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  • 1.
    Hultman, Kristin
    et al.
    Department of Physiotherapy, Ryhov County Hospital, Jönköping, Sweden.
    Fältström, Anne
    Department of Physiotherapy, Ryhov County Hospital, Jönköping, Sweden.
    Öberg, Ulrika
    Futurum – The Academy of Healthcare, County Council Jönköping, Sweden.
    The effect of early physiotherapy after an acute ankle sprain2010In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 12, no 2, p. 65-73Article in journal (Refereed)
    Abstract [en]

    Ankle sprain is one of the most common injuries treated in emergency departments (ED). In clinical practice, these injuries are expected to heal by themselves, often without any treatment other than short information about the RICE regime (rest, ice, compression and elevation). Still, remaining symptoms are reported to occur in 30% of the cases. The aim of this study was to evaluate the effect of early physiotherapy intervention after an acute ankle sprain. Sixty-five patients were recruited from the ED at a general hospital in Sweden (mean age 35 years; 30 women), and allocated into an intervention group with early physiotherapy or a control group. Both groups were evaluated 6 weeks and 3 months after their injury. As primary outcome, the disease-specific Foot and Ankle Outcome Score (FAOS) was used. The patients also rated their physical activity ability and how satisfied they were with their ankle on a visual analogue scale (VAS). The intervention group made significant improvements compared with the control group at both evaluations measured with FAOS and the VAS questions. These findings indicate that early physiotherapy intervention has a positive effect on patient-focused foot and ankle function after an acute ankle sprain. © 2010 Informa UK Ltd.

  • 2.
    Siebers, Agneta
    et al.
    Rehabiliteringsmedicinska kliniken Länssjukhuset Ryhov.
    Öberg, Ulrika
    Futurum Länssjukhuset Ryhov.
    Skargren, Elisabeth
    Linköping University, Department of Medicine and Health Sciences, Physiotherapy. Linköping University, Faculty of Health Sciences.
    The effect of modified constraint –induced movement therapy on spasticity and motor function of the affected arm in patients with chronic stroke.2010In: Physiotherapy Canada, ISSN 0300-0508, E-ISSN 1708-8313, ISSN 0300-0508, Vol. 62, no 4, p. 388-366Article in journal (Refereed)
    Abstract [en]

     

    Purpose: The purpose of this study was to explore the effect of modified constraint-induced movement therapy (CIMT) in a real-world clinical setting on spasticity and functional use of the affected arm and hand in patients with spastic chronic hemiplegia.

    Method: A prospective consecutive quasi-experimental study design was used. Twenty patients with spastic hemiplegia (aged 22–67 years) were tested before and after 2-week modified CIMT in an outpatient rehabilitation clinic and at 6 months. The Modified Ashworth Scale (MAS), active range of motion (AROM), grip strength, Motor Activity Log (MAL), Sollerman hand function test, and Box and Block Test (BBT) were used as outcome measures.

    Results: Reductions (p<0.05–0.001) in spasticity (MAS) were seen both after the 2-week training period and at 6-month follow-up. Improvements were also seen in AROM (median change of elbow extension 5°, dorsiflexion of hand 10°), grip strength (20 Newton), and functional use after the 2-week training period (MAL: 1 point; Sollerman test: 8 points; BBT: 4 blocks). The improvements persisted at 6-month follow-up, except for scores on the Sollerman hand function test, which improved further.

    Conclusion: Our study suggests that modified CIMT in an outpatient clinic may reduce spasticity and increase functional use of the affected arm in spastic chronic hemiplegia, with improvements persisting at 6 months.

     

  • 3.
    Öberg, Ulrika
    Linköping University, Department of Clinical and Experimental Medicine, Orthopaedics. Linköping University, Faculty of Health Sciences.
    Functional assessment system of lower-extremity dysfunction1996Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The Functional Assessment System (FAS) is a new instrument for evaluation of lower-extremity dysfunction. It consists of 20 variables, representing major lower--extremity functions related to daily life activities. The variables are divided into five groups: hip impairment, knee impairment, physical disability, social disability, and paiu variables. The grouping agrees fairly well with the WHO classification of impairment, disabilities and handicaps. Every variable is given a disability score on a five-point scale. The scores are plotted into a diagram, giving an individual functional profile. The profile can be used to document present functional status, for goal-setting, and for follow-up after treatment. It can also be used to design individual training programs.

    The aim of this thesis was:

    • to present the new Functional Assessment System (FAS)

    • to examine the metric properties of the FAS, and

    • to apply the FAS in some clinical situations.

    The FAS was applied on a series of patients with osteoarthritis of the hip or knee. Content validity was tested with factor analysis. The obtained factor structure agreed very well with the preliminary grouping of the variables. Concurrent validity was tested by comparison with measurements from the AIMS (Arthritis Impact Measurement Scales), the Rosser-Kind index (for evaluation of quality of life), and a radiographic scale for grading of osteoarthritis. There was a good agreement between the measurements of the FAS and the physical variables of the AIMS. There was also a good agreement between the FAS and the results obtained by the Rosser-Kind index. There was a low agreement between the FAS and the psychosocial variables of the AIMS. There was also a low correlation between the radiographic grading of osteoarthritis and the functional status recorded with the FAS. Inter-tester reliability was evaluated as correlation between the measurements performed by two independent physiotherapists. There was an almost perfect agreement between the two testers. The FAS was also tested for discriminatory power. It showed a good ability to differentiate between healthy subjects and patients with osteoarthritis. It also had a good power to discriminate between different degrees of the disease. The disability group of variables had better discriminstory power than the impairment group of variables. Most variables had a high specificity, whereas high sensitivity was mainly found in the disability group of variables and pain. The FAS was used to measure outcome after arthroplasty. A baseline functional status was recorded before surgery, and a goal profile was made. Six months later there was a striking improvement, especially in the disability variables and pain, and there was a high degree of goal achievement of most patients in most variables. Patients admitted for arthroplasty were examined for age-related diffirences in founctional status, Despite the fact that age was not included in the criteria for operation, old people had significantly lower functional status. This finding may indicate a hidden age criterion for referral of patients for arthroplasty. The age-related changes were mainly found in the disability group of variables. These findings may speak in favor of early surgery of patients with osteoarthritis.

    To summarize: The FAS had very good metric properties, such as validity, intertester reliability, discriminatory power, sensitivity and specificity. It was also a useful instrument in a clinical setting to record functional status, to set an individual treatment goal, and as an instrument for follow-up and outcome measurements. It was also sensitive in detecting age-related differences in patients admitted for arthroplasty. It can be used to communicate functional status to other health professionals, and to establish realistic goals for the patient.

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