrent low back pain and WAD. The discriminative ability and clinical validity displayed in pointing precision, postural sway and cervical axial rotation speed imply that such tests can be valuable tools in the assessment of chronic neck pain patients, and for selecting and evaluating treatment interventions. Indications of improvements seen in the pilot-study support a future RCT.

  • 356.
    Röijezon, Ulrik
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Björklund, Martin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Djupsjöbacka, Mats
    Högskolan i Gävle.
    The slow and fast components of postural sway in chronic neck pain2011In: Manual Therapy, ISSN 1356-689X, E-ISSN 1532-2769, Vol. 16, no 3, p. 273-278Article in journal (Refereed)
    Abstract [en]

    Objective: To evaluate the slow and fast components of postural control in quiet stance in subjects with chronic neck pain, associations between postural sway and self-rated characteristics and to study the impact of anthropometrics on postural sway.

    Design: A single-blinded cross-sectional study including two separate data collections.

    Subjects: Sample 1: Persons with chronic non-specific neck pain (NS, n=24), whiplash associated disorders (WAD, n=21). Healthy subjects were controls (CON, n=21). Sample 2: Women only, 98 NS and 32 CON subjects.

    Methods: Subject performed a quiet stance test with eyes closed on a force platform while the center of pressure (CoP) trajectory was measured. Sample 1 was tested on a firm surface for 30 seconds, while sample 2 was tested on both firm and foam surfaces for 190 seconds. The CoP signal was decomposed into the slow and fast components and the magnitude of these signals were calculated. Anthropometrics were included as covariate in the analysis of group differences if correlated with postural sway variables. Group differences in the sway variables were evaluated, as well as association between postural sway and self-ratings of symptoms, functioning and kinesiophobia.

    Results: Increased magnitude of the slow sway component was found for both neck pain groups. Increasing age was associated with increased magnitude of the fast component. Surface conditions had no effect on group difference. For WAD, associations were found between the magnitude of the slow component and self-rated characteristics related to physical functioning, sensory alterations and psychosocial functioning. For NS, concurrent low back pain was associated with increased postural sway.

    Conclusion: Postural control can be altered in chronic neck pain. This effect was present only for the slow sway component, which implies aberration in sensory feedback or processing of sensory information. Associations between postural sway and self-rated characteristics in WAD support the clinical validity of postural control assessment in this group. Increased postural sway found in NS with concurrent low back pain suggests an important role of generalised spinal pain on postural control alterations.

  • 357.
    Rönnbäck, Moa
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Karlsson, Victoria
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Effects of moderate intensity treadmill walking on experimentally induced pain in the calf muscle2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 358.
    Rönnquist, Anneli
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Heitmann, Emelie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Posturalt svaj vid olika sensoriska förutsättningar hos unga personer med intellektuellt funktionshinder2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakrund: Personer med intellektuellt funktionshinder (IF) har nedsatt postural balans och faller oftare än personer utan IF. Varför de faller är ännu oklart.

    Syfte: Undersöka sensoriska strategier för att upprätthålla balansen samt hur en kognitiv uppgift påverkar hos ungdomar med IF i jämförelse med en åldersmatchad kontrollgrupp.

    Metod: Testgruppen bestod av 56 unga personer (16-20 år) med lätt till moderat IF. Kontrollgruppen bestod av 43 åldersmatchade personer utan IF. Posturalt svaj undersöktes under olika sensoriska förutsättningar för att utmana balansorganen. Det ingick även en kognitiv uppgift. Svajhastigheten mättes indirekt med hjälp av en kraftplatta då testpersonerna stod i en upprätt position.

    Resultat: De unga personerna med IF hade en signifikant ökad svajhastighet under olika sensoriska förutsättningar i jämförelse med kontrollgruppen, även om svarsmönstret för de olika förutsättningarna var likadana. Den kognitiva uppgiften gav inte en signifikant högre svajhastighet än någon av de andra sensoriska förutsättningarna.

    Konklusion: Unga personer med IF har nedsatt postural stabilitet. Eftersom svarsmönstret för olika sensoriska förutsättningar ser liknande ut tyder detta på att ungdomar med IF inte förlitar sig mer på något sensoriskt system än något annat, jämfört med kontrollgruppen. En kognitiv uppgift ger inte en högre svajhastighet än någon av de andra sensoriska förutsättningarna vilket tyder på att en tillförd kognitiv uppgift inte påverkar svajhastigheten signifikant om personens övriga sensoriska system är ostörda.

  • 359.
    Rönnqvist, Louise
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Rösblad, Birgit
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Kinematic analysis of unimanual reaching and grasping movements in children with hemiplegic cerebral palsy2007In: CLIN BIOMECH, ISSN 0268-0033, Vol. 22, no 2, p. 165-175Article in journal (Refereed)
  • 360.
    Rösblad, Birgit
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    The development of reaching and eye-hand coordination2006In: The development of Hand Skills in Children / [ed] Henderson A , Pehoski C, St, Louis: Mosby Elsevier , 2006Chapter in book (Other academic)
  • 361.
    Rösblad, Birgit
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Andersson, Gerd
    Pettersson, Kurt
    Effects of botulinum toxin type A and a programme of functional activity to improve manual ability in children and adolescents with cerebral palsy.2007In: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 41, no 5, p. 250-8Article in journal (Refereed)
    Abstract [en]

    We aimed to evaluate the effectiveness of a clinical programme that combined botulinum toxin injections with a functional activity programme to improve manual ability in children and adolescents with cerebral palsy. A total of 25 young people age range 2 to 19 years participated. They were given injections of botulinum toxin type A into spastic muscles in the upper extremities and participated in a functional activity training programme. Standardised clinical assessments were made before injections, one to two months after, and six months after, the final injections. To assess if the treatment had changed their ability to use the treated hand in activities of everyday life a questionnaire was given to the parents. The families thought that the ability had improved, and that the improvements took place both during the first three months after treatment and after more than six months after the final injections. The ability to extend wrist and fingers actively and the position of the thumb had improved significantly both in the short and long- term. This study supports the assumption that a programme combining botulinum toxin A injections with training in functional activity improves manual ability in young people with cerebral palsy.

  • 362.
    Sandberg, Camilla
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Engström, Karl Gunnar
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Dellborg, Mikael
    Thilén, Ulf
    Wadell, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Johansson, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Heart Centre, Umeå.
    The level of physical exercise is associated with self-reported health status (EQ-5D) in adults with congenital heart disease2015In: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881, Vol. 22, no 2, p. 240-248Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The prognosis in adults with congenital aortic valve disease is usually favourable; nevertheless, a number of medical and social factors might hamper long-term prognosis and quality of life. With a focus on physical exercise level, data from the Swedish National Registry on Congenital Heart Disease (SWEDCON) were analysed and variables associated with health-related quality of life in adults with congenital aortic valve disease were identified.

    METHODS: In this registry study, SWEDCON was searched for adult patients with isolated congenital aortic valve disease and valid EuroQol-5Dimensions health questionnaire (EQ-5D) data.

    RESULTS: This study identified 315 patients. The majority (n = 202, 64%) reported best possible health status (EQ-5Dindex = 1) whereas 113 (35%) reported some impairment (EQ-5Dindex < 1) with mean EQ-5Dindex 0.73 ± 0.17. In a multivariate logistic regression model, self-reported physical exercise > 3 h/week was independently associated with best possible health status (EQ-5Dindex = 1; p = 0.013). Moreover presence of cardiovascular symptoms (p < 0.001), active smoking (p = 0.002), history of valve surgery (p = 0.017), low educational level (p = 0.022), and higher systolic blood pressure (p = 0.029) were independently associated with impaired health status (EQ-5Dindex < 1).

    CONCLUSIONS: Physical exercise >3 h/week was, as a single variable, associated with best possible health status in adults with congenital aortic valve disease. In contrast, a number of medical and social factors are associated with worse self-reported health status. Among these, symptoms, smoking, and educational level are potential targets for modification and intervention. There is a need for studies investigating the effect of increased level of physical exercise in patients with congenital aortic valve disease.

  • 363.
    Sandberg, Camilla
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Umeå Heart Centre.
    Thilen, U.
    Wadell, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Engström, Karl-Gunnar
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Johansson, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Umeå Heart Centre.
    Complex adult congenital heart disease is associated with impaired skeletal muscle function2013In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 34, no Supplement: 1, p. 383-383Article in journal (Refereed)
    Abstract [en]

    Purpose: Complex congenital heart disease is often associatedwith impaired physical functioning, usually measured as peak oxygen uptake in an exercise test. Skeletal muscle function is, however, less studied in these patients.

    Methods: Unilateral isotonic shoulder flexion was tested in 79 adultpatients (mean age 36.6±14.8 years, 31 females) with congenital heartdisease, classed as either "complex" (n=41, 51.9%) or "simple" (n=38, 48.1%). The patients were sitting comfortably in a chair with their back touching the wall and holding a weight (2 kg for women and 3 kg for men) in the hand of the tested side. The patients were asked to elevate the arm, from 0 to 90 degrees flexion, as many times as possible. The pace of 20 contractions per minute was held using a metronome.

    Results: Patients with complex lesions performed less shoulder flexions compared with patients with simple lesions (29.2±10.0 vs. 54.6±25.8, p<0.001). In univariate analysis including a number of demographic and clinical variables, only complexity of cardiac lesion (p<0.001) and on-going cardiac medications (p=0.012) were associated with shouldermuscle function, of which complexity (p<0.001) remained significant in multivariate analysis.

    Conclusion: There is a marked difference in shoulder muscle functionbetween patients with complex and simple congenital heart disease. Such differences might affect ability to perform daily activities and contribute to impaired overall physical functioning. Rehabilitation targeting muscle function may be indicated in patients with complexcongenital heart disease.

  • 364.
    Sandberg, Camilla
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Umeå Heart Centre.
    Wadell, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gradmark, Anna
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Umeå Heart Centre.
    Thilen, U.
    Engström, Karl-Gunnar
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Johansson, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Umeå Heart Centre.
    Physical activity level in adults with congenital heart disease: effects of gender and complexity of heart lesion2013In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 34, no Supplement: 1, p. 382-383Article in journal (Refereed)
    Abstract [en]

    Purpose: Many adults with congenital heart disease have reduced exercise capacity but only little is known about habitual physical activityin this group. The aim of this study was to investigate habitual physicalactivity level in a cohort of adults with congenital heart disease.

    Methods: Seventy-five adult patients (29 females) aged 37.2±15.1 yearswith congenital heart disease classed as either simple or complex were studied with a combined accelerometer and heart rate monitor (Actiheart). The patients carried the Actiheart during 5 consecutive days, and where encouraged to proceed with their usual daily activities. Data was analysed with the Actiheart Software version 2.2. A mean ofPhysical Activity Level (PAL) (PAL=Total Energy Expenditure/Resting Energy Expenditure) over 4 days was calculated. PAL < 1.45 was categorised as low, 1.45-1.6 as moderate and >1.6 as high.

    Results: Forty-three patients (57,3%) had low PAL, 18 (24%) moderate PAL and 14 (16,7%) high PAL. PAL was lower in women compared to men (1.32±0.10 vs. 1.52±0.18, p < 0.001). PAL was higher in patients withsimple compared with complex congenital heart disease (1.50±0.21 vs. 1.39±0.14, p = 0.019). Among men, active smoking (p=0.015) and lower age (p=0.04) were independently associated with higher PAL, whereas no such associations were observed among women.

    Conclusion: The majority of the observed patients had low PAL and women had lower PAL compared to men. PAL was related to complexity ofheart lesion. Efforts to increase habitual physical activity may beindicated in this population, especially in women and patients withcomplex congenital heart disease.

  • 365.
    Sandberg, Malin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Dynesius, Joel
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Genusperspektiv på samband mellan graden av upplevd funktionsnedsättning och arbetsbörda i hemmet hos män och kvinnor med nack- och ländryggsbesvär2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 366.
    Sandell, Christofer
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Frykman, M
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Chesky, K
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Playing-related musculoskeletal disorders and stress-related problems among percussionists2009In: Medical problems of performing artists, ISSN 0885-1158, E-ISSN 1938-2766, Vol. 24, no 4, p. 175-180Article in journal (Refereed)
    Abstract [en]

    This cross-sectional study examined the prevalence of self-reported playing-related musculoskeletal disorders (PRMDs) and stress-related health problems among percussionists. Data for the present study were extracted from the University of North Texas Musician Health Survey (UNT-MHS) data set. Subjects (n = 279) were included if they identified auxiliary percussion (i.e., tambourine, triangle, bells, rattle, wood block), drum set, marimba, steel drum, timpani, vibraphone, xylophone, or other percussion as their primary instrument. Prevalence rates for PRMDs and stress-related health problems were determined for the total percussion group and for separate instrument categories. Of the total group, 77% reported one or more PRMDs. The keyboard percussionists (marimba, vibraphone, xylophone, and steel drum) reported the significantly highest prevalence (89%), followed by auxiliary and other percussionists (79%) and membranophone percussionists, including drum set and timpani (74%). The highest region-specific prevalence of PRMDs for the whole group was found in the bilateral hand and low back regions. Stress due to work environment was considered moderate to high by 75% of the respondents. Regarding stress-related health problems, percussionists reported primarily problems with fatigue, depression, and stage fright. The overall findings of this study show that PRMDs and stress-related health problems are a major concern for percussionists and warrant further research.

  • 367.
    Sandlund, Marlene
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Motion interactive games for children with motor disorders: motivation, physical activity, and motor control2011Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    As motion interactive games have become more widespread the interest in using these games in rehabilitation of children with motor disorders has increased among both clinical professionals and the families of these children. The general aim of this thesis was to evaluate the feasibility of using interactive games in rehabilitation of children to promote motivation for practice, physical activity, and motor control. A systematic review of published intervention studies was conducted to obtain an overview of existing research and the current levels of evidence for using interactive games in motor rehabilitation of children. Sixteen studies met the inclusion criteria, out of these three were randomized controlled trials while half were case series or case reports. Thirteen studies presented positive findings, which indicated a promising potential. However, more convincing research is needed.

    Commercially available motion interactive games have only been used in a few studies on motor control, and in none of these home based practice was provided. Moreover, no earlier studies have evaluated if these games may increase motivation for training and daily physical activity among children with disabilities. To address these issues a feasibility intervention including 15 children in the ages 6-16 years and with mild to moderate cerebral palsy was conducted. Each child was provided with a Sony PlayStation2â and the EyeToyâ games in Play3, and was recommended to practice with the provided games for at least 20 minutes/day during four weeks. The intervention was evaluated with gaming diaries, physical activity monitors (SenseWear Armband), interviews with the parents, and the clinical motor tests Movement Assessment Battery for Children-2 (mABC-2), Bruininks-Oseretsky Test of Motor Proficiency subtest 5:6, and the 1 Minute Walk Test. In addition, 3D motion analysis was used to evaluate effects on quality of goal-directed arm movements towards virtual and real objects, respectively.

    Motivation for practice and compliance of training were high, although declining somewhat during the course of the four weeks. The children’s physical activity increased significantly during the intervention. However, four children were excluded from this analysis due to lack of complete data from the physical activity monitors. According to mABC-2 the children’s motor performance improved, but there were both floor and ceiling effects, indicating a low sensibility of this test. The two additional motor tests showed only non-significant progress. Results from the 3D motion analysis suggest that the children improved movement precision when playing the games, movement smoothness when reaching for real objects, and used a more economic reaching strategy with less trunk involvement. In the interviews the parents expressed the view that motion interactive games promote positive experiences of physical training and add elements of social interaction to the training. They also experienced less urge to take on a coaching role. The training provided by the games was considered unspecific and there was a desire for individualized games to better address the unique rehabilitative need of each child.

    In conclusion, it is feasible to use motion interactive games in home rehabilitation for children with cerebral palsy to promote short term motivation for practice and general physical training. Specific effects on motor control need to be further explored and there is also a need for reliable tests that are adequate and sensitive enough to capture changes in movement control. In future development of interactive games for rehabilitation purposes, it is a challenge to preserve the motivational and social features of games while at the same time optimizing an individualized physical training.

  • 368.
    Sandlund, Marlene
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Dock, Katarina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Häger, Charlotte K
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lindh Waterworth, Eva
    Umeå University, Faculty of Social Sciences, Department of Informatics.
    Motion interactive video games in home training for children with cerebral palsy: parents' perceptions2012In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 34, no 11, p. 925-933Article in journal (Refereed)
    Abstract [en]

    Purpose: To explore parents' perceptions of using low-cost motion interactive video games as home training for their children with mild/moderate cerebral palsy.

    Method: Semi-structured interviews were carried out with parents from 15 families after participation in an intervention where motion interactive games were used daily in home training for their child. A qualitative content analysis approach was applied.

    Results: The parents' perception of the training was very positive. They expressed the view that motion interactive video games may promote positive experiences of physical training in rehabilitation, where the social aspects of gaming were especially valued. Further, the parents experienced less need to take on coaching while gaming stimulated independent training. However, there was a desire for more controlled and individualized games to better challenge the specific rehabilitative need of each child.

    Conclusions: Low-cost motion interactive games may provide increased motivation and social interaction to home training and promote independent training with reduced coaching efforts for the parents. In future designs of interactive games for rehabilitation purposes, it is important to preserve the motivational and social features of games while optimizing the individualized physical exercise.

  • 369.
    Sandlund, Marlene
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Domellöf, Erik
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Grip, Helena
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rönnqvist, Louise
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Effect of practice with motion interactive video games on goal-directed arm movements in children with cerebral palsy: a kinematic evaluationManuscript (preprint) (Other academic)
    Abstract [en]

    Objective: The aim of the present study was to evaluate the quality of goal-directed arm movements in children with cerebral palsy after four weeks of daily practice with motion interactive games, and to explore and compare the applicability of various kinematic parameters in a virtual context compared to a situation with real objects.

    Methods: Fifteen children with CP, 6-16 years, practiced with the EyeToyâ for PlayStation2â in their homes during four weeks. Before and after the intervention kinematics and kinetics were captured with a five camera motion analysis system (Proreflex, Qualisys AB, Gothenburg, Sweden) and a force plate. The children performed arm movements towards both virtual and real targets.

    Results: The children used a more economic reaching strategy with shorter Centre of pressure paths, improved Movement precision, and reduced variability in Maximal shoulder angles during play after practice. Transfer of improved motor control to goal-directed arm movements towards real targets was also indicated by increased Movement smoothness, and while reaching with the non-dominant side, reduced Centre of pressure paths path. The spatiotemporal characteristics proved complex to interpret in terms of improved motor control.

    Conclusions: When taking the constraints of the tasks into account the relevant kinematic parameters explored support the conclusion that practice with motion interactive games resulted in an improved motor control. The results of this study illuminate the importance of considering both the nature of the task and the context in which movements are performed when selecting and interpreting kinematic parameters.

  • 370.
    Sandlund, Marlene
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Domellöf, Erik
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Grip, Helena
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rönnqvist, Louise
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Häger, Charlotte K.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Training of goal directed arm movements with motion interactive video games in children with cerebral palsy: a kinematic evaluation2014In: Developmental Neurorehabilitation, ISSN 1751-8423, E-ISSN 1751-8431, Vol. 17, no 5, p. 318-326Article in journal (Refereed)
    Abstract [en]

    Objective: The main aim of this study was to evaluate the quality of goal-directed arm movements in 15 children with cerebral palsy (CP) following four weeks of home-based training with motion interactive video games. A further aim was to investigate the applicability and characteristics of kinematic parameters in a virtual context in comparison to a physical context.

    Method: Kinematics and kinetics were captured while the children performed arm movements directed towards both virtual and physical targets.

    Results: The children’s movement precision improved, their centre of pressure paths decreased, as did the variability in maximal shoulder angles when reaching for virtual objects. Transfer to a situation with physical targets was mainly indicated by increased movement smoothness.

    Conclusion: Training with motion interactive games seems to improve arm motor control in children with CP. The results highlight the importance of considering both the context and the task itself when investigating kinematic parameters.

  • 371.
    Sandlund, Marlene
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Grip, Helena
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Domellöf, Erik
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Rönnqvist, Louise
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Low-cost motion interactive video games in home training for children with cerebral palsy: A kinematic evaluation2011In: 2011 International Conference on Virtual Rehabilitation, ICVR / [ed] Daniel Thalmann, IEEE conference proceedings, 2011Conference paper (Refereed)
    Abstract [en]

    3D motion analysis was applied to assess goal-directed arm movements in 15 children with cerebral palsy (CP) before and after four weeks of home training with low-cost motion interactive video games. The results indicated that the children improved movement precision when playing the virtual games, improved movement smoothness when reaching for real targets, and reduced the involvement of the trunk especially when reaching with the non-dominant side. © 2011 IEEE.

  • 372.
    Sandlund, Marlene
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hoshi, Kei
    Umeå University, Faculty of Social Sciences, Department of Informatics.
    Lindh Waterworth, Eva
    Umeå University, Faculty of Social Sciences, Department of Informatics.
    Häger-Ross, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    A conceptual framework for design of interactive computer play in rehabilitation of children with sensorimotor disorders2009In: Physical Therapy Reviews, ISSN 1083-3196, E-ISSN 1743-288X, Vol. 14, no 5, p. 348-354Article in journal (Refereed)
  • 373.
    Sandlund, Marlene
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    McDonough, Suzanne
    Häger-Ross, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Interactive computer play in rehabilitation of children with sensorimotor disorders: a systematic review2009In: Developmental medicine and child neurology, ISSN 1469-8749, Vol. 51, no 3, p. 173-179Article in journal (Refereed)
    Abstract [en]

    The aim of this review was to examine systematically the evidence for the application of interactive computer play in the rehabilitation of children with sensorimotor disorders. A literature search of 11 electronic databases was conducted to identify articles published between January 1995 and May 2008. The review was restricted to reports of intervention studies evaluating the impact of interactive computer play on motor rehabilitation in children. For each study the quality of the methods and the strength of the evidence were assessed by two independent reviewers using the guidelines of the American Academy for Cerebral Palsy and Developmental Medicine. A total of 74 articles were identified, of which 16 met the inclusion criteria. Three studies were randomized controlled trials (RCTs) and half were case series or case reports. Areas investigated were movement quality, spatial orientation and mobility, and motivational aspects. Thirteen studies presented positive findings. Two of the three RCTs investigating movement quality and one level III study examining spatial orientation showed no significant improvements. Interactive computer play is a potentially promising tool for the motor rehabilitation of children but the level of evidence is too limited to assess its value fully. Further and more convincing research is needed.

  • 374.
    Sandlund, Marlene
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Waterworth, Eva
    Umeå University, Faculty of Social Sciences, Department of Informatics.
    Häger-Ross, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Using motion interactive games to promote physical activity and enhance motor performance in children with cerebral palsy2011In: Developmental Neurorehabilitation, ISSN 1751-8423, E-ISSN 1751-8431, Vol. 14, no 1, p. 15-21Article in journal (Refereed)
    Abstract [en]

    Objective: To explore the feasibility of using low-cost motion interactive games as a home-based intervention for children with cerebral palsy (CP).

    Methods: Fourteen children with CP, 6–16 years old, practiced with the EyeToy for PlayStation2® in their homes during 4 weeks. Outcome measures were physical activity monitors, Movement Assessment Battery for Children-2 (mABC-2), Bruininks-Oseretsky Test of Motor Proficiency (sub-test 5 : 6), 1 Minute Walk Test and gaming diaries.

    Results: Motivation for practice and compliance of training were high. The children's physical activity increased during the intervention and activity monitors were feasible to use, although data loss may be a concern. According to mABC-2 the children's motor performance improved, but there were both floor and ceiling effects. The two additional motor tests showed only non-significant progress.

    Conclusion: It is highly feasible to use motion interactive games in home rehabilitation for children with CP. Specific motor effects need to be further explored.

  • 375.
    Sandström, Marianne
    et al.
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Development and evaluation of a new questionnaire for rating perceived participation2007In: Clinical rehabilitation, ISSN 0269-2155, Vol. 21, p. 833-845Article in journal (Refereed)
  • 376.
    Schnabel, Annette
    et al.
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Bengs, Carita
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Wiklund, Maria
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS). Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Modernità, stress e ricerca dell'autogestione emotiva2012In: Salute e Società. La medicina delle emozioni e delle cognizioni, ISSN 1723-9427, no 2, p. 74-89Article in journal (Refereed)
    Abstract [en]

    Sociology has a longstanding tradition in describing the emotional regime of modernity as "disciplining" effect, accompanied by an increased demand for selfregulation (Elias). Recently, researchers stressed that we nowadays observe a growing informalization of emotion rules (Wouters) and an increased demand for the emotional labour (Hochschild). The tension between disciplinary limitation of emotions and their informalization is mirrored in the growing necessity to psychologically and chemically alter and optimize emotions (Neckel). Beyond a mere theoretical analysis of this tension, the article empirically explores the selfperceptions and self-management strategies of young women in Sweden in order to cope with felt oppression and stress in relation to the emotional and behavioural demands of their environment.

  • 377. Schneiders, Anthony G
    et al.
    Davidsson, Åsa
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hörman, Elvira
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sullivan, S John
    Functional movement screenTM normative values in a young, active population2011In: International journal of sports physical therapy, ISSN 2159-2896, Vol. 6, no 2, p. 75-82Article in journal (Refereed)
    Abstract [en]

    Background: The Functional Movement ScreenTM (FMSTM) is a screening instrument which evaluates selective fundamental movement patterns to determine potential injury risk. However, despite its global use, there are currently no normative values available for the FMSTM.

    Objectives: To establish normative values for the FMSTM in a population of active, healthy individuals. Secondary aims were to investigate whether performance differed between males and females, between those with and without a previous history of injury, and to establish real-time inter-rater reliability of the FMSTM.

    Methods: Two hundred and nine (108 females and 101 males) physically active individuals, aged between 18 and 40 years, with no recent (<6 weeks) history of musculoskeletal injury were recruited. All participants performed the FMSTM and were scored using the previously established standardized FMSTM criteria. A representative sub-group participant sample (28%) determined inter rater reliability.

    Results: The mean composite FMSTM score was 15.7 with a 95% confidence interval between 15.4 and 15.9 out of a possible total of 21. There was no statistically significant difference in scores between females and males (t 207= .979, p = .329), or those who reported a previous injury and those who did not (t207 = .688, p= .492). Inter-rater reliability (ICC 3,1) for the composite FMSTM score was .971, demonstrating excellent reliability. Inter-rater reliability (Kappa) for individual test components of the FMSTM demonstrated substantial to excellent agreement (0.70 — 1.0).

    Discussion and Conclusion: This cross-sectional study provides FMSTM reference values for young, activeindividuals, which will assist in the interpretation of individual scores when screening athletes for musculoskeletal injury and performance factors.

  • 378.
    Singh, Erik
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Tideryd, Henrik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Effekt av låg och högbelastande motorisk kontrollträning hos patienter med perifer nociceptiv ländryggssmärta: en randomiserad kontrollerad studie2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 379.
    Skoglund, Jörgen
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Test-retest and inter-observer reliability of abattery of physical performance tests for the Military Service2013Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Militära operationer kräver ofta soldater med hög fysisk kapacitet. Valida och reliabla tester vid urval till fysiskt krävande uppgifter såsom militära operationer är därför viktiga för att identifiera de individer som löper en ökad risk att drabbas av skador. Syftet med denna studie var att bedöma test-återtest och inter-bedömarreliabilitet av testerna: lyft med kettlebells, chins och statiskt ryggtest.

    Metod:

    En test-återtest med en bedömare och en inter-bedömartest med fyra bedömare genomfördes. Totalt inkluderades 43 försökspersoner i studien med en medelålder på 25.6 år. Testerna genomfördes vid två tillfällen med en veckas intervall.

    Resultat:

    Test-retest reliabilitet visade utmärkta intra-class correlation coefficient (ICC) värden (0.84-0.98). Standard error of measurement (SEM) % värdena för test-retest var ganska små med undantag för testet lyft med kettlebells där ett högre SEM% värde noterades (8.5%-16.5%). Smallest real difference (SRD) visade 8.09 för lyft med kettlebells, 2.29 för chins och 22.09 för statiskt ryggtestet. ICC-värdena för inter-bedömar reliabilitet var nästan perfekta (0.99-1.00) och SEM% värdena var relativt små (0.96-9.07). Lyft med kettlebells visade SRD värden mellan 0.75 och 1.46, chins 1.36-1.93 och statiskt ryggtest 1.99-3.81.

    Slutsats:

    Studien visade utmärkta resultat vid undersökning av test-återtest och inter-bedömarreliabilitet på det aktuella testbatteriet för soldater. Vi anser att resultatet från denna studie kan ge värdefull information för forskare och kliniker som vill använda dessa tester för att bedöma soldaters fysiska prestationsförmåga.

  • 380. Sole, G
    et al.
    Tengman, Eva
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Grip, H
    Selling, Jonas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Knee kinematics during stair descent more than 20 years following anterior cruciate ligament injury2014Conference paper (Other academic)
  • 381. Sole, Gisela
    et al.
    Hamrén, Jonas
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Milosavljevic, Stephan
    Nicholson, Helen
    Sullivan, S John
    Test-retest reliability of isokinetic knee extension and flexion.2007In: Archives of physical medicine and rehabilitation, ISSN 0003-9993, Vol. 88, no 5, p. 626-31Article in journal (Refereed)
  • 382. Sole, Gisela
    et al.
    Tengman, Eva
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Grip, Helena
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Knee kinematics during stair descent 20 years following anterior cruciate ligament rupture with and without reconstruction2016In: Clinical Biomechanics, ISSN 0268-0033, E-ISSN 1879-1271, Vol. 32, p. 180-186Article in journal (Refereed)
    Abstract [en]

    Background: Changes and asymmetries for walking gait have been explored extensively following injuries of anterior cruciate ligaments within ten years of injury or reconstruction. We examined longer term knee joint kinematics of reconstructed and non-reconstructed knees during stair descent compared to controls. Methods: Three-dimensional knee kinematics during stair descent were registered for 33 subjects with ACL reconstruction, 36 subjects with ACL rupture managed with physiotherapy only and 31 uninjured controls. Injured subjects were 23.5 (2.1) years following injury. Linear mixed models were used to compare temporal variables and knee kinematics during stance phase between groups and contralateral sides. Findings: Walking speed was slower for the both ACL-injured groups compared to controls and stance duration was longer for the injured than the uninjured sides of the physiotherapy-only group. Compared to controls, the physiotherapy-only group had significantly less adduction at initial foot contact of the injured and uninjured knees. The uninjured side of the physiotherapy-only group also had less flexion than controls at initial foot contact and during weight acceptance. Compared to the surgically-managed group, the injured sides of the physiotherapy-only groups had significantly less adduction at initial contact, peak adduction during weight acceptance, and peak flexion during propulsion. Interpretation: Independent of treatment, altered knee kinematics exist more than 20 years following ACL injury during stair descent. We suggest that future studies investigating short and long-term kinematic outcomes of ACL injury could evaluate stair descent with particular emphasis on weight acceptance of stance, and potential associations to perceived knee function.

  • 383.
    Srinivasan, Divya
    et al.
    Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, Sweden.
    Rudolfsson, Thomas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, Sweden.
    Mathiassen, Svend Erik
    Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, Sweden.
    Between- and within-subject variance of motor variability metrics in females performing repetitive upper-extremity precision work2015In: Journal of Electromyography & Kinesiology, ISSN 1050-6411, E-ISSN 1873-5711, Vol. 25, no 1, p. 121-129Article in journal (Refereed)
    Abstract [en]

    Kinematic motor variability is extensively studied in occupational, clinical and sports biomechanics, but the consistency of most motor variability metrics have never been reported. In this study, fourteen subjects performed a repetitive pipetting task on three separate days. Movements of hand, arm and pipette tip were recorded in 3D and used to compute shoulder elevation, elbow flexion and shoulder-arm coordination angles, as well as pipette-tip endpoint precision. Cycle-to-cycle motor variability was quantified using linear dispersion measures of standard kinematics properties such as peak velocity, range of motion, and inter-segmental relative phase. Between- and within-subject consistencies of these variability metrics were quantified by variance components estimated using a nested random effects model. For most metrics, the variance between subjects was larger than that between days and cycles. Entering the variance components in statistical power equations showed that for most metrics, a total of 80-100 subjects will be required to detect a 20% difference between two groups with sufficient power, while this difference can typically be detected in repeated-measures (paired) designs using 25 subjects. The reported between- and within-subject variance components can be used as a data base to facilitate efficient designs of future studies of kinematic motor variability.

  • 384.
    Stenberg, Gunilla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Genusperspektiv på rehabilitering för patienter med rygg- och nackbesvär i primärvård2012Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Introduction

    Gender as a social and cultural construction has an impact on physiotherapist and patient beliefs, understanding, and behaviour and could affect physiotherapy encounters. Gender studies in early rehabilitation are scarce. The aim of this thesis was to study gender during different parts of the rehabilitation process for primary health care patients with neck and back pain.

    Method

    The analyses are based on data from three different samples. One sample is composed of physiotherapists and two samples consist of patients consulting primary health care providers because of neck and back pain. All data were gathered from primary health care provided in Västerbotten County.

    Baseline data on 73 physiotherapists and 586 of their patients with neck and back pain were collected by questionnaire during three consecutive days in 2006. Patient data included affected pain site and treatment procedures used by the physiotherapist (Study I). Differences in treatment procedures used by female and male physiotherapists and differences in use for female or male patients were analysed using Chi square-test, Fisher’s exact tests, Mann-Whitney U tests and logistic regressions with cluster analysis.

    Thematised interviews with 12 patients were made before the patient’s first appointment with a physiotherapist or doctor and repeated after three months. Data were analysed according to grounded theory (Study II) and qualitative content analysis (Study III).

    A comprehensive questionnaire was answered at the first appointment when patients sought a physiotherapist in primary health care. The questionnaires included questions about pain intensity, self-rated health, function, psychological stress reactions, domestic work, work environment, self-efficacy and kinesiophobia. Response patterns were linked to the International Classification of Functioning Disability and Health (ICF) and analysed using principal component analysis (PCA) and partial least squares projections to latent structures (PLS).

    Result

    Patients were given the same treatment procedures irrespective of gender. The treatment procedures most often used were training of joint motion (48%), training of muscle functions and strength training (31%), massage (31%), physical treatment (28%), information about health/ill health (24%), and acupuncture (18%). Female and male physiotherapists used the same treatment procedures with a few exceptions. Female physiotherapists used treatment for mental functions and acupuncture more often than male physiotherapists. The women gave their patients a unique mixture of treatment procedures more frequently (43%) compared to their male colleagues (25%). Male physiotherapists used more training of joint motion.

    "To be confirmed" emerged as the core category when analysing interviews that considered expectations or experiences. Five categories were extracted: "To be taken seriously", "To get an explanation", "To be individually assessed and treated", "To be invited to participate", and "To be taken care of in a trustworthy environment". These were factors leading to confirmation. Two ideal types were identified: "confident" and "ambiguous". The "confident" did not doubt their right to health care and blamed their work for causing the pain. They related to a positive identity of strong or hard working. The "ambiguous" were afraid of being regarded as old, whining women and not being taken seriously. They were ashamed of having neck or back pain and blamed themselves; they thought they were not fit enough. The ideal types were not completely defined by gender, but more men were among the "confident" ideal type and more women were among the "ambiguous" type. Patients reacted differently to feelings of being confirmed or not, and this depended on whether they were the "confident" or "ambiguous" ideal type.

    The "confident" were satisfied and reacted with reorientation when they felt confirmed, even if they were not totally cured. When not confirmed, the "confident" reacted with anger, frustration, and feelings of shame or remained proud and blamed the health care personnel for being incompetent.

    The "ambiguous" also were satisfied and felt reoriented when they were confirmed. They then moved from being an "ambiguous" type to a more "confident" type. When the "ambiguous" were not confirmed in healthcare, they became dissatisfied and unhappy. They doubted the assessment, felt forlorn, and felt increased shame. Not being confirmed was experienced more negatively by women than by men irrespective of ideal type.

    Interesting information was found about how patients view their body in relation to pain during analysis of expectations and experiences in study II interviews. This led to Study III.

    In study III, "Fear of hurting the fragile body" emerged as an interview theme. Five categories supported or undermined beliefs about pain and physical activity: "The mechanical body", "Messages about activity", "Earlier experiences of pain and activity", "To be a good citizen", and "Support to be active". Patients thought their pain was due to tissue damage and viewed their bodies in a mechanical way. Clear messages from health care personnel about activity led to less fear of physical activity. Vague and contradictory messages led to more fear. Gender-stereotyped messages were given to patients. "The take it carefully" was such a message, and was more often to women when women were thought to be weak and in need of training. Another message was "Pain goes with heavy work". This message was more often given to men when men were thought to be strong and not in need of training. Earlier experiences of pain and activity could have been positive or negative. If positive, the experiences led to less fear of engaging in physical activity. A wish to be a good citizen, such as being a good parent, led to patients being more engaged in child care and playing more than they thought was good for their pain. Women, more than men, expressed avoidance of sick leave because they did not want to be a burden to society or to their work colleagues. Patients were anxious about how to do the "correct" exercises to avoid further injury. Practical support and a follow up to adjust the training program were important to reduce the fear of engaging in physical activity and to maintain motivation.

    One hundred and eighteen patients (84 women and 34 men) completed the questionnaire. PCA of all questions identified five significant components. The model explained 37% of the variance. The predictive power was 17%. PC1 explained 17% of the variance and the predictive power was 0.13%.

    PC1 was mainly explained by questions classified in ICF as Activity and Participation. These included questions about physical function and self-efficacy (classified as Content of Thought). Questions about support (classified as Environmental Factors) and stress reactions (classified as Body Function (Emotional Functions)) mainly explained PC2. PC3 was mainly explained by reported pain and symptoms from muscles (classified as Body Functions) and domestic work and leisure time activities (classified as Activity and Participation).

    There were differences in t-scores between women and men in PC2 (p=0.045) and PC3 (p=0.003). Variables that discriminated between women and men were questions about stress reactions and support at work in PC2, and questions about pain intensity and domestic work in PC3.

    Conclusion

    As a physiotherapist working with neck and back pain rehabilitation patients, it is important to be aware of both one’s own and the patient’s preconceptions about women and men. It is also important to be aware of the impact of gender on the professional role when choosing treatment procedures in order to ensure that choices will be based on evidence of effectiveness and not from stereotypes. Awareness of the patient’s individual needs and subsequent adaptation of treatments is also important.

    Some patients display a negative self-assessment and shame. They need more support to be able to reorient. Unless these patients are confirmed, they are at risk of prolonged disability.

    Gender stereotypes can hinder rehabilitation of neck and back pain if women are seen as weak and in need of protection and men are seen as strong and not in need of preventive muscle training.

    When assessing neck and back pain patients with questionnaires, gender has less significance than when asking questions about physical function and self-efficacy. Questions about emotions of stress reactions, support at work, and pain intensity contribute to gender differences for women. Questions on the level of domestic work contribute to gender differences for men.

  • 385.
    Stenberg, Gunilla
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Ahlgren, Christina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    A gender perspective on physiotherapy treatment in patients with neck and back pain2010In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 12, no 1, p. 35-41Article in journal (Refereed)
    Abstract [en]

    Women report more pain from the musculoskeletal system, and more disability, than do men. As a consequence, women more often seek healthcare than men do, and are more often on sick leave. Research shows that female patients and male patients are treated differently by physicians and that the physician's gender also influenced the choice of treatment. The aim was to study whether the patients’ and/or the physiotherapists’ gender influences physiotherapy treatments for patients with neck and/or low back pain. During 3 days in April 2006, 73 physiotherapists in primary care and private practices collected information on 586 patients with neck and/or low back pain. The information included data on the affected pain sites and the treatment procedures used by the physiotherapist. Baseline data on the physiotherapists were collected with a questionnaire. The results showed that female and male physiotherapists mainly used the same treatment procedures, but with some differences. The female physiotherapists used significantly more acupuncture and procedures directed toward treatment of mental function. They also gave their patients a unique combination of treatment procedures to a greater extent than their male colleagues. The malte physiotherapists used significantly more training of joint mobility. Male and female patients were given the same treatment.

  • 386.
    Stenberg, Gunilla
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Ahlgren, Christina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    "Getting confirmation": gender in expectations and experiences of healthcare for neck or back patients2012In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 44, no 2, p. 163-171Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study was to explore, from a gender perspective, patients' expectations prior to seeking healthcare for neck or back pain, and their subsequent experiences of the care and rehabilitation they received.

    Methods: Thematized interviews with 12 patients, 7 women and 5 men, using open-ended questions, were analysed according to grounded theory. Each patient was interviewed before their first appointment with a physiotherapist or general practitioner and 3 months later.

    Results: Analysis resulted in 5 categories: "To be taken seriously", "Getting an explanation", "To be invited to participate", "To be assessed and treated individually", and "To be taken care of in a trustworthy environment", which were linked by a core category "Getting confirmation". Two ideal types were identified: the "Confident" type, characterized by self-confidence and pride, and the "Ambiguous" type, characterized by disparagement and shame. The categories were partly perceived in different ways from the two ideal types. The ideal types were not defined by sex; however, more men were found to be of the "Confident" type and more women of the "Ambiguous" type.

    Conclusion: Gender appears to affect expectations and experiences, in addition to how patients view and express their problems. Healthcare professionals should take this into account in consultations.

  • 387.
    Stenberg, Gunilla
    et al.
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS). Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Ahlgren, Christina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    'I am afraid to make the damage worse': fear of engaging in physical activity among patients with neck or back pain : a gender perspective2014In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, no 1, p. 146-154Article in journal (Refereed)
    Abstract [en]

    Rationale: Neck and back pain are major public health problems in Western societies and cause considerable disability and health service use. Swedish women report more severe neck and back pain compared with Swedish men. Most studies on the aetiology of gender differences in pain deal with biological mechanisms, and less with the role of psychological and sociocultural factors. 'Pain beliefsis a sociocultural factor and can be expressed in different ways among women and men. It is important to know what pain beliefs are held by neck and back pain patients, especially when medical guidelines recommend that back pain patients stay physically active.

    Aim: Exploring pain beliefs in relation to physical activity among neck and back pain patients consulting primary health care.

    Method: Twelve patients (seven women, five men) consulting primary health care for an initial episode of neck or back pain were interviewed before their first appointment with a physiotherapist or general practitioner and 3 months later. The interviews covered patient experiences of neck or back pain, consequences, strategies and treatment experiences. The interviews were analysed with qualitative content analysis from a gender perspective.

    Result: One theme 'Fear of hurting the fragile body' was expressed by all neck or back pain patients. Five categories were identified 'The mechanical body', 'Messages about activity', 'Earlier experiences of pain and activity', 'To be a good citizen' and 'Support to be active' supported or undermined beliefs about pain and physical activity. Gender expressions occurred in the categories 'Messages about activity', 'To be a good citizen' and 'Support to be active'.

    Conclusions: Neck or back pain patients in the study saw the body as fragile and were afraid of hurting it. Notions of gender had an impact on the given advice about activity and on how patients perceived the message about staying active.

  • 388.
    Stenberg, Gunilla
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lundquist, Anders
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics.
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Ahlgren, Christina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Similarities and differences: patterns of reported problems and ICF classification in women and men with back or neck pain seeking physiotherapy treatmentManuscript (preprint) (Other academic)
    Abstract [en]

    Objective: The primary aim of this study was to examine similarities and differences in problem areas reported by women and men who seek physiotherapy treatment for back or neck pain. A second aim was to evaluate the appropriateness of ICF classification in relation to gender.

    Methods: Principal component analysis (PCA) and partial least squares of latent structures (PLS) were used to analyse questionnaire data including background data, questions about pain, domestic work, stress, EQ-5D, Neck Disability Index (NDI), Oswestry Disability Questionnaire (ODQ), psychosocial and physical workload, Tampa Scale and Functional Self-Efficacy Scale.

    Results: One hundred and eighteen patients (84 women and 34 men) completed the questionnaire. Men and women scored similarly on the NDI, ODQ, Functional Self Efficacy, and Tampa Scale, but women rated higher on stress reactions. PCA showed that questions from the NDI, ODQ and Functional Self-Efficacy Scale explained most of the variance in this patient group. Questions about stress and social support at work constituted the second component. Questions about domestic workload and pain comprised the third component. Gender differences were found in the two last components.

    Conclusion: Further investigation of the impact of gender on neck and back pain in different cultures is important.

  • 389.
    Stening, Emelia
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Andmyr, Fredrik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    The physical Capacity of Nursing Students: A Comparison between Japanese and Swedish Students2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 390.
    Stenlund, Therese
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Ahlgren, Christina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lindahl, Bernt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Burell, Gunilla
    Knutsson, Anders
    Stegmayr, Birgitta
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine. Medicin.
    Birgander, Lisbeth Slunga
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Patients with burnout in relation to gender and a general population2007In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 35, no 5, p. 516-523Article in journal (Refereed)
    Abstract [en]

    Aims: The aims of this study were to describe gender differences in patients with burnout and compare these patients with a general population with respect to physical, psychosocial and work variables. Methods: Data were collected from a total of 136 patients (96 women and 40 men, 41,6 ± 7,4 years), diagnosed with stress-related disease and burnout at the Stress Clinic, University Hospital of Umeå. Data on burnout, physical, psychosocial and work characteristics were compared with similar data from a geographical and age-matched population based survey, the 2004 Northern Sweden MONICA study. The survey sample included a total of 573 participants (283 women and 290 men, 40,7 ± 8,5 years). Results: Women with burnout reported a higher rate of impaired awakening, lower job control, greater proportion of unpaid work and worked to a greater extent ``with people'' compared to men. Men with burnout had a more restricted social network and reported working more overtime than women. Patients with burnout reported a higher rate of unemployment, a more restricted social network and higher work demands compared to a general population. Women with burnout reported less emotional support, a more sedentary work situation, high job strain and worked to a greater extent ``with people'' than women from the general population. Conclusions: There are some differences in working conditions and social network between women and men with burnout. Patients with burnout differ from a general population regarding individual and social factors as well as work-related factors.

  • 391.
    Stenlund, Therese
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Ahlgren, Christina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lindahl, Bernt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Burell, Gunilla
    Department of Public Health and Caring Sciences, University of Uppsala.
    Steinholtz, Katarina
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Edlund, Curt
    Nilsson, Leif
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Umeå University, Faculty of Science and Technology, Department of Mathematics and Mathematical Statistics.
    Knutsson, Anders
    Department of Health Sciences, Mid Sweden University.
    Slunga Birgander, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Cognitively oriented behavioral rehabilitation in combination with Qigong for patients on long-term sick leave because of burnout: REST - a randomized clinical trial2009In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 16, no 3, p. 294-303Article in journal (Refereed)
    Abstract [en]

    Background

    Despite an increase in the occurrence of burnout, there is no agreement on what kind of rehabilitation these patients should be offered.

    Purpose

    Primary aim of this study was to evaluate effects on psychological variables and sick leave rates by two different group rehabilitation programs for patients on long-term sick leave because of burnout. Rehabilitation program A (Cognitively oriented Behavioral Rehabilitation (CBR) and Qigong) was compared with rehabilitation program B (Qigong only).

    Method

    In a randomized clinical trial, 96 women and 40 men with a mean age of 41.6 ± 7.4 years were allocated to one of the two rehabilitation programs.

    Results

    A per-protocol analysis showed no significant difference in treatment efficacy between the groups. Both groups improved significantly over time with reduced levels of burnout, self-rated stress behavior, fatigue, depression, anxiety, obsessive–compulsive symptoms, and sick leave rates. In an intention-to-treat analysis, patients in program A had fewer obsessive–compulsive symptoms and larger effect sizes in self-rated stress behavior and obsessive–compulsive symptoms compared to patients in program B.

    Conclusion

    This study showed no differences in effect between CBR and Qigong compared with Qigong only in a per-protocol analysis. Both rehabilitation programs showed positive effect for patients with burnout.

  • 392.
    Stenlund, Therese
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Birgander, Lisbeth Slunga
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Lindahl, Bernt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Ahlgren, Christina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Nilsson, Leif
    Umeå University, Faculty of Science and Technology, Department of Mathematics and Mathematical Statistics.
    Effects of qigong in patients with burnout: a randomized controlled trial2009In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 41, no 9, p. 761-767Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate the efficacy of Qigong in rehabilitation for patients with burnout. DESIGN: Prospective, randomized controlled trial. SUBJECTS: Eighty-two patients (68 women and 14 men, mean age 44.3 (standard deviation 9.1) years) diagnosed with burnout.

    METHODS: Basic care was offered to both the intervention and the control group. Patients in the intervention group received basic care and, in addition, performed Qigong twice a week for 12 weeks. Psychological variables, health-related quality of life, perceived relaxation and physical measurements were assessed at baseline and after the intervention period.

    RESULTS: No significant difference in treatment efficacy between the groups was found by either intention-to-treat or per-protocol analyses. Both groups improved significantly over time, with reduced levels of burnout, fatigue, anxiety and depression, and increased dynamic balance and physical capacity. CONCLUSION: In this study, a Qigong intervention twice a week for 12 weeks had no additional effect beyond basic care for patients with burnout.

  • 393.
    Stenlund, Therese
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Lindström, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Granlund, Marie
    Burell, Gunilla
    Cardiac rehabilitation for the elderly: Qi Gong and group discussions.2005In: European journal of cardiovascular prevention and rehabilitation, ISSN 1741-8267, Vol. 12, no 1, p. 5-11Article in journal (Refereed)
  • 394. Stenlund, Therese
    et al.
    Slunga Birgander, L
    Lindahl, B
    Ahlgren, Christina
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy. Sjukgymnastik.
    The effects of Qi Gong in persons with burnout2007Conference paper (Other academic)
  • 395.
    Stenlund, Tobias
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Öhberg, Fredrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Lundström, Ronnie
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Lindroos, Ola
    Dept. of Forest Biomaterials & Technology, Swedish University of Agricultural Sciences, Sweden.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Inter- and intra-tester reliability when measuring seated spinal postures with inertial sensors2014In: International Journal of Industrial Ergonomics, ISSN 0169-8141, E-ISSN 1872-8219, Vol. 44, no 5, p. 732-738Article in journal (Refereed)
    Abstract [en]

    Prolonged awkward sitting postures may be associated with neck or back pain, but it is often unclear which specific postures cause most problems and which mechanisms that may underlie the pain. In order to increase the knowledge in this field, it seems crucial first of all to be able to analyse, in depth, different seated spinal postures. A problem is however the lack of reliable and direct measurement methods of the posture, especially for sitting. Recently developed systems with inertial sensor attached along the spine have potential for this purpose. The aim of the present study was therefore to test the reliability of using such a system to assess various seated postures. Inter- and intra-tester as well as intra-subject relative reliability was estimated with intra-class correlation coefficient (ICC). Absolute reliability was estimated with standard error of measurement (SEM) and smallest detectable change (SDC). Ten + ten healthy subjects and four testers participated. Three standardised unsupported seated postures (lumbar lordosis, lumbar kyphosis and neutral posture) and two standing postures (neutral and lumbar kyphosis) were evaluated using five sensors attached to the head, the thorax (high and low), the lumbar spine and the pelvis. The ICC for intra-tester reliability ranged from 0.37 to 0.90, SEM 2.5-12.0 degrees, and SDC 7.1-333 degrees where the largest measurement error was from the head. Intra-tester reliability was higher than inter-tester reliability but not as good as intra-subject reliability. The intra-tester absolute reliability was nevertheless not considered sufficient to distinguish smaller differences. The low reliability may depend on inertial sensor size and attachment but also on the tester's accuracy. This study shows that assessing unsupported seated spinal postures with inertial sensors could be performed with higher reliability if done by the same, rather than different, testers. Relevance to industry: Prolonged awkward seated postures at work may be associated with back and neck pain and should therefore be analysed. Inertial sensor units is a promising tool to measure spinal posture. Smaller sensors attached by one skilled tester directly onto the body will most likely improve assessment in the future. (C) 2014 Elsevier B.V. All rights reserved.

  • 396.
    Stensdotter, Ann Katrin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Grip, Helena
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Hodges, P
    Häger Ross, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Quadriceps activity and movement in response to unpredictable sagital support-surface translations2007Conference paper (Other academic)
  • 397.
    Stensdotter, Ann Katrin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Grip, Helena
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Hodges, P W
    Häger-Ross, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Quadriceps activity and movement reactions in response to unpredictable sagittal support-surface translations in women with patellofemoral pain.2008In: Journal of Electromyography & Kinesiology, ISSN 1050-6411, E-ISSN 1873-5711, Vol. 18, no 2, p. 298-307Article in journal (Refereed)
    Abstract [en]

    Patellofemoral pain (PFP) may be related to unfavorable knee joint loading. Delayed and/or reduced activity of vastus medialis obliquus (VMO) and different movement patterns have been identified in individuals with PFP in some studies, whereas other studies have failed to show a difference compared to non-affected controls. The discrepancy between study results may depend on the different tasks that have been investigated. No previous study has investigated these variables in postural responses to unpredictable perturbations in PFP. Whole body three dimensional kinematics and surface EMG of quadriceps muscles activation was studied in postural responses to unpredictable support surface translations in 17 women with PFP who were pain free at the time of testing, and 17 matched healthy controls. The results of the present study showed earlier onset of VMO activity and associated changes in kinematics to anterior platform translation in the PFP subjects. We suggest that the relative timing between the portions quadriceps muscles may be task specific and part of an adapted response in attempt to reduce knee joint loading. This learned response appears to remain even when the pain is no longer present.

  • 398.
    Stensdotter, Ann Katrin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hodges, P
    Öhberg, Fredrik
    Häger-Ross, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Quadriceps EMG in open and closed kinetic chain in women with patellofemoral pain2007Conference paper (Other academic)
  • 399.
    Stensdotter, Ann-Katrin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Motor control of the knee: kinematic and EMG studies of healthy individuals and people with patellofemoral pain2005Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Patellofemoral pain (PFP) is believed to be associated with deficits in coordination between the different heads of the quadriceps muscle; however, considerable debate exists in the literature regarding the presence of such a deficit. Discrepancies between studies may be explained by differences in experimental tasks, such as whether the task is performed with open (OKC) or closed kinetic chain (CKC), or whether the activity is voluntary or triggered. Particular interest has been directed toward the function of the vastus medialis obliquus (VMO), which is a short muscle with limited ability to exert torque across the knee joint, but probably has a particular role in controlling patellofemoral joint position. Another short muscle that may influence knee joint position control is popliteus (POP), which is located in the back of the knee.

    This thesis investigates task specific activity of quadriceps in CKC versus OKC and studies the relative activity between the four heads of the quadriceps in PFP subjects compared to controls without knee pain in voluntary activity (CKC and OKC) and postural responses to balance perturbations. In addition, this thesis investigates the presumed function of POP for control of joint position in postural tasks in healthy individuals.

    All subjects were of normal weight and height and between 18 and 40 years. Quadriceps activity was tested for isometric with identical joint configuration in CKC and OKC, and it was performed as a reaction time task. Balance perturbations were elicited by unpredictable anterior and posterior translations of the support surface. Function of POP was investigated in unpredictable support surface translations and in self induced provocations to balance by moving the arms. Muscle activity was recorded with electromyography (EMG). Optic kinematic analysis was used to obtain specific movement responses to perturbations of balance.

    The quadriceps muscles were activated differently in CKC and OKC. VMO was activated earlier and to a greater degree in CKC. Rectus femoris was activated earlier and to a greater degree in OKC. PFP subjects reacted slower in both CKC and OKC, but there was no difference between groups in the relative activity between the different heads of the quadriceps. In the unpredictable support surface translation in the anterior direction, PFP subjects responded with earlier onset of VMO and with greater trunk and hip flexion in the anterior translation. POP activation in response to support surface translations in both directions occurred before all other muscles measured. In the self-initiated provocations of balance, POP was activated after the initiation of the balance provocation.

    This thesis concludes that quadriceps activity was task specific. The lack of difference between groups in OKC and CKC, and the difference between groups in postural responses suggest that variations in motor behaviour may occur only in tasks habitually performed. Differences in muscle activation patterns may be related to compensatory strategies to unload the quadriceps muscles and the patellofemoral joint. Furthermore, this thesis suggests that POP muscle may have a particular role in active control of the knee joint.

  • 400.
    Stensdotter, Ann-Katrin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Andersson, Per-Ivar
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rydh, Anders
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Diagnostic Radiology.
    Häger-Ross, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Q-angle variations in standing and supine positions and for different measurement methods in women with and without patellofemoral pain2009In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 11, no 2, p. 88-96Article in journal (Refereed)
567891011 351 - 400 of 509
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