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  • 201.
    Peolsson, Anneli
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Peterson, Gunnel
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Uppsala University, Sweden.
    Trygg, Johan
    Umeå University, Sweden.
    Nilsson, David
    Umeå University, Sweden.
    Multivariate analysis of ultrasound-recorded dorsal strain sequences: Investigation of dynamic neck extensions in women with chronic whiplash associated disorders2016Ingår i: Scientific Reports, E-ISSN 2045-2322, Vol. 6, artikel-id 30415Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Whiplash Associated Disorders (WAD) refers to the multifaceted and chronic burden that is common after a whiplash injury. Tools to assist in the diagnosis of WAD and an increased understanding of neck muscle behaviour are needed. We examined the multilayer dorsal neck muscle behaviour in nine women with chronic WAD versus healthy controls during the entire sequence of a dynamic low-loaded neck extension exercise, which was recorded using real-time ultrasound movies with high frame rates. Principal component analysis and orthogonal partial least squares were used to analyse mechanical muscle strain (deformation in elongation and shortening). The WAD group showed more shortening during the neck extension phase in the trapezius muscle and during both the neck extension and the return to neutral phase in the multifidus muscle. For the first time, a novel non-invasive method is presented that is capable of detecting altered dorsal muscle strain in women with WAD during an entire exercise sequence. This method may be a breakthrough for the future diagnosis and treatment of WAD.

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  • 202.
    Perera, Nirmala
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Federat Univ Australia, Australia.
    Too many rib ticklers? Injuries in Australian womens cricket (PhD Academy Award)2019Ingår i: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 53, nr 22, s. 1436-1437Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    n/a

  • 203.
    Perera, Nirmala
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Federat Univ Australia, Australia; Univ Oxford, England; Ctr Sport Exercise and Osteoarthrit Res Versus Arth, England; La Trobe Univ, Australia.
    Kemp, Joanne L.
    Federat Univ Australia, Australia; La Trobe Univ, Australia.
    Joseph, Corey
    Monash Hlth, Australia.
    Finch, Caroline F.
    Edith Cowan Univ, Australia.
    Epidemiology of hospital-treated cricket injuries sustained by women from 2002-2003 to 2013-2014 in Victoria, Australia2019Ingår i: Journal of Science and Medicine in Sport, ISSN 1440-2440, E-ISSN 1878-1861, Vol. 22, nr 11, s. 1213-1218Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: To present the first comprehensive epidemiological profile of hospital-treated injuries sustained by female cricketers from 2002-2003 to 2013-2014 in Victoria, Australia. Design: Analysis of routinely collected hospital data (detailed case-series). Methods: A retrospective analysis of hospital-treatment data associated with cricket injuries sustained by women between 1 July 2002 and 30 June 2014, inclusive were extracted from databases held by the Victorian Injury Surveillance Unit in Australia. Results: Over the 12-year period, 668 cases were treated in Victoria. Of these, 547 were emergency department (ED)-presentations. There were 121 hospital-admissions, of which, the length of stay was amp;lt;2 days for 78.5% cases. All cases were treated and released, and no fatalities were reported. The 10-14 year age group most frequently presented to ED (19.9%) and were most commonly admitted to hospital (16.5% of the total admissions). Fractures were the most common cause of hospital-admissions (47.1%) but only accounted for 17.2% of the ED-presentations. Dislocations, sprains and strains, were the most common (36.4%) cause of ED-presentations. The head was the most commonly injured anatomical location (27.8% of ED-presentations and 28.1% of hospital-admissions), followed by the wrist and hand (27.8% ED-presentations and 17.4% hospital-admissions). Conclusions: These findings provide the first overview of the nature of injuries requiring hospital attendance in female cricketers, and a foundation to inform the development of targeted injury prevention programs for female cricketers. (C) 2019 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  • 204.
    Perera, Nirmala
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Federat Univ Australia, Australia; Univ Oxford, England; La Trobe Univ, Australia; Ctr Sport Exercise and Osteoarthrit Res Versus Arth, England.
    Kountouris, Alex
    Cricket Australia, Australia.
    Kemp, Joanne L.
    La Trobe Univ, Australia.
    Joseph, Corey
    Monash Hlth, Australia.
    Finch, Caroline F.
    Edith Cowan Univ, Australia.
    The incidence, prevalence, nature, severity and mechanisms of injury in elite female cricketers: A prospective cohort study2019Ingår i: Journal of Science and Medicine in Sport, ISSN 1440-2440, E-ISSN 1878-1861, Vol. 22, nr 9, s. 1014-1020Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: Incidence, prevalence, nature, severity and mechanisms of injury in elite female cricketers over two seasons from March 2014 to March 2016, inclusive. Design: Prospective cohort study. Methods: Injury data collected via Cricket Australias Athlete Management System on all elite female players over two seasons were analysed. Profiles of the nature, anatomical location and mechanism of injuries were presented according to dominant player position. Injury incidence rates were calculated based on match playing hours. Results: There were 600 medical-attention injuries; with 77.7% players reporting amp;gt;= 1 injury. There were 79.5% acute injuries compared to gradual onset injuries. Of the all medical-attention injuries, 20.2% led to time-loss; 34.7% were match-time-loss injuries. Match injury incidence was 424.7 injuries/10,000 h for all injuries and 79.3 injuries/10,000 h for time-loss injuries. Of all the injuries, 31.8% were muscle injuries and 16.0% joint sprains. Wrist and hand (19.8%), lumbar spine (16.5%) and knee (14.9%) injuries were the most common time-loss injuries. Six players sustained lumber spine bone stress injury that resulted in the most days missed due to injury (average 110.5 days/injury). Conclusions: There is a need to focus on specific injuries in female cricket, including thigh, wrist/hand and knee injuries because of their frequency, and lumbar spine injuries because of their severity. (C) 2019 Sports Medicine Australia. Published by Elsevier Ltd.

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  • 205.
    Perera, Nirmala
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Åkerlund, Ida
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Hägglund, Martin
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Motivation for sports participation, injury prevention expectations, injury risk perceptions and health problems in youth floorball players2019Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 27, nr 11, s. 3722-3732Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose Describe the motivation for floorball participation, injury prevention expectations, injury risk perceptions and prevalence of health problems in youth floorball players at the start of the season. Methods This cross-sectional survey is part of a larger Sport Without Injury ProgrammE (SWIPE) project and provides baseline data before a cluster randomised controlled trial of an injury prevention program (Knee Control). A baseline survey (online and paper based) was collected from 47 teams with 471 youth floorball players from two provinces of Sweden before the start of the 2017 season. Results The mean age for 140 females and 331 males was 13.7 (+/- 1.5) and 13.3 (+/- 1.0) years, respectively. The two most significant motivators for floorball participation were being part of the team (82% females, 75% males) and friends (65% females, 70% males). Fractures (84% females, 90% males), eye injuries (90% females, 83% males) and concussion (82% females, 83% males) were perceived as the most severe injuries. 93% of players believed that sports injuries can be prevented, while 74% believed it is unlikely that they will sustain an injury. Existing health problems at the beginning of the season were prevalent in 33% of players, with 65% being injuries and 35% illnesses. 17% of existing injuries at the start of the season caused time-loss from play and 17% required medical attention. Conclusion Social aspects were the greatest motivators for floorball participation in youths, suggesting that these factors are important to retain sports participants. The high number of health problems in youth is a concern; as such more effort, resources and priority should be given to sports safety programs. Many players believed that sports injuries can be prevented, possibly providing a fertile ground for implementation of such programs.

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  • 206.
    Persson, Jan
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för hälso- och sjukvårdsanalys. Linköpings universitet, Hälsouniversitetet.
    Bernfort, Lars
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för hälso- och sjukvårdsanalys. Linköpings universitet, Hälsouniversitetet. Region Östergötland, Hjärt- och Medicincentrum, Allergicentrum US.
    Wåhlin, Charlotte
    Region Östergötland, Hjärt- och Medicincentrum, Arbets- och miljömedicin. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Karolinska Institutet, Sweden.
    Öberg, Birgitta
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Hälsouniversitetet.
    Ekberg, Kerstin
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet.
    Costs of production loss and primary health care interventions for return-to-work of sick-listed workers in Sweden2015Ingår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, nr 9, s. 771-776Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: The aim of this study was to investigate, from the perspective of society, the costs of sick leave and rehabilitation of recently sick-listed workers with musculoskeletal disorders (MSD) or mental disorders (MD). Methods: In a prospective cohort study, 812 sick-listed workers with MSD (518) or MD (294) were included. Data on consumption of health care and production loss were collected over six months from an administrative casebook system of the health care provider. Production loss was estimated based on the number of sick-leave days. Societal costs were based on the human capital approach. Results: The mean costs of production loss per person were EUR 5978 (MSD) and EUR 6381 (MD). Health care interventions accounted for 9.3% (MSD) and 8.2% (MD) of the costs of production loss. Corresponding figures for rehabilitation activities were 3.7% (MSD) and 3.1% (MD). Health care interventions were received by about 95% in both diagnostic groups. For nearly half of the cohort, no rehabilitation intervention at all was provided. Conclusions: Costs associated with sick leave were dominated by production loss. Resources invested in rehabilitation were small. By increasing investment in early rehabilitation, costs to society and the individual might be reduced. Implications for Rehabilitation Resources invested in rehabilitation for sick-listed with musculoskeletal and mental disorders in Sweden are very small in comparison with the costs of production loss. For policy makers, there may be much to gain through investments into improved rehabilitation processes for return to work. Health care professionals need to develop rehabilitative activities aiming for return to work, rather than symptoms treatment only.

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  • 207. Beställ onlineKöp publikationen >>
    Peterson, Gunnel
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Neck muscle function in individuals with persistent pain and disability after whiplash injury2016Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Background: Neck pain and disability are common after whiplash injury. One year after the accident up to 50 % still have symptoms called whiplash associated disorders (WAD). Despite decades of research the cause of persistent pain and disability are largely unknown and effective treatment and diagnostic tools are lacking. Altered neck muscle function may cause pain and disability, and real-time non-invasive methods that investigate both superficial and deep neck muscle function need to be evaluated.

    Aim: The general aim of the work presented in this thesis was to investigate mechanical neck muscle function and evaluate effects of three different exercise interventions related to neck muscle function in individuals with persistent pain and disability after whiplash injury.

    Method: The thesis comprised two studies, reported in four papers. Study A was a prospective randomized controlled trail with 216 participants. The effects of three exercise interventions; neck-specific exercises, neck-specific exercises with behavioral approach and prescription of physical activity were evaluated. Neck muscle endurance, perceived pain following testing, kinesiophobia and satisfaction with treatment were compared between the three groups (paper I). Study B was an experimental case-control study with participants consecutively recruited from the randomized controlled trial. Deformation and deformation rates in the neck muscles were investigated with real-time ultrasound imaging during ten repetitive arm elevations (paper II-IV). To investigate ventral neck muscles, 26 individuals with WAD were compared with 26 healthy controls (paper II). The dorsal neck muscles were investigated in paper III, including 40 individuals with WAD and 40 controls. In total 46 individuals, 23 with WAD and 23 healthy controls were included in paper IV to develop ventral neck muscle interaction models.

    Results: Paper I: Participants in the two neck-specific exercise groups (with and without behavioral approach) showed increased dorsal neck muscle endurance (p = 0.003), decreased pain intensity following testing (p = 0.04) and were more satisfied with treatment (p < 0.001) than participants in the prescribed physical activity group. Kinesiophobia did not significantly differ between groups (p > 0.12).

    Paper II: Deformation and deformation rate showed linear positive relationship between ventral muscle pairs in healthy controls, especially between superficial and deep neck muscles. This relationship was weaker or absent in the WAD group.

    Paper III: The WAD group had higher deformation rates in the deepest dorsal neck muscles during the first and tenth (only women) arm elevations compared to the control group (p < 0.04). Women in the WAD group showed a weaker linear relationship between the two deepest dorsal neck muscles compared to women in the control group.

    Paper IV: The results revealed two different ventral neck muscle models in individuals with WAD and healthy controls (R2Y = 0.72, Q2Y = 0.59). The models were capable to detect different neck muscle interplay in people with WAD.

    Conclusion: Neck-specific exercise intervention with or without a behavioral approach appears to improve neck muscle endurance in individuals with persistent WAD. Decreased pain after the neck muscle endurance test also suggests improved tolerance of load in these two groups. Altered mechanical neck muscle function was revealed in individuals with WAD indicating decreased muscular support for maintain a stable cervical spine during repetitive arm elevations. The results show great promise for improved diagnosis of neck muscle function in WAD.

    Delarbeten
    1. THE EFFECT OF 3 DIFFERENT EXERCISE APPROACHES ON NECK MUSCLE ENDURANCE, KINESIOPHOBIA, EXERCISE COMPLIANCE, AND PATIENT SATISFACTION IN CHRONIC WHIPLASH
    Öppna denna publikation i ny flik eller fönster >>THE EFFECT OF 3 DIFFERENT EXERCISE APPROACHES ON NECK MUSCLE ENDURANCE, KINESIOPHOBIA, EXERCISE COMPLIANCE, AND PATIENT SATISFACTION IN CHRONIC WHIPLASH
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    2015 (Engelska)Ingår i: Journal of Manipulative and Physiological Therapeutics, ISSN 0161-4754, E-ISSN 1532-6586, Vol. 38, nr 7, s. 465-746.e4Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Objective: The purpose of this study was to compare the effects of 3 different exercise approaches on neck muscle endurance (NME), kinesiophobia, exercise compliance, and patient satisfaction in patients with chronic whiplash. Methods: This prospective randomized clinical trial included 216 individuals with chronic whiplash. Participants were randomized to 1 of 3 exercise interventions: neck-specific exercise (NSE), NSE combined with a behavioral approach (NSEB), or prescribed physical activity (PPA). Measures of ventral and dorsal NME (endurance time in seconds), perceived pain after NME testing, kinesiophobia, exercise compliance, and patient satisfaction were recorded at baseline and at the 3- and 6-month follow-ups. Results: Compared with individuals in the prescribed physical activity group, participants in the NSE and NSEB groups exhibited greater gains in dorsal NME (P = .003), greater reductions in pain after NME testing (P = .03), and more satisfaction with treatment (P less than .001). Kinesiophobia and exercise compliance did not significantly differ between groups (P greater than .07). Conclusion: Among patients with chronic whiplash, a neck-specific exercise intervention (with or without a behavioral approach) appears to improve NME. Participants were more satisfied with intervention including neck-specific exercises than with the prescription of general exercise.

    Ort, förlag, år, upplaga, sidor
    MOSBY-ELSEVIER, 2015
    Nyckelord
    Exercise Therapy; Neck Pain; Whiplash Injuries; Rehabilitation
    Nationell ämneskategori
    Sjukgymnastik Medicin och hälsovetenskap Hälsovetenskaper
    Identifikatorer
    urn:nbn:se:liu:diva-122438 (URN)10.1016/j.jmpt.2015.06.011 (DOI)000362450700003 ()26387858 (PubMedID)
    Anmärkning

    Funding Agencies|Swedish government; Swedish Social Insurance Agency through the REHSAM Foundation [RS2010/009]; Centre for Clinical Research Sormland at Uppsala University Sweden; Medical Research Council of Southeast Sweden; Center for Clinical Research of Ostergotland; Uppsala-Orebro Regional Research Council Sweden; Health Practitioner Research Fellowship from Queensland Health; University of Queensland (NHMRC CCRE Spinal Pain, Injury, and Health); Swedish Research Council; Wennergren Foundation

    Tillgänglig från: 2015-11-03 Skapad: 2015-11-02 Senast uppdaterad: 2017-12-01
    2. Altered ventral neck muscle deformation for individuals with whiplash associated disorder compared to healthy controls: A case-control ultrasound study
    Öppna denna publikation i ny flik eller fönster >>Altered ventral neck muscle deformation for individuals with whiplash associated disorder compared to healthy controls: A case-control ultrasound study
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    2015 (Engelska)Ingår i: Manual Therapy, ISSN 1356-689X, E-ISSN 1532-2769, Vol. 20, nr 2, s. 319-327Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Previous studies have shown altered neck muscle function in individuals with chronic whiplash associated disorder (WAD). However, we lack real-time investigations with non-invasive methods that can distinguish between the different ventral neck muscle layers. This study investigated deformations and deformation rates in the sternocleidomastoid (SCM), longus capitis (Lcap), and longus colli (Lco) muscles with real-time ultrasonography. Twenty-six individuals with WAD were compared with 26 controls, matched for age and sex. Ultrasound imaging of the SCM, Lcap, and Lco were recorded during 10 repetitive arm elevations. The first and tenth arm elevations were post-process analyzed with speckle tracking. There were few significant differences in the deformations or deformation rates in the SCM, Lcap, and Lco between the WAD and control group. In controls, deformations and deformation rates showed linear positive relationships between SCM/Lcap, SCM/Lco, and Lcap/Lco which increased from the first arm elevation (R(2) = 0.14-0.70); to the tenth arm elevation (R(2) = 0.51-0.71). The WAD group showed similar or weaker linear relationship (R(2) < 0.19) during the tenth compared to the first (R(2) < 0.44) arm elevation except for deformations in Lcap/Lco (R(2) = 0.13-0.57). This result indicated that deformations and deformation rates in one muscle were correlated by similar deformations and deformation rates in other neck muscles in the control group, but this interplay between muscles was not found in the WAD group.

    Nationell ämneskategori
    Sjukgymnastik
    Identifikatorer
    urn:nbn:se:liu:diva-115920 (URN)10.1016/j.math.2014.10.006 (DOI)000352769200013 ()25454684 (PubMedID)
    Tillgänglig från: 2015-03-24 Skapad: 2015-03-24 Senast uppdaterad: 2017-12-04
    3. CHANGES IN DORSAL NECK MUSCLE FUNCTION IN INDIVIDUALS WITH CHRONIC WHIPLASH-ASSOCIATED DISORDERS: A REAL-TIME ULTRASOUND CASE-CONTROL STUDY
    Öppna denna publikation i ny flik eller fönster >>CHANGES IN DORSAL NECK MUSCLE FUNCTION IN INDIVIDUALS WITH CHRONIC WHIPLASH-ASSOCIATED DISORDERS: A REAL-TIME ULTRASOUND CASE-CONTROL STUDY
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    2016 (Engelska)Ingår i: Ultrasound in Medicine and Biology, ISSN 0301-5629, E-ISSN 1879-291X, Vol. 42, nr 5, s. 1090-1102Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Impaired neck muscle function leads to disability in individuals with chronic whiplash-associated disorder (WAD), but diagnostic tools are lacking. In this study, deformations and deformation rates were investigated in five dorsal neck muscles during 10 arm elevations by ultrasonography with speckle tracking analyses. Forty individuals with chronic WAD (28 women and 12 men, mean age = 37 y) and 40 healthy controls matched for age and sex were included. The WAD group had higher deformation rates in the multifidus muscle during the first (p &lt; 0.04) and 10th (only women, p &lt; 0.01) arm elevations compared with the control group. Linear relationships between the neck muscles for deformation rate (controls: R-2 = 0.24-0.82, WAD: R-2 = 0.05-0.74) and deformation of the deepest muscles (controls: R-2 = 0.61-0.32, WAD: R-2 = 0.15-0.01) were stronger for women in the control group versus women with WAD, indicating there is altered interplay between dorsal neck muscles in chronic WAD. (C) 2016 World Federation for Ultrasound in Medicine & Biology.

    Ort, förlag, år, upplaga, sidor
    ELSEVIER SCIENCE INC, 2016
    Nyckelord
    Whiplash injury; Ultrasonography; Neck muscles; Spine
    Nationell ämneskategori
    Hälsovetenskaper
    Identifikatorer
    urn:nbn:se:liu:diva-127550 (URN)10.1016/j.ultrasmedbio.2015.12.022 (DOI)000373385300008 ()26921149 (PubMedID)
    Anmärkning

    Funding Agencies|Swedish government; Swedish Social Insurance Agency through the REHSAM Foundation [RS2010/009]; Swedish Research Council; Centre for Clinical Research Sormland at Uppsala University Sweden; Uppsala-Orebro Regional Research Council Sweden

    Tillgänglig från: 2016-05-04 Skapad: 2016-05-03 Senast uppdaterad: 2018-03-27
    4. Novel insights into the interplay between ventral neck muscles in individuals with whiplash-associated disorders
    Öppna denna publikation i ny flik eller fönster >>Novel insights into the interplay between ventral neck muscles in individuals with whiplash-associated disorders
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    2015 (Engelska)Ingår i: Scientific Reports, E-ISSN 2045-2322, Vol. 5, nr 15289Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Chronic whiplash-associated disorder (WAD) is common after whiplash injury, with considerable personal, social, and economic burden. Despite decades of research, factors responsible for continuing pain and disability are largely unknown, and diagnostic tools are lacking. Here, we report a novel model of mechanical ventral neck muscle function recorded from non-invasive, real-time, ultrasound measurements. We calculated the deformation area and deformation rate in 23 individuals with persistent WAD and compared them to 23 sex-and age-matched controls. Multivariate statistics were used to analyse interactions between ventral neck muscles, revealing different interplay between muscles in individuals with WAD and healthy controls. Although the cause and effect relation cannot be established from this data, for the first time, we reveal a novel method capable of detecting different neck muscle interplay in people with WAD. This non-invasive method stands to make a major breakthrough in the assessment and diagnosis of people following a whiplash trauma.

    Ort, förlag, år, upplaga, sidor
    NATURE PUBLISHING GROUP, 2015
    Nationell ämneskategori
    Sjukgymnastik
    Identifikatorer
    urn:nbn:se:liu:diva-122524 (URN)10.1038/srep15289 (DOI)000362884300001 ()26472599 (PubMedID)
    Anmärkning

    Funding Agencies|Swedish government; Swedish Social Insurance Agency through the REHSAM foundation; Swedish Research Council; Centre for Clinical Research Sormland at Uppsala University Sweden; Uppsala-Orebro Regional Research Council Sweden

    Tillgänglig från: 2015-11-09 Skapad: 2015-11-06 Senast uppdaterad: 2022-09-15
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    Neck muscle function in individuals with persistent pain and disability after whiplash injury
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    Errata: changes made in the electronic version
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  • 208.
    Peterson, Gunnel
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden.
    Dedering, Asa
    Department of Neurobiology, Care Sciences and Society, Div of Physiotherapy, Karolinska Institutet, Sweden. Dep of Physical Therapy, Karolinska University Hospital, Sweden.
    Andersson, Erika
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Medicinska fakulteten.
    Nilsson, David
    Department of Chemistry, Computational Life Science Cluster, Umeå University, Sweden.
    Trygg, Johan
    Department of Chemistry, Computational Life Science Cluster, Umeå University, Sweden.
    Peolsson, Michael
    Department of Chemistry, Computational Life Science Cluster, Umeå University, Sweden.
    Wallman, Thorne
    Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden. Uppsala University, Public Health & Caring Sciences, Family Medicine & Preventiven Medicine Section, Uppsala, Sweden.
    Peolsson, Anneli
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Altered ventral neck muscle deformation for individuals with whiplash associated disorder compared to healthy controls: A case-control ultrasound study2015Ingår i: Manual Therapy, ISSN 1356-689X, E-ISSN 1532-2769, Vol. 20, nr 2, s. 319-327Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Previous studies have shown altered neck muscle function in individuals with chronic whiplash associated disorder (WAD). However, we lack real-time investigations with non-invasive methods that can distinguish between the different ventral neck muscle layers. This study investigated deformations and deformation rates in the sternocleidomastoid (SCM), longus capitis (Lcap), and longus colli (Lco) muscles with real-time ultrasonography. Twenty-six individuals with WAD were compared with 26 controls, matched for age and sex. Ultrasound imaging of the SCM, Lcap, and Lco were recorded during 10 repetitive arm elevations. The first and tenth arm elevations were post-process analyzed with speckle tracking. There were few significant differences in the deformations or deformation rates in the SCM, Lcap, and Lco between the WAD and control group. In controls, deformations and deformation rates showed linear positive relationships between SCM/Lcap, SCM/Lco, and Lcap/Lco which increased from the first arm elevation (R(2) = 0.14-0.70); to the tenth arm elevation (R(2) = 0.51-0.71). The WAD group showed similar or weaker linear relationship (R(2) < 0.19) during the tenth compared to the first (R(2) < 0.44) arm elevation except for deformations in Lcap/Lco (R(2) = 0.13-0.57). This result indicated that deformations and deformation rates in one muscle were correlated by similar deformations and deformation rates in other neck muscles in the control group, but this interplay between muscles was not found in the WAD group.

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  • 209.
    Peterson, Gunnel
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Uppsala University, Sweden.
    Landén Ludvigsson, Maria
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i västra Östergötland, Rehab Väst.
    OLeary, Shaun P.
    University of Queensland, Australia; Queensland Heatlh, Australia.
    Dedering, Asa M.
    Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Wallman, Thorne
    Uppsala University, Sweden; Uppsala University, Sweden.
    Jonsson, Margaretha I. N.
    County Council Vastmanland, Sweden.
    Peolsson, Anneli
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. University of Queensland, Australia.
    THE EFFECT OF 3 DIFFERENT EXERCISE APPROACHES ON NECK MUSCLE ENDURANCE, KINESIOPHOBIA, EXERCISE COMPLIANCE, AND PATIENT SATISFACTION IN CHRONIC WHIPLASH2015Ingår i: Journal of Manipulative and Physiological Therapeutics, ISSN 0161-4754, E-ISSN 1532-6586, Vol. 38, nr 7, s. 465-746.e4Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The purpose of this study was to compare the effects of 3 different exercise approaches on neck muscle endurance (NME), kinesiophobia, exercise compliance, and patient satisfaction in patients with chronic whiplash. Methods: This prospective randomized clinical trial included 216 individuals with chronic whiplash. Participants were randomized to 1 of 3 exercise interventions: neck-specific exercise (NSE), NSE combined with a behavioral approach (NSEB), or prescribed physical activity (PPA). Measures of ventral and dorsal NME (endurance time in seconds), perceived pain after NME testing, kinesiophobia, exercise compliance, and patient satisfaction were recorded at baseline and at the 3- and 6-month follow-ups. Results: Compared with individuals in the prescribed physical activity group, participants in the NSE and NSEB groups exhibited greater gains in dorsal NME (P = .003), greater reductions in pain after NME testing (P = .03), and more satisfaction with treatment (P less than .001). Kinesiophobia and exercise compliance did not significantly differ between groups (P greater than .07). Conclusion: Among patients with chronic whiplash, a neck-specific exercise intervention (with or without a behavioral approach) appears to improve NME. Participants were more satisfied with intervention including neck-specific exercises than with the prescription of general exercise.

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  • 210.
    Peterson, Gunnel
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Uppsala University, Sweden.
    Nilsson, David
    Umeå University, Sweden.
    Peterson, Simon
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Dedering, Asa
    Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Trygg, Johan
    Umeå University, Sweden.
    Wallman, Thorne
    Uppsala University, Sweden.
    Peolsson, Anneli
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    CHANGES IN DORSAL NECK MUSCLE FUNCTION IN INDIVIDUALS WITH CHRONIC WHIPLASH-ASSOCIATED DISORDERS: A REAL-TIME ULTRASOUND CASE-CONTROL STUDY2016Ingår i: Ultrasound in Medicine and Biology, ISSN 0301-5629, E-ISSN 1879-291X, Vol. 42, nr 5, s. 1090-1102Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Impaired neck muscle function leads to disability in individuals with chronic whiplash-associated disorder (WAD), but diagnostic tools are lacking. In this study, deformations and deformation rates were investigated in five dorsal neck muscles during 10 arm elevations by ultrasonography with speckle tracking analyses. Forty individuals with chronic WAD (28 women and 12 men, mean age = 37 y) and 40 healthy controls matched for age and sex were included. The WAD group had higher deformation rates in the multifidus muscle during the first (p &lt; 0.04) and 10th (only women, p &lt; 0.01) arm elevations compared with the control group. Linear relationships between the neck muscles for deformation rate (controls: R-2 = 0.24-0.82, WAD: R-2 = 0.05-0.74) and deformation of the deepest muscles (controls: R-2 = 0.61-0.32, WAD: R-2 = 0.15-0.01) were stronger for women in the control group versus women with WAD, indicating there is altered interplay between dorsal neck muscles in chronic WAD. (C) 2016 World Federation for Ultrasound in Medicine & Biology.

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  • 211.
    Peterson, Gunnel
    et al.
    Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Uppsala University, Sweden.
    Nilsson, David
    Umeå University, Sweden.
    Trygg, Johan
    Umeå University, Sweden.
    Falla, Deborah
    University of Gottingen, Germany; University Hospital Gottingen, Germany.
    Dedering, Asa
    Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Wallman, Thorne
    Uppsala University, Sweden; Uppsala University, Sweden.
    Peolsson, Anneli
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Novel insights into the interplay between ventral neck muscles in individuals with whiplash-associated disorders2015Ingår i: Scientific Reports, E-ISSN 2045-2322, Vol. 5, nr 15289Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Chronic whiplash-associated disorder (WAD) is common after whiplash injury, with considerable personal, social, and economic burden. Despite decades of research, factors responsible for continuing pain and disability are largely unknown, and diagnostic tools are lacking. Here, we report a novel model of mechanical ventral neck muscle function recorded from non-invasive, real-time, ultrasound measurements. We calculated the deformation area and deformation rate in 23 individuals with persistent WAD and compared them to 23 sex-and age-matched controls. Multivariate statistics were used to analyse interactions between ventral neck muscles, revealing different interplay between muscles in individuals with WAD and healthy controls. Although the cause and effect relation cannot be established from this data, for the first time, we reveal a novel method capable of detecting different neck muscle interplay in people with WAD. This non-invasive method stands to make a major breakthrough in the assessment and diagnosis of people following a whiplash trauma.

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  • 212.
    Peterson, Gunnel
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Uppsala Univ, Sweden.
    Nilsson, David
    Umea Univ, Sweden.
    Trygg, Johan
    Umea Univ, Sweden.
    Peolsson, Anneli
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Neck-specific exercise improves impaired interactions between ventral neck muscles in chronic whiplash: A randomized controlled ultrasound study2018Ingår i: Scientific Reports, E-ISSN 2045-2322, Vol. 8, artikel-id 9649Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Chronic pain and disability is common in whiplash-associated disorders (WAD), leading to personal suffering, sick leave, and social cost. The cervical spine is heavily dependent on muscular support and whiplash injury can cause damage to the neck muscles, but diagnostic tools to measure neck muscle impairment and evaluate exercise interventions are lacking. Therefore, the present study investigated ventral neck muscle interactions in 26 individuals with chronic WAD randomized to neck-specific exercise (NSE) or remaining on a waiting list (WL) in 3 months. We performed real-time, non-invasive ultrasound measurements with speckle tracking analysis and calculated the deformation area and deformation rate in three ventral neck muscles. Multivariate statistics were used to analyse interactions between the muscles. After 3 months of NSE, significant improvements were observed in neck muscle interactions and pain intensity in the NSE group compared to the WL group. Thus, this study demonstrates that non-invasive ultrasound can be a diagnostic tool for muscle impairment and used to evaluate exercise interventions in WAD and stands to make a breakthrough for better management in chronic WAD.

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  • 213.
    Peterson, Gunnel
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Uppsala Univ, Sweden.
    OLeary, Shaun
    Univ Queensland, Australia; Queensland Hlth, Australia.
    Nilsson, David
    Umea Univ, Sweden.
    Moodie, Katherine
    Univ Queensland, Australia.
    Tucker, Kylie
    Univ Queensland, Australia.
    Trygg, Johan
    Umea Univ, Sweden.
    Peolsson, Anneli
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Ultrasound imaging of dorsal neck muscles with speckle tracking analyses - the relationship between muscle deformation and force2019Ingår i: Scientific Reports, E-ISSN 2045-2322, Vol. 9, artikel-id 13688Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The development of methods of non-invasive measurement of neck muscle function remains a priority in the clinical sciences. In this study, dorsal neck muscle deformation vs time curves (deformation area) were evaluated against incremental force, recorded from non-invasive real-time ultrasound measurement. The results revealed subject-specific moderate to strong linear or non-linear relationships between deformation and force. Test-retest variability showed strong reliability for all five neck muscles summed together and fair to good reliability for the five muscles evaluated separately. Multivariate statistics were used to analyse the interactions between the dorsal neck muscles during different percentages of maximal voluntary contraction (MVC). Low force (10-20% MVC) was related to muscle shortening; higher force (40-80% MVC) showed combination of shortening and elongation deformation in the muscle interactions. The muscle interactions during isometric MVC test were subject-specific, with different combinations and deformations of the five neck muscles. Force amp;gt;= 40% MVC were associated with a forward movement of the cervical spine that affected the ultrasound measurement of the dorsal neck muscles. Ultrasound with speckle-tracking analyses may be best used to detect low levels (amp;lt;40% MVC) of neck muscle activity.

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  • 214.
    Peterson, Gunnel
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Region Sörmland, Uppsala University, Sweden.
    Peolsson, Anneli
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Kroniska whiplashbesvär – ultraljud kan påvisa förändrad funktion i ventrala nackmuskler2016Ingår i: Best Practice Nordic, ISSN 1902-7583, s. 29-31Artikel, forskningsöversikt (Övrig (populärvetenskap, debatt, mm))
  • 215.
    Peterson, Gunnel
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Region Sörmland, Uppsala University, Sweden.
    Peolsson, Anneli
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Nackspecifik träning utvärderad med ultraljud förbättrar muskelfunktionen efter whiplashskada2018Ingår i: Best Practice Nordic, ISSN 1902-7583Artikel, forskningsöversikt (Övrig (populärvetenskap, debatt, mm))
  • 216.
    Pietilä Holmner, Elisabeth
    et al.
    Umea Univ, Sweden.
    Stålnacke, Britt-Marie
    Umea Univ, Sweden.
    Enthoven, Paul
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Stenberg, Gunilla
    Umea Univ, Sweden.
    ”The acceptance” of living with chronic pain – an ongoing process: A qualitative study of patient experiences of multimodal rehabilitation in primary care2018Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 50, nr 1, s. 73-79Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To explore patient experiences of participating in multimodal pain rehabilitation in primary care. Subjects: Twelve former patients (7 women and 5 men) in multimodal rehabilitation in primary care were interviewed about their experiences of multimodal rehabilitation. Methods: The interviews were analysed using qualitative content analysis. Results: Analysis resulted in 4 categories: (i) from discredited towards obtaining redress; (ii) from uncertainty towards knowledge; (iii) from loneliness towards togetherness; and (iv) "acceptance of pain": an ongoing process. The results show that having obtained redress, to obtain knowledge about chronic pain, and to experience fellowship with others with the same condition were helpful in the acceptance process. However, there were patients who found it difficult to reconcile themselves with a life with chronic pain after multimodal rehabilitation. To find what was "wrong" and to have a medical diagnosis and cure were important. Conclusion: Patients in primary care multimodal rehabilitation experience a complex, ongoing process of accepting chronic pain. Four important categories were described. These findings will help others to understand the experience and perspective of patients with chronic pain who engage in multimodal rehabilitation.

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  • 217.
    Pohl, Petra
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Rörelse och Hälsa.
    The Ronnie Gardiner Method: An Innovative Music-Based Intervention for Neurological Rehabilitation - Theoretical Background and Contemporary Research with Focus on Parkinson`s Disease2018Ingår i: Neurophysiology and Rehabilitation, ISSN 2641-8991, Vol. 1, nr 1, s. 32-37Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The Ronnie Gardiner Method (RGM) is an innovative, practitioner-led, music-based intervention using sensorimotor and cognitive integration. RGM was originally developed by the Swedish musician Ronnie Gardiner. Since 2010, RGM has been successfully implemented within neurorehabilitation in many countries. The purpose of this article is to outline some of the theoretical assumptions underpinning the potential benefits from this intervention, using Parkinson’s disease as an example. RGM is based on principles of neuroplasticity, motor learning, and postural control, and uses energizing, beat-based music to provide multisensory input (visual, audio, kinetic, and tactile) in order to stimulate experience-dependent neuroplastic processes. It aims at stimulating cognitive and motor function (e.g., memory, concentration, executive function, multitasking, coordination, mobility, balance, and motor skills). In addition, it may aid body awareness, self-esteem, and social skills. RGM has been scientifically evaluated as a means of multimodal sensory stimulation after stroke and as a means of improving mobility and cognitive function in Parkinson’s disease. RGM is a complex multi-task intervention with the potential to be beneficial in different settings and in different neurological conditions. It can be performed either while standing up or sitting down and can be practiced with the advantages gained as a group activity or individually, which makes it very flexible. It is currently being used as rehabilitation activity for people with stroke, Parkinson’s disease, multiple sclerosis, dementia, and depression. Furthermore, RGM is used in programs targeting healthy aging, ADHD, autism, and dyslexia, and in ordinary school environments.

  • 218.
    Pohl, Petra
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Rörelse och Hälsa. Univ Gothenburg, Sweden.
    Carlsson, Gunnel
    Univ Gothenburg, Sweden.
    Kall, Lina Bunketorp
    Sahlgrenska Univ Hosp Molndal, Sweden; Univ Gothenburg, Sweden.
    Nilsson, Michael
    Univ Gothenburg, Sweden; Univ Newcastle, Australia.
    Blomstrand, Christian
    Univ Gothenburg, Sweden.
    A qualitative exploration of post-acute stroke participants experiences of a multimodal intervention incorporating horseback riding2018Ingår i: PLOS ONE, E-ISSN 1932-6203, Vol. 13, nr 9, artikel-id e0203933Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Multimodal rehabilitation interventions delivered in late phase of stroke recovery involve physical (motor and sensory), social, and cognitively challenging activities. Horseback riding can be incorporated within such interventions, leading to meaningful long-term improvements when applied to individuals with moderate levels of disability. There is a lack of research illuminating stroke survivors experiences and perceptions of horseback riding in the context of multimodal interventions. Aim To explore stroke survivors experiences of participation in a multimodal group-based intervention that included horseback riding. Methods An explorative interview study was conducted with individual face-to-face interviews performed on a single occasion, utilising a semi-structured interview guide. Eighteen participants were purposively selected from a larger trial (mean age 62, 12 men, 6 women) within four weeks after treatment completion. The interview duration was between 17 and 50 minutes. The data was analysed using a qualitative content analysis method. Findings Four broad themes were identified from the analysis. These themes were: transformative experiences; human-horse interaction; togetherness and belonging; and the all-in-one solution. Interacting with the horse and peers had a profound emotional impact on the participants. The participants also reported having learned new skills, increased self-efficacy and self-esteem, and improvements in balance and gait, all of which could be transferred to everyday life. The horse itself played a central role, but other components, such as the other group members, the instructors, and the challenging tasks on the horseback, were also important. Conclusion A multimodal rehabilitation intervention that includes horseback riding may provide stroke survivors in a late phase of recovery with rich pleasurable experiences that may have life-changing and profound impacts on their emotional and physical state.

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  • 219.
    Pohl, Petra
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Rörelse och Hälsa. Univ Gothenburg, Sweden.
    Carlsson, Gunnel
    Univ Gothenburg, Sweden.
    Kall, Lina Bunketorp
    Sahlgrenska Univ Hosp Molndal, Sweden; Univ Gothenburg, Sweden.
    Nilsson, Michael
    Univ Gothenburg, Sweden; Univ Newcastle, Australia.
    Blomstrand, Christian
    Univ Gothenburg, Sweden.
    Experiences from a multimodal rhythm and music-based rehabilitation program in late phase of stroke recovery - A qualitative study2018Ingår i: PLOS ONE, E-ISSN 1932-6203, Vol. 13, nr 9, artikel-id e0204215Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Rehabilitative stroke interventions based on principles of multimodal stimulation have the potential to profoundly affect neuroplastic processes beyond the sub-acute phase. In order to identify important core mechanisms, there is a need to explore how interventions that combine physical, social, sensory, and cognitively challenging activities are perceived and experienced by the participants. This qualitative study, based on an interpretive interactionist perspective, explored the experiences of stroke survivors who participated in a group-based multimodal rehabilitation program based on rhythm and music. Methods and findings Within four weeks after completion of the multimodal rehabilitation program, face-to-face semi-structured interviews were conducted on a single occasion with 15 purposively selected individuals (mean age 65, 8 men, 7 women). The interview duration was between 13 and 44 minutes. Qualitative content analysis with an inductive approach was used to analyze data. Three categories were identified, each containing several sub-categories: To be intellectually challenged (energy-consuming activity and coordinating multiple input and output), Perceived therapeutic benefits (motor skills, cognitive skills, emotional and psychological responses), and Pros and cons with social integration (fellowship, competing with others, and instructor characteristics). From these categories, an overall theme was derived: The multifaceted layers of multimodal stimulation. Enjoying music, being part of a group with peers, a skilled instructor, and being able to manage the challenging movements, were related to positive experiences. In contrast, negative experiences were associated with not being able to perform the exercises, and with group members who dominated the conversational space. Conclusion This study shows that access to a multimodal rehabilitation program with rhythm and music as operating ingredients may contribute to positive experiences for many individuals in a late phase after stroke in terms of motor, cognitive, as well as emotional enhancements. Important components were the music, the social interaction, the challenging exercises, and the skilled instructor.

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  • 220.
    Prentice, Heather A.
    et al.
    Kaiser Permanente, CA 92108 USA.
    Lind, Martin
    Aarhus Univ Hosp, Denmark.
    Mouton, Caroline
    Clin Eich Ctr Hosp Luxembourg, Luxembourg.
    Persson, Andreas
    Oslo Univ Hosp, Norway; Haukeland Hosp, Norway.
    Magnusson, Henrik
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Gabr, Ayman
    Univ Coll London Hosp, England.
    Seil, Romain
    Clin Eich Ctr Hosp Luxembourg, Luxembourg.
    Engebretsen, Lars
    Oslo Univ Hosp, Norway; Haukeland Hosp, Norway.
    Samuelsson, Kristian
    Univ Gothenburg, Sweden.
    Karlsson, Jon
    Univ Gothenburg, Sweden.
    Forssblad, Magnus
    Karolinska Inst, Sweden.
    Haddad, Fares S.
    Univ Coll London Hosp, England.
    Spalding, Tim
    UHCW, England.
    Funahashi, Tadashi T.
    Southern Calif Permanente Med Grp, CA USA.
    Paxton, Liz W.
    Kaiser Permanente, CA 92108 USA.
    Maletis, Gregory B.
    Southern Calif Permanente Med Grp, CA USA.
    Patient demographic and surgical characteristics in anterior cruciate ligament reconstruction: a description of registries from six countries2018Ingår i: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 52, nr 11, artikel-id 716Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective Findings from individual anterior cruciate ligament reconstruction (ACLR) registry studies are impactful, but how various registries from different countries compare with different patient populations and surgical techniques has not been described. We sought to describe six ACLR registry cohorts to understand variation across countries. Methods Five European registries and one US registry participated. For each registry, all primary ACLR registered between registry establishment through 31December 2014 were identified. Descriptive statistics included frequencies, proportions, medians and IQRs. Revision incidence rates following primary ACLR were computed. Results 101 125 ACLR were included: 21820 in Denmark, 300 in Luxembourg, 17556 in Norway, 30422 in Sweden, 2972 in the UK and 28055 in the US. In all six cohorts, males (range: 56.8%-72.4%) and soccer injuries (range: 14.1%-42.3%) were most common. European countries mostly used autografts (range: 93.7%-99.7%); allograft was most common in the US (39.9%). Interference screw was the most frequent femoral fixation in Luxembourg and the US (84.8% and 42.9%), and suspensory fixation was more frequent in the other countries (range: 43.9%-75.5%). Interference was the most frequent tibial fixation type in all six cohorts (range: 64.8%-98.2%). Three-year cumulative revision probabilities ranged from 2.8% to 3.7%. Conclusions Similarities in patient demographics and injury activity were observed between all cohorts of ACLR. However, graft and fixation choices differed. Revision rates were low. This work, including amp;gt;100 000 ACLR, is the most comprehensive international description of contemporary practice to date.

  • 221.
    Prowse, Ashleigh
    et al.
    Faculty of Health Science and Medicine, Bond University, Gold Coast, Queensland, Australia.
    Aslaksen, Berit
    Department of Physiotherapy, Karolinska University Hospital, Huddinge, Sweden.
    Kierkegaard, Marie
    Department of Physiotherapy, Karolinska University Hospital, Huddinge, Sweden; Department of Neurobiology, Care Sciences and Society (NVS), Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden.
    Furness, James
    Faculty of Health Science and Medicine, Bond University, Gold Coast, Queensland, Australia.
    Gerdhem, Paul
    Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Huddinge, Sweden.
    Abbott, Allan
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Faculty of Health Science and Medicine, Bond University, Gold Coast, Queensland, Australia.
    Reliability and concurrent validity of postural asymmetry measurement in adolescent idiopathic scoliosis.2017Ingår i: World Journal of Orthopedics, E-ISSN 2218-5836, Vol. 8, nr 1, s. 68-76Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: To investigate the reliability and concurrent validity of the Baseline(®) Body Level/Scoliosis meter for adolescent idiopathic scoliosis postural assessment in three anatomical planes.

    METHODS: This is an observational reliability and concurrent validity study of adolescent referrals to the Orthopaedic department for scoliosis screening at Karolinska University Hospital, Stockholm, Sweden between March-May 2012. A total of 31 adolescents with idiopathic scoliosis (13.6 ± 0.6 years old) of mild-moderate curvatures (25° ± 12°) were consecutively recruited. Measurement of cervical, thoracic and lumbar curvatures, pelvic and shoulder tilt, and axial thoracic rotation (ATR) were performed by two trained physiotherapists in one day. The intraclass correlation coefficient (ICC) was used to determine the inter-examiner reliability (ICC2,1) and the intra-rater reliability (ICC3,3) of the Baseline(®) Body Level/Scoliosis meter. Spearman's correlation analyses were used to estimate concurrent validity between the Baseline(®) Body Level/Scoliosis meter and Gold Standard Cobb angles from radiographs and the Orthopaedic Systems Inc. Scoliometer.

    RESULTS: There was excellent reliability between examiners for thoracic kyphosis (ICC2,1 = 0.94), ATR (ICC2,1 = 0.92) and lumbar lordosis (ICC2,1 = 0.79). There was adequate reliability between examiners for cervical lordosis (ICC2,1 = 0.51), however poor reliability for pelvic and shoulder tilt. Both devices were reproducible in the measurement of ATR when repeated by one examiner (ICC3,3 0.98-1.00). The device had a good correlation with the Scoliometer (rho = 0.78). When compared with Cobb angle from radiographs, there was a moderate correlation for ATR (rho = 0.627).

    CONCLUSION: The Baseline(®) Body Level/Scoliosis meter provides reliable transverse and sagittal cervical, thoracic and lumbar measurements and valid transverse plan measurements of mild-moderate scoliosis deformity.

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  • 222.
    Prowse, Ashleigh
    et al.
    Department of Physiotherapy, Faculty of Health Science and Medicine, Bond University, Robina, Australia.
    Pope, Rodney
    Department of Physiotherapy, Faculty of Health Science and Medicine, Bond University, Robina, Australia.
    Gerdhem, Paul
    Department of Orthopaedics, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.
    Abbott, Allan
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Hälsouniversitetet. Department of Physiotherapy, Karolinska University Hospital, Huddinge, Sweden.
    Reliability and validity of inexpensive and easily administered anthropometric clinical evaluation methods of postural asymmetry measurement in adolescent idiopathic scoliosis: a systematic review2016Ingår i: European spine journal, ISSN 0940-6719, E-ISSN 1432-0932, Vol. 25, nr 2, s. 450-466Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    PURPOSE:

    As accurate and reproducible measurements of spinal curvature are crucial in the examination of patients with adolescent idiopathic scoliosis (AIS), this systematic review aims to report on the reliability and validity of a range of inexpensive and easily administered anthropometric methods of postural asymmetry measurement in an AIS population, to inform practice in a clinical setting.

    METHODS:

    A systematic search of health research databases located studies assessing reliability and validity of inexpensive and easily administered anthropometric measures.

    RESULTS:

    Fourteen studies satisfied eligibility criteria. The methodological quality of included studies ranged from low to high. Validity studies were of moderate to high quality. In total, nine clinically applicable, inexpensive and easily administered anthropometric methods were identified, for assessing AIS curvature. All methods demonstrated high to very high inter-observer and intra-observer reliability. Reported criterion validity of the scoliometer and 2D photographs, when compared to Cobb angle assessed from radiographs, ranged from low to very high. iPhone measurements correlated well with scoliometer measurements. 2D photography results had a moderate to high correlation with 3D topography results.

    CONCLUSIONS:

    Overall, strong levels of evidence exist for iPhone and scoliometer measurements, with a high to very high reliability and moderate to very high validity. Moderate levels of evidence exist for scoliometer with mathematical formula and clinical examination with moderate and low validity, respectively. Limited evidence exists for aesthetic tools TRACE and AI and 2D photography. These results indicate there are accurate and reproducible anthropometric measures that are inexpensive and applicable in therapy settings to assess postural asymmetry; however, these only exist for measurement in the transverse plane, despite 3D characteristics of AIS. Further research is required into an inexpensive and easily administered method that can assess postural asymmetry in all anatomical planes.

  • 223.
    Rahnama, Leila
    et al.
    Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Univ Social Welf and Rehabil Sci, Iran.
    Peterson, Gunnel
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Uppsala Univ, Sweden.
    Kazemnejad, Anoshirvan
    Tarbiat Modares Univ, Iran.
    Trygg, Johan
    Umeå Univ, Sweden.
    Peolsson, Anneli
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Alterations in the Mechanical Response of Deep Dorsal Neck Muscles in Individuals Experiencing Whiplash-Associated Disorders Compared to Healthy Controls: An Ultrasound Study2018Ingår i: American Journal of Physical Medicine & Rehabilitation, ISSN 0894-9115, E-ISSN 1537-7385, Vol. 97, nr 2, s. 75-82Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective The aim of this study was to investigate and compare the mechanical responses of dorsal neck muscles in individuals with whiplash-associated disorders (WAD) versus healthy individuals. Design This study included 36 individuals with WAD (26 women and 10 men) and 36 healthy controls (26 women and 10 men). Ultrasound imaging with speckle tracking was used to measure deformation and deformation rate in five dorsal neck muscles during a neck extension task. Results Compared with controls, individuals with WAD showed higher deformations of the semispinalis cervicis (P = 0.02) and multifidus (P = 0.002) muscles and higher deformation rates (P = 0.03 and 0.0001, respectively). Among individuals with WAD, multifidus deformation and deformation rate were significantly associated with pain, disability, and fatigue (r = 0.31-0.46, P = 0.0001-0.01). Conclusions These findings indicate that the mechanical responses of the deep dorsal neck muscles differ between individuals with WAD and healthy controls, possibly reflecting that these muscles use altered strategies while performing a neck extension task. This finding provides new insight into neck muscles pathology in patients with chronic WAD and may help improve rehabilitation programs. To Claim CME Credits Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME Objectives Upon completion of this article, the reader should be able to: (1) Summarize the mechanical responses of dorsal neck muscles during loading of the neck muscles via an extension task in individuals with chronic whiplash associated disorders and healthy volunteers; (2) Differentiate mechanical responses between five dorsal neck muscles while loading the neck via an extension task; and (3) Describe the relationships between the mechanical responses of the dorsal neck muscles with the patients perception of neck pain, disability, and fatigue. Level Advanced Accreditation The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 0.5 AMA PRA Category 1 Credit(s). Physicians should only claim credit commensurate with the extent of their participation in the activity.

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  • 224.
    Rambaud, Alexandre J. M.
    et al.
    Univ Jean Monnet, France; Sport Ctr, France.
    Ardern, Clare
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. La Trobe Univ, Australia.
    Thoreux, Patricia
    Univ Paris, France; Arts and Metiers ParisTech, France.
    Regnaux, Jean-Philippe
    French Sch Publ Hlth EHESP, France; INSERM, France.
    Edouard, Pascal
    Univ Jean Monnet, France; Univ Hosp St Etienne, France.
    Criteria for return to running after anterior cruciate ligament reconstruction: a scoping review2018Ingår i: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 52, nr 22, s. 1437-1444Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Objective To describe the criteria used to guide clinical decision-making regarding when a patient is ready to return to running (RTR) after ACL reconstruction. Design Scoping review. Data sources The MEDLINE (PubMed), EMBASE, Web of Science, PEDro, SPORT Discus and Cochrane Library electronic databases. We also screened the reference lists of included studies and conducted forward citation tracking. Eligibility criteria for selecting studies Reported at least one criterion for permitting adult patients with primary ACL reconstruction to commence running postoperatively. Results 201 studies fulfilled the inclusion criteria and reported 205 time-based criteria for RTR. The median time from when RTR was permitted was 12 postoperative weeks (IQR=3.3, range 5-39 weeks). Fewer than one in five studies used additional clinical, strength or performance-based criteria for decision-making regarding RTR. Aside from time, the most frequently reported criteria for RTR were: full knee range of motion or amp;gt;95% of the non-injured knee plus no pain or pain amp;lt;2 on visual analogue scale; isometric extensor limb symmetry index (LSI)amp;gt; 70% plus extensor and flexor LSIamp;gt; 70%; and hop test LSIamp;gt; 70%. Conclusions Fewer than one in five studies reported clinical, strength or performance-based criteria for RTR even though best evidence recommends performance-based criteria combined with time-based criteria to commence running activities following ACL reconstruction.

  • 225.
    Romu, Thobias
    et al.
    Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik. Linköpings universitet, Tekniska fakulteten. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    West, Janne
    Linköpings universitet, Institutionen för medicin och hälsa. Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Spetz, Anna-Clara
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Lindblom, Hanna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Lindh Åstrand, Lotta
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Hammar, Mats
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Borga, Magnus
    Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik. Linköpings universitet, Tekniska fakulteten. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Dahlqvist Leinhard, Olof
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för radiologiska vetenskaper. Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Radiofysikavdelningen US.
    The effect of flip-angle on body composition using calibrated water-fat MRI.2016Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    This study tested how the flip angle affects body composition analysis by MRI, if adipose tissue is used as an internal intensity reference. Whole-body water-fat images with flip angle 5° and 10° were collected from 29 women in an ongoing study. The images were calibrated based on the adipose tissue signal and whole-body total adipose, lean and soft tissue volumes were measured. A mean difference of 0.29 L, or 0.90 % of the average volume, and a coefficient of variation of 0.40 % was observed for adipose tissue.

  • 226.
    Rosen, Annelie
    et al.
    Karolinska Institute, Sweden.
    Lekander, Mats
    Karolinska Institute, Sweden; Stockholm University, Sweden.
    Jensen, Karin
    Karolinska Institute, Sweden.
    Sachs, Lisbeth
    Karolinska Institute, Sweden.
    Petrovic, Predrag
    Karolinska Institute, Sweden.
    Ingvar, Martin
    Karolinska Institute, Sweden.
    Enblom, Anna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Karolinska Institute, Sweden.
    Retracted article: The Effects of Positive or Neutral Communication during Acupuncture for Relaxing Effects: A Sham-Controlled Randomized Trial2016Ingår i: Evidence-based Complementary and Alternative Medicine, ISSN 1741-427X, E-ISSN 1741-4288, Vol. 2016, s. 11-, artikel-id 3925878Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction. The link between patient-clinician communication and its effect on clinical outcomes is an important clinical issue that is yet to be elucidated. Objective. Investigating if communication type (positive or neutral) about the expected treatment outcome affected (i) participants(expectations and (ii) short-term relaxation effects in response to genuine or sham acupuncture and investigating if expectations were related to outcome. Methods. Healthy volunteers (n = 243, mean age of 42) were randomized to one treatment with genuine or sham acupuncture. Within groups, participants were randomized to positive or neutral communication, regarding expected treatment effects. Visual Analogue Scales (0-100 millimeters) were used to measure treatment expectations and relaxation, directly before and after treatment. Results. Participants in the positive communication group reported higher treatment expectancy, compared to the neutral communication group (md 12 versus 6 mm, p = 0.002). There was no difference in relaxation effects between acupuncture groups or between communication groups. Participants with high baseline expectancy perceived greater improvement in relaxation, compared to participants with low baseline levels (md 27 versus 15 mm, p = 0.022). Conclusion. Our data highlights the importance of expectations for treatment outcome and demonstrates that expectations can be effectively manipulated using a standardized protocol that in future research may be implemented in clinical trials.

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  • 227.
    Ryösä, A.
    et al.
    Department of Orthopaedics and Traumatology, Turku University Central Hospital, Turku, Finland.
    Kukkonen, J.
    Department of Surgery, Division of Orthopaedics and Traumatology, Satakunnan Keskussairaala, Pori, Finland.
    Björnsson, Hanna
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Ortopedkliniken i Linköping.
    Moosmayer, S.
    Department of Orthopaedic Surgery, Martina Hansens Hospital, Sandvika, Norway.
    Holmgren, Theresa
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Ortopedkliniken i Linköping.
    Ranebo, M.
    Lanssjukhuset Kalmar Ortopedkliniken, Kalmar, Sweden.
    Bøe, B.
    Division of Orthopaedic Surgery, Oslo Universitetssykehus Ulleval, Oslo, Norway.
    Äärimaa, V.
    Department of Orthopaedics and Traumatology, Turku University Central Hospital, Turku, Finland.
    Acute Cuff Tear Repair Trial (ACCURATE): Protocol for a multicentre, randomised, placebo-controlled trial on the efficacy of arthroscopic rotator cuff repair2019Ingår i: BMJ Open, E-ISSN 2044-6055, Vol. 9, nr 5, artikel-id e025022Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction Rotator cuff tear is a very common and disabling condition that can be related to acute trauma. Rotator cuff tear surgery is a well-established form of treatment in acute rotator cuff tears. Despite its widespread use and almost a gold standard position, the efficacy of an arthroscopic rotator cuff repair is still unknown. The objective of this trial is to investigate the difference in outcome between arthroscopic rotator cuff repair and inspection of the shoulder joint defined as placebo surgery in patients 45–70 years of age with an acute rotator tear related to trauma.

    Methods and analysis Acute Cuff Tear Repair Trial (ACCURATE) is a randomised, placebo-controlled, multicentre efficacy trial with sample size of 180 patients. Concealed allocation is done in 1:1 ratio. The randomisation is stratified according to participating hospital, gender and baseline Western Ontario Rotator Cuff Index (WORC). Both groups receive the same standardised postoperative treatment and physiotherapy. The primary outcome measure is the change in WORC score from baseline to 2-year follow-up. Secondary outcome measures include Constant-Murley Score, the Numerical Rating Scale for pain, subjective patient satisfaction and the health-related quality of life instrument 15 dimensions (15D). Patients and outcome assessors are blinded from the allocated intervention. The primary analysis of results will be conducted according to intention-to-treat analysis.

    Ethics and dissemination The study protocol for this clinical trial has been approved by the Ethics Committee of the Hospital District of Southwest Finland and Regional Ethics Committee in Linköping Sweden and Regional Committees for Medical and Health Research Ethics South East in Norway. Every recruiting centre will apply local research approvals. The results of this study will be submitted for publication in peer-reviewed journals.

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  • 228.
    Sandberg, Klas
    et al.
    Östergötlands Läns Landsting, Närsjukvården i östra Östergötland, Rehab öst. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i östra Östergötland, Medicinkliniken ViN. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi.
    Kleist, Marie
    Linköpings universitet, Institutionen för medicin och hälsa. Östergötlands Läns Landsting, Närsjukvården i östra Östergötland, Rehab öst. Linköpings universitet, Medicinska fakulteten.
    Falk, Lars
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland. Region Östergötland, Hjärt- och Medicincentrum, Hudkliniken i Östergötland.
    Enthoven, Paul
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland.
    Effects of Twice-Weekly Intense Aerobic Exercise inQ1 Early Subacute Stroke: A Randomized Controlled Trial2016Ingår i: Archives of Physical Medicine and Rehabilitation, ISSN 0003-9993, E-ISSN 1532-821X, Vol. 97, nr 8, s. 1244-1253Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE:

    To examine the effects of 12 weeks of twice-weekly intensive aerobic exercise on physical function and quality of life after subacute stroke.

    DESIGN:

    Randomized controlled trial.

    SETTING:

    Ambulatory care.

    PARTICIPANTS:

    Patients (N=56; 28 women) aged ≥50 years who had a mild stroke (98% ischemic) and were discharged to independent living and enrolled 20 days (median) after stroke onset.

    INTERVENTIONS:

    Sixty minutes of group aerobic exercise, including 2 sets of 8 minutes of exercise with intensity up to exertion level 14 or 15 of 20 on the Borg rating of perceived exertion scale, twice weekly for 12 weeks (n=29). The nonintervention group (n=27) received no organized rehabilitation or scheduled physical exercise.

    MAIN OUTCOME MEASURES:

    Primary outcome measures included aerobic capacity on the standard ergometer exercise stress test (peak work rate) and walking distance on the 6-minute walk test (6MWT). Secondary outcome measures included maximum walking speed for 10m, balance on the timed Up and Go (TUG) test and single leg stance (SLS), health-related quality of life on the European Quality of Life Scale (EQ-5D), and participation and recovery after stroke on the Stroke Impact Scale (SIS) version 2.0 domains 8 and 9. Participants were evaluated pre- and postintervention. Patient-reported measures were also evaluated at 6-month follow-up.

    RESULTS:

    The following improved significantly more in the intervention group (pre- to postintervention): peak work rate (group × time interaction, P=.006), 6MWT (P=.011), maximum walking speed for 10m (P<.001), TUG test (P<.001), SLS right and left (eyes open) (P<.001 and P=.022, respectively), and SLS right (eyes closed) (P=.019). Aerobic exercise was associated with improved EQ-5D scores (visual analog scale, P=.008) and perceived recovery (SIS domain 9, P=.002). These patient-reported improvements persisted at 6-month follow-up.

    CONCLUSIONS:

    Intensive aerobic exercise twice weekly early in subacute mild stroke improved aerobic capacity, walking, balance, health-related quality of life, and patient-reported recovery.

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  • 229.
    Sandlund, Marlene
    et al.
    Umeå University, Sweden.
    Skelton, Dawn A.
    Glasgow Caledonian University, Scotland.
    Pohl, Petra
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Ahlgren, Christina
    Umeå University, Sweden.
    Melander-Wikman, Anita
    Luleå University of Technology, Sweden.
    Lundin-Olsson, Lillemor
    Umeå University, Sweden.
    Gender perspectives on views and preferences of older people on exercise to prevent falls: a systematic mixed studies review2017Ingår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 17, artikel-id 58Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: To offer fall prevention exercise programs that attract older people of both sexes there is a need to understand both womens and mens views and preferences regarding these programs. This paper aims to systematically review the literature to explore any underlying gender perspectives or gender interpretations on older peoples views or preferences regarding uptake and adherence to exercise to prevent falls. Methods: A review of the literature was carried out using a convergent qualitative design based on systematic searches of seven electronic databases (PubMed, CINAHL, Amed, PsycINFO, Scopus, PEDro, and OTseeker). Two investigators identified eligible studies. Each included article was read by at least two authors independently to extract data into tables. Views and preferences reported were coded and summarized in themes of facilitators and barriers using a thematic analysis approach. Results: Nine hundred and nine unique studies were identified. Twenty five studies met the criteria for inclusion. Only five of these contained a gender analysis of mens and womens views on fall prevention exercises. The results suggests that both women and men see women as more receptive to and in more need of fall prevention messages. The synthesis from all 25 studies identified six themes illustrating facilitators and six themes describing barriers for older people either starting or adhering to fall prevention exercise. The facilitators were: support from professionals or family; social interaction; perceived benefits; a supportive exercise context; feelings of commitment; and having fun. Barriers were: practical issues; concerns about exercise; unawareness; reduced health status; lack of support; and lack of interest. Considerably more women than men were included in the studies. Conclusion: Although there is plenty of information on the facilitators and barriers to falls prevention exercise in older people, there is a distinct lack of studies investigating differences or similarities in older womens and mens views regarding fall prevention exercise. In order to ensure that fall prevention exercise is appealing to both sexes and that the inclusion of both men and women are encouraged, more research is needed to find out whether gender differences exists and whether practitioners need to offer a range of opportunities and support strategies to attract both women and men to falls prevention exercise.

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  • 230.
    Sandon, Alexander
    et al.
    Karolinska Inst, Sweden; Vastmanland Reg Hosp, Sweden.
    Forssblad, Magnus
    Karolinska Inst, Sweden.
    Hägglund, Martin
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Waldén, Markus
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Hassleholm Hosp, Sweden.
    Should "garbage in-garbage out" be replaced by "little in-little out"? Questionnaire response rates need to be improved in surgical quality registries!2019Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 27, nr 8, s. 2387-2388Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    n/a

  • 231.
    Schwellnus, Martin
    et al.
    University of Pretoria, South Africa.
    Soligard, Torbjorn
    Int Olymp Comm, Switzerland.
    Alonso, Juan-Manuel
    Qatar Orthoped and Sports Medical Hospital, Qatar.
    Bahr, Roald
    Qatar Orthoped and Sports Medical Hospital, Qatar; Norwegian School Sport Science, Norway; Olymp Training Centre Olympiatoppen, Norway.
    Clarsen, Ben
    Norwegian School Sport Science, Norway; Olymp Training Centre Olympiatoppen, Norway.
    Paul Dijkstra, H.
    Qatar Orthoped and Sports Medical Hospital, Qatar.
    Gabbett, Tim J.
    University of Queensland, Australia; Australian Catholic University, Australia.
    Gleeson, Michael
    University of Loughborough, England.
    Hägglund, Martin
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Hutchinson, Mark R.
    University of Illinois, IL USA.
    Janse Van Rensburg, Christa
    University of Pretoria, South Africa.
    Meeusen, Romain
    Vrije University of Brussel, Belgium.
    Orchard, John W.
    University of Sydney, Australia.
    Pluim, Babette M.
    Royal Dutch Lawn Tennis Assoc, Netherlands; VUmc AMC, Netherlands.
    Raftery, Martin
    World Rugby, Ireland.
    Budgett, Richard
    Int Olymp Comm, Switzerland.
    Engebretsen, Lars
    Int Olymp Comm, Switzerland; Norwegian School Sport Science, Norway; University of Oslo, Norway.
    How much is too much? (Part 2) International Olympic Committee consensus statement on load in sport and risk of illness2016Ingår i: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 50, nr 17, s. 1043-1052Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The modern-day athlete participating in elite sports is exposed to high training loads and increasingly saturated competition calendar. Emerging evidence indicates that inappropriate load management is a significant risk factor for acute illness and the overtraining syndrome. The IOC convened an expert group to review the scientific evidence for the relationship of loadincluding rapid changes in training and competition load, competition calendar congestion, psychological load and traveland health outcomes in sport. This paper summarises the results linking load to risk of illness and overtraining in athletes, and provides athletes, coaches and support staff with practical guidelines for appropriate load management to reduce the risk of illness and overtraining in sport. These include guidelines for prescription of training and competition load, as well as for monitoring of training, competition and psychological load, athlete well-being and illness. In the process, urgent research priorities were identified.

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  • 232.
    Sjödahl, Jenny
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Gutke, Annelie
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. University of Gothenburg, Sweden.
    Ghaffari, Ghazaleh
    Linköpings universitet, Institutionen för medicinsk teknik. Linköpings universitet, Tekniska fakulteten.
    Strömberg, Tomas
    Linköpings universitet, Institutionen för medicinsk teknik, Biomedicinsk instrumentteknik. Linköpings universitet, Tekniska fakulteten.
    Öberg, Birgitta
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Response of the muscles in the pelvic floor and the lower lateral abdominal wall during the Active Straight Leg Raise in women with and without pelvic girdle pain: An experimental study2016Ingår i: Clinical Biomechanics, ISSN 0268-0033, E-ISSN 1879-1271, Vol. 35, s. 49-55Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The relationship between activation of the stabilizing muscles of the lumbopelvic region during the Active Straight Leg Raise test and pelvic girdle pain remains unknown. Therefore, the aim was to examine automatic contractions in relation to pre-activation in the muscles of the pelvic floor and the lower lateral abdominal wall during leg lifts, performed as the Active Straight Leg Raise test, in women with and without persistent postpartum pelvic girdle pain. Methods: Sixteen women with pelvic girdle pain and eleven pain-free women performed contralateral and ipsilateral leg lifts, while surface electromyographic activity was recorded from the pelvic floor and unilaterally from the lower lateral abdominal wall. As participants performed leg lifts onset time was calculated as the time from increased muscle activity to leg lift initiation. Findings: No significant differences were observed between the groups during the contralateral leg lift. During the subsequent ipsilateral leg lift, pre-activation in the pelvic floor muscles was observed in 36% of women with pelvic girdle pain and in 91% of pain-free women (P = 0.01). Compared to pain-free women, women with pelvic girdle pain also showed significantly later onset time in both the pelvic floor muscles (P = 0.01) and the muscles of the lower lateral abdominal wall (P amp;lt; 0.01). Interpretation: We suggest that disturbed motor activation patterns influence womens ability to stabilize the pelvis during leg lifts. This could be linked to provocation of pain during repeated movements. (C) 2016 Elsevier Ltd. All rights reserved.

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  • 233.
    Sjödahl, Jenny
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Region Östergötland, Hjärt- och Medicincentrum, Magtarmmedicinska kliniken.
    Walter, Susanna
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Magtarmmedicinska kliniken.
    Johansson, Elin
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten.
    Ingemansson, Anna
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten.
    Ryn, Ann-Katrine
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken US.
    Hallböök, Olof
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken US.
    Combination therapy with biofeedback, loperamide, and stool-bulking agents is effective for the treatment of fecal incontinence in women - a randomized controlled trial2015Ingår i: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 50, nr 8, s. 965-974Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective. Biofeedback and medical treatments have been extensively used for moderate fecal incontinence (FI). There is limited data comparing and combining these two treatments. The objective of this study was to evaluate the effect of biofeedback and medical treatments, separately and in combination. Material and methods. Sixty-four consecutive female patients, referred to a tertiary centre for FI, were included. The patients were randomized to start with either biofeedback (4-6 months) or medical treatment with loperamide and stool-bulking agents (2 months). Both groups continued with a combination of treatments, i.e. medical treatment was added to biofeedback and vice versa. A two-week prospective bowel symptom diary and anorectal physiology were evaluated at baseline, after single-and combination treatments. Results. Fifty-seven patients completed the study. Median number of leakage episodes during two weeks decreased from 6 to 3 (p less than 0.0001) from baseline to completion. The patients showed a significant (1) decrease in number of leakages without forewarning (p = 0.04); (2) decrease in number of stools with urgency (p = 0.001); (3) decrease in number of loose stool consistency; and (4) an increase in rectal sensory thresholds, both for maximum tolerable rectal pressure and first sensation (less than 0.01). The combination treatment was superior to both single treatments in terms of symptoms and functions. There was no significant difference between the two groups at any time point. Conclusions. The combination therapy with biofeedback and medical treatment is effective for symptom relief in FI. The symptom improvement was associated with improved fecal consistency, reduced urgency, and increased rectal sensory thresholds.

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  • 234.
    Sjöholm, Hanna
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Region Jönköping, Sweden.
    Hägg, Staffan
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Medicinska fakulteten. Region Jönköping, Sweden.
    Nyberg, Lars
    Luleå tekniska universitet, Sweden.
    Kammerlind, Ann-Sofi
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Region Jönköping, Sweden.
    Reliability of test procedures for postural reactions in people with acute stroke2018Ingår i: International Journal of Therapy and Rehabilitation, ISSN 1741-1645, E-ISSN 1759-779X, Vol. 25, nr 11, s. 576-586Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Regaining and maintaining balance requires postural reactions such as righting reactions, equilibrium reactions, and protective reactions. There is a lack of uniform, standardised, and reliable testing procedures for postural reactions. The aim of the present study was to examine the intra- And interrater reliability of a newly developed postural reactions assessment for use in people with acute stroke. Methods: The Postural Reactions Test was developed based on the literature, on previous tests, and on input from an expert panel. A total of 10 physiotherapists assessed a total of 20 video recordings of people with acute stroke performing each postural reaction. These assessments were carried out on two occasions at least 2 weeks apart. The study thus included 400 ratings. Findings: For intrarater reliability, the overall proportion of agreement was 86 - 93% for the different postural reactions. For interrater reliability, the most common score for each participant and the number of physiotherapists giving that score were noted. A median of 9-10 out of 10 physiotherapists scored the same value. Conclusions: The results indicate that the Postural Reactions Test can be used to reliably assess function in people with acute stroke and that the test can complement the existing assessments for people with affected postural control

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  • 235.
    Sjöholm, Hanna
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Rehabilitation Centre, Region Jönköping County, Jönköping, Sweden.
    Hägg, Staffan
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Diagnostikcentrum, Klinisk farmakologi. 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
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Futurum, Region Jönköping County, Jönköping, Sweden.
    Correction: The Cone Evasion Walk test: Reliability and validity in acute stroke (vol 24, e1744, 2019)2019Ingår i: Physiotherapy Research International, ISSN 1358-2267, E-ISSN 1471-2865, Vol. 24, nr 3, artikel-id e1801Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    n/a

  • 236.
    Sjöholm, Hanna
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Rehabilitation Centre, Region Jönköping County, Jönköping, Sweden.
    Hägg, Staffan
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Diagnostikcentrum, Klinisk farmakologi. 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
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Futurum, Region Jönköping County, Jönköping, Sweden.
    The Cone Evasion Walk test: Reliability and validity in acute stroke2019Ingår i: Physiotherapy Research International, ISSN 1358-2267, E-ISSN 1471-2865, Vol. 24, nr 1, artikel-id e1744Artikel i tidskrift (Refereegranskat)
    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.

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  • 237.
    Soligard, Torbjorn
    et al.
    Int Olymp Comm, Switzerland.
    Schwellnus, Martin
    University of Pretoria, South Africa.
    Alonso, Juan-Manuel
    Qatar Orthoped and Sports Medical Hospital, Qatar.
    Bahr, Roald
    Qatar Orthoped and Sports Medical Hospital, Qatar; Norwegian School Sport Science, Norway; Olymp Training Centre Olympiatoppen, Norway.
    Clarsen, Ben
    Norwegian School Sport Science, Norway; Olymp Training Centre Olympiatoppen, Norway.
    Paul Dijkstra, H.
    Qatar Orthoped and Sports Medical Hospital, Qatar.
    Gabbett, Tim
    Australian Catholic University, Australia; University of Queensland, Australia.
    Gleeson, Michael
    University of Loughborough, England.
    Hägglund, Martin
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Hutchinson, Mark R.
    University of Illinois, IL USA.
    Janse van Rensburg, Christa
    University of Pretoria, South Africa.
    Khan, Karim M.
    University of British Columbia, Canada.
    Meeusen, Romain
    Vrije University of Brussel, Belgium.
    Orchard, John W.
    University of Sydney, Australia.
    Pluim, Babette M.
    Royal Dutch Lawn Tennis Assoc, Netherlands; VUmc AMC, Netherlands.
    Raftery, Martin
    World Rugby, Ireland.
    Budgett, Richard
    Int Olymp Comm, Switzerland.
    Engebretsen, Lars
    Int Olymp Comm, Switzerland; Norwegian School Sport Science, Norway; University of Oslo, Norway.
    How much is too much? (Part 1) International Olympic Committee consensus statement on load in sport and risk of injury2016Ingår i: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 50, nr 17, s. 1030-1041Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Athletes participating in elite sports are exposed to high training loads and increasingly saturated competition calendars. Emerging evidence indicates that poor load management is a major risk factor for injury. The International Olympic Committee convened an expert group to review the scientific evidence for the relationship of load (defined broadly to include rapid changes in training and competition load, competition calendar congestion, psychological load and travel) and health outcomes in sport. We summarise the results linking load to risk of injury in athletes, and provide athletes, coaches and support staff with practical guidelines to manage load in sport. This consensus statement includes guidelines for (1) prescription of training and competition load, as well as for (2) monitoring of training, competition and psychological load, athlete well-being and injury. In the process, we identified research priorities.

  • 238.
    Stenberg, Gunilla
    et al.
    Umeå University, Sweden.
    Pietila Holmner, Elisabeth
    Umeå University, Sweden.
    Stalnacke, Britt-Marie
    Umeå University, Sweden.
    Enthoven, Paul
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland.
    Healthcare professional experiences with patients who participate in multimodal pain rehabilitation in primary care - a qualitative study2016Ingår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 38, nr 20-21, s. 2085-2094Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: Exploring healthcare professional experiences of Multimodal rehabilitation (MMR) in primary care. Methods: Fourteen healthcare professionals (11 women, 3 men) were individually interviewed about their work with MMR in primary care. Interviews covered experiences of assessing patients and work with patients in the programme. Transcribed interviews were analysed by qualitative content analysis. Results: The analysis resulted in four categories: select patients for success; a multilevel challenge; ethical dilemmas and considering what is a good result. MMR work was experienced as useful and efficient, but also challenging because of patient complexity. Preconceptions about who is a suitable patient for MMR influenced the selection of patients (e.g. gender, different culture). Interviewees were conflicted about not to being able to offer MMR to patients who were not going to return to work. They thought that there were more factors to evaluate MMR than by the proportion that return to work. Conclusions: Healthcare professionals perceive MMR as a helpful method for treating chronic pain patients. At the same time, they thought that only including patients who would return to work conflicted with their ethical views on equal healthcare for all patients. Preconceptions can influence selection for, and work with, MMR.

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  • 239.
    Stenberg, Gunilla
    et al.
    Umeå universitet, Umeå, Sweden.
    Stålnacke, Britt-Marie
    Umeå universitet, Umeå, Sweden.
    Enthoven, Paul
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland.
    Implementing multimodal pain rehabilitation in primary care - a health care professional perspective.2017Ingår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 39, nr 21, s. 2173-2181Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: To explore professional perspectives on how to start and work with multimodal pain rehabilitation within primary healthcare.

    METHODS: Fourteen healthcare professionals (11 women, 3 men) were individually interviewed about their experiences of starting and working with multimodal pain. Interviews were transcribed and analyzed by qualitative content analysis. This study was part of a larger project, which aimed at evaluating multimodal pain rehabilitation in primary care.

    RESULTS: The analysis resulted in six categories. Two categories were about management engagement: putting the focus on rehabilitation and creating appropriate conditions. Three were about professional engagement: importance of driving spirits, creating a program - a process, and good teamwork - not a coincidence. The last category was about professional gain from multimodal rehabilitation (MMR): team work is enriching.

    CONCLUSIONS: To enable implementation of MMR in primary care, managers on all organizational levels must take responsibility for allowing rehabilitation to be a priority. A driving spirit among the professionals facilitates the start, but the entire team is important when processing a program. Creating good teamwork requires hard work, e.g., negotiations for consensus about rehabilitation, and assumption of responsibility by each team member. Collaboration between professionals was perceived to strengthen and enhance knowledge about the patients. Implications for rehabilitation Much can be gained from conducting multimodal pain rehabilitation in primary care. Front line managers and those at other organizational levels must prioritize and create appropriate conditions to facilitate multimodal pain rehabilitation in primary care. Creation of an effective multimodal rehabilitation team requires that each team member takes responsibility, drops the focus on individual rehabilitation, seek member consensus about the content of the rehabilitation, and confer equal worth to each team member. The process of creating a program can be facilitated, especially at the beginning, if the team is supported by speciality pain clinics or more experienced teams.

  • 240.
    Strauch, Stefanie
    et al.
    Sahlgrens Univ Hosp, Sweden.
    Hagstromer, Maria
    Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
    Bäck, Maria
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Sahlgrens Univ Hosp, Sweden; Univ Gothenburg, Sweden.
    Objectively Assessed Physical Activity in the Oldest Old Persons With Coronary Artery Disease2019Ingår i: Journal of Geriatric Physical Therapy, ISSN 1539-8412, E-ISSN 2152-0895, Vol. 42, nr 4, s. E69-E76Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background and Purpose: Accelerometer threshold values to detect physical activity intensity in the oldest old persons with coronary artery disease (CAD) are lacking as well as knowledge about their free-living physical activity behavior. The purpose of this study was 2-fold. (1) To assess the sensitivity and specificity of 3 existing intensity threshold values for Acti-Graph accelerometers for the oldest old persons with CAD. (2) To assess free-living physical activity, applying the threshold values with the highest sensitivity and specificity for assessing at least moderate intensity, among these persons. Methods: In a cross-sectional design, a total of 24 persons with CAD, mean age 87.5 (3.7) years, participated in the study at a university hospital in Sweden. To assess the sensitivity and specificity of the existing threshold values, the participants walked at different speeds wearing the accelerometer at a pace corresponding to individualized perceived exertion at light, moderate, and high intensity according to the Borg Rating of Perceived Exertion Scale. For the free-living physical activity assessment, the persons wore the accelerometer for 7 consecutive days. The percentage agreement for light-, moderate-, and high-intensity threshold values, as well as receiver operating characteristic curves, was used to identify the sensitivity and specificity of the existing threshold values for moderate intensity. Results and Discussion: The threshold values for at least moderate intensity at 1041 counts per minute according to Copeland had the highest sensitivity (0.739) and specificity (0.609) to identify at least moderate intensity for the ActiGraph GT3X+ accelerometer. In a free-living setting, the oldest old persons with CAD spent 11 of 13.5 (81%) waking hours in a sedentary position and, of the 2.5 hours of being active, 19 minutes (2%) were at least at moderate intensity. Nine of 24 persons (38%) reached 20 minutes of moderate- to vigorous-intensity physical activity 3 days a week, according to guidelines for exercise-based cardiac rehabilitation. Conclusions: The existing threshold values according to Copeland had the highest sensitivity and specificity to identify at least moderate intensity and are valid for use in the oldest old persons with CAD. Using accelerometry as an objective measurement for physical activity can help further improve our understanding of free-living physical activity behavior and to assess relationships between free-living physical activity and health outcomes among the oldest old persons with CAD.

  • 241.
    Svanberg, Mikael
    et al.
    Psychosomat Medical Clin, Västerås, Sweden; University of Örebro, Sweden.
    Stålnacke, Britt-Marie
    Umeå University, Sweden; Danderyd Hospital, Sweden.
    Enthoven, Paul
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Brodda-Jansen, Gunilla
    Gerdle, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum. Danderyd Hospital, Sweden; Institute Psychophysiol Behav Med, Sweden.
    Boersma, Katja
    University of Örebro, Sweden.
    IMPACT OF EMOTIONAL DISTRESS AND PAIN-RELATED FEAR ON PATIENTS WITH CHRONIC PAIN: SUBGROUP ANALYSIS OF PATIENTS REFERRED TO MULTIMODAL REHABILITATION2017Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 49, nr 4, s. 354-361Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Multimodal rehabilitation programmes (MMRP) for chronic pain could be improved by determining which patients do not benefit fully. General distress and pain-related fear may explain variations in the treatment effects of MMRP. Design: Cohort study with a cross-sectional, prospective part. Patients: Chronic musculoskeletal pain patients referred to 2 hospital-based pain rehabilitation clinics. Methods: The cross-sectional part of this study cluster analyses patients (n = 1,218) with regard to distress and pain-related fear at first consultation in clinical pain rehabilitation and describes differences in external variables between clusters. The prospective part follows the subsample of patients (n = 260) participating in MMRP and describes outcome post-treatment. Results: Four distinct subgroups were found: (i) those with low levels of distress and pain-related fear; (ii) those with high levels of pain-related fear; (iii) those with high levels of distress; and (iv) those with high levels of distress and pain-related fear. These subgroups showed differences in demographics, pain characteristics, quality of life, and acceptance, as well as the degree of MMRP participation and MMRP outcome. Conclusion: Among patients with chronic pain referred to MMRP there are subgroups with different profiles of distress and pain-related fear, which are relevant to understanding the adaptation to pain and MMRP outcome. This knowledge may help us to select patients and tailor treatment for better results.

  • 242.
    Tagesson, Sofi
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Ortopedkliniken i Linköping.
    Kvist, Joanna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Greater fear of re-injury and increased tibial translation in patients who later sustain an ACL graft rupture or a contralateral ACL rupture: a pilot study2016Ingår i: Journal of Sports Sciences, ISSN 0264-0414, E-ISSN 1466-447X, Vol. 34, nr 2, s. 125-132Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim was to compare fear of re-injury, patient reported function, static and dynamic tibial translation and muscle strength assessed before and 5 weeks after an anterior cruciate ligament (ACL) reconstruction between individuals who sustained a subsequent ACL graft rupture or a contralateral ACL injury within 5 years after the reconstruction, and individuals with no subsequent injury. Nineteen patients were investigated before, and 5 weeks after an ACL reconstruction with a quadruple hamstring tendon graft. At 5 years follow up, 3 patients had sustained an ACL graft rupture and 2 patients had sustained a contralateral ACL rupture. Fear of re-injury, confidence with the knee, patient reported function, activity level, static and dynamic tibial translation and muscle strength were assessed. The re-injured group reported greater fear of re-injury and had greater static tibial translation in both knees before the ACL reconstruction compared to those who did not sustain another ACL injury. There were no other differences between groups. In conclusion, fear of re-injury and static tibial translation before the index ACL reconstruction were greater in patients who later on suffered an ACL graft rupture or a contralateral ACL rupture. These factors may predict a subsequent ACL injury.

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  • 243.
    Tagesson (Sonesson), Sofi
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Rörelse och Hälsa.
    Kvist, Joanna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Dynamic and static tibial translation in patients with anterior cruciate ligament deficiency initially treated with a structured rehabilitation protocol2017Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 25, nr 8, s. 2337-2346Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE:

    To compare dynamic and static tibial translation, in patients with anterior cruciate ligament deficiency, at 2- to 5-year follow-up, with the tibial translation after 4 months of rehabilitation initiated early after the injury. Secondarily, to compare tibial translation in the injured knee and non-injured knee and explore correlations between dynamic and static tibial translation.

    METHODS:

    Twelve patients with ACL rupture were assessed at 3-8 weeks after ACL injury, after 4 months of structured rehabilitation, and 2-5 years after ACL injury. Sagittal tibial translation was measured during the Lachman test (static translation) and during gait (dynamic translation) using a CA-4000 electrogoniometer.

    RESULTS:

    Static tibial translation was increased bilateral 2-5 years after ACL injury, whereas the dynamic tibial translation was unchanged. Tibial translation was greater in the injured knee compared with the non-injured knee (Lachman test 134 N 9.1 ± 1.0 vs. 7.0 ± 1.7 mm, P = 0.001, gait 5.6 ± 2.1 vs. 4.7 ± 1.8 mm, P = 0.011). There were no correlations between dynamic and static tibial translation.

    CONCLUSION:

    Dynamic tibial translation was unchanged in spite of increased static tibial translation in the ACL-deficient knee at 2- to 5-year follow-up compared to directly after rehabilitation. Dynamic tibial translation did not correlate with the static tibial translation. A more normal gait kinematics may be maintained from completion of a rehabilitation programme to mid-term follow-up in patients with ACL deficiency treated with rehabilitation only.

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  • 244.
    Tagesson (Sonesson), Sofi
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Rörelse och Hälsa.
    Kvist, Joanna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Ardern, Clare
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. School of Allied Health, La Trobe University, Melbourne, Australia, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
    Österberg, Annika
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden.
    Grävare Silbernagel, Karin
    Department of Physical Therapy, University of Delaware, Newark, DE, USA..
    Psychological factors are important to return to pre-injury sport activity after anterior cruciate ligament reconstruction: expect and motivate to satisfy.2017Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 25, nr 5, s. 1375-1384Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: To describe individuals' expectations, motivation, and satisfaction before, during, and after rehabilitation for ACL reconstruction and to explore how these factors were associated with return to pre-injury sport activity at 1-year follow-up.

    METHODS: Sixty-five individuals (34 males), median age 22 (15-45) years, scheduled for ACL reconstruction participated. Participants completed the International Knee Documentation Committee Subjective Knee Form (IKDC-SKF) and questions about expectations, satisfaction, and motivation pre-operatively and at 16 and 52 weeks after surgery.

    RESULTS: Prior to surgery, 86 % of participants stated that their goal was to return to their pre-injury sport activity. Those who had returned to their pre-injury sport activity at 52 weeks were more motivated during rehabilitation to return to their pre-injury activity level, more satisfied with their activity level and knee function at 52 weeks, and scored significantly higher on the IKDC-SKF [median 92.0 (range 66.7-100.0)] at 52 weeks, compared to those who had not returned [median 77.6 (range 50.6-97.7)].

    CONCLUSION: Prior to ACL reconstruction, most participants expected to return to their pre-injury activity level. Higher motivation during rehabilitation was associated with returning to the pre-injury sport activity. The participants who had returned to their pre-injury sport activity were more satisfied with their activity level and knee function 1 year after the ACL reconstruction. Facilitating motivation might be important to support individuals in achieving their participation goals after ACL reconstruction.

    LEVEL OF EVIDENCE: Prospective cohort study, Level II.

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  • 245.
    Tagesson (Sonesson), Sofi
    et al.
    Östergötlands Läns Landsting, Centrum för kirurgi, ortopedi och cancervård, Ortopedkliniken i Linköping. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Öberg, Birgitta
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Kvist, Joanna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Static and dynamic tibial translation before, 5 weeks after, and 5 years after anterior cruciate ligament reconstruction2015Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 23, nr 12, s. 3691-3697Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: To evaluate static and dynamic tibial translation before, 5 weeks after, and 5 years after anterior cruciate ligament (ACL) reconstruction. To explore whether static and dynamic tibial translation are correlated.

    METHODS: Ten patients undergoing quadruple hamstring tendon graft ACL reconstruction were evaluated before, 5 weeks after, and 5 years after ACL reconstruction. Sagittal tibial translation was measured during the Lachman test (static translation) and during gait (dynamic translation) using a CA-4000 electrogoniometer.

    RESULTS: Five years after ACL reconstruction, static tibial translation did not differ between knees (Lachman test 90 N and 134 N n.s.). In contrast, there was greater maximal anterior tibial translation during gait in ACL-reconstructed knees than in uninjured knees (5.5 ± 1.4 vs. 4.5 ± 1.6 mm, P = 0.028). There were no differences in static or dynamic tibial translation between the 5-year follow-up and before ACL reconstruction or between the 5-year follow-up and the 5-week follow-up. There were no correlations between static and dynamic tibial translation.

    CONCLUSION: Although static tibial translation did not differ between knees 5 years after ACL reconstruction, dynamic tibial translation during gait was greater in ACL-reconstructed knees than in uninjured knees. Neither static nor dynamic tibial translation changed 5 years after ACL reconstruction as compared to before surgery and 5 weeks after surgery. Static tibial translation did not correlate with dynamic tibial translation.

    CLINICAL RELEVANCE: This study indicates that although the knee is stable during static measurements, kinematics during gait is impaired 5 years after ACL reconstruction. This may affect the return to sport and risk of osteoarthritis.

    LEVEL OF EVIDENCE: Case series, Level IV.

  • 246.
    Theis, Jennifer C
    et al.
    Faculty of Health Science and Medicine, Bond Institute of Health and Sport, Bond University; Department of Orthopaedics, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Karolinska University Hospital.
    Grauers, Anna
    Department of Orthopaedics, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Karolinska University Hospital; Department of Orthopaedics, Sundsvall and Härnösand County Hospital.
    Diarbakerli, Elias
    Department of Orthopaedics, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Karolinska University Hospital.
    Savvides, Panayiotis
    Department of Orthopaedics, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Karolinska University Hospital.
    Abbott, Allan
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Faculty of Health Science and Medicine, Bond Institute of Health and Sport, Bond University; Department of Physical Therapy, Karolinska University Hospital; Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.
    Gerdhem, Paul
    Department of Orthopaedics, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Karolinska University Hospital.
    An observational study on surgically treated adult idiopathic scoliosis patients' quality of life outcomes at 1- and 2-year follow-ups and comparison to controls.2017Ingår i: Scoliosis and spinal disorders, ISSN 2397-1789, Vol. 12, artikel-id 11Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Prospective data on health-related quality of life in patients with idiopathic scoliosis treated surgically as adults is needed. We compared preoperative and 1- and 2-year follow-up data in surgically treated adults with idiopathic scoliosis with juvenile or adolescent onset. Results were compared to untreated adults with scoliosis and population normative data.

    METHODS: A comparison of preoperative and 1- and 2-year follow-up data of 75 adults surgically treated for idiopathic scoliosis at a mean age of 28 years (range 18 to 69) from a prospective national register study, as well as a comparison with age- and sex-matched data from 75 untreated adults with less severe scoliosis and 75 adults without scoliosis, was made. Outcome measures were EuroQol-5 dimensions (EQ-5D) and Scoliosis Research Society (SRS)-22r questionnaire.

    RESULTS: In the surgically treated, EQ-5D and SRS-22r scores had statistically significant improvements at both 1- and 2-year follow-ups (all p  < 0.015). The effect size of surgery on EQ-5D at 1-year follow-up was large (r = -0.54) and small-medium (r = -0.20) at 2-year follow-up. The effect size of surgery on SRS-22r outcomes was medium-large at 1- and 2-year follow-ups (r = -0.43 and r = -0.42 respectively). At the 2-year follow-up, the EQ-5D score and the SRS-22r subscore were similar to the untreated scoliosis group (p = 0.56 and p = 0.91 respectively), but lower than those in the adults without scoliosis (p < 0.001 for both comparisons).

    CONCLUSIONS: Adults with idiopathic scoliosis experience an increase in health-related quality of life following surgery at 2-year follow-up, approaching the health-related quality of life of untreated individuals with less severe scoliosis, but remain lower than normative population data.

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  • 247.
    Thomee, R.
    et al.
    Gothenburg University, Sweden.
    Waldén, Markus
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten.
    Hägglund, Martin
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Return to sports after anterior cruciate ligament injury: neither surgery nor rehabilitation alone guarantees success-it is much more complicated2015Ingår i: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 49, nr 22, s. 1422-1422Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    n/a

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  • 248. Beställ onlineKöp publikationen >>
    Tigerstrand Grevnerts, Hanna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Rörelse och Hälsa.
    Treatment Decision after Anterior Cruciate Ligament Injury, and Evaluation of Measurement Properties of a Patient Reported Outcome Measure2019Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [sv]

    Bakgrund: Efter en främre korsbandsskada syftar behandlingen att återställa knäfunktionen. Utvärdering av framstegen är av vikt, och adekvata mätmetoder för detta är nödvändigt. International Knee Documentation Committtee Subjective Knee Form (IKDC-SKF) är ett patientskattningsformulär som är välanvänt över hela världen vid främre korsbandsskador. Det utvärderar symptom, funktion och fysisk aktivitet. Det har inte funnits tillgängligt på svenska tidigare och det har heller inte funnits någon sammanställning över formulärets mätegenskaper.

    Efter en främre korsbandsskada måste förr eller senare beslut om behandling fattas, om patienten ska genomgå en rekonstruktionsoperation för främre korsbandet, med efterföljande rehabilitering, eller enbart rehabilitering. Det finns riktlinjer som gör gällande att en korsbandsrekonstruktion kan vara ett adekvat alternativ när patienten har höga aktivitetskrav eller lider av instabilitet i knäleden. Det är dock ej fastställt vilka faktorer ortopedläkare och fysioterapeuter anser viktiga för att rekommendera rekonstruktionsoperation. Det är inte heller klargjort när efter skada och på vilka grunder faktiska behandlingsbeslut fattas, och hur orsaken till beslutet hänger samman med patientens självrapporterade symptom och funktion.

    Syfte: Det övergripande syftet med avhandlingen var att utvärdera mätegenskaper för ett patientskattningsformulär som utvärderar funktion efter en främre korsbandsskada, samt att överblicka beslutsprocessen för behandling efter en främre korsbandsskada.

    Metod: En systematisk genomgång utfördes av studier som utvärderat mätegenskaper för IKDC-SKF. Studierna värderades avseende metodologi och resultat. IKDC-SKF översattes till svenska, och den svenska versionens mätegenskaper prövades.

    En enkätstudie utfördes där 98 svenska ortopedläkare och 391 svenska fysioterapeuter fick skatta 21 faktorers betydelse för valet att rekommendera rekonstruktionsoperation av främre korsbandet. Ortopedläkare och fysioterapeuter fick även skatta vikten av sin egen och motpartens bedömning samt patientens önskan, i valet av behandling.

    I en prospektiv kohortstudie följdes 219 patienter med en främre korsbandsskada, från 6 veckor och upp till 12 månader efter skadan. Data om vilken behandling patienten genomgått, när behandling valdes och grunder för behandling samlades in från patient och ortopedläkare och jämfördes med patientskattad aktivitetsnivå innan skada, instabilitet och funktion.

    Resultat: Den systematiska genomgången av IKDC-SKF och prövningen av den svenska versionens mätegenskaper visade att IKDC-SKF uppvisar goda mätegenskaper och går att tolka i kliniken?

    Svenska ortopedläkare och fysioterapeuter anser att ung ålder, höga aktivitetskrav, knäkrävande arbete och instabilitet trots adekvat rehabilitering är faktorer som indicerar behov av rekonstruktionsoperation av främre korsbandet. 

    Ett tidigt beslut för rekonstruktionsoperation efter främre korsbandsskada fattas i hög grad på grund av höga aktivitetskrav, och dessa patienter har även högre aktivitetsnivå innan skada. Ett senare beslut för rekonstruktionsoperation fattas i hög grad på grund av instabilitet och höga aktivitetskrav, medan ett sent beslut fattas i hög grad på grund av instabilitet. Ett beslut att enbart behandla med rehabilitering fattas i hög grad på grund av att patienten har tillräckligt god funktion eller inte har några besvär från instabilitet. Det var inga skillnader i patientskattad funktion och instabilitet mellan de patienter där rekonstruktionsoperation valdes och de som valde att behandla med enbart rehabilitering.

    Sammanfattning: IKDC-SKF visar goda mätegenskaper och kan rekommenderas för användning hos patienter med en främre korsbandsskada och andra knärelaterade diagnoser.

    Efter en främre korsbandsskada fattas ett tidigt beslut för rekonstruktionsoperation på grund av höga aktivitetskrav. Ett senare beslut för rekonstruktionsoperation fattas när patienten lider av instabilitet och nedsatt knäfunktion, medan ett beslut för enbart rehabilitering valdes när funktion och knästabilitet var god. Det var inga skillnader mellan patienter där man valt rekonstruktionsoperation och enbart rehabilitering, avseende skattad funktion och instabilitet. Både ortopedläkarens och fysioterapeutens bedömning samt patientens önskan är viktig i valet av behandling.

    Delarbeten
    1. The measurement properties of the IKDC-subjective knee form.
    Öppna denna publikation i ny flik eller fönster >>The measurement properties of the IKDC-subjective knee form.
    2015 (Engelska)Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 23, nr 12, s. 3698-3706Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    PURPOSE: To evaluate the methodological quality of studies reporting on the measurement properties of the International Knee Documentation Committee subjective knee form (IKDC-SKF) and to evaluate their results following the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) guidelines.

    METHODS: Systematic search of articles published about the measurement properties of the IKDC-SKF, review of the studies' methodological quality, and synthesis of the results using the COSMIN guidelines.

    RESULTS: Twenty-six studies were identified and reviewed. There was strong evidence for good internal consistency, test-retest reliability, and responsiveness. There was moderate evidence for good content and structural validity. With the SF36 as a gold standard, the level of evidence for criterion validity was indeterminate. There was conflicting evidence for hypothesis testing and not enough evidence to evaluate measurement error and cross-cultural validity. There were no floor or ceiling effects.

    CONCLUSIONS: This review shows that the IKDC-SKF is a measurement instrument with good internal consistency, test-retest reliability, content and structural validity, and responsiveness and interpretability (no floor and ceiling effects). Further evaluation of measurement error, minimal important change, and hypotheses testing is recommended. The IKDC-SKF seems to be useful as a general instrument for all kinds of knee injuries, which might facilitate its clinical use in situations in which time is a factor.

    LEVEL OF EVIDENCE: Systematic review, Level III.

    Nationell ämneskategori
    Sjukgymnastik
    Identifikatorer
    urn:nbn:se:liu:diva-115921 (URN)10.1007/s00167-014-3283-z (DOI)000365715800034 ()25193574 (PubMedID)
    Tillgänglig från: 2015-03-24 Skapad: 2015-03-24 Senast uppdaterad: 2019-10-14
    2. Translation and testing of measurement properties of the Swedish version of the IKDC subjective knee form
    Öppna denna publikation i ny flik eller fönster >>Translation and testing of measurement properties of the Swedish version of the IKDC subjective knee form
    Visa övriga...
    2017 (Engelska)Ingår i: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 27, nr 5, s. 554-562Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    To translate to Swedish language and cross-culturally adapt the IKDC-SKF and to test the measurement properties of the Swedish version of IKDC-SKF in ACL-injured patients undergoing reconstruction surgery.The translation and cross-cultural adaption was performed according to guidelines. Seventy-six patients with an ACL injury filled out the IKDC-SKF and other questionnaires before ACL reconstruction and at 4, 6, and 12months after surgery. A total of 203 patients from the Swedish ACL Registry participated at 8months post-operative. Measurement properties were tested according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines.The Swedish IKDC-SKF had high internal consistency (Cronbachs alpha=0.90) and test-retest reliability (ICC2,1=0.92, CI 95%: 0.81-0.97, Pamp;lt;.001). A single factor solution accounted for 46.1% of the variance in IKDC-SKF scores. Criterion validity was moderate to high. All ten predefined hypotheses for hypothesis testing were confirmed. The six hypotheses for responsiveness testing were confirmed. The effect size was 1.8, the standardized response mean was 1.9, the and minimal clinically important difference was 13.9 points.The Swedish version of the IKDC-SKF had good measurement properties and can be recommended for use in a population of ACL-deficient patients undergoing ACL reconstruction.

    Ort, förlag, år, upplaga, sidor
    WILEY, 2017
    Nyckelord
    ACL injury; ACL reconstruction; knee surgery; patient reported outcome
    Nationell ämneskategori
    Sjukgymnastik
    Identifikatorer
    urn:nbn:se:liu:diva-137085 (URN)10.1111/sms.12861 (DOI)000398783800012 ()28207954 (PubMedID)
    Anmärkning

    Funding Agencies|Swedish National Centre for Research in Sports

    Tillgänglig från: 2017-05-05 Skapad: 2017-05-05 Senast uppdaterad: 2021-12-28
    3. Activity demands and instability are the most important factors for recommending to treat ACL injuries with reconstruction
    Öppna denna publikation i ny flik eller fönster >>Activity demands and instability are the most important factors for recommending to treat ACL injuries with reconstruction
    Visa övriga...
    2018 (Engelska)Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 26, nr 8, s. 2401-2409Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    The purpose of the study was to (1) study and compare the factors that Swedish orthopaedic surgeons and physical therapists consider important for recommending ACL reconstruction and, (2) to assess how orthopaedic surgeons and physical therapists consider their own and each others, as well as patients, roles are in the treatment decision. A web-based survey assessing the relevance of 21 predetermined factors, in the choice to recommend ACL reconstruction, was sent to orthopaedic surgeons and physical therapists. Respondents were also asked to rate the importance of the assessment made by themselves, the other clinician (physical therapists rated the importance of surgeons, surgeons rated the importance of physical therapists), and the patients preferences. Orthopaedic surgeons agreed of eight, and physical therapists of seven factors as important in the choice to recommend ACL reconstruction. The factors both groups reported as important were; "patients wishes to return to contact/pivoting sports", "instability in physical activity", "instability in activities of daily living despite adequate rehabilitation", "physically demanding occupation", and "young age". Both professions rated their own and each others assessments as well as patients wishes as important for the decision to recommend ACL reconstruction. Orthopaedic surgeons and physical therapists agree about factors that are important for their decision to recommend ACL reconstruction, showing that both professions share a common ground in perceptions of factors that are important in recommending ACL reconstruction. Diagnostic study: Level III.

    Ort, förlag, år, upplaga, sidor
    SPRINGER, 2018
    Nyckelord
    Knee; Anterior cruciate ligament injury; Treatment decision; ACL reconstruction
    Nationell ämneskategori
    Sjukgymnastik
    Identifikatorer
    urn:nbn:se:liu:diva-150231 (URN)10.1007/s00167-018-4846-1 (DOI)000439446600026 ()29411079 (PubMedID)
    Tillgänglig från: 2018-08-22 Skapad: 2018-08-22 Senast uppdaterad: 2021-12-28
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  • 249.
    Tigerstrand Grevnerts, Hanna
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Rörelse och Hälsa.
    Fältström, Anne
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Ryhov Cty Hosp, Sweden.
    Sonesson, Sofi
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Ortopedkliniken i Linköping.
    Gauffin, Håkan
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Ortopedkliniken i Linköping.
    Carlfjord, Siw
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten.
    Kvist, Joanna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Activity demands and instability are the most important factors for recommending to treat ACL injuries with reconstruction2018Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 26, nr 8, s. 2401-2409Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The purpose of the study was to (1) study and compare the factors that Swedish orthopaedic surgeons and physical therapists consider important for recommending ACL reconstruction and, (2) to assess how orthopaedic surgeons and physical therapists consider their own and each others, as well as patients, roles are in the treatment decision. A web-based survey assessing the relevance of 21 predetermined factors, in the choice to recommend ACL reconstruction, was sent to orthopaedic surgeons and physical therapists. Respondents were also asked to rate the importance of the assessment made by themselves, the other clinician (physical therapists rated the importance of surgeons, surgeons rated the importance of physical therapists), and the patients preferences. Orthopaedic surgeons agreed of eight, and physical therapists of seven factors as important in the choice to recommend ACL reconstruction. The factors both groups reported as important were; "patients wishes to return to contact/pivoting sports", "instability in physical activity", "instability in activities of daily living despite adequate rehabilitation", "physically demanding occupation", and "young age". Both professions rated their own and each others assessments as well as patients wishes as important for the decision to recommend ACL reconstruction. Orthopaedic surgeons and physical therapists agree about factors that are important for their decision to recommend ACL reconstruction, showing that both professions share a common ground in perceptions of factors that are important in recommending ACL reconstruction. Diagnostic study: Level III.

    Ladda ner fulltext (pdf)
    fulltext
  • 250.
    Tigerstrand Grevnerts, Hanna
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Rörelse och Hälsa.
    Gravare Silbernagel, K.
    University of Delaware, DE USA.
    Tagesson (Sonesson), Sofi
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Rörelse och Hälsa.
    Ardern, Clare
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Aspetar Orthopaed and Sports Medical Hospital, Qatar.
    Österberg, Annika
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Uppsala University, Sweden.
    Gauffin, Håkan
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Ortopedkliniken i Linköping.
    Kvist, Joanna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Translation and testing of measurement properties of the Swedish version of the IKDC subjective knee form2017Ingår i: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 27, nr 5, s. 554-562Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    To translate to Swedish language and cross-culturally adapt the IKDC-SKF and to test the measurement properties of the Swedish version of IKDC-SKF in ACL-injured patients undergoing reconstruction surgery.The translation and cross-cultural adaption was performed according to guidelines. Seventy-six patients with an ACL injury filled out the IKDC-SKF and other questionnaires before ACL reconstruction and at 4, 6, and 12months after surgery. A total of 203 patients from the Swedish ACL Registry participated at 8months post-operative. Measurement properties were tested according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines.The Swedish IKDC-SKF had high internal consistency (Cronbachs alpha=0.90) and test-retest reliability (ICC2,1=0.92, CI 95%: 0.81-0.97, Pamp;lt;.001). A single factor solution accounted for 46.1% of the variance in IKDC-SKF scores. Criterion validity was moderate to high. All ten predefined hypotheses for hypothesis testing were confirmed. The six hypotheses for responsiveness testing were confirmed. The effect size was 1.8, the standardized response mean was 1.9, the and minimal clinically important difference was 13.9 points.The Swedish version of the IKDC-SKF had good measurement properties and can be recommended for use in a population of ACL-deficient patients undergoing ACL reconstruction.

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