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  • 1.
    Fristedt, Sofi
    et al.
    Jonköping University, Sweden; Futurum Regiona Jönköping County.
    Kammerlind, Ann-Sofi
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Futurum Region Jönköping County, Sweden.
    Bravell Ernsth, Marie
    Jonköping University, Sweden.
    Fransson, Eleonor I.
    Jonköping University, Sweden.
    Concurrent validity of the Swedish version of the life-space assessment questionnaire2016In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 16, p. 181-Article in journal (Refereed)
    Abstract [en]

    Background: The Life-Space Assessment (LSA), developed in the USA, is an instrument focusing on mobility with respect to reaching different areas defined as life-spaces, extending from the room where the person sleeps to mobility outside ones hometown. A newly translated Swedish version of the LSA (LSA-S) has been tested for test-retest reliability, but the validity remains to be tested. The purpose of the present study was to examine the concurrent validity of the LSA-S, by comparing and correlating the LSA scores to other measures of mobility. Method: The LSA was included in a population-based study of health, functioning and mobility among older persons in Sweden, and the present analysis comprised 312 community-dwelling participants. To test the concurrent validity, the LSA scores were compared to a number of other mobility-related variables, including the Short Physical Performance Battery (SPPB) as well as "stair climbing", "transfers", "transportation", "food shopping", "travel for pleasure" and "community activities". The LSA total mean scores for different levels of the other mobility-related variables, and measures of correlation were calculated. Results: Higher LSA total mean scores were observed with higher levels of all the other mobility related variables. Most of the correlations between the LSA and the other mobility variables were large (r = 0.5-1.0) and significant at the 0.01 level. The LSA total score, as well as independent life-space and assistive life-space correlated with transportation (0.63, 0.66, 0.64) and food shopping (0.55, 0.58, 0.55). Assistive life-space also correlated with SPPB (0.47). With respect to maximal life-space, the correlations with the mobility-related variables were generally lower (below 0.5), probably since this aspect of life-space mobility is highly influenced by social support and is not so dependent on the individuals own physical function. Conclusion: LSA was shown to be a valid measure of mobility when using the LSA total, independent LS or assistive LSA.

  • 2.
    Gustavsson, Ann-Sofi
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences.
    Noaksson, Lisbeth
    Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences.
    Grahn-Kronhed, Ann-Charlotte
    Primary Health Care Centre, Vadstena, Sweden.
    Möller, Margareta
    Department of Research and Development, Varberg Hospital, Varberg, Sweden.
    Möller, Claes
    Department of Audiology, Sahlgrenska University Hospital, Göteborg, Sweden.
    Changes in balance performance in physically active elderly people aged 73-802000In: Scandinavian Journal of Rehabilitation Medicine, ISSN 0036-5505, E-ISSN 1940-2228, Vol. 32, no 4, p. 168-172Article in journal (Refereed)
    Abstract [en]

    In our hospital in 1989 a series of 30 healthy elderly people participated in a study to evaluate the effect of physical training on improving balance. Thereafter, the majority of the people in this group continued with some kind of balance training. Seven years later we followed up 17 of the people who had participated in the original study. We wanted to evaluate the balance performance of these physically active elderly people (mean age 80.5 years) and compare it with their balance performance 7 years previously. Balance was found to be significantly impaired compared with 1989 in four out of six static balance tests. The time required to walk 30 m had increased significantly. The subjective ratings of vertigo and balance problems had not changed significantly, neither had the number of correct steps when walking forwards on one line and backwards between two lines. In dynamic posturography, the test with sway-referenced visual cues showed improved postural control, but no change in sway was seen in the other five sensory conditions. When sudden backward translations of the platform occurred, increased latencies of force response were seen.

  • 3.
    Hermansen, Anna
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Activity and Health.
    Cleland, Joshua A.
    Franklin Pierce University, NH USA .
    Kammerlind, Ann-Sofi
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Peolsson, L.C.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Evaluation of Physical Function in Individuals 11 to 14 Years after AnteriorCervical Decompression and Fusion Surgery: A Comparison betweenPatients and Healthy Reference Samples and Between 2 Surgical Techniques2014In: Journal of Manipulative and Physiological Therapeutics, ISSN 0161-4754, E-ISSN 1532-6586, Vol. 37, no 2, p. 87-96Article in journal (Refereed)
    Abstract [en]

    Objective: The purpose of this study was to evaluate neck-related physical function in individuals 11 to 14 years after anterior cervical decompression and fusion (ACDF) surgery for degenerative cervical disk disease and to compare the long-term outcome of 2 surgical techniques, including the Cloward procedure and cervical intervertebral fusion cage. Methods: In this cross-sectional study, 51 individuals, 11 years or more after ACDF, underwent testing of cervical active range of motion, hand-grip strength, static and dynamic balance, neck muscle endurance, and completed pain ratings. The participants values were compared with values of age-and sex-matched healthy individuals to evaluate impairments. Correlations between different test scores and pain were performed. Group differences were analyzed between the 2 surgical techniques. Results: Sixty-five percent and 82% exhibited impairment in ventral and dorsal neck muscle endurance, respectively. Impairment rates of 18% to 39% for cervical active range of motion, 27% to 43% for hand-grip strength, 37% for standing balance, and 35% for dynamic balance were recorded. Twenty-nine percent of the participants had impairment (greater than30 mm visual analog scale) in pain. There were no significant differences in physical function between the 2 surgical treatment groups (Cloward procedure or cervical intervertebral fusion cage) (P = .10-.92). Conclusions: In those studied, a large percentage of patients who had anterior cervical decompression and fusion surgery have impairments in neck-related physical function when compared 11 to 14 years after surgery with age-and sex-matched healthy reference individuals. Neck-specific function, but not balance, was statistically correlated to pain. Neck muscle endurance was most affected, and balance impairments were also present in one-third of the individuals. There were no differences in long-term physical function between the 2 surgical techniques.

  • 4.
    Hermansen, Anna
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.
    Peolsson, Anneli
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.
    Kammerlind, Ann-Sofi
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Futurum Region Jönköping County.
    Hjelm, Katarina
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Women’s experiences of daily life after anterior cervical decompression and fusion surgery: A qualitative interview study2016In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 48, no 4, p. 352-358Article in journal (Refereed)
    Abstract [en]

    Subjects: Fourteen women aged 39-62 years (median 52 years), were included 1.5 to 3 years after ACDF for cervical degenerative disc disease.

    Methods: Individual semi-structured interviews were analyzed by qualitative content analysis with an inductive approach.

    Results: The women described their experiences of daily life in five different ways; Experiences of recovery; Experiences of symptoms in daily life influence feelings and thoughts; Making daily life work; Importance of social  and occupational networks; Experiences of the influence of healthcare professionals and interventions on daily life.

    Conclusion: This interview study provides insight into women’s daily life after ACDF. While improved after surgery, informants also experienced remaining symptoms and limitations in daily life. A variety of mostly active coping strategies were used to manage daily life. Social support from family, friends, occupational networks and healthcare professionals positively influenced daily life. These findings provide knowledge on aspects of daily life that should be considered in individualized postoperative care and rehabilitation in an attempt to provide better outcomes in women after ACDF.

  • 5.
    Hugosson, Svante
    et al.
    Öron Örebro.
    Tjell, Carsten
    Öron Skövde.
    Karlberg, Mikael
    Öron Lund.
    Ledin, Torbjörn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    Kammerlind, Ann-Sofi
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Physiotherapy. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Cervikogen yrsel - eller fobisk postural vertigo (spänningsyrsel)--- Vanlig yrselorsak men omöjlig att diagnostisera?2003In: Svensk ÖNH tidskrift, ISSN 1400-0121, Vol. 10, p. 16-18Article in journal (Other academic)
    Abstract [sv]

      

  • 6.
    Kammerlind, Ann-Sofi
    Linköping University, Department of Department of Health and Society, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Vestibular rehabilitation therapy in dizziness and disequilibrium2005Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Dizziness and disequilibrium can be caused by several dysfunctions within the balance system, and are common symptoms especially in higher ages. The general aim of this thesis was to evaluate the effects of vestibular rehabilitation therapy in patients with dizziness and disequilibrium, and to examine the influence of age, vestibular function and psychological aspects on recovery.

    Four study samples were included in the thesis: physically active elderly, central vestibular dysfunction (CVD), acute unilateral vestibular loss (AUVL), and in the last study both AUVL and CVD. The measurements static and dynamic clinical balance tests, V AS, EuroQol, Hospital Anxiety and Depression Scale, UCLA Dizziness Questionnaire, Dizziness Handicap Inventory, Dizziness Beliefs Scale, electronystagmography, vestibular-evoked myogenic potentials, and computerized dynamic posturography were used.

    The change in balance performance over a 7-year period was evaluated in 17 physically active elderly. Both static clinical balance tests and maximum walking speed showed impaired balance. The amount of sway measured by computerized dynamic posturography had not changed, but increased latencies of force response to sudden backward translations of the platform were seen.

    The effects of balance training were evaluated in 23 elderly patients with dizziness and disequilibrium caused by CVD. Patients were randomized to exercise group or control group. The exercise group received group balance training twice a week for eight weeks. Improvements were seen only in the exercise group in clinical balance tests, dynamic posturography, maximum walking speed and subjective ratings.

    The effects of home training with and without additional individualized physical therapy were evaluated in a randomized controlled study of 54 patients during six months after AUVL. Similar recovery was seen in the two training groups. Higher age correlated with worse performance on clinical balance tests on follow-ups but not with change over time. Higher age also correlated with higher subjective ratings of vertigo at the six-month follow-up. Greater caloric vestibular asymmetry correlated with worse performance on clinical balance tests and higher subjective ratings.

    In a long-term follow-up after 3-6 years, about half of the patients reported residual symptoms after the AUVL. Patients with and without reported symptoms differed with respect to health-related quality of life, anxiety and depression, but not in clinical balance tests, electronystagmography or vestibular-evoked myogenic potentials.

    The test-retest and inter-rater reliability of, and the relationships between, clinical balance tests and subjective ratings and questionnaires were assessed in 50 patients with residual symptoms of dizziness and disequilibrium after AUVL or CVD. Sharpened Romberg's test with eyes closed, standing on foam with eyes closed, standing on one leg with eyes open, and walking in a figure-of-eight were the most reliable and appropriate clinical balance tests. Clinical balance tests were seldom correlated with subjective ratings and questionnaires, which shows the importance of measuring both aspects of dizziness and disequilibrium.

    In conclusion, balance performance deteriorates with aging, vestibular rehabilitation therapy may improve balance and decrease symptoms of dizziness and disequilibrium, and it is important to use clinical balance tests together with subjective ratings and questionnaires in these patients.

    List of papers
    1. Changes in balance performance in physically active elderly people aged 73-80
    Open this publication in new window or tab >>Changes in balance performance in physically active elderly people aged 73-80
    Show others...
    2000 (English)In: Scandinavian Journal of Rehabilitation Medicine, ISSN 0036-5505, E-ISSN 1940-2228, Vol. 32, no 4, p. 168-172Article in journal (Refereed) Published
    Abstract [en]

    In our hospital in 1989 a series of 30 healthy elderly people participated in a study to evaluate the effect of physical training on improving balance. Thereafter, the majority of the people in this group continued with some kind of balance training. Seven years later we followed up 17 of the people who had participated in the original study. We wanted to evaluate the balance performance of these physically active elderly people (mean age 80.5 years) and compare it with their balance performance 7 years previously. Balance was found to be significantly impaired compared with 1989 in four out of six static balance tests. The time required to walk 30 m had increased significantly. The subjective ratings of vertigo and balance problems had not changed significantly, neither had the number of correct steps when walking forwards on one line and backwards between two lines. In dynamic posturography, the test with sway-referenced visual cues showed improved postural control, but no change in sway was seen in the other five sensory conditions. When sudden backward translations of the platform occurred, increased latencies of force response were seen.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-27788 (URN)10.1080/003655000750060913 (DOI)11201623 (PubMedID)12535 (Local ID)12535 (Archive number)12535 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
    2. Effects of balance training in elderly people with nonperipheral vertigo and unsteadiness
    Open this publication in new window or tab >>Effects of balance training in elderly people with nonperipheral vertigo and unsteadiness
    2001 (English)In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 15, no 5, p. 463-470Article in journal (Refereed) Published
    Abstract [en]

    Objective: To evaluate the effect of balance training in group in elderly people with nonperipheral vertigo and unsteadiness.

    Design: Randomized controlled study.

    Setting: Ear, nose and throat department, University Hospital, Sweden.

    Subjects: Twenty-three elderly subjects with nonperipheral vertigo and/or unsteadiness randomized into training group and control group.

    Intervention: The training group attended balance training in group twice a week for eight weeks.

    Main outcome measures: Timed static balance tests, walking tests and six sensory organization tests on EquiTest dynamic posturography were performed before and after the training period. Besides, the patients estimated their vertigo and unsteadiness on a visual analogue scale (VAS) before and after the training period.

    Results: The training group improved significantly in standing on one leg with eyes open, walking forward on a line, walking speed, in three out of six tests on dynamic posturography and estimated less vertigo and unsteadiness measured with VAS. No changes were seen in the control group.

    Conclusion: Balance training in elderly people with nonperipheral vertigo and unsteadiness seems to improve both objective and perceived balance.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-27824 (URN)10.1191/026921501680425180 (DOI)12576 (Local ID)12576 (Archive number)12576 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
    3. Effects of home training and additional physical therapy on recovery after acute unilateral vestibular loss: a randomized study
    Open this publication in new window or tab >>Effects of home training and additional physical therapy on recovery after acute unilateral vestibular loss: a randomized study
    2005 (English)In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 19, no 1, p. 54-62Article in journal (Refereed) Published
    Abstract [en]

    Objective: To evaluate the effects of additional physical therapy on recovery after acute unilateral vestibular loss given to patients receiving home training.

    Design: Randomized controlled trial.

    Setting: Ear, nose and throat departments in three hospitals.

    Subjects: Fifty-four patients (mean age 52 years) with acute unilateral vestibular loss within the last week confirmed with electronystagmography testing were included. Patients with central neurologic or auditory symptoms or other vertigo disease were excluded.

    Interventions: Home training with or without additional physical therapy 12 times during 10 weeks.

    Main measures: Electronystagmography testing was performed before and after the training period. Clinical static (Romberg?s test, sharpened Romberg?s test, standing on foam and standing on one leg) and dynamic (walking forward and backward on a line) balance tests and subjective ratings of vertigo and balance problems on a visual analogue scale were done one week, 10 weeks and six months after the start of training.

    Results: Similar changes were seen in the two training groups.

    Conclusions: No significant differences in outcome regarding balance function or perceived symptoms were found between home training with or without additional physical therapy.

    National Category
    Social Sciences
    Identifiers
    urn:nbn:se:liu:diva-29391 (URN)10.1191/0269215505cr830oa (DOI)14725 (Local ID)14725 (Archive number)14725 (OAI)
    Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2017-12-13Bibliographically approved
    4. Influence of asymmetry of vestibular caloric response and age on balance and perceived symptoms after acute unilateral vestibular loss
    Open this publication in new window or tab >>Influence of asymmetry of vestibular caloric response and age on balance and perceived symptoms after acute unilateral vestibular loss
    2006 (English)In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 20, no 2, p. 142-148Article in journal (Refereed) Published
    Abstract [en]

    Objective: To evaluate the influence of asymmetry of vestibular caloric response and age on balance and perceived symptoms after acute unilateral vestibular loss.

    Design: Prospective study.

    Setting: Ear, nose and throat departments in three hospitals.

    Subjects: Fifty-four patients (mean age 52 years) with acute unilateral vestibular loss participating in a randomized controlled training study were included.

    Main measures: Electronystagmography testing was performed within one week after onset of symptoms and after 10 weeks. The outcome measures clinical static balance tests (sharpened Romberg's test with eyes closed, standing on foam with eyes closed, and standing on one leg with eyes open and closed) and subjective symptom ratings on a visual analogue scale were done after one week, 10 weeks and six months. The correlation between age and asymmetry of vestibular caloric response, respectively, and the outcome measures were analysed.

    Results: Greater caloric asymmetry correlated with poorer performance at the sharpened Romberg's test and standing on one leg with eyes closed at all three follow-ups (rho=-0.31 to -0.54), and with higher symptom ratings at the 10-week and six-month follow-ups (rho=0.30-0.60). Higher age was associated with poorer performance on the sharpened Romberg's test and standing on one leg at all three follow-ups (rho=0.31-0.64), but did not change over time. Higher age was also associated with higher ratings of vertigo at the six-month follow-up, and less reduction of vertigo between the 10-week and six-month follow-ups (rho=0.29-0.48).

    Conclusions: A higher degree of asymmetry of vestibular caloric response and high age seem to be associated with poor outcome in balance and perceived symptoms after acute unilateral vestibular loss.

    National Category
    Social Sciences
    Identifiers
    urn:nbn:se:liu:diva-33400 (URN)10.1191/0269215506cr886oa (DOI)19416 (Local ID)19416 (Archive number)19416 (OAI)
    Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2017-12-13Bibliographically approved
    5. Long-term follow-up after acute unilateral vestibular loss and comparison between subjects with and without remaining symptoms
    Open this publication in new window or tab >>Long-term follow-up after acute unilateral vestibular loss and comparison between subjects with and without remaining symptoms
    2005 (English)In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 125, no 9, p. 946-953Article in journal (Refereed) Published
    Abstract [en]

    Conclusions. About half of the subjects in this study reported remaining symptoms 3–6 years after acute unilateral vestibular loss. Differences could be seen between subjects with and without remaining symptoms regarding health-related quality of life, anxiety and depression.

    Objective. To evaluate the presence of self-rated remaining symptoms 3–6 years after acute unilateral vestibular loss, and to compare subjects with and without such symptoms.

    Material and methods. Firstly, 51 subjects answered a questionnaire which included the EuroQol EQ-5D, the Hospital Anxiety and Depression Scale, the University of California Los Angeles Dizziness Questionnaire, visual analogue scales and the Dizziness Handicap Inventory. Secondly, nine subjects with and nine without remaining symptoms participated in an extended testing procedure, including electronystagmography (ENG), determination of vestibular-evoked myogenic potentials (VEMPs) and clinical balance tests.

    Results. In the first part of the study, 27 subjects reported remaining symptoms, 3 reported 1 additional period of symptoms and 21 had not experienced any symptoms at all in the 3–6 years since acute unilateral vestibular loss. In the second part, the group with remaining symptoms rated a lower health-related quality of life and a higher level of anxiety and depression. There were no differences between the two groups in terms of ENG tests, VEMPs or clinical balance tests.

    National Category
    Social Sciences
    Identifiers
    urn:nbn:se:liu:diva-29392 (URN)10.1080/00016480510043477 (DOI)14726 (Local ID)14726 (Archive number)14726 (OAI)
    Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2017-12-13Bibliographically approved
    6. Reliability of clinical balance tests and subjective ratings in dizziness and disequilibrium
    Open this publication in new window or tab >>Reliability of clinical balance tests and subjective ratings in dizziness and disequilibrium
    2005 (English)In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 7, no 3, p. 96-107Article in journal (Refereed) Published
    Abstract [en]

    The aim was to assess (i) the test–retest and inter-rater reliability of, and (ii) the relationships between, commonly used clinical balance tests and subjective ratings in subjects with dizziness and disequilibrium. Fifty subjects (26 men and 24 women, mean age 63 years) with dizziness and disequilibrium following acute unilateral vestibular loss or central neurological dysfunction were tested with static and dynamic clinical balance tests, visual analogue scales (VAS), University of California Los Angeles Dizziness Questionnaire (UCLA-DQ), Dizziness Beliefs Scale (DBS), European Quality of Life questionnaire (EQ-5D), Dizziness Handicap Inventory (DHI), and Hospital Anxiety and Depression Scale (HADS). Most tests showed good test–retest and inter-rater reliability. Few correlations were seen between objective and subjective tests, but several correlations were found between the different subjective instruments. Sharpened Romberg's test eyes closed, standing on foam eyes closed, standing on one leg eyes open and walking in a figure-of-eight are recommended as reliable and appropriate clinical balance tests in subjects with dizziness and disequilibrium. Subjects with central lesions may have difficulties when rating their symptoms on VAS. Total scores rather than scores for separate items are recommended for UCLA-DQ and DHI.

    National Category
    Social Sciences
    Identifiers
    urn:nbn:se:liu:diva-29393 (URN)10.1080/14038190510010403 (DOI)14727 (Local ID)14727 (Archive number)14727 (OAI)
    Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2017-12-13Bibliographically approved
  • 7.
    Kammerlind, Ann-Sofi
    et al.
    Linköping University, Department of Department of Health and Society, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Bergquist Larsson, Pia
    Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences.
    Ledin, Torbjörn
    Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences.
    Skargren, Elisabeth
    Linköping University, Department of Department of Health and Society, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Reliability of clinical balance tests and subjective ratings in dizziness and disequilibrium2005In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 7, no 3, p. 96-107Article in journal (Refereed)
    Abstract [en]

    The aim was to assess (i) the test–retest and inter-rater reliability of, and (ii) the relationships between, commonly used clinical balance tests and subjective ratings in subjects with dizziness and disequilibrium. Fifty subjects (26 men and 24 women, mean age 63 years) with dizziness and disequilibrium following acute unilateral vestibular loss or central neurological dysfunction were tested with static and dynamic clinical balance tests, visual analogue scales (VAS), University of California Los Angeles Dizziness Questionnaire (UCLA-DQ), Dizziness Beliefs Scale (DBS), European Quality of Life questionnaire (EQ-5D), Dizziness Handicap Inventory (DHI), and Hospital Anxiety and Depression Scale (HADS). Most tests showed good test–retest and inter-rater reliability. Few correlations were seen between objective and subjective tests, but several correlations were found between the different subjective instruments. Sharpened Romberg's test eyes closed, standing on foam eyes closed, standing on one leg eyes open and walking in a figure-of-eight are recommended as reliable and appropriate clinical balance tests in subjects with dizziness and disequilibrium. Subjects with central lesions may have difficulties when rating their symptoms on VAS. Total scores rather than scores for separate items are recommended for UCLA-DQ and DHI.

  • 8.
    Kammerlind, Ann-Sofi
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Futurum Region Jönköping County, Sweden.
    Ernsth Bravell, Marie
    Jonköping University, Sweden.
    Fransson, Eleonor I.
    Jonköping University, Sweden; Karolinska Institute, Sweden.
    Prevalence of and factors related to mild and substantial dizziness in community-dwelling older adults: a cross-sectional study2016In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 16, p. 159-Article in journal (Refereed)
    Abstract [en]

    Background: Dizziness is highly prevalent among older people and associated with many health factors. The aim of the study was to determine the prevalence of and factors related to dizziness among community-dwelling older adults in Sweden. In contrast to previous studies, the subjects with dizziness were divided into two groups, mild and substantial dizziness, according to the frequency and intensity of dizziness. Methods: A sample of 305 older persons between 75 and 90 years of age (mean age 81 years) were interviewed and examined. Subjects with dizziness answered the University of California Los Angeles Dizziness Questionnaire and questions about provoking movements. The groups with substantial, mild, or no dizziness were compared with regard to age, sex, diseases, drugs, blood pressure, physical activity, exercises, falls, fear of falling, quality of life, general health, mobility aids, and physical performance. Results: In this sample, 79 subjects experienced substantial and 46 mild dizziness. Subjects with substantial dizziness were less physically active, reported more fear of falling, falls, depression/anxiety, diabetes, stroke/TIA, heart disease, a higher total number of drugs and antihypertensive drugs, lower quality of life and general health, and performed worse physically. Conclusions: There are many and complex associations between dizziness and factors like falls, diseases, drugs, physical performance, and activity. For most of these factors, the associations are stronger in subjects with substantial dizziness compared with subjects with mild or no dizziness; therefore, it is relevant to differ between mild and substantial dizziness symptoms in research and clinical practice in the future.

  • 9.
    Kammerlind, Ann-Sofi
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Fristedt, Sofi
    Jonköping University, Sweden .
    Ernsth Bravell, Marie
    Jonköping University, Sweden .
    Fransson, Eleonor I.
    Jonköping University, Sweden Karolinska Institute, Sweden .
    Test-retest reliability of the Swedish version of the Life-Space Assessment Questionnaire among community-dwelling older adults2014In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 28, no 8, p. 817-823Article in journal (Refereed)
    Abstract [en]

    Objective: To examine the test-retest reliability of the Swedish version of the Life-Space Assessment Questionnaire. Design: Test-retest reliability study. Subjects: A total of 298 community-dwelling subjects between 75 and 90 years of age. Methods: The Life-Space Assessment Questionnaire was translated into Swedish. By personal interviews during home visits and two weeks later by telephone interviews the subjects were asked about their life-space mobility during the past four weeks, and how often and whether they were independent or needed assistance from another person or equipment to reach different life-space levels. Results: None of the four scoring methods showed significant difference between test sessions. The mean (SD) total scores were 65 (22) and 65 (23) out of the maximum possible score of 120 at the two sessions. High levels were found for independent, assisted, and maximal life-space at both sessions. Intraclass correlation coefficients and weighted Kappa-values between 0.84-0.94 were found for the total score, the independent, and the assisted life-space levels, indicating good to excellent reliability. A lower Kappa-value was observed for the maximal life-space level, mainly owing to skewed distributions. The method error values showed that a change of 10 in the total score and a change of one level in any of the three life-space levels can be considered to indicate a real change in clinical practice. Conclusion: The Swedish version of the Life-Space Assessment Questionnaire can be reliably used among community-dwelling older adults.

  • 10.
    Kammerlind, Ann-Sofi
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences.
    Håkansson, Jenny
    Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences.
    Skogsberg, Maria
    Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences.
    Effects of balance training in elderly people with nonperipheral vertigo and unsteadiness2001In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 15, no 5, p. 463-470Article in journal (Refereed)
    Abstract [en]

    Objective: To evaluate the effect of balance training in group in elderly people with nonperipheral vertigo and unsteadiness.

    Design: Randomized controlled study.

    Setting: Ear, nose and throat department, University Hospital, Sweden.

    Subjects: Twenty-three elderly subjects with nonperipheral vertigo and/or unsteadiness randomized into training group and control group.

    Intervention: The training group attended balance training in group twice a week for eight weeks.

    Main outcome measures: Timed static balance tests, walking tests and six sensory organization tests on EquiTest dynamic posturography were performed before and after the training period. Besides, the patients estimated their vertigo and unsteadiness on a visual analogue scale (VAS) before and after the training period.

    Results: The training group improved significantly in standing on one leg with eyes open, walking forward on a line, walking speed, in three out of six tests on dynamic posturography and estimated less vertigo and unsteadiness measured with VAS. No changes were seen in the control group.

    Conclusion: Balance training in elderly people with nonperipheral vertigo and unsteadiness seems to improve both objective and perceived balance.

  • 11.
    Kammerlind, Ann-Sofi
    et al.
    Linköping University, Department of Department of Health and Society, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Ledin, Torbjörn
    Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences.
    Skargren, Elisabeth
    Linköping University, Department of Department of Health and Society, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Ödkvist, Lars
    Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences.
    Long-term follow-up after acute unilateral vestibular loss and comparison between subjects with and without remaining symptoms2005In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 125, no 9, p. 946-953Article in journal (Refereed)
    Abstract [en]

    Conclusions. About half of the subjects in this study reported remaining symptoms 3–6 years after acute unilateral vestibular loss. Differences could be seen between subjects with and without remaining symptoms regarding health-related quality of life, anxiety and depression.

    Objective. To evaluate the presence of self-rated remaining symptoms 3–6 years after acute unilateral vestibular loss, and to compare subjects with and without such symptoms.

    Material and methods. Firstly, 51 subjects answered a questionnaire which included the EuroQol EQ-5D, the Hospital Anxiety and Depression Scale, the University of California Los Angeles Dizziness Questionnaire, visual analogue scales and the Dizziness Handicap Inventory. Secondly, nine subjects with and nine without remaining symptoms participated in an extended testing procedure, including electronystagmography (ENG), determination of vestibular-evoked myogenic potentials (VEMPs) and clinical balance tests.

    Results. In the first part of the study, 27 subjects reported remaining symptoms, 3 reported 1 additional period of symptoms and 21 had not experienced any symptoms at all in the 3–6 years since acute unilateral vestibular loss. In the second part, the group with remaining symptoms rated a lower health-related quality of life and a higher level of anxiety and depression. There were no differences between the two groups in terms of ENG tests, VEMPs or clinical balance tests.

  • 12.
    Kammerlind, Ann-Sofi
    et al.
    Linköping University, Department of Department of Health and Society, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Ledin, Torbjörn
    Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences.
    Ödkvist, Lars
    Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences.
    Skargren, Elisabeth
    Linköping University, Department of Department of Health and Society, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Effects of home training and additional physical therapy on recovery after acute unilateral vestibular loss: a randomized study2005In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 19, no 1, p. 54-62Article in journal (Refereed)
    Abstract [en]

    Objective: To evaluate the effects of additional physical therapy on recovery after acute unilateral vestibular loss given to patients receiving home training.

    Design: Randomized controlled trial.

    Setting: Ear, nose and throat departments in three hospitals.

    Subjects: Fifty-four patients (mean age 52 years) with acute unilateral vestibular loss within the last week confirmed with electronystagmography testing were included. Patients with central neurologic or auditory symptoms or other vertigo disease were excluded.

    Interventions: Home training with or without additional physical therapy 12 times during 10 weeks.

    Main measures: Electronystagmography testing was performed before and after the training period. Clinical static (Romberg?s test, sharpened Romberg?s test, standing on foam and standing on one leg) and dynamic (walking forward and backward on a line) balance tests and subjective ratings of vertigo and balance problems on a visual analogue scale were done one week, 10 weeks and six months after the start of training.

    Results: Similar changes were seen in the two training groups.

    Conclusions: No significant differences in outcome regarding balance function or perceived symptoms were found between home training with or without additional physical therapy.

  • 13.
    Kammerlind, Ann-Sofi
    et al.
    Linköping University, Department of Department of Health and Society, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Ledin, Torbjörn
    Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences.
    Ödkvist, Lars
    Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences.
    Skargren, Elisabeth
    Linköping University, Department of Department of Health and Society, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Influence of asymmetry of vestibular caloric response and age on balance and perceived symptoms after acute unilateral vestibular loss2006In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 20, no 2, p. 142-148Article in journal (Refereed)
    Abstract [en]

    Objective: To evaluate the influence of asymmetry of vestibular caloric response and age on balance and perceived symptoms after acute unilateral vestibular loss.

    Design: Prospective study.

    Setting: Ear, nose and throat departments in three hospitals.

    Subjects: Fifty-four patients (mean age 52 years) with acute unilateral vestibular loss participating in a randomized controlled training study were included.

    Main measures: Electronystagmography testing was performed within one week after onset of symptoms and after 10 weeks. The outcome measures clinical static balance tests (sharpened Romberg's test with eyes closed, standing on foam with eyes closed, and standing on one leg with eyes open and closed) and subjective symptom ratings on a visual analogue scale were done after one week, 10 weeks and six months. The correlation between age and asymmetry of vestibular caloric response, respectively, and the outcome measures were analysed.

    Results: Greater caloric asymmetry correlated with poorer performance at the sharpened Romberg's test and standing on one leg with eyes closed at all three follow-ups (rho=-0.31 to -0.54), and with higher symptom ratings at the 10-week and six-month follow-ups (rho=0.30-0.60). Higher age was associated with poorer performance on the sharpened Romberg's test and standing on one leg at all three follow-ups (rho=0.31-0.64), but did not change over time. Higher age was also associated with higher ratings of vertigo at the six-month follow-up, and less reduction of vertigo between the 10-week and six-month follow-ups (rho=0.29-0.48).

    Conclusions: A higher degree of asymmetry of vestibular caloric response and high age seem to be associated with poor outcome in balance and perceived symptoms after acute unilateral vestibular loss.

  • 14.
    Ledin, Torbjörn
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences.
    Kammerlind, Ann-Sofi
    Linköping University, Department of Department of Health and Society, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Tamber, A-L
    Avdeling for helsefag, Högskolan i Oslo och Medicinska fakulteten, Universitetet i Oslo, Norge.
    Yrsel och balansrubbningar2004In: FYSS för alla: en bok om att röra på sig för att må bättre samt att förebygga och behandla sjukdomar / [ed] Jan Henriksson, Stockholm: Yrkesföreningar för fysisk aktivitet , 2004Chapter in book (Other academic)
    Abstract [sv]

    Yrsel är vanligt förekommande och förekomsten ökar med stigande ålder. Nedsatt, förlorad eller störd funktion i en eller flera av balanssystemets delar kan orsakas av åldrande samt av många olika sjukdomar och skador och leda till störd balansfunktion och rörelseillusioner (yrsel). Diagnostiken består av bl.a. anamnestagning, tester av vestibulär funktion, lägestester och bedömning av den posturala kontrollen. Vi diskuterar i denna framställning några yrseltillstånd där rörelseträning är betydelsefull för största möjliga tillfrisknande. Akut perifert vestibulärt bortfall av ena sidans balansnervsfunktion ger akut insättande kraftig yrsel och balansrubbning. Tillfrisknandet kan påskyndas genom stimulering av central kompensation med ögonrörelser, huvudrörelser och balansövningar av successivt ökad intensitet. Vid BPPV (godartad lägesyrsel) har otoliter lossnat och förflyttats från hinnsäck till båggång vilket ger yrsel vid huvudrörelser och kroppslägesändringar. Vid BPPV används två olika behandlingsprinciper; habitueringsträning och manöverbehandling. Skador i det centrala nervsystemet och åldersrelaterade förändringar av balanssystemets funktion kan också leda till yrsel och balansrubbningar. Yrsel och balanssvårigheter hos äldre är en riskfaktor för fall och frakturer. Vid skador på centrala nervsystemet och vid åldersrelaterad yrsel syftar träningen till förbättrad balans, koordination och styrka, minskad rörelserädsla och ökad aktivitetsgrad.

  • 15.
    Ledin, Torbörn
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences.
    Kammerlind, Ann-Sofi
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Yrsel och balansrubbningar2009In: Ordination motion, Bromberg , 2009, 1, p. 162-165Chapter in book (Other academic)
    Abstract [sv]

    Visste du att svenska läkare allt oftare skriver ut motion på recept? Att vi mår bättre när vi rör på oss och att det kan förebygga många skador är ett obestritt faktum, men att fysisk aktivitet även kan lindra och behandla krämpor och sjukdomar som redan har uppstått är ny kunskap. Det är inte farligt att vara fysiskt aktiv då man drabbats av sjukdom bara man undviker för hög belastning. Det kan dock vara svårt att veta vilka träningsformer som är bra och vilka man ska undvika. I boken Ordination:motion förmedlar svenska experter, främst läkare och sjukgymnaster, fakta på ett ingående och lättförståeligt sätt. Boken består av två delar - en »friskdel« för att förebygga sjukdom och en »sjukdel« som visar hur vi kan lindra vissa sjukdomar med hjälp av vardagsmotion och därmed uppnå bättre hälsa. Boken bygger på FYSS 2008, som är skriven av en rad medicinska experter och används inom sjukvården.

  • 16.
    Peolsson, Anneli
    et al.
    Linköping University, Department of Department of Health and Society, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Kammerlind, Ann-Sofi
    Linköping University, Department of Department of Health and Society, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Ledin, Torbjörn
    Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences.
    Dynamic posturography in patients with cervical disc disease compared with patients with whiplash-associated disorders and healthy volunteers2004In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 6, no 4, p. 173-181Article in journal (Refereed)
    Abstract [en]

    Background: Today there is limited knowledge of postural control and remaining dizziness after anterior cervical decompression and fusion (ACDF).

    Objective: The purpose of the present study was to compare the results from dynamic posturography (sensory organization test (SOT) 1–6 and SOT 1–2 in flexed and extended neck position, respectively) in patients with cervical disc disease with healthy controls and with patients with a previous whiplash-associated disorder (WAD). Another purpose was to investigate which objective and/or subjective factors that were related to the outcome on SOT 5 and SOT 6 in patients after ACDF.

    Design: Fifteen patients, half with self-perceived dizziness, who had undergone ACDF with cervical carbon fibre intervertebral fusion cage, were consecutively included in the study. Background data, active range of motion of the neck, neck and hand strength, neck muscle endurance and subjective variables were used in a multiple regression model to find the strongest factor of a good postural performance.

    Results: Not only WAD patients but also a major part of ACDF patients had dizziness and impaired postural control. Male patients without dizziness, with a low pain and disability level had the best results on dynamic posturography. Conclusions: Many patients with cervical disc disease had remaining disability due to postural control and are in need of specific physiotherapy after ACDF.

  • 17.
    Peolsson, Anneli
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Landén Ludvigsson, Maria
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Overmeer, Thomas
    Malardalen University, Sweden .
    Dedering, Asa
    Karolinska University Hospital, Sweden .
    Bernfort, Lars
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Allergy Center.
    Johansson, Gun
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Kammerlind, Ann-Sofi
    Linköping University, Department of Medical and Health Sciences, Physiotherapy. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Peterson, Gunnel
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Effects of neck-specific exercise with or without a behavioural approach in addition to prescribed physical activity for individuals with chronic whiplash-associated disorders: a prospective randomised study2013In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 14, no 311Article in journal (Refereed)
    Abstract [en]

    Background: Up to 50% of chronic whiplash associated disorders (WAD) patients experience considerable pain and disability and remain on sick-leave. No evidence supports the use of physiotherapy treatment of chronic WAD, although exercise is recommended. Previous randomised controlled studies did not evaluate the value of adding a behavioural therapy intervention to neck-specific exercises, nor did they compare these treatments to prescription of general physical activity. Few exercise studies focus on patients with chronic WAD, and few have looked at patients ability to return to work and the cost-effectiveness of treatments. Thus, there is a great need to develop successful evidence-based rehabilitation models. The study aim is to investigate whether neck-specific exercise with or without a behavioural approach (facilitated by a single caregiver per patient) improves functioning compared to prescription of general physical activity for individuals with chronic WAD. less thanbrgreater than less thanbrgreater thanMethods/Design: The study is a prospective, randomised, controlled, multi-centre study with a 2-year follow-up that includes 216 patients with chronic WAD (andgt;6 months and andlt;3 years). The patients (aged 18 to 63) must be classified as WAD grade 2 or 3. Eligibility will be determined with a questionnaire, telephone interview and clinical examination. The participants will be randomised into one of three treatments: (A) neck-specific exercise followed by prescription of physical activity; (B) neck-specific exercise with a behavioural approach followed by prescription of physical activity; or (C) prescription of physical activity alone without neck-specific exercises. Treatments will be performed for 3 months. We will examine physical and psychological function, pain intensity, health care consumption, the ability to resume work and economic health benefits. An independent, blinded investigator will perform the measurements at baseline and 3, 6, 12 and 24 months after inclusion. The main study outcome will be improvement in neck-specific disability as measured with the Neck Disability Index. All treatments will be recorded in treatment diaries and medical records. less thanbrgreater than less thanbrgreater thanDiscussion: The study findings will help improve the treatment of patients with chronic WAD.

  • 18.
    Peolsson, Anneli
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Öberg, Birgitta
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Wibault, Johanna
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Dedering, Åsa
    Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.
    Zsigmond, Peter
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Neurosurgery.
    Bernfort, Lars
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Allergy Center.
    Kammerlind, Ann-Sofi
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping. Futurum, County Council Jönköping, Sweden .
    Persson, Liselott
    Lunds University, Sweden.
    Löfgren, Håkan
    Ryhov Hospital, Jönköping, Sweden .
    Outcome of physiotherapy after surgery for cervical disc disease: a prospective randomised multi-centre trial2014In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 15, no 34Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Many patients with cervical disc disease require leave from work, due to long-lasting, complex symptoms, including chronic pain and reduced levels of physical and psychological function. Surgery on a few segmental levels might be expected to resolve disc-specific pain and reduce neurological deficits, but not the non-specific neck pain and the frequent illness. No study has investigated whether post-surgery physiotherapy might improve the outcome of surgery. The main purpose of this study was to evaluate whether a well-structured rehabilitation programme might add benefit to the customary post-surgical treatment for cervical disc disease, with respect to function, disability, work capability, and cost effectiveness.

    METHODS/DESIGN:

    This study was designed as a prospective, randomised, controlled, multi-centre study. An independent, blinded investigator will compare two alternatives of rehabilitation. We will include 200 patients of working age, with cervical disc disease confirmed by clinical findings and symptoms of cervical nerve root compression. After providing informed consent, study participants will be randomised to one of two alternative physiotherapy regimes; (A) customary treatment (information and advice on a specialist clinic); or (B) customary treatment plus active physiotherapy. Physiotherapy will follow a standardised, structured programme of neck-specific exercises combined with a behavioural approach. All patients will be evaluated both clinically and subjectively (with questionnaires) before surgery and at 6 weeks, 3 months, 6 months, 12 months, and 24 months after surgery. The main outcome variable will be neck-specific disability. Cost-effectiveness will also be calculated.

    DISCUSSION:

    We anticipate that the results of this study will provide evidence to support physiotherapeutic rehabilitation applied after surgery for cervical radiculopathy due to cervical disc disease.

  • 19.
    Sjöholm, Hanna
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Rehabilitation Centre, Region Jönköping County, Jönköping, Sweden.
    Hägg, Staffan
    Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Pharmacology. Futurum, Region Jönköping County, Jönköping, Sweden.
    Nyberg, Lars
    Department of Health Sciences, Luleå University of Technology, Luleå, Sweden.
    Rolander, Bo
    Futurum, Region Jönköping County, Jönköping, Sweden.
    Kammerlind, Ann-Sofi
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Futurum, Region Jönköping County, Jönköping, Sweden.
    The Cone Evasion Walk test: Reliability and validity in acute stroke2019In: Physiotherapy Research International, ISSN 1358-2267, E-ISSN 1471-2865, Vol. 24, no 1, article id e1744Article in journal (Refereed)
    Abstract [en]

    Objective

    To estimate the reliability and validity of the Cone Evasion Walk test (CEW), a new test assessing the ability to evade obstacles, in people with acute stroke.

    Methods

    To estimate the reliability of the CEW, video recordings of 20 people with acute stroke performing the test were assessed by 10 physiotherapists on two occasions, resulting in a total of 400 ratings. Patients performed the CEW (n = 221), functional ambulation classification (FAC; n = 204), Timed Up and Go (TUG; n = 173), TUG cognitive (TUG‐cog; n = 139), Serial 7s attention task from the Montreal Cognitive Assessment (MoCA‐S7; n = 127), and the Star Cancellation Test (SCT; n = 151). These tests and side of lesion (n = 143) were used to examine construct validity. The predictive validity was evaluated in relation to falls during the following 6 months (n = 203).

    Results

    The intraclass correlation coefficients for intrarater and interrater reliability were 0.88–0.98. For validity, there were significant correlations between the CEW and FAC (rs = −0.67), TUG (rs = 0.45), MoCA‐S7 (rs = −0.36), and SCT total score (rs = −0.36). There was a significant correlation between the number of cones touched on the left side and the proportion of cancelled stars on the left (rs = −0.23) and right (rs = 0.23) side in the SCT. Among right hemisphere stroke participants (n = 79), significantly more persons hit cones on the left side (n = 25) than the right side (n = 8), whereas among those with a left hemisphere stroke (n = 64) significantly more persons hit cones on the right side (n = 11) than the left (n = 3). Cox regression showed that participants who touched four to eight cones had an increased risk of falls over time (hazard ratio 2.11, 95% CI [1.07, 4.17]) compared with those who touched none.

    Conclusion

    The new CEW test was reliable and valid in assessing the ability to evade obstacles while walking and to predict falls in patients with acute stroke.

  • 20.
    Treleaven, Julia
    et al.
    University of Queensland, Australia.
    Peterson, Gunnel
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Uppsala University, Sweden.
    Landén Ludvigsson, Maria
    Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in West Östergötland, Department of Rehabilitation in Motala. Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy.
    Kammerlind, Ann-Sofi
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Futurum Region Jönköping County, Sweden.
    Peolsson, Anneli
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.
    Balance, dizziness and proprioception in patients with chronic whiplash associated disorders complaining of dizziness: A prospective randomized study comparing three exercise programs2016In: Manual Therapy, ISSN 1356-689X, E-ISSN 1532-2769, Vol. 22, p. 122-130Article in journal (Refereed)
    Abstract [en]

    Background: Dizziness and unsteadiness are common symptoms following a whiplash injury. Objective: To compare the effect of 3 exercise programs on balance, dizziness, proprioception and pain in patients with chronic whiplash complaining of dizziness. Design: A sub-analysis of a randomized study. Methods: One hundred and forty subjects were randomized to either a physiotherapist-guided neck-specific exercise (NSE), physiotherapist-guided neck-specific exercise, with a behavioural approach (NSEB) or prescription of general physical activity (PPA) group. Pre intervention, 3, 6 and 12 months post baseline they completed the University of California Los Angeles Dizziness Questionnaire (UCLA-DQ), Visual Analogue Scales (VAS) for, dizziness at rest and during activity and physical measures (static and dynamic clinical balance tests and head repositioning accuracy (HRA)). Results: There were significant time by group differences with respect to dizziness during activity and UCLA-Q favouring the physiotherapy led neck specific exercise group with a behavioural approach. Within group analysis of changes over time also revealed significant changes in most variables apart from static balance. Conclusion: Between and within group comparisons suggest that physiotherapist led neck exercise groups including a behavioural approach had advantages in improving measures of dizziness compared with the general physical activity group, although many still complained of dizziness and balance impairment. Future studies should consider exercises specifically designed to address balance, dizziness and cervical proprioception in those with persistent whiplash. Crown Copyright (C) 2015 Published by Elsevier Ltd. All rights reserved.

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