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  • 51.
    Bäcklund, Catharina
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för kostvetenskap.
    Sundelin, Gunnevi
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Larsson, Christel
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för kostvetenskap.
    Effects on physical activity of a 2-year lifestyle intervention in overweight and obese children2011Inngår i: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 13, nr 3, s. 97-109Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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

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

  • 52.
    Bäcklund, Catharina
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för kostvetenskap.
    Sundelin, Gunnevi
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Larsson, Christel
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för kostvetenskap.
    Evaluation of 2-year family-based lifestyle intervention regarding physical activity among children with overweight and obesity2011Konferansepaper (Fagfellevurdert)
  • 53.
    Bäcklund, Catharina
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för kostvetenskap.
    Sundelin, Gunnevi
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Larsson, Christel
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för kostvetenskap.
    Validity of an armband measuring energy expenditure in overweight and obese children2010Inngår i: Medicine & Science in Sports & Exercise, ISSN 0195-9131, E-ISSN 1530-0315, Vol. 42, nr 6, s. 1154-1161Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: To examine the ability of the SenseWear Pro2 Armband (SWA) to accurately assess energy expenditure in free-living overweight or obese children during a two-week period, by comparison with energy expenditure measured using the doubly labeled water (DLW) method. A second aim was to examine which software version, Innerview Professional 5.1 or Sensewear Professional 6.0, are the most appropriate for use together with SWA in overweight and obese children.

    Method: A random sample of 22 healthy, overweight or obese children (11 girls and 11 boys) aged 8-11 years was recruited from an ongoing intervention study. Energy expenditure in free-living conditions was simultaneously assessed with the SWA and DLW methods during a 14-day period. All data from the SWA were analyzed using InnerView Professional software versions 5.1 (SWA 5.1) and 6.1 (SWA 6.1).

    Results: An accurate estimation in energy expenditure was obtained when SWA 5.1 was used, showing a non-statistically significant difference corresponding to 17 (1200) kJ[middle dot]d-1 compared with the energy expenditure measured using the DLW method. However, when SWA 6.1 was used a statistically significant (18%) underestimation of energy expenditure was obtained, corresponding to 1962 (1034) kJ[middle dot]d-1 compared with the DLW method.

    Conclusion: The SWA together with software version 5.1, but not 6.1, is a valid method for accurately measuring energy expenditure at group level of free-living overweight and obese children.

  • 54.
    Bäcklund, Catharina
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för kostvetenskap.
    Sundelin, Gunnevi
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Larsson, Christel
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för kostvetenskap.
    Validity of measured energy expenditure in overweight and obese children when using Inner View Professional software v5.1 and 6.1 together with SenseWear Pro2 Armband2009Inngår i: 7th International Conference on Diet and Activity Methods, 2009Konferansepaper (Fagfellevurdert)
    Abstract [en]

    The aim was to investigate the validity of SenseWear Pro2 Armband (SWA) when assessing energy expenditure of overweight and obese children. A random selection of 22 children with an isoBMI>25 were recruited from 8-11 year olds participating in an intervention study. Energy expenditure in free-living condition was assessed during 14 days by using SWA. The armband was worn 24h/d, and removed only for water activities. Total energy expenditure was measured with double labelled water (DLW) method during the same period covered by SWA. During the data collection, an updated version of the software used by SWA was released and data were analysed with both software version. The validity when using software version 5.1 (SWA5.1) and 6.1 (SWA6.1) was investigated by comparison with measured energy expenditure by DLW method. In total, 11 girls and 11 boys with mean age of 10.3±0.99 years and isoBMI 22.8±0.62 participated. The average wearing time of SWA was 12 days (range 7-14) and 23.3 h/day (range 18.8-24.0). There was no statistically significant difference in mean physical activity level (PAL) by SWA5.1 compared by DLW-method. A minor non-significant underestimation of energy expenditure 0.02±1.20 MJ/day (95%CI -0.55,0.52) measured by SWA5.1 compared with DLW-method was shown. However, the children's PAL according to SWA6.1 was 1.37 compared with 1.68 according to DLW method. When assessed by SWA6.1 there was a significant underestimation of energy expenditure by 1.96±1.03MJ/day (95%CI-2.42,-1.50) compared with DLW-method. The differences between SWA5.1 andSWA6.1 may be partly explained bya statistically significant difference in the amount of time the two software versions have registered time spent on different activity levels (MET<3, MET3-<6, MET6-<9, MET≥9). When comparing time spent on sedentary activities (MET<3) significantly less time was assessed by SWA5.1 compared with SWA6.1, 18±2.1 h/d and 20±2.4 h/d respectively. These differences became more apparent at higher METs. A significantly longer time spent on activities with MET≥9, was assessed by SWA5.1 compared with SWA6.1, 11±26 min/d and 2.5±5.3 min/d respectively. In conclusion, the SWA with software v 5.1, but not with software v 6.1, is a valid device to accurately measure energy expenditure at group level in overweight and obese children during free-living condition.

  • 55.
    Carlsson, Maine
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Haglin, Lena
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Rosendahl, Erik
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik. Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Gustafson, Yngve
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Poor nutritional status is associated with urinary tract infection among older people living in residential care facilities2013Inngår i: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 17, nr 2, s. 186-191Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    To investigate factors associated with poor nutritional status in older people living in residential care facilities. Methods: 188 residents (136 women, 52 men) with physical and cognitive impairments participated. Mean age was 84.7 y (range 65-100). The Mini Nutritional Assessment (MNA), Barthel ADL Index, Mini Mental State Examination (MMSE), and Geriatric Depression Scale were used to evaluate nutritional status, activities of daily living, cognitive status and depressive symptoms. Medical conditions, clinical characteristics and prescribed drugs were recorded. Univariate and multivariate regressions were used to investigate associations with MNA scores. Results: The mean MNA score was 20.5 +/- 3.7 (range 5.5-27) and the median was 21 (interquartile range (IQR) 18.8-23.0). Fifteen per cent of participants were classified as malnourished and 66% at risk of malnutrition. Lower MNA scores were independently associated with urinary tract infection (UTI) during the preceding year (beta = -0.21, P = 0.006), lower MMSE scores (beta = 0.16, P = 0.030), and dependent in feeding (beta = -0.14, P = 0.040). Conclusion: The majority of participants were at risk of or suffering from malnutrition. Urinary tract infection during the preceding year was independently associated with poor nutritional status. Dependence in feeding was also associated with poor nutritional status as were low MMSE scores for women. Prospective observations and randomized controlled trials are necessary to gain an understanding of a causal association between malnutrition and UTI.

  • 56.
    Carlsson, Maine
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Håglin, Lena
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Rosendahl, Erik
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Gustafson, Yngve
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Malnutrition and infections among elderly peopleManuskript (preprint) (Annet vitenskapelig)
  • 57.
    Carlsson, Maine
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Littbrand, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Gustafson, Yngve
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Lundin-Olsson, Lillemor
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Lindelöf, Nina
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Rosendahl, Erik
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik. Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Håglin, Lena
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Effects of high-intensity exercise and protein supplement on muscle mass in ADL dependent older people with and without malnutrition: a randomized controlled trial2011Inngår i: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 15, nr 7, s. 554-560Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background  Loss of muscle mass is common among old people living in institutions but trials that evaluate interventions aimed at increasing the muscle mass are lacking.

    Objective, participants and intervention  This randomized controlled trial was performed to evaluate the effect of a high-intensity functional exercise program and a timed protein-enriched drink on muscle mass in 177 people aged 65 to 99 with severe physical or cognitive impairments, and living in residential care facilities.

    Design  Three-month high-intensity exercise was compared with a control activity and a protein-enriched drink was compared with a placebo drink. A bioelectrical impedance spectrometer (BIS) was used in the evaluation. The amount of muscle mass and body weight (BW) were followed-up at three and six months and analyzed in a 2 × 2 factorial ANCOVA, using the intention to treat principle, and controlling for baseline values.

    Results  At 3-month follow-up there were no differences in muscle mass and BW between the exercise and the control group or between the protein and the placebo group. No interaction effects were seen between the exercise and nutritional intervention. Long-term negative effects on muscle mass and BW was seen in the exercise group at the 6-month follow-up.

    Conclusion  A three month high-intensity functional exercise program did not increase the amount of muscle mass and an intake of a protein-enriched drink immediately after the exercise did not induce any additional effect on muscle mass. There were negative long-term effects on muscle mass and BW, indicating that it is probably necessary to compensate for an increased energy demand when offering a high-intensity exercise program.

  • 58.
    Carlström, Sara
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Israelsson, Rebecka
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Nack- och ryggpatienters kinesiofobi och tilltro till sin förmåga: vid sjukgymnastbesök2011Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
  • 59.
    Christianson, Monica
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Umeå universitet, Samhällsvetenskapliga fakulteten, Umeå centrum för genusstudier (UCGS).
    Aléx, Lena
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Fjellman-Wiklund, Anncristine
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Hammarström, Anne
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin. Umeå universitet, Samhällsvetenskapliga fakulteten, Umeå centrum för genusstudier (UCGS).
    Lundman, Berit
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Sex and gender traps and springboards: a focus group study among gender researchers in medicine and health sciences2012Inngår i: Health Care for Women International, ISSN 0739-9332, E-ISSN 1096-4665, Vol. 33, nr 8, s. 739-755Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    We explored the difficulties that gender researchers encounter in their research and the strategies they use for solving these problems. Sixteen Swedish researchers, all women, took part in focus group discussions; the data were analyzed using qualitative content analysis. The problems reported fell into four main categories: the ambiguity of the concepts of sex and gender; traps associated with dichotomization; difficulties with communication; and issues around publication. Categories of suggested problem-solving strategies were adaptation, pragmatism, addressing the complexities, and definition of terms. Here the specific views of gender researchers in medicine and health sciences-"medical insiders"-bring new challenges into focus.

  • 60.
    Conradsson, M
    et al.
    Umeå universitet, Medicinsk fakultet, Samhällsmedicin och rehabilitering, Geriatrik.
    Lundin-Olsson, Lillemor
    Umeå universitet, Medicinsk fakultet, Samhällsmedicin och rehabilitering, Sjukgymnastik.
    Lindelöf, Nina
    Umeå universitet, Medicinsk fakultet, Samhällsmedicin och rehabilitering, Geriatrik.
    Littbrand, Håkan
    Umeå universitet, Medicinsk fakultet, Samhällsmedicin och rehabilitering, Geriatrik.
    Malmqvist, L
    Gustafson, Yngve
    Umeå universitet, Medicinsk fakultet, Samhällsmedicin och rehabilitering, Geriatrik.
    Rosendahl, Erik
    Umeå universitet, Medicinsk fakultet, Samhällsmedicin och rehabilitering, Geriatrik.
    The Berg balance scale: Intra-rater reliability in older people dependent in ADL living residential care facilities2007Konferansepaper (Annet vitenskapelig)
  • 61.
    Conradsson, Mia
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Littbrand, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik. Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Boström, Gustaf
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Lindelöf, Nina
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Gustafson, Yngve
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Rosendahl, Erik
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik. Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Is a change in functional capacity or dependency in activities of daily living associated with a change in mental health among older people living in residential care facilities?2013Inngår i: Clinical Interventions in Aging, ISSN 1176-9092, E-ISSN 1178-1998, Vol. 8, s. 1561-1568Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: Functional capacity and dependency in activities of daily living (ADL) could be important mediators for an association between physical exercise and mental health. The aim of this study was to investigate whether a change in functional capacity or dependency in ADL is associated with a change in depressive symptoms and psychological well-being among older people living in residential care facilities, and whether dementia can be a moderating factor for this association.

    Methods: A prospective cohort study was undertaken. Participants were 206 older people, dependent in ADL, living in residential care facilities, 115 (56%) of whom had diagnosed dementia. Multivariate linear regression, with comprehensive adjustment for potential confounders, was used to investigate associations between differences over 3 months in Berg Balance Scale (BBS) and Geriatric Depression Scale (GDS-15) scores, and in BBS and Philadelphia Geriatric Center Morale Scale (PGCMS) scores. Associations were also investigated between differences in Barthel ADL Index and GDS-15 scores, and in Barthel ADL Index and PGCMS scores.

    Results: There were no significant associations between changes in scores over 3 months; the unstandardized beta for associations between BBS and GDS-15 was 0.026 (P=0.31), BBS and PGCMS 0.045 (P=0.14), Barthel ADL Index and GDS-15 0.123 (P=0.06), and Barthel ADL Index and PGCMS -0.013 (P=0.86). There were no interaction effects for dementia.

    Conclusion: A change in functional capacity or dependency in ADL does not appear to be associated with a change in depressive symptoms or psychological well-being among older people living in residential care facilities. These results may offer one possible explanation as to why studies of physical exercise to influence these aspects of mental health have not shown effects in this group of older people.

  • 62.
    Conradsson, Mia
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Littbrand, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Boström, Gustaf
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Lindelöf, Nina
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Gustafson, Yngve
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Rosendahl, Erik
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Is a change in physical capacity or dependence in ADL associated with a change in mental health among older people living in residential care facilities?Manuskript (preprint) (Annet vitenskapelig)
  • 63.
    Conradsson, Mia
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Littbrand, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Lindelöf, Nina
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Gustafson, Yngve
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Rosendahl, Erik
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Effects of a high-intensity functional exercise programme on depressive symptoms and psychological well-being among older people living in residential care facilities: a cluster-randomized controlled trial2010Inngår i: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 14, nr 5, s. 565-576Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: To evaluate the effects of a high-intensity functional exercise programme on depressive symptoms and psychological well-being among older people dependent in activities of daily living (ADL) and living in residential care facilities.

    Method: Cluster-randomized controlled study. Participants were 191 older people, aged 65–100, dependent in ADL and with Mini Mental State Examination scores between 10 and 30. One-hundred (52%) of the participants had a diagnosed dementia disorder. A high-intensity functional weight-bearing exercise programme and a control activity were performed in groups. Sessions were held five times over each two week period for three months, a total of 29 times. The outcome measures, Geriatric Depression Scale (GDS-15) and Philadelphia Geriatric Center Morale Scale (PGCMS) were blindly assessed at baseline, three and six months.

    Results: At baseline, mean ± SD (range) for GDS was 4.4 ± 3.2 (0–14), and for PGCMS 11.0 ± 3.5 (2–17). There were no significant differences in GDS or PGCMS between the exercise and the control group at the three and six month follow-ups in the total sample. Among people with dementia, there was a between-group difference at three months in PGCMS scores in favour of the exercise group.

    Conclusion: A high-intensity functional exercise programme seems generally not to influence depressive symptoms or psychological well-being among older people dependent in ADL and living in residential care facilities. An individualized and multifactorial intervention may be needed in this group. However, an exercise programme as a single intervention may have a short-term effect on well-being among people with dementia.

  • 64.
    Conradsson, Mia
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Lundin-Olsson, Lillernor
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Lindelöf, Nina
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Littbrand, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Malmqvist, Lisa
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Gustafson, Yngve
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Rosendahl, Erik
    Physiotherapy Unit, Department of Health Sciences, Luleå University of Technology.
    Berg balance scale: intrarater test-retest reliability among older people dependent in activities of daily living and living in residential care facilities2007Inngår i: Physical Therapy, ISSN 0031-9023, E-ISSN 1538-6724, Vol. 87, nr 9, s. 1155-1163Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background and Purpose: The Berg Balance Scale (BBS) is frequently used to assess balance in older people, but knowledge is lacking about the absolute reliability of BBS scores. The aim of this study was to investigate the absolute and relative intrarater test-retest reliability of data obtained with the BBS when it is used among older people who are dependent in activities of daily living and living in residential care facilities.

    Subjects: The participants were 45 older people (36 women and 9 men) who were living in 3 residential care facilities. Their mean age was 82.3 years (SD=6.6, range=68-96), and their mean score on the Mini Mental State Examination was 17.5 (SD=6.3, range=4-30).

    Methods: The BBS was assessed twice by the same assessor. The intrarater test-retest reliability assessments were made at approximately the same time of day and with 1 to 3 days in between assessments. Absolute reliability was calculated using an analysis of variance with a 95% confidence level, as suggested by Bland and Altman. Relative reliability was calculated using the intraclass correlation coefficient (ICC). Results The mean score was 30.1 points (SD=15.9, range=3-53) for the first BBS test and 30.6 points (SD=15.6, range=4-54) for the retest. The mean absolute difference between the 2 tests was 2.8 points (SD=2.7, range=0-11). The absolute reliability was calculated as being 7.7 points, and the ICC was calculated to .97.

    Discussion and Conclusion: Despite a high ICC value, the absolute reliability showed that a change of 8 BBS points is required to reveal a genuine change in function among older people who are dependent in activities of daily living and living in residential care facilities. This knowledge is important in the clinical setting when evaluating an individual's change in balance function over time in this group of older people.

  • 65.
    Conradsson, Mia
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Rosendahl, Erik
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik. Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Littbrand, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik. Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Gustafson, Yngve
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Olofsson, Birgitta
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Lövheim, Hugo
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Usefulness of the Geriatric Depression Scale 15-item version among very old people with and without cognitive impairment2013Inngår i: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 17, nr 5, s. 81s. 638-645Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: The aim of this population-based study was to investigate the usefulness of the Geriatric Depression Scale 15-item version (GDS-15) to assess depressive symptoms among very old people with differing levels of cognitive function.

    Methods: The 834 participants were aged 85 and over. Feasibility of GDS-15 was evaluated as the proportion of people who completed the scale. Concurrent criterion validity was evaluated by calculating correlations between GDS-15 and Philadelphia Geriatric Center Morale Scale (PGCMS). PGCMS measures psychological wellbeing which is closely related with depressive symptoms. Correlations were calculated within groups according to cognitive function assessed with Mini-Mental State Examination (MMSE); 0-4, 5-9, 10-14, 15-19, 20-24, 25-27, and 28-30, using Pearson's two-sided correlation and compared using Fisher r-to-z transformation. Internal consistency of the GDS-15 was evaluated by calculating Cronbach's in each group.

    Results: In total, 651 (78%) of the 834 participants completed the GDS-15. For the two MMSE-groups with scores of <10, the proportion who completed GDS-15 were 1% and 42%, respectively, compared to 65-95% in the MMSE-groups with scores of 10. Cronbach's in each MMSE-group ranged from 0.636 (MMSE 28-30) to 0.821 (MMSE 5-9). The level of correlation between GDS-15 and PGCMS did not significantly differ between MMSE-groups with scores of 5-27 compared to the MMSE-group with scores of 28-30.

    Conclusions: The GDS-15 seems to have an overall usefulness to assess depressive symptoms among very old people with an MMSE score of 10 or more. More studies are needed to strengthen the validity of GDS-15 among older people with MMSE scores of 10-14. For older people with MMSE scores lower than 10, there is a need to develop and validate other measurements.

  • 66.
    Dahlgren, Gunilla
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Carlsson, Daniel
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Moorhead, Anne
    Health and Rehabilitation Sciences Research Institute, School of Health Sciences, University of Ulster, Co. Antrim, Northern Ireland, United Kingdom.
    Häger-Ross, Charlotte
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    McDonough, Suzanne M
    Health and Rehabilitation Sciences Research Institute, School of Health Sciences, University of Ulster, Co. Antrim, Northern Ireland, United Kingdom.
    Test-retest reliability of step counts with the ActivPAL™ device in common daily activities.2010Inngår i: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 32, nr 3, s. 386-90Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The ActivPAL device is a well-established physical activity monitor for assessment of physical activity. AIM: To investigate test-retest reliability of step counts and establish minimal detectable changes (MDC) in step count to account for intra device error over time in various physical activities. METHODS: Healthy participants (n=24, age range, 19-28 years) performed activities on two occasions, 1 week apart, in a laboratory setting; self-paced floor walking, treadmill walking at three different speeds (3.2 km/h, 4.5 km/h and 4.5 km/h with incline), treadmill jogging (8.0 km/h), stair walking and cycling on an exercise bike at three speeds (45 rpm, 60 rpm and 75 rpm). Relative reliability was calculated using intraclass correlation coefficient (ICC) and Spearman correlation. Absolute reliability was assessed using standard error of measurement (SEM) and coefficient of repeatability (CR). RESULTS: The ActivPAL showed high to very high relative reliability for treadmill walking at all speeds and stair walking, while self-paced normal floor walking showed moderate reliability. The absolute reliability was the best for treadmill walking activities, slightly increased for self-paced walking, followed by stair walking and jogging. The use of activity monitors during cycling has been questioned and our results confirm a low absolute and relative reliability. MDC values varied according to the type of activity e.g. treadmill walking 4.5 km/h (10 steps), walking on the floor (45 steps). Data loss in this study (10-13%) was higher than previously reported. CONCLUSIONS: The ActivPAL is reliable for treadmill walking, jogging and self-paced walking. MCD varies according to the activity and should be considered when establishing true change over time.

  • 67.
    Dahlgren, Gunilla
    et al.
    Umeå universitet, Medicinsk fakultet, Samhällsmedicin och rehabilitering, Sjukgymnastik.
    Hjalmarsson, U
    Lundin-Olsson, Lillemor
    Umeå universitet, Medicinsk fakultet, Samhällsmedicin och rehabilitering, Sjukgymnastik.
    Reliability of the swedish version of the shoulder rating questionnaire, SRQ-S2007Konferansepaper (Annet vitenskapelig)
  • 68.
    Darwén, Anna
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Besvärsförekomst och datoranvändning bland gymnasieungdomar: En pilotstudie av besvärsförekomst i rörelse- och  stödjeorganen, datorvanor samt riskbedömning av datorarbete2012Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
  • 69.
    Domellöf, Erik
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Rösblad, Birgit
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Rönnqvist, Louise
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Impairment severity selectively affects the control of proximaland distal components of reaching movements in children with hemiplegic cerebral palsy2009Inngår i: Developmental Medicine & Child Neurology, ISSN 0012-1622, E-ISSN 1469-8749, Vol. 51, nr 10, s. 807-816Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study explored proximal-to-distal components during goal-directed reaching movements in children with mild or moderate hemiplegic cerebral palsy (HCP); [seven females, fourmales;mean age 8y 6mo; SD 27mo], compared with age-matched, typically developing children (seven females, fivemales; mean age 8y 3mo [SD 25mo]. Severity of HCP was assessed following the approach of Claeys et al. Optoelectronic registrations were made during unimanual reaching-to-grasp and reaching-to-hit movements with both the affected non-preferred and unaffected with HCP, particularly those withmoderate impairment, displayed less optimal spatiotemporal organization of movements performed with the affected arm. Compared with the goal to hit, and increasingly with more severe impairment, children with HCP adapted to the goal to grasp by recruiting augmented shoulder movements when reaching with the affected side. A resulting impact on distal kinematics was found in shorter, straighter, and less segmentedmovement paths. Thus, depending on severity of hemispheric lesions and task complexity, unilateral brain injuries in HCPmay selectively affect neural pathways underlying both proximal and distal arm movement control. Levels of both ipsi- and  ontralateral activation in relation to side and lesion severity should be considered in future studies on prehension movements in HCP.

  • 70.
    Dybäck, Malin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Forsberg, Johanna
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Fysisk aktivitet på Recept (FaR): Vem förskriver, vilka patienter får recept och vad påverkar förskrivnig?2011Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
  • 71.
    Dygd Norberg, Marie
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Påhman, Ebba
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Fysisk aktivitet i grupp vid arbetsrelaterad stress2012Oppgave
  • 72.
    Edström, Anna
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Kan balansförmågan förbättras och antal fall minskas hos personer över 65 år med en multimodal intervention?: En SSED studie med 3 månaders uppföljning.2013Independent thesis Advanced level (degree of Master (One Year)), 20 poäng / 30 hpOppgave
    Abstract [sv]

    Introduktion: Fall bland äldre personer är vanligt förekommande i vårt samhälle.  Höga kostnader och  personligt lidande är en konsekvens av detta. Det är viktigt att identifiera vilka fallrisker som finns och hitta metoder för att kunna förebygga fall och att främja fortsatt aktivitet och delaktighet. Multimodala fallförebyggande program har visat sig minska fallolyckor.

    Syfte: Att undersöka om den fallförebyggande interventionen ”Aktiv livstil hela livet” kan förbättra balansförmågan och minska antal fall hos personer över 65 år med risk för fall.

    Metod: En Single Subject Experimental Design användes, totalt 6 deltagare medverkade i interventionen som var utformad som en studiecirkel med totalt 12 träffar, innehållande olika teoretiska teman och balansträning, som leddes av olika professioner såsom sjukgymnast, arbetsterapeut och sjuksköterska. Balansen mättes med Timed up and go, Timed up and go manual och Sit-to-stand, Falls-Efficacy Scale Swedish version användes som mätning av tilltro till egen balans. Antalet fall mättes genom självrapportering. Uppföljning skedde efter 3 månader.

    Resultat: 67% av mätresultaten visade  på signifikant förbättrad balans. 5 av 6 deltagare uppgav en minskning av antal fall. Alla deltagare ökade tilltro till sin egen balans.

    Konklusion: Denna intervention verkar kunna förbättra balans och förebygga fall hos personer över 65 år med fallrisk.

  • 73.
    Eklund, Elsine
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Svensson, Elisabeth
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Häger-Ross, Charlotte
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Functional performance and experienced limitations of daily life in people with charcot-marie-tooth's disease2007Konferansepaper (Annet vitenskapelig)
  • 74.
    Eklund, Elsine
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Svensson, Elisabeth
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Häger-Ross, Charlotte
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Hand function and disability of the arm, shoulder and hand in Charcot-Marie-Tooth disease2009Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 31, nr 23, s. 1955-1962Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: The aim of the present study was to examine hand function and disability in persons with Charcot-Marie-Tooth disease (CMT) and to evaluate the possible correlations between hand function and disability.

    Methods: Nine male, 11 female (24-73 yrs) persons with CMT in northern Sweden and a matched control group of 18 men, 22 women (21-73 yrs) participated in the study. Measurements applied were tests of dexterity (Box and Block Test; Nine-Hole Peg test), grip strength (Grippit®), tactile gnosis (Shape Texture Identification test) and upper-limb disability (Disabilities of the Arm Shoulder and Hand questionnaire, DASH).

    Results: Hand function in CMT was reduced (p<0.001) to about 60% of normal, as indicated by each of the separate outcome measures as well as by a constructed summary index of hand function. DASH score median was 38.8 (range 0-66.7) and was clearly related to hand function (r=0.64-0.83).

    Conclusion: Reduced hand function in CMT was found at different dimensions according to the International Classification of Functioning, Disability and Health (ICF). We suggest that DASH can be used in persons with CMT though clinicians should be aware that patients might score lower than expected, possibly due to a long process of adaptation when learning to live with a slowly progressive disease.

  • 75.
    Eklund, Malin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Gustafsson, Johanna
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Sambander mellan stress och användande av olika copingstrategier hos flickor och poikar: En enkätstudie bland gymnasieungdomar i Umeå2011Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
  • 76.
    Elcadi, Guilherme H.
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    Forsman, Mikael
    Public Health Sciences, Karolinska Institute, Centre for Musculoskeletal Research, University of Gävle.
    Aasa, Ulrika
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Fahlström, Martin
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    Crenshaw, Albert G.
    Department of Occupational and Public Health , University of Gävle.
    Shoulder and forearm oxygenation and myoelectric activity in patients with work related muscle pain and healthy subjects2013Inngår i: European Journal of Applied Physiology, ISSN 1439-6319, E-ISSN 1439-6327, Vol. 113, nr 5, s. 1103-1115Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    We tested hypotheses of (i) reduced oxygen usage, oxygen recovery, blood flow and oxygen consumption; and (ii) increased muscle activity for patients diagnosed with work related muscle pain in comparison to healthy controls. Oxygenation was measured with near infrared spectroscopy (NIRS), and muscle activity with EMG for the extensor carpi radialis (ECR) and trapezius descendens (TD) muscles. Eighteen patients with diffuse neck-shoulder-arm pain and seventeen controls (matched in age and sex) were equipped with NIRS and EMG probes. After determining an individual’s maximum voluntary contraction (MVC) force, short term (20 sec) isometric contractions for the ECR and TD of 10%, 30%, 50% and 70% MVC generated ∆StO2% and StO2% recovery (Rslope) from NIRS, and RMS%max from EMG signals. In addition, upper arm venous (VO) and arterial (AO) occlusions generated slopes of total hemoglobin (HbTslope) and deoxyhemoglobin (HHbslope) for the resting ECR as surrogates of blood flow and oxygen consumption, respectively. Mixed Model analyses, t-tests, and Mann-Whitney test were used to assess differences between groups. There was no significant difference in MVC between groups for either muscle. Also, ∆StO2%, Rslope for either muscle, and ECR-HbTslope were not different between groups, thus our hypotheses of reduced oxygen use, recovery, and blood flow for patients were not confirmed. However, patients had a significantly lower ECR-HHbslope confirming our hypothesis of reduced consumption. Further, there was no difference in RMS%max during contractions meaning that the hypothesis of increased activity for patients was not confirmed. When taking into account the number of NIRS variables studied, differences we found between our patient group and healthy controls (i.e. in forearm oxygen consumption and shoulder oxygen saturation level) may be considered modest. Overall our findings may have been impacted by the fact that our patients and controls were similar in muscle strength, which is in contrast to previous studies.

  • 77.
    Elcadi, Guilherme H
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    Forsman, Mikael
    Public Health Sciences, Karolinska Institute, Centre for Musculoskeletal Research, University of Gävle.
    Hallman, David
    Department of Occupational and Public Health, University of Gävle .
    Aasa, Ulrika
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Fahlström, Martin
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    Crenshaw, Albert G
    Department of Occupational and Public Health, University of Gävle .
    No differences in oxygenation in the forearm and shoulder of patients with work-related muscle pain and healthy subjects during a low-load sustained contractionManuskript (preprint) (Annet vitenskapelig)
    Abstract [en]

    A frequently ascribed symptom associated to work-related muscle pain (WRMP) is muscle fatigue. Studies investigating oxygenation and hemodynamics in association to fatigue development in the muscles of patients with WRMP are sparse. Inadequate oxygen consumption and/or inadequate blood supply can influence the ability of the muscles to withstand fatigue. In this study we applied near-infrared spectroscopy (NIRS) and electromyography (EMG) to investigate oxygenation, hemodynamics and muscle activity in the extensor carpi radialis (ECR) and trapezius (TD) muscles of patients with WRMP and healthy controls. Eighteen patients with diffuse neck-shoulder-arm pain and 17 controls (matched in age and sex) were equipped with NIRS and EMG probes. After determination of maximal voluntary contraction (MVC) a sustained contraction of 15% MVC was performed with a cutoff for the maximum time of 12 min. Variables generated were StO2% and HbT from NIRS and RMS%max and MPF from EMG during the contraction. T tests and Mann-Whitney tests were used for analyzes of differences in MVC and endurance times. Full factorial repeated measures analyses of variance (ANOVA) were used to assess differences between patients and controls in NIRS and EMG parameters over time. Results showed no differences in MVC between patients and controls. We found, however, a shorter endurance time for patients compared to controls. There were no significant differences in StO2%, HbT, RMS and MPF responses during contraction between groups for the ECR. For the TD there was a group effect for StO2% with patients showing a lower level at rest and throughout the contraction. For the ECR and TD oxygenation, hemodynamics, RMS and MPF there were no straightforward differences between patients and controls that could explain the differences in endurance time. Therefore, we conclude that the shorter endurance time seen in the present study was not measurable by physiological indicators investigated in this group of patients.

  • 78.
    Elcadi, Guilherme H
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin. Högskolan Gävle.
    Forsman, Mikael
    Högskolan Gävle; Karolinska institutet Stockholm.
    Hallman, David M
    Högskolan Gävle.
    Aasa, Ulrika
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Fahlstrom, Martin
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Professionell utveckling. Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering.
    Crenshaw, Albert G
    Högskolan Gävle.
    Oxygenation and hemodynamics do not underlie early muscle fatigue for patients with work-related muscle pain.2014Inngår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 9, nr 4, artikkel-id e95582Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Patients suffering from work-related muscle pain (WRMP) fatigue earlier during exercise than healthy controls. Inadequate oxygen consumption and/or inadequate blood supply can influence the ability of the muscles to withstand fatigue. However, it remains unknown if oxygenation and hemodynamics are associated with early fatigue in muscles of WRMP patients. In the present study we applied near-infrared spectroscopy (NIRS) on the extensor carpi radialis (ECR) and trapezius (TD) muscles of patients with WRMP (n = 18) and healthy controls (n = 17). Our objective was to determine if there were group differences in endurance times for a low-level contraction of 15% maximal voluntary contraction (MVC)--sustained for 12-13 min, and to see if these differences were associated with differences in muscle oxygenation and hemodynamics. At baseline, oxygen saturation (StO2%) was similar between groups for the ECR, but StO2% was significantly lower for TD for the WRMP patients (76%) compared to controls (85%) (P<0.01). Also, baseline ECR blood flow was similar in the two groups. For both muscles there were a larger number of patients, compared to controls, that did not maintain the 15% MVC for the allotted time. Consequently, the endurance times were significantly shorter for the WRMP patients than controls (medians, ECR: 347 s vs. 582 s; TD: 430 s vs. 723 s respectively). Responses in StO2% during the contractions were not significantly different between groups for either muscle, i.e. no apparent difference in oxygen consumption. Overall, we interpret our findings to indicate that the early fatigue for our WRMP patients was not associated with muscle oxygenation and hemodynamics.

  • 79. Eliasson, AC
    et al.
    Rösblad, Birgit
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering.
    Häger-Ross, Charlotte
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Control of reaching movements in 6-year-old prematurely born children with motor problems: an intervention study2003Inngår i: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 5, nr 1, s. 33-48Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim was to improve the control of reaching movements in prematurely born children with impaired coordination. Fifteen 6-year-old prematurely born children (birth weight < 1500 g) practised mouse-controlled computer games daily for 4 weeks. In addition, as a control condition, each child practised trampoline jumping for an equally long perios. The outcome was measured in terms of: (1) computer game skill, (2) kinematic analysis of planar reaching movements on a digitizing tablet, and (3) motor performance measured with the Movement ABC. After intervention, all the assessments used showed an improvement although only the skill in performing the computer game was clearly related to the type of intervention. Lack of tight correlation between computer game practice and performance on the digitizing tablet might be due to minor but crucial differences in control aspects between the task. The present results indicate that the expectation of transfer even to every similar tasks should be low. The findings thus support a task-specific approach to practice, while corroborating the positive impact of non-specific intervention.

  • 80. Eliasson, Ann-Christian
    et al.
    Krumlinde-Sundholm, Lena
    Rösblad, Birgit
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Beckung, Eva
    Arner, Marianne
    Ohrvall, Ann-Marie
    Rosenbaum, Peter
    Using the MACS to facilitate comunication about manual abilities of children with cerebral palsy.2007Inngår i: Developmental Medicine & Child Neurology, ISSN 0012-1622, E-ISSN 1469-8749, Vol. 49, nr 2, s. 156-7Artikkel i tidsskrift (Fagfellevurdert)
  • 81. Eliasson, Ann-Christin
    et al.
    Krumlinde-Sundholm, Lena
    Rösblad, Birgit
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Beckung, Eva
    Arner, Marianne
    Ohrvall, Ann-Marie
    Rosenbaum, Peter
    The Manual Ability Classification System (MACS) for children with cerebral palsy: scale development and evidence of validity and reliability.2006Inngår i: Developmental Medicine & Child Neurology, ISSN 0012-1622, E-ISSN 1469-8749, Vol. 48, nr 7, s. 549-54Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The Manual Ability Classification System (MACS) has been developed to classify how children with cerebral palsy (CP) use their hands when handling objects in daily activities. The classification is designed to reflect the child's typical manual performance, not the child's maximal capacity. It classifies the collaborative use of both hands together. Validation was based on the experience within an expert group, a review of the literature, and thorough analysis of children across a spectrum of function. Discussions continued until consensus was reached, first about the constructs, then about the content of the five levels. Parents and therapists were interviewed about the content and the description of levels. Reliability was tested between pairs of therapists for 168 children (70 females, 98 males; with hemiplegia [n=52], diplegia [n=70], tetraplegia [n=19], ataxia [n=6], dyskinesia [n=19], and unspecified CP [n=2]) between 4 and 18 years and between 25 parents and their children's therapists. The results demonstrated that MACS has good validity and reliability. The intraclass correlation coefficient between therapists was 0.97 (95% confidence interval 0.96-0.98), and between parents and therapist was 0.96 (0.89-0.98), indicating excellent agreement.

  • 82. Eliasson, Ann-Christin
    et al.
    Rösblad, Birgit
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Goal-directed traning of daily activities - model for intervention2008Inngår i: Improving hand function in cerebral palsy : theory, evidence and intervention / [ed] Eliasson, Ann-Christin, Burtner, Patricia A, 2008Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 83. Eliasson, Ann-Christin
    et al.
    Rösblad, Birgit
    Umeå universitet, Medicinsk fakultet, Samhällsmedicin och rehabilitering, Sjukgymnastik.
    Forssberg, Hans
    Disturbances in programming goal-directed arm movements in children with ADHD2004Inngår i: Developmental Medicine & Child Neurology, ISSN 0012-1622, E-ISSN 1469-8749, Vol. 46, nr 1, s. 19-27Artikkel i tidsskrift (Fagfellevurdert)
  • 84.
    Elinge, Eva
    et al.
    Umeå universitet, Medicinsk fakultet, Samhällsmedicin och rehabilitering, Geriatrik.
    Stenvall, Michael
    Umeå universitet, Medicinsk fakultet, Samhällsmedicin och rehabilitering, Geriatrik.
    von Heideken Wågert, Petra
    Umeå universitet, Medicinsk fakultet, Samhällsmedicin och rehabilitering, Geriatrik.
    Löfgren, Britta
    Umeå universitet, Medicinsk fakultet, Samhällsmedicin och rehabilitering, Arbetsterapi.
    Gustafson, Yngve
    Umeå universitet, Medicinsk fakultet, Samhällsmedicin och rehabilitering, Geriatrik.
    Nyberg, Lars
    Umeå universitet, Medicinsk fakultet, Samhällsmedicin och rehabilitering, Sjukgymnastik.
    Daily life among the oldest old with and without previous hip fractures2005Inngår i: Scandinavian journal of occupational therapy, ISSN 1103-8128, Vol. 12, nr 2, s. 51-8Artikkel i tidsskrift (Fagfellevurdert)
  • 85.
    Eljansbo, Erik
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Rova, Ellen
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Styrkeförhållandet mellan olika rörelser vid maximal isokinetisk kraftutveckling hos patienter med KOL jämfört med friska vuxna individer2014Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Introduktion: Förhållandet i muskelstyrka mellan olika rörelser har tidigare beskrivits hos män med kroniskt obstruktiv lungsjukdom (KOL), information saknas för att generalisera resultat till båda könen. Tidigare studier saknas även beträffande eventuella skillnader mellan patienter med KOL och friska kontroller, detta är  viktigt för att finna den effektivaste träningsmodaliteten. Syfte:Fastställa styrkeförhållandet hos patienter med KOL mellan olika rörelser vid maximal isokinetisk kraftutveckling. Jämföra skillnader med friska kontroller, avseende styrkeförhållande, andfåddhet och muskeltrötthet. Avsåg även att illustrera hur långt ett elastiskt band behöver sträckas ut för att optimera träning. Metod:Tretton personer med KOL (steg II-IV), samt 14 friska kontroller utförde åtta maximala styrketester i en isokinetisk dynamometer. Försökspersonerna skattade andfåddhet och muskeltrötthet enligt Borgs CR-10 skala. Isokinetiskt  peakvärde, andfåddhet samt muskeltrötthet analyserades. Resultat:Grupperna utvecklade högst kraft i knäextension. Kontrollgruppen hade signifikant högre kraftutveckling i de flesta teströrelserna i övre extremiteten. Styrkeförhållandet hos grupperna såg likadant ut, förutom vid skulderextension. Kontrollgruppen skattade signifikant lägre avseende andfåddhet och muskeltrötthet, samt på andfåddhet i förhållande till muskeltrötthet. Konklusion: Studien visar att personer med KOL och friska kontroller har ett liknande styrkeförhållande. Individer med KOL har en muskulär nedsättning i övre extremiteten och skattar högre på andfåddhet och muskeltrötthet vid ett givet muskelarbete jämfört med friska kontroller

  • 86.
    Enberg, Birgit
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Work experiences among healthcare professionals in the beginning of their professional careers: a gender perspective2009Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Swedish healthcare organizations have undergone substantial organizational and economic restructuring during the 1990s due to financial cutbacks. Little is known about recently graduated healthcare professionals´ work experience in healthcare and their future career preferences. The overall aims of this thesis was, to increase knowledge about how recently graduated healthcare professionals in Sweden perceive their work in healthcare organizations. A gender perspective is adopted.

    In this national cross-sectional study, four stratified random samples were separately drawn from the 1999 Swedish university graduates who were nurses (NS), occupational therapists (OT), physical therapists (PT) and (registered) physicians (PN) and who at the time of the sampling procedure were living in Sweden. Stratification was performed by sex. A total of 3989 were eligible and of those, 1434 were selected: 535 NS, 250 OT, 250 PT and 399 PN.

    A questionnaire was constructed containing questions about socio-demographic factors, working conditions, career preferences,  work satisfaction and questions about the responsibility for and actual work with home and family, the so called unpaid household work. The questionnaires also contained questions measuring psychosocial working conditions: the effort-reward imbalance questionnaire (ERI-Q) and the demand-control questionnaire (DCQ). Collection of the data for NS, OT and PT was completed in March 2002 and for PN in May 2003. The response rate was 81% and 76% respectively. The total sample thus consists of 1145 participants; 423 nurses, 212 occupational therapists, 205 physiotherapists and 305 physicians. 

    Most of the respondents were employed in the public sector, but many desired privately employment within the coming five year period, men more often than women. Career preferences for future work differed between women and men. A majority indicated that they did not have the opportunity to pursue knowledge development in the professional field during working hours and nearly one half could not work as independently as they wished. Satisfaction with work in general was high, but many were dissatisfied with management at work and a majority was dissatisfied with the work organization. This dissatisfaction was associated with the opportunity to work as independently as they wished and the opportunity to pursue knowledge development in the professional field. Significantly more women than men had the main responsibility for home and family and did most of the unpaid household work.

    Among the OT and PT working for county councils and municipalities, the results revealed that those working for municipalities, experienced low control at work compared with those working for county councils. No differences were found between OT and PT or between men and women in the two professions regarding the DCQ and the ERI-Q except for the WOC scale. Women had significantly higher scores on the WOC scale compared with men. Logistic regression analyses revealed a significant association between WOC and ERI, effort, reward and sex. One fourth of the OT and PT working for county councils and municipalities was dissatisfied with their job and this dissatisfaction was significantly associated with type of employer, reward and effort-reward imbalance (in the ERI-Q) and control (in the DCQ).

    Differences regarding scoring on the ERI-Q were found between nurses and physicians working in county councils but not between women and men in the same group, with the exception of the scores on overcommitment. Significantly more nurses were defined as having high effort, low reward and effort-reward imbalance compared with the physicians. More women in the NS and PN group were defined as experiencing WOC compared to men.  Logistic regression analyses revealed significant associations between experiences of WOC and ERI, effort and reward. Nearly one fifth in the NS and PN group were dissatisfied with work and this dissatisfaction was particularly high among those with high effort, low reward, those with the greatest imbalance between effort and reward and those who experienced high overcommitment.

    In conclusion, in order to limit future work related problems and to be able to retain well educated professionals in healthcare work, dissatisfaction among the recently graduated must be taken seriously. Healthcare employers should better utilize the knowledge that recently graduated possess, regarding for example how to be a part of the development of the profession and the job. It is also important that healthcare employers address gender (in) equality at work and that work environments allow both women and men to combine careers with family duties.

  • 87.
    Enberg, Birgit
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Nordin, Catharina
    Öhman, Ann
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap. Umeå universitet, Samhällsvetenskapliga fakulteten, Umeå centrum för genusstudier (UCGS).
    Work experiences of novice occupational therapists and physiotherapists in public sector employment: analyses using two occupational stress models2010Inngår i: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 12, nr 1, s. 42-49Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to evaluate how recently graduated occupational therapists and physiotherapists, employed by the Swedish county councils and municipalities, experience working in public sector healthcare organization. The study group, 262 occupational therapists and physiotherapists who graduated in 1999, is a sub-sample drawn from a national cross-sectional survey. Data were collected in their third year after graduation. The Swedish Demand-control Questionnaire and the Effort-reward Imbalance Questionnaire together with self-constructed questions were used to evaluate psychosocial factors at work. The results reveal that few were exposed to job strain or effort-reward imbalance (ERI). More were defined as having work-related overcommitment (WOC). Logistic regression analyses revealed a significant association between WOC and ERI, sex, degree of effort and degree of reward. One quarter was dissatisfied with their work and this dissatisfaction was significantly associated with ERI, reward (in the ERI questionnaire), control (in the Demand-control Questionnaire) and type of employer. In conclusion, combining the Demand-control model and the ERI model made it possible to describe and analyse varying aspects of the work of novice occupational therapists and physiotherapists in public sector healthcare.

  • 88.
    Enberg, Birgit
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Stenlund, Hans
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap.
    Sundelin, Gunnevi
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Öhman, Ann
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap.
    Work satisfaction, career preferences and unpaid household work among recently graduated health-care professionals: a gender perspective2007Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 21, nr 2, s. 169-177Artikkel i tidsskrift (Fagfellevurdert)
  • 89.
    Enberg, Birgit
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Stenlund, Hans
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap.
    Öhmnan, Ann
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap. Umeå universitet, Samhällsvetenskapliga fakulteten, Umeå centrum för genusstudier (UCGS).
    Gendered career preferences, work satisfaction and unpaid household work among recently graduated physiciansManuskript (Annet vitenskapelig)
  • 90.
    Enberg, Birgit
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Sundelin, Gunnevi
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Öhman, Ann
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap. Umeå universitet, Samhällsvetenskapliga fakulteten, Umeå centrum för genusstudier (UCGS).
    Work experiences among nurses and physicians in the beginning of their professional careers: analyses using the effort-reward imbalance modelManuskript (Annet vitenskapelig)
  • 91.
    Engdal, Maria
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Lidström, Jakob
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Optimized arm muscle activation after stroke: A pilot study evaluating two loading conditions by use of EMG and force recording.2013Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund ändamål - Styrketräning har på senare år vunnit mark i rehabilitering för strokepatienter . Det pågår dock fortfarande debatt om hur man bäst tränar muskler med nedsatt funktion till följd av en stroke. Syftet med denna pilotstudie var att testa om personer med nedsatt muskelfunktion efter stroke kan optimera sin muskelaktivitet och producera mer kraft i en postural bilateral övning, jämfört med en icke postural ensidig övning.

    Metod - I den här pilotstudien mättes kraft och EMG för fyra muskler i övre extremiteten hos personer drabbade av stroke (n=4) som utförde två olika isometriska belastningsövningar, 1)"Dog-to-Cobra" (DOC), en postural bilateral övning och 2) "Overcoming-Isometric-Load" (OIL), en icke postural ensidig övning.Data normaliserades till % av maximum i de två övningarna och jämfördes med resultaten från friska kontroller (n=4). Graden av kokontraktion för triceps/biceps beräknades för båda övningarna för de båda grupperna.Resultat - Alla strokepatienter producerade mer eller samma kraft i DOC jämfört med OIL. Kontrollgruppen producerade samma mängd kraft i DOC som i OIL. Kokontraktioner mellan biceps och triceps var högre i OIL än i DOC för stroke gruppen.

     

     

    Slutsats - Personer med stroke tycks utveckla mer kraft med mindre kokontraktioner i DOC än i OIL. För att bättre förstå dessa två övningar och individuell variation i utförandet behöver framtida studier vara större och standardiseras ytterligare.

  • 92.
    Engström, Ida
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Främre knäsmärta efter främre korsbandsrekonstruktion  med graft från patellar-eller hamstringssenor: en jämförelse mellan ett accelerat- och standard rehabiliteringsprotokoll2013Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
    Abstract [sv]

    BakgrundEndast sparsam kunskap finns idag avseende hur graden av främre knäsmärta samt förmågan att gå pä knä kan påverkas av rehabiliteringsprogrammet som patienten genomgår efter en främre korsbandsrekonstruktion.

     SyfteUndersöka om det föreligger några skillnader avseende främre knäsmärta samt förmåga att gå pä knä mellan patienter som genomgått främre korsbandsrekonstruktion med patellarsenegraft respektive hamstringsgraft; i kombination med rehabilitering efter ett accelererat- respektive standardprotokoll fyra och 24 månader postoperativt.

    StudiedesignProspektiv randomiserad interventionsstudie.

    Material och MetodEtthundrasextioen patienter med främre korsbandsskada som randomiserats till artroskopisk rekonstruktion med graft från patellarsena eller hamstringssenor samt två olika rehabiliteringsprotokoll. Functional Knee Score for Anterior Knee Pain användes för bedömning av främre knäsmärta och Kartus Kneewalking test för bedömning av knägång.

    ResultatIngen signifikant skillnad kunde påvisas avseende främre knäsmärta mellan grupperna oavsett graftval eller rehabiliteringsprotokoll. Avseende knägång fanns en signifikant skillnad (p<o.001) mellan grupperna vid båda uppföljningstillfällena, där de patienter som var opererade med patellarsena hade större besvär jämfört med de som var opererade med senor från hamstrings.

    SlutsatsIngen signifikant skillnad vad gäller främre knäsmärta gick att urskilja varken mellan de olika graften eller de olika rehabiliteringsprotokollen. Avseende knästående bör eventuellt patienter som i sitt arbete eller sin idrott utsätts för många knästående moment avrådas från att genomgå främre korsbandsrekonstruktion med patellarsenegraft.

  • 93. Ericsson, Pernilla
    et al.
    Björklund, Martin
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Wahlström, Jens
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Exposure assessment in different occupational groups at a hospital using Quick Exposure Check (QEC): A pilot study2012Inngår i: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 41, nr Supplement 1, s. 5718-5720Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In order to test the feasibility and sensitivity of the ergonomic exposure assessment tool Quick Exposure Check (QEC), a pilot-study was conducted. The aim was to test QEC in different occupational groups to compare the exposure in the most common work task with the exposure in the work task perceived as the most strenuous for the neck/shoulder region, and to test intra-observer reliability. One experienced ergonomist observed 23 workers. The mean observation time was 45 minutes, waiting time and time for complementary questions included. The exposure scores varied between the different occupational groups as well as between workers within the occupational groups. Eighteen workers rated their most common work task as also being the most strenuous for the neck/shoulder region. For the remaining five workers, the mean exposure score were higher both for the neck and shoulder/arm in the most common work task. Intra-observer reliability shows agreement in 86% of the exposure interactions in the neck and in 71% in the shoulder/arm. QEC seems to fulfill the expectations of being a quick, sensible and practical exposure assessment tool that covers physical risk factors in the neck, upper extremities and low back.

  • 94.
    Eriksson, Britt-Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Keep moving to retain the healthy self: A theoretical understanding of physical exercise in the lives of individuals with Parkinson's disease2011Independent thesis Advanced level (degree of Master (One Year)), 20 poäng / 30 hpOppgave
  • 95.
    Eriksson, Britt-Marie
    et al.
    Centralsjukhuset, Karlstad.
    Arne, Mats
    Uppsala University, Uppsala and County Council of Värmland.
    Ahlgren, Christina
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Keep moving to retain the healthy self: the meaning of physical exercise in individuals with Parkinson's disease2013Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 35, nr 26, s. 2237-2244Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: The aim of this study was to explore and generate an understanding of the meaning of physical exercise in the lives of individuals with Parkinson's disease (PD) participating in an exercise program. Method: A qualitative design, using Grounded Theory methodology, was used. Eleven individuals diagnosed with PD were interviewed. Results: The core category "Keep moving to retain the healthy self" identified the continuing process of maintaining functions and activities in the individuals' lives, in which exercise was a major contribution. Two categories, "Having explicit life goals" and "Having confidence in one's own ability", were important prerequisites for adherence to physical exercise. Four categories - "Taking rational position", "Exercising to slow progression", "Exercising to achieve well-being" and "Using exercise as coping strategy" - were generated as important for starting and maintaining exercise habits. Conclusions: Insights into the process of exercising in view of living with PD were generated, which have implications for strategies in promoting physical exercise in older individuals with PD.

  • 96.
    Eriksson, Jeanette
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Olika uppvärmningsmetoder vid kvantitativ sensorisk testning(QST) av temperatur och vibrationssinne- en pilotstudie2013Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
    Abstract [sv]

    IntroduktionI Sverige rapporterade 3 % av kvinnorna och 14 % av männen att de exponerades för vibrerande handverktyg minst en fjärdedel av arbetstiden. Arbete med vibrerande verktyg kan medföra skador på muskel-, och nervfunktion samt reflexer och cirkulation. Ofta räcker inte enbart en klinisk neurologisk undersökning för att fastställa skada, objektiva sensoriska mätningar kan användas som ett komplement för att bekräfta eller stärka kliniska misstankar.  Ett kvantitativt sensoriskt test (QST), undersöker tröskelvärden för exempelvis temperatur och vibration, dvs den lägsta stimuli-intensitet som krävs för att provocera fram en specifik sensorisk upplevelse. En fingertemperatur på mellan 32-34˚C eftersträvas inför testerna genom olika uppvärmningsmetoder. Syftet med denna pilotstudie var att undersöka skillnaderna gällande SI-index och temperaturperceptionströsklar för värme och kyla mellan två uppvärmningsmetoder, acklimatisering under filtar respektive cykelergometertest innan QST. Metod Denna pilotstudie genomfördes på sex försökspersoner vid tre separata tillfällen, där två uppvärmningsmetoder undersöktes, acklimatisering under filtar samt cykelergometertest. Försöken delades upp i två delar, en för respektive uppvärmningsmetod, där mätning av fingertemperatur, vibrametriundersökning, och termotest genomfördes. Känseltrösklar för vibration beräknades med ett sensibilitetsindex (SI-index), med ett normalvärde över 0,80, och temperaturperceptionströsklar för värme respektive kyla definerades utifrån medelvärdet ur två test-serier, där normaltemperaturer är under 42˚C för värme respektive över 23˚C för kyla.ResultatVid jämförelse mellan uppvärmning under filtar respektive cykelergometertest observerades inga skillnader för SI-index (p=0,86), temperaturperceptionströsklar för värme (p=0,95) eller  temperaturperceptionströsklar för kyla (p=0,81). Resultaten indikerade att hudtemperaturen ökade lika mycket vid acklimatisering under filtar som vid cykling. Kliniskt innebär detta att filt är mer kostnadseffektivt, samt enklare att använda då alla inte är lämpliga att genomföra ett cykelergometertest.

  • 97.
    Eriksson, Kerstin Margareta
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering. Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    A 3-year lifestyle intervention in primary health care: effects on physical activity, cardiovascular risk factors, quality of life and cost-effectiveness2010Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Background: A sedentary lifestyle diminishes quality of life (QOL) and contributes to increasing prevalence of obesity, diabetes and cardiovascular diseases (CVD), and thus increases the economic burden on health care and society. Expensive and tightly controlled lifestyle interventions reduce cardiovascular risk and onset of diabetes. Transferring these findings to the primary care setting is of clinical importance. The primary aim of this thesis was to apply a lifestyle intervention program in the primary care setting among individuals with moderate-to-high risk for CVD, and evaluate the effects on physical activity, cardiovascular risk factor levels and QOL. A secondary aim was to investigate the cost-effectiveness.

    Methods: A randomized controlled trial with one intervention group (n=75) and one control group (n=76) with follow-up at 3, 12, 24 and 36 months was used. Patients with the diagnosis obesity, hypertension, dyslipidemia, type 2 diabetes or any combination thereof (mean age 54 yr, 57% female) were recruited from a primary health centre in northern Sweden. The three-month intervention period consisted of group-based supervised exercise sessions and diet counselling, followed by regular, but sparse, group meetings with a behavioural approach during three years. Clinical measurements included anthropometrics, aerobic fitness, blood pressure and metabolic traits. Questionnaires on self-reported physical activity, stages of change for physical activity, and QOL were used. In a cost-utility analysis the costs, gained quality-adjusted life years (QALY), and savings in health care were considered. Probability of cost-effectiveness was described using Net Monetary Benefit Method.

    Results: Overall, the lifestyle intervention generated beneficial improvements in anthropometrics, blood pressure, aerobic fitness and activity level, and QOL, compared to the control group which only received one information meeting.  At 36 months, intention-to-treat analyses showed that lifestyle modification reduced waist circumference (–2.2 cm), waist-hip ratio (–0.02), systolic blood pressure (–5.1 mmHg), and diastolic blood pressure (–1.6 mmHg) and significantly improved aerobic fitness (5%).  BMI, lipid or glucose values did not differ between groups. Progression to active stages of change for physical activity and increases in time spent exercising and total physical activity were reported. Both physical and mental dimensions of QOL were improved during the study period, but after 3 years differences persisted mainly in physical dimensions. Cost per gained QALY was low, 1668-4813 USD (savings not counted). Visits to family physicians significantly decreased and there was a net saving of 47 USD per participant. Probabilities of cost-effectiveness were 89-100% when 50 000 USD was used as threshold of willingness to pay for a gained QALY.

    Conclusions: A group-based lifestyle intervention program in a primary health care setting favourably influences cardiovascular risk-factor profiles, increases physical activity level, and improves several dimensions of QOL in high-risk individuals, at least up to 3 years. The intervention method was highly cost-effective in relation to standard care. The results emphasize the advantage of an intervention that combines supervised exercise with regular follow-ups for reaching long term effects.  The study high-lights the feasibility of lifestyle interventions in the primary care setting and the importance of health care professionals supporting change in lifestyle.

  • 98.
    Eriksson, Kerstin Margareta
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Hagberg, Lars
    Departement of Social medicine and Public Health and centre for Health Care Science Örebro County Council.
    Lindholm, Lars
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Malmgren-Olsson, Eva-Britt
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Österlind, Jonas
    Department of Medicine Sunderby Hospital Luleå.
    Eliasson, Mats
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
    Quality of life and cost-effectiveness of a 3-year trial of lifestyle intervention in primary health care2010Inngår i: Archives of Internal Medicine, ISSN 0003-9926, E-ISSN 1538-3679, Vol. 170, nr 16, s. 1470-1479Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Lifestyle interventions reduce cardiovascular risk and diabetes but reports on long term effects on quality of life (QOL) and health care utilization are rare. The aim was to investigate the impact of a primary health care based lifestyle intervention program on QOL and cost-effectiveness over 3 years.

    Methods: 151 men and women, age 18-65 yr, at moderate-to-high risk for cardiovascular disease, were randomly assigned to either lifestyle intervention with standard care or standard care alone. Intervention consisted of supervised exercise sessions and diet counseling for 3 months, followed by regular group meetings during 3years. Change in QOL was measured with EuroQol (EQ-5D, EQ VAS), the 36-item Short Form Health Survey (SF-36), and the SF-6D.  The health economic evaluation was performed from a societal view and a treatment perspective. In a cost-utility analysis the costs, gained quality-adjusted life years (QALY) and savings in health care were considered. Cost-effectiveness was also described using the Net Monetary Benefit Method.

    Results: Significant differences between groups over the 3-yr period were shown in EQ VAS, SF-6D and SF-36 physical component summary but not in EQ-5D or SF-36 mental component summary. There was a net saving of 47 USD per participant. Costs per gained QALY, savings not counted, were 1,668 – 4,813 USD. Probabilities of cost-effectiveness were 89 – 100 %, when 50 000 USD was used as stakeholder’s threshold of willingness to pay for a gained QALY.

    Conclusion: Lifestyle intervention in primary care improves QOL and is highly cost-effective in relation to standard care.

  • 99. Eriksson, Lisbeth
    et al.
    Lindström, Britta
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Ekenberg, Lilly
    Patients' experiences of telerehabilitation at home after shoulder joint replacement2011Inngår i: Journal of Telemedicine and Telecare, ISSN 1357-633X, E-ISSN 1758-1109, Vol. 17, s. 25-30Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    We investigated the experience of ten patients who received video-based physiotherapy at home for two months after a shoulder joint replacement. Videoconferencing took place via the patient's home broadband connection at a bandwidth of 256-768 kbit/s. Qualitative interviews were carried out, transcribed and analysed. Through qualitative content analysis six categories were identified: (1) a different reinforced communication; (2) pain-free exercising as an effective routine; (3) from a dependent patient to a strengthened person at home; (4) closeness at a distance; (5) facilitated daily living; and (6) continuous physiotherapy chain. The access to bodily knowledge, continuity, collaboration and being at home were all aspects that contributed to the patients' recovery. The patients described experiences of safety, and strengthening during their daily exercise routine at home. The frequent interplay with the patient during telerehabilitation made it possible for the physiotherapist to make an individual judgement about each patient; this could be one reason for the positive findings. Home video-based physiotherapy may be useful in other kinds of physiotherapy.

  • 100. Eriksson, Lisbeth
    et al.
    Lindström, Britta
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Gard, Gunvor
    Lysholm, Jack
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Ortopedi.
    Physiotherapy at a distance: a controlled study of rehabilitation at home after a shoulder joint operation.2009Inngår i: Journal of Telemedicine and Telecare, ISSN 1357-633X, E-ISSN 1758-1109, Vol. 15, nr 5, s. 215-220Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    We explored the benefit of video communication in home rehabilitation after shoulder joint replacement and compared it to referral for physiotherapy in the conventional way. A total of 22 patients were included in the study. The intervention group (n = 10) had training at home under the supervision of a physiotherapist at the hospital using videoconferencing. The control group (n = 12) had physiotherapy training in a conventional way in their home town. All patients had the same postoperative, three-phase-programme for two months. The outcome measures were a Visual Analogue Scale (VAS) for pain, range of motion (ROM), shoulder function ability (Constant score and SRQ-S) and health-related quality of life (SF-36). Questions about areas of priority for improvement and general satisfaction with the shoulder were also included. The telemedicine group received a greater number of treatments compared to the control group. After the intervention, there were significant improvements in VAS-pain, Constant score and SRQ-S for both groups. The telemedicine group improved significantly more in all three measurements than the control group (P < 0.001 for all). When changes from baseline to follow-up were compared, the telemedicine group improved significantly more in terms of decrease in pain (P = 0.004) and vitality (P = 0.001) than the control group. Despite some limitations, there seem to be clear benefits from physiotherapy at a distance with a telemedicine technique that allows patients to obtain access to physiotherapy at home.

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