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Kjellman, Görel
Publications (10 of 17) Show all publications
Abbott, A., Kjellman, G. & Peolsson, A. (2013). Multidimensional assessment of pain related disability after surgery for cervical disc disease. In: APA Conference 2013: New moves. Paper presented at National Conference of the Australian Physiotherapy Association (APA) Conference 2013, Melbourne, Australia, 17-20 October 2013 (pp. 2-2). Australian Physiotherapy Association
Open this publication in new window or tab >>Multidimensional assessment of pain related disability after surgery for cervical disc disease
2013 (English)In: APA Conference 2013: New moves, Australian Physiotherapy Association , 2013, p. 2-2Conference paper, Oral presentation with published abstract (Other academic)
Abstract [en]

Questions: Given only 25% of patients, 10 year post-surgery for cervical disc disease report clinically meaningful improvements in functional disability, what are the biopsychosocial factors associated with continued long-term disability? What are the implications for physiotherapy practice?

Design: Cross-sectional observational study.

Participants: Ninety patients who had undergone anterior discectomy and fusion (ACDF) surgery 10-13 years prior.

Outcome Measures: The Neck Disability Index (NDI), ACDF surgery type, surgical fusion status, patient age and Part 1 of the West Haven-Yale multidimensional pain inventory Swedish version (MPI-S) were entered into a statistical model. Part 1 of the MPI-S contains 5 subscales: pain severity, interference, life control, affective distress and support.

Results: Seventy-three patients answered the questionnaires. Non-linear categorical regression modeling (CATREG) of the selected predictive variables explained 76.1% of the variance in NDI outcomes 10-13 years post ACDF. Of these predictors, MPI-S affective distress subscale (β = 0.635, p = <0.001) and pain severity subscale (β = 0.354, p = <0.001) were significant individual predictors of NDI ratings.

Conclusion: This is the first study to investigate potential factors associated with prolonged functional disability greater than 10 years post-surgery for cervical disc disease. The results suggest the importance of not only pain severity but also screening affective distress as a potential barrier to physical functioning in patients previously operated for cervical disc disease. Future research on the utility of affect-focused body awareness therapy and pain coping strategies for post-surgical patients with continuing pain and physical disability is indicated.

Key Practice Points:

•  The screening of pain severity and affective distress is of importance for patients presenting with continuing physical disability after previous surgery for cervical disc disorders

•  Affect-focused body awareness therapies and pain coping strategies may be a potential treatment alternative for patients with continuing pain and physical disability.

Place, publisher, year, edition, pages
Australian Physiotherapy Association, 2013
National Category
Physiotherapy
Identifiers
urn:nbn:se:liu:diva-123556 (URN)
Conference
National Conference of the Australian Physiotherapy Association (APA) Conference 2013, Melbourne, Australia, 17-20 October 2013
Available from: 2015-12-21 Created: 2015-12-21 Last updated: 2016-12-02Bibliographically approved
Peolsson, A., Kjellman, G. & Öberg, B. (2007). Intervention vid nackbesvär: Manuella tekniker och träningsterapi har god effekt. Fysioterapi, 1, 40-47
Open this publication in new window or tab >>Intervention vid nackbesvär: Manuella tekniker och träningsterapi har god effekt
2007 (Swedish)In: Fysioterapi, ISSN 1653-5804, Vol. 1, p. 40-47Article in journal (Other academic) Published
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-37850 (URN)39666 (Local ID)39666 (Archive number)39666 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2013-09-03Bibliographically approved
Peolsson, A. & Kjellman, G. (2007). Neck Muscle Endurance in Nonspecific Patients With Neck Pain and in Patients After Anterior Cervical Decompression and Fusion. Journal of Manipulative and Physiological Therapeutics, 30(5), 343-350
Open this publication in new window or tab >>Neck Muscle Endurance in Nonspecific Patients With Neck Pain and in Patients After Anterior Cervical Decompression and Fusion
2007 (English)In: Journal of Manipulative and Physiological Therapeutics, ISSN 0161-4754, E-ISSN 1532-6586, Vol. 30, no 5, p. 343-350Article in journal (Refereed) Published
Abstract [en]

Objective

The purpose of this study was to investigate differences in ventral and dorsal neck muscle endurance (NME) among men and women with nonspecific neck pain (NP) or cervical disk disease (who had anterior cervical decompression and fusion [ACDF]) and healthy controls (C). Another purpose was to investigate changes in NME after intervention.

Methods

Neck muscle endurance was measured in patients with NP (n = 78) and ACDF (n = 25) before and after the treatment period, and their results were compared to each other and to sex-specific reference values from controls (n = 116) at both the individual and group levels.

Results

Patients had significantly decreased (P < .01) NME compared with control subjects, except for ventral NME in female patients with NP before treatment and male patients with ACDF after treatment. Female patients with ACDF had lower ventral NME than female patients with NP (P < .01). Among the patients, 35% to 100% had NME disability, with most of them having a lower rate than the 95% confidence interval of controls. Female patients with NP and male patients with ACDF showed improvement (P < .05) after treatment. Flexion/extension ratio in patients with NP (P = .36), but not in patients with ACDF (P < .0001), returned to normal levels after treatment. There was a significant negative correlation (P < .02) between NME and Neck Disability Index in both patient groups, except for ventral NME in patients with NP before treatment.

Conclusion

Many patients had impairment in NME before and after treatment. This suggests that additional exercise of specific training for NME should be incorporated into the rehabilitation program, which may improve treatment outcome.

Keywords
Disability, Neck muscles, Physical endurance, Spine, Treatment
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-49666 (URN)10.1016/j.jmpt.2007.04.008 (DOI)
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2017-12-12Bibliographically approved
Larsson, H. & Kjellman, G. (2007). Polio- en bortglömd sjukdom. Incitament, 5, 403-406
Open this publication in new window or tab >>Polio- en bortglömd sjukdom
2007 (Swedish)In: Incitament, ISSN 1103-503X, Vol. 5, p. 403-406Article in journal (Other (popular science, discussion, etc.)) Published
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-41131 (URN)55238 (Local ID)55238 (Archive number)55238 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2011-01-11
Larsson, H. & Kjellman, G. (2007). Riskfaktorer för benskörhet och frakturer efter polio. Incitament, 4, 301-304
Open this publication in new window or tab >>Riskfaktorer för benskörhet och frakturer efter polio
2007 (Swedish)In: Incitament, ISSN 1103-503X, Vol. 4, p. 301-304Article in journal (Other (popular science, discussion, etc.)) Published
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-41126 (URN)55230 (Local ID)55230 (Archive number)55230 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2011-01-11
Kjellman, G. & Öberg, B. (2006). Comparison of three disability questionnaries for low back and neck pain with focus on test-retest reliability and sensitivity of change. In: The 8th Low Back Pain Forum,2006.
Open this publication in new window or tab >>Comparison of three disability questionnaries for low back and neck pain with focus on test-retest reliability and sensitivity of change
2006 (English)In: The 8th Low Back Pain Forum,2006, 2006Conference paper, Published paper (Other academic)
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-34933 (URN)24170 (Local ID)24170 (Archive number)24170 (OAI)
Available from: 2009-10-10 Created: 2009-10-10
Kjellman, G. (2004). Nackbesvär, prognostiska faktorer och behandlingseffekter. Incitament (6), 427-429
Open this publication in new window or tab >>Nackbesvär, prognostiska faktorer och behandlingseffekter
2004 (Swedish)In: Incitament, ISSN 1103-503X, no 6, p. 427-429Article in journal (Other (popular science, discussion, etc.)) Published
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-22474 (URN)1717 (Local ID)1717 (Archive number)1717 (OAI)
Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2011-01-12
Öberg, B., Enthoven, P., Kjellman, G. & Skargren, E. (2003). Back pain in primary care: a prospective cohort study of clinical outcome and healthcare consumption. Advances in Physiotherapy, 5(3), 98-108
Open this publication in new window or tab >>Back pain in primary care: a prospective cohort study of clinical outcome and healthcare consumption
2003 (English)In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 5, no 3, p. 98-108Article in journal (Refereed) Published
Abstract [en]

The aim was to describe the clinical course without active treatment in patients with low back and neck pain visiting primary care. A prospective consecutive study was done with follow-ups weekly for 6 weeks and at 3, 6, 12 and 30 months. Main outcome measures were proportion of patients who were free of pain and back-related disability and proportion of patients found to have received additional healthcare at 3-, 6-, 12- and 30-month follow-ups. The physiotherapist predicted additional treatment. Eighty consecutive patients were included. 39 low back pain and 17 neck pain patients underwent 30 months of follow-up. The results on a group level were consistent from about 4 weeks. In the low back pain group, 41% reported no pain and no disability after 30 months, within 3 months 33% and within 30 months 64% had received additional healthcare. In the neck pain group, 12% reported no pain and no disability after 30 months, within 3 months 59% and within 30 months 71% had received additional healthcare. A higher proportion of the patients, predicted with a high probability to seek additional care also reported additional care. It can be expected that half the back pain patients being cared for in primary care will continue to suffer from problems 30 months later. The slope of recovery is most prominent during the first 4 weeks, and a worse outcome is in the neck pain patients. Further healthcare is not equal to self-reported back pain problems at baseline. The 4-week evaluation can be used to predict groups with future healthcare utilization up until 30 months. Further studies including larger cohorts are needed to confirm the results.

National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-26265 (URN)10.1080/14038190310004862 (DOI)10775 (Local ID)10775 (Archive number)10775 (OAI)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
Enthoven, P., Skargren, E., Kjellman, G. & Öberg, B. (2003). Course of back pain in primary care: a prospective study of physical measures. Journal of Rehabilitation Medicine, 35(4), 168-173
Open this publication in new window or tab >>Course of back pain in primary care: a prospective study of physical measures
2003 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 35, no 4, p. 168-173Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To describe physical measures used in patients with back pain when no specific treatment is given, to examine associations between change over time in these measures and changes in pain and back-related disability, and to study the value of physical measures at baseline and at a 4-week follow-up to predict outcome at 12 months.

DESIGN: A prospective consecutive study.

SUBJECTS: Forty-four patients presenting with low back pain in primary care.

METHODS: The patients underwent a physical examination at baseline and at 4 weeks. Follow-up was carried out using questionnaires until 12 months. Linear regression was used to identify predictors.

RESULTS: Most measures had improved significantly at the 4-week follow-up. Thoracolumbar rotation, isometric endurance back extensors, and fingertip-to-floor distance at 4 weeks were significant predictors for pain intensity and back-related disability at the 12-month follow-up. Eighteen out of 44 patients reported an increase in pain after the assessment of the physical measures at baseline. This group of patients improved more in physical measures between baseline and the 4-week follow-up.

CONCLUSION: Physical measures assessed at the 4-week follow-up, but not at baseline, could provide important additional information for identifying those patients at risk for worse outcome in pain or back-related disability at 12 months.

National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-26264 (URN)10.1080/16501970306124 (DOI)10774 (Local ID)10774 (Archive number)10774 (OAI)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
Andersson, A., Ekberg, K., Enthoven, P., Kjellman, G., Ockander, M., Skargren, E., . . . Öberg, B. (2003). Vad är en god arbetslivsinriktad rehabilitering? Slutsatser baserade på en litteratursammanställning. Linköping: Linköpings Universitet, Landstinget och Försäkringskassa i Östergötland
Open this publication in new window or tab >>Vad är en god arbetslivsinriktad rehabilitering? Slutsatser baserade på en litteratursammanställning
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2003 (Swedish)Report (Other academic)
Place, publisher, year, edition, pages
Linköping: Linköpings Universitet, Landstinget och Försäkringskassa i Östergötland, 2003
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-28318 (URN)13450 (Local ID)13450 (Archive number)13450 (OAI)
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2013-09-03
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