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  • 301.
    Mangold, Jasmin
    et al.
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Rehabiliteringsmedicinska kliniken. Univ Hosp Tubingen, Germany.
    Divanoglou, Anestis
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Rehabiliteringsmedicinska kliniken.
    Middleton, James W.
    Royal North Shore Hosp, Australia; Univ Sydney, Australia; Royal Rehab, Australia.
    Joergensen, Sophie
    Lund Univ, Sweden; Skane Univ Hosp, Sweden.
    The Swedish version of the Moorong Self-Efficacy Scale (s-MSES) - translation process and psychometric properties in a community setting2024Inngår i: Spinal Cord, ISSN 1362-4393, E-ISSN 1476-5624Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Study designPsychometric study.ObjectivesTo i) describe the translation process and ii) explore the data completeness, targeting, reliability and aspects of validity of the Swedish version of Moorong Self-Efficacy Scale (s-MSES).SettingsCommunity rehabilitation program.MethodsNinety-two program participants and 42 peer mentors with spinal cord injury (SCI) in Active Rehabilitation training programs (enrolled in the International Project for the Evaluation of activE Rehabilitation (Inter-PEER)) were included. The s-MSES was completed online, once for program participants and twice for peer mentors. The translation process was based on guidelines and involved researchers, clinicians and consumers.ResultsMinor linguistic adaptations were made. Ninety-one percent obtained a total score. As expected, peer mentors exhibited ceiling effects in all subscales. Cronbach ' s alpha for the total scale was 0.92 (subscales 0.74-0.83). The intraclass correlation coefficient was excellent for the total and subscale scores (0.78-0.91). The s-MSES exhibited sensitivity to changes and there were no systematic changes between evaluation points. The s-MSES correlated significantly and positively with life satisfaction and resilience, and negatively with depression/anxiety.ConclusionThe s-MSES was translated through a rigorous, consumer-involved process ensuring accurate linguistic translation and cultural adaptation. Our results support the data completeness, targeting, reliability and aspects of validity of the s-MSES. The s-MSES can thus be considered suitable to assess self-efficacy in persons with SCI in community rehabilitation settings. The now available Swedish version of the MSES will facilitate national research, clinical evaluations and international comparisons.SponsorshipNot applicable.

  • 302.
    Marques-Sule, Elena
    et al.
    Univ Valencia, Spain.
    Hansen, Dominique
    Hasselt Univ, Belgium.
    Almenar, Luis
    Hosp Univ & Politecn La Fe, Spain; Inst Salud Carlos III, Spain.
    Deka, Pallav
    Michigan State Univ, MI USA.
    Sentandreu-Mano, Trinidad
    Univ Valencia, Spain.
    Lopez-Vilella, Raquel
    Hosp Univ & Politecn La Fe, Spain.
    Klompstra, Leonie
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för omvårdnad och reproduktiv hälsa. Linköpings universitet, Medicinska fakulteten.
    Machado, Felipe V. C.
    Hasselt Univ, Belgium.
    What motivates heart transplantation patients to exercise and engage in physical activity? A network analysis2023Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aims After heart transplantation (HTx), increments in physical activity (PA) are strongly recommended. However, participation rates in exercise-based cardiac rehabilitation and engagement in PA are insufficient in many patients. Hence, this study aimed to explore the central factors and the interconnections among distinct types of motivation to exercise, PA, sedentary time, psychosomatic, diet, and activity limitation characteristics in post-HTx patients. Methods and results This is a cross-sectional study involving 133 post-HTx patients (79 men, mean age 57 +/- 13 years, mean time from transplantation 55 +/- 42 months) recruited from an outpatient clinic in Spain. The patients were asked to fill in questionnaires measuring self-reported PA, motivation to exercise, kinesiophobia, musculoskeletal pain, quality of sleep, depression, functional capacity, frailty, sarcopenia risk, and diet quality. Two network structures were estimated: one network including PA and one network including sedentary time as nodes. The relative importance of each node in the network structures was determined using centrality analyses. According to the strength centrality index, functional capacity and identified regulation (subtypes of motivation to exercise) are the two most central nodes of the network (strength: z-score = 1.35-1.51). Strong and direct connections emerged between frailty and PA and between sarcopenia risk and sedentary time. Conclusion Functional capacity and autonomous motivation to exercise are the most promising targets of interventions to improve PA levels and sedentary time in post-HTx patients. Furthermore, frailty and sarcopenia risk were found to mediate the effects of several other factors on PA and sedentary time.

  • 303.
    Marques-Sule, Elena
    et al.
    Univ Valencia, Spain.
    Soderlund, Anne
    Malardalen Univ, Sweden.
    Almenar, Luis
    Hosp Univ & Politecn La Fe, Spain; Univ Valencia, Spain; CIBERCV, Spain.
    Victoria Espi-Lopez, Gemma
    Univ Valencia, Spain.
    Lopez-Vilella, Raquel
    Hosp Univ & Politecn La Fe, Spain.
    Bäck, Maria
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Sahlgrens Univ Hosp, Sweden.
    Influence on kinesiophobia by disability, physical, and behavioural variables after a heart transplantation( )2022Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 21, nr 6, s. 537-543Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Background From clinical experience, kinesiophobia represents a barrier to being physically active after a heart transplantation (HTx), but studies in this field are lacking. Identifying the factors associated with kinesiophobia is essential to determine preventive interventions to avoid negative consequences for health. Aims To study the influence of disability, physical, and behavioural variables on kinesiophobia in patients with an HTx. Methods A total of 117 patients with an HTx [51 women; mean age 56 (SD 12.1) years] were recruited at an outpatient clinic. These patients were asked to fill in questionnaires measuring kinesiophobia, self-reported physical activity (PA), exercise self-efficacy, motivation for PA, and disability. A multiple regression analysis was conducted to examine the statistical prediction of kinesiophobia as a dependent variable, with the questionnaires, gender and education as independent variables. Results The independent variables explained 70% of the variance in kinesiophobia. The prediction model was significant (F = 32.1, P < 0.001). The time from transplantation (standardised coefficient, beta; -0.17), the total exercise self-efficacy (-0.16), extrinsic motivation (-0.23), and the disability total score (0.63) were significant predictors of kinesiophobia, while the independent variables of gender, education, intrinsic motivation, and the PA total score were not significant. Conclusions This study highlights that a short time from transplantation, low self-efficacy, low extrinsic motivation, and a high level of disability explained high levels of kinesiophobia in patients after an HTx. These results suggest that an increased awareness of the biopsychosocial health perspective is essential in order to maximising patient outcomes after an HTx.

  • 304.
    Mazzoni, Anne-Sophie
    et al.
    Uppsala Univ, Sweden; Uppsala Univ, Sweden.
    Bjorke, Ann Christin Helgesen
    Univ Agder, Norway.
    Stenling, Andreas
    Univ Agder, Norway; Umea Univ, Sweden.
    Börjeson, Sussanne
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för omvårdnad och reproduktiv hälsa. Linköpings universitet, Medicinska fakulteten.
    Sjoevall, Katarina
    Kristianstad Univ, Sweden.
    Berntsen, Sveinung
    Uppsala Univ, Sweden; Univ Agder, Norway.
    Demmelmaier, Ingrid
    Uppsala Univ, Sweden; Univ Agder, Norway.
    Nordin, Karin
    Uppsala Univ, Sweden; Univ Agder, Norway.
    The Role of Long-Term Physical Activity in Relation to Cancer-Related Health Outcomes: A 12-Month Follow-up of the Phys-Can RCT2023Inngår i: Integrative Cancer Therapies, ISSN 1534-7354, E-ISSN 1552-695X, Vol. 22, artikkel-id 15347354231178869Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose:While moderate-to-vigorous intensity physical activity (MVPA) is associated with various health improvements shortly after completion of exercise interventions, it remains unclear which health benefits can be expected when MVPA levels are maintained in the long term in cancer survivors. We aimed to assess the associations of (1) MVPA level at 12-month follow-up and (2) long-term MVPA patterns (from immediately post-intervention to 12-month follow-up) with different cancer-related health outcomes. Methods:In the Physical training and Cancer (Phys-Can) RCT, 577 participants diagnosed with breast (78%), prostate (19%), or colorectal (3%) cancer were randomized to 6 months of exercise during curative cancer treatment. Accelerometer-assessed physical activity and outcome data (ie, cancer-related fatigue, health-related quality of life [HRQoL], anxiety and depression, functioning in daily life, cardiorespiratory fitness, sedentary time and sleep) were collected immediately post-intervention and at 12-month follow-up. Based on the samples median of MVPA immediately post-intervention (65 minutes/day) and the changes between the 2 measurement points, 4 categories with different long-term MVPA patterns were created: High & Increasing, High & Decreasing, Low & Increasing, and Low & Decreasing. Multiple linear regression analyses were performed for the analyses. Results:A total of 353 participants were included in the analyses. At 12-month follow-up, a higher MVPA level was significantly associated with lower fatigue in 3 domains (general fatigue [& beta; = -.33], physical fatigue [& beta; = -.53] and reduced activity [& beta; = -.37]), higher cardiorespiratory fitness (& beta; = .34) and less sedentary time (& beta; = -.35). For long-term MVPA patterns, compared to the participants in the "Low & Decreasing" category, those in the "High & Increasing" category reported significantly lower fatigue in 3 domains (general fatigue [& beta; = -1.77], physical fatigue [& beta; = -3.36] and reduced activity [& beta; = -1.58]), higher HRQoL (& beta; = 6.84) and had less sedentary time (& beta; = -1.23). Conclusion:Our results suggest that long-term physical activity is essential for improving health outcomes post-intervention in cancer survivors. Cancer survivors, including those who reach recommended MVPA levels, should be encouraged to maintain or increase MVPA post-intervention for additional health benefits.

    Fulltekst (pdf)
    fulltext
  • 305.
    McEvoy, Claire
    et al.
    International Centre for Allied Health Evidence, University of South Australia, Adelaide, Australia.
    Wiles, Louise
    International Centre for Allied Health Evidence, University of South Australia, Adelaide, Australia.
    Bernhardsson, Susanne
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Närhälsan Hönö/Öckerö Rehabilitation, Region Västra Götaland, Sweden.
    Grimmer, Karen
    International Centre for Allied Health Evidence, University of South Australia, Adelaide, Australia.
    Triage for Patients with Spinal Complaints: A Systematic Review of the Literature2017Inngår i: Physiotherapy Research International, ISSN 1358-2267, E-ISSN 1471-2865, Vol. 22, nr 1, artikkel-id e1639Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study is to provide a systematic overview of the past decade of literature on processes of triage for patients with spinal pain, outcomes measured and markers of effectiveness.

  • 306.
    Merolli, Mark
    et al.
    School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia; Health and Biomedical Informatics Centre, The University of Melbourne, Melbourne, Australia.
    Busuttil, Maria-Louisa
    Consumer Affairs and Civil Liberties, Ministry for Social Dialogue, Valletta, Malta.
    Wåhlin, Charlotte
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Arbets- och miljömedicin. Unit of Intervention and Implementation Research, Karolinska Institutet, Institute for Environmental Medicine, Stockholm, Sweden.
    Green, Ann
    Faculty of Health and Life Sciences, Coventry University, Coventry, United Kingdom of Great Britain and Northern Ireland.
    Global communication practices of physiotherapists on Twitter2019Inngår i: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 21, nr 1, s. 20-26Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Social media have offered professional communities the opportunity to be digitally connected. The hashtag #GlobalPT was conceived and promoted from 2015 and has acted as a slogan for the globally connected physiotherapy community. This study explores the global reach and dominant communication themes that emerged during a set time frame that represented the single largest period of #GlobalPT activity.

    Method: Using purposive sampling, 988 publically available tweets including the hashtag #GlobalPT were studied. Descriptive statistical analysis was conducted to quantify tweet data and qualitative, inductive phenomenological thematic content analysis to describe latent themes within the tweets.

    Results: #GlobalPT activity was noted across 24 countries (UK top represented) and four languages (929/988, 94.03% in English). Europe was the most active area (738/988, 74.70%), followed by Oceania (120/988, 12.15%). Thematic content analysis identified eight themes within the communication practices of the physiotherapy community on Twitter. The three major themes were: sharing information (108/377, 28.65%), promotional activity (93/377, 24.67%) and positive feedback (69/377, 18.30%).

    Conclusion: The professional communication practices of physiotherapists on Twitter show a global spread of communication. The themes provide preliminary evidence for social media’s unique potential to assist the World Confederation for Physical Therapy strategic vision.

    Fulltekst (pdf)
    fulltext
  • 307.
    Migueles, Jairo H.
    et al.
    Univ Granada, Spain.
    Cadenas-Sanchez, Cristina
    Univ Granada, Spain.
    Rowlands, Alex V.
    Univ Leicester, England; NIHR Leicester Biomed Res Ctr, England; Univ South Australia, Australia.
    Henriksson, Pontus
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Univ Granada, Spain; Karolinska Inst, Sweden.
    Shiroma, Eric J.
    NIA, MD 20892 USA.
    Acosta, Francisco M.
    Univ Granada, Spain.
    Rodriguez-Ayllon, Maria
    Univ Granada, Spain.
    Esteban-Cornejo, Irene
    Univ Granada, Spain; Northeastern Univ, MA 02115 USA.
    Plaza-Florido, Abel
    Univ Granada, Spain.
    Gil-Cosano, Jose J.
    Univ Granada, Spain.
    Ekelund, Ulf
    Norwegian Sch Sport Sci, Norway.
    van Hees, Vincent T.
    Netherlands eSci Ctr, Netherlands.
    Ortega, Francisco B.
    Univ Granada, Spain; Karolinska Inst, Sweden.
    Comparability of accelerometer signal aggregation metrics across placements and dominant wrist cut points for the assessment of physical activity in adults2019Inngår i: Scientific Reports, E-ISSN 2045-2322, Vol. 9, artikkel-id 18235Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Large epidemiological studies that use accelerometers for physical behavior and sleep assessment differ in the location of the accelerometer attachment and the signal aggregation metric chosen. This study aimed to assess the comparability of acceleration metrics between commonly-used body-attachment locations for 24 hours, waking and sleeping hours, and to test comparability of PA cut points between dominant and non-dominant wrist. Forty-five young adults (23 women, 18-41 years) were included and GT3X + accelerometers (ActiGraph, Pensacola, FL, USA) were placed on their right hip, dominant, and non-dominant wrist for 7 days. We derived Euclidean Norm Minus One g (ENMO), Low-pass filtered ENMO (LFENMO), Mean Amplitude Deviation (MAD) and ActiGraph activity counts over 5-second epochs from the raw accelerations. Metric values were compared using a correlation analysis, and by plotting the differences by time of the day. Cut points for the dominant wrist were derived using Lins concordance correlation coefficient optimization in a grid of possible thresholds, using the nondominant wrist estimates as reference. They were cross-validated in a separate sample (N = 36, 10 women, 22-30 years). Shared variances between pairs of acceleration metrics varied across sites and metric pairs (range in r(2) : 0.19-0.97, all p amp;lt; 0.01), suggesting that some sites and metrics are associated, and others are not. We observed higher metric values in dominant vs. non-dominant wrist, thus, we developed cut points for dominant wrist based on ENMO to classify sedentary time (amp;lt;50 mg), light PA (50-110 mg), moderate PA (110-440 mg) and vigorous PA (amp;gt;= 440 mg). Our findings suggest differences between dominant and non-dominant wrist, and we proposed new cut points to attenuate these differences. ENMO and LFENMO were the most similar metrics, and they showed good comparability with MAD. However, counts were not comparable with ENMO, LFENMO and MAD.

    Fulltekst (pdf)
    fulltext
  • 308.
    Mohtadi, Nicholas
    et al.
    Department of Surgery, University of Calgary Sport Medicine Centre, Calgary, Alberta, Canada.
    Ardern, Clare
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Engebretsen, Lars
    Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway.
    Why all the fuss about paediatric ACL rupture: isnt the meniscus much more important?2018Inngår i: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 52, nr 7, s. 417-418Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [en]

    n/a

  • 309.
    Molander, Peter
    et al.
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutionen för hälsa, medicin och vård. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Novo, Mehmed
    Umea Univ, Sweden.
    Hallstam, Andrea
    Karolinska Inst, Sweden.
    Lofgren, Monika
    Karolinska Inst, Sweden.
    Stalnacke, Britt-Marie
    Umea Univ, Sweden; Karolinska Inst, Sweden.
    Gerdle, Björn
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Ehlers-Danlos Syndrome and Hypermobility Syndrome Compared with Other Common Chronic Pain Diagnoses-A Study from the Swedish Quality Registry for Pain Rehabilitation2020Inngår i: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 9, nr 7, artikkel-id 2143Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Although chronic pain is common in patients with Ehlers-Danlos syndrome (EDS) and hypermobility syndromes (HMS), little is known about the clinical characteristics of these groups. The main aim was to compare EDS/HMS with common local and generalized pain conditions with respect to Patient Reported Outcome Measures (PROMs). Data from the Swedish Quality Register for Chronic Pain (SQRP) from 2007 to 2016 (n= 40,518) were used, including patients with EDS/HMS (n= 795), fibromyalgia (n= 5791), spinal pain (n= 6693), and whiplash associated disorders (WAD) (n= 1229). No important differences in the PROMs were found between EDS and HMS. Women were represented in > 90% of EDS/HMS cases and fibromyalgia cases, and in about 64% of the other groups. The EDS/HMS group was significantly younger than the others but had a longer pain duration. The pain intensity in EDS/HMS was like those found in spinal pain and WAD; fibromyalgia had the highest pain intensity. Depressive and anxiety symptoms were very similar in the four groups. Vitality-a proxy for fatigue-was low both in EDS/HMS and fibromyalgia. The physical health was lower in EDS/HMS and fibromyalgia than in the two other groups. Patients with EDS/HMS were younger, more often female, and suffered from pain for the longest time compared with patients who had localized/regional pain conditions. Health-care clinicians must be aware of these issues related to EDS/HMS both when assessing the clinical presentations and planning treatment and rehabilitation interventions.

    Fulltekst (pdf)
    fulltext
  • 310.
    Molander, Peter
    et al.
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Novo, Mehmed
    Umea Univ, Sweden.
    Ringqvist, Asa
    Skane Univ Hosp, Sweden.
    Hallstam, Andrea
    Danderyd Hosp, Sweden.
    Hesser, Hugo
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Region Östergötland, Sinnescentrum, Öron- näsa- och halskliniken. Orebro Univ, Sweden.
    Lofgren, Monika
    Danderyd Hosp, Sweden.
    Stalnacke, Britt-Marie
    Umea Univ, Sweden.
    Gerdle, Björn
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    INTERDISCIPLINARY PAIN REHABILITATION FOR PATIENTS WITH EHLERS-DANLOS SYNDROME AND HYPERMOBILITY SPECTRUM DISORDERS2024Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 56, artikkel-id jrm12431Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: Chronic pain is a common manifestation of Ehlers-Danlos syndrome and hypermobility spectrum disorders; thus it is often suggested that patients undergo generic interdisciplinary pain rehabilitation, despite there being little evidence to support this decision. The aim of this study is to examine the effectiveness of standard rehabilitation programmes for chronic pain on patients with Ehlers-Danlos syndrome and hypermobility spectrum disorders, compared with patients with other chronic pain disorders. Subjects: Data, collected between 2008 and 2016, were extracted from a Swedish national registry. The patient data comprised of 406 cases with Ehlers-Danlos syndrome or hypermobility spectrum disorders, 784 cases with a whiplash -related diagnosis, 3713 cases with diagnoses relating to spinal pain, and 2880 cases of fibromyalgia. Methods: The differences between groups on key outcome measures from pre- to 1 -year follow-up after interdisciplinary pain rehabilitation were analysed using linear mixed effects models. Sensitivity analysis in the form of pattern -mixture modelling was conducted to discern the impact of missing data. Results: No significant differences were found in improvements from pre- to 1 -year follow-up for patients with Ehlers-Danlos syndrome or hypermobility spectrum disorder compared with other diagnostic groups regarding measures of health -related quality of life, mental health, or fatigue. At followup, differences in pain interference (d = -0.34 (95% confidence interval [95% CI] -0.5 to -0.18)), average pain (d = 0.22 (95% CI 0.11-0.62)) and physical functioning (d = 2.19 (95% CI 1.61-2.77)) were detected for the group with spinal -related diagnoses in relation to those with EDS/HSD, largely due to pre-treatment group differences. Sensitivity analysis found little evidence for missing data influencing the results. Conclusion: This study suggests that patients with Ehlers-Danlos syndrome/hypermobility spectrum disorders may benefit from inclusion in an interdisciplinary pain rehabilitation programme.

  • 311.
    Molgaard Nielsen, A
    et al.
    Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
    Hartvigsen, J
    Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark; Chiropractic Knowledge Hub, Campusvej 55, 5230, Odense M, Denmark.
    Kongsted, A
    Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark; Chiropractic Knowledge Hub, Campusvej 55, 5230, Odense M, Denmark.
    Öberg, Birgitta
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten.
    Enthoven, Paul
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten.
    Abbott, Allan
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Ortopedkliniken i Linköping.
    Lauridsen, H.H
    Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
    The patient enablement instrument for backpain: reliability, content validity, constructvalidity and responsiveness2021Inngår i: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 19, artikkel-id 116Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

    Currently, there are no outcome measures assessing the ability of people with non-specific low back pain to self-manage their illness. Inspired by the ‘Patient Enablement Instrument’, we developed the Patient Enablement Instrument for Back Pain (PEI-BP). The aim of this study was to describe the development of the Patient Enablement Instrument for Back Pain (PEI-BP) and investigate content validity, construct validity, internal consistency, test–retest reliability, measurement error, responsiveness and floor and ceiling effects.

    Methods

    The PEI-BP consists of 6 items that are rated on a 0–10 Numeric Rating Scale. Measurement properties were evaluated using the COSMIN taxonomy and were based on three cohorts from primary care with low back pain: The content validity cohort (N = 14) which participated in semi-structured interviews, the GLA:D® Back cohort (N = 272) and the test–retest cohort (N = 37) which both completed self-reported questionnaires. For construct validity and responsiveness, enablement was compared to disability (Oswestry Disability Index), back pain beliefs (Brief Illness Perception Questionnaire), fear avoidance (Fear-Avoidance Beliefs Questionnaire—physical activity), mental health (SF-36), educational level and number of previous episodes of low back pain.

    Results

    The PEI-BP was found to have acceptable content validity, construct validity, reliability (internal consistency, test–retest reliability and measurement error) and responsiveness. The Smallest Detectable Change was 10.1 points illustrating that a patient would have to change more than 1/6 of the scale range for it to be a true change. A skewed distribution towards the high scores were found at baseline indicating a potentially problematic ceiling effect in the current population.

    Conclusions

    The PEI-BP can be considered a valid and reliable tool to measure enablement on people seeking care for non-specific LBP. Further testing of the PEI-BP in populations with more severe LBP is recommended.

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  • 312.
    Molgaard Nielsen, A
    et al.
    University of Southern Denmark, Denmark.
    Hartvigsen, J
    Nordic Institute of Chiropractic and Clinical Biomechanics, Denmark; University of Southern Denmark, Denmark .
    Öberg, Birgitta
    Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård.
    Enthoven, Paul
    Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård.
    Abbott, Allan
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Ortopedkliniken i Linköping.
    Lauridsen, H H
    University of Southern Denmark, Denmark.
    The Patient Enablement Instrument for Back Pain: Reliability, Content Validity, Construct Validity and Responsiveness2020Annet (Annet (populærvitenskap, debatt, mm))
    Abstract [en]

    Background

    Currently, there are no outcome measures assessing the ability of people with non-specific low back pain to self-manage their illness. Inspired by the ‘Patient Enablement Instrument’, we developed the Patient Enablement Instrument for Back Pain (PEI-BP). The aim of this study was to describe the development of the Patient Enablement Instrument for Back Pain (PEI-BP) and investigate content validity, construct validity, internal consistency, test-retest reliability, measurement error, responsiveness and floor and ceiling effects.

    Methods

    The PEI-BP consists of 6 items that are rated on a 0-10 Numeric Rating Scale. Measurement properties were evaluated using the COSMIN taxonomy and were based on three cohorts from primary care with low back pain: The content validity cohort (N=14) which participated in semi-structured interviews, the GLA:D Back cohort (N=272) and the test-retest cohort (N=37) which both completed self-reported questionnaires. For construct validity and responsiveness, enablement was compared to disability (Oswestry Disability Index), back pain beliefs (Brief Illness Perception Questionnaire), fear avoidance (Fear-Avoidance Beliefs Questionnaire – physical activity), mental health (SF-36), educational level and number of previous episodes of low back pain.

    Results

    The PEI-BP was found to have acceptable content validity, construct validity, reliability (internal consistency, test-retest reliability and measurement error) and responsiveness. The Smallest Detectable Change was 10.1 points illustrating that a patient would have to change more than 1/6 of the scale range for it to be a true change. A skewed distribution towards the high scores were found at baseline indicating a potentially problematic ceiling effect in the current population.

    Conclusions

    The PEI-BP can be considered a valid and reliable tool to measure enablement on people seeking care for non-specific LBP. Further testing of the PEI-BP in populations with more severe LBP is recommended.

  • 313.
    Moosmayer, Stefan
    et al.
    Martina Hansens Hospital, Norway.
    Marius Ekeberg, Ole
    Helse Fonna Hospital, Norway.
    Björnsson Hallgren, 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.
    Heier, Ingar
    Vestfold Hospital, Norway.
    Kvalheim, Synnove
    Oslo University Hospital, Norway.
    Blomquist, Jesper
    Haraldsplass Deaconess Hospital, Norway.
    Hugo Pripp, Are
    Oslo University Hospital, Norway.
    Gunnar Juel, Nils
    Oslo University Hospital, Norway.
    Harald Kjellevold, Stein
    Haraldsplass Deaconess Hospital, Norway.
    Ivar Brox, Jens
    Oslo University Hospital, Norway.
    KALK study: ultrasound guided needling and lavage (barbotage) with steroid injection versus sham barbotage with and without steroid injection - protocol for a randomized, double-blinded, controlled, multicenter study2017Inngår i: BMC Musculoskeletal Disorders, E-ISSN 1471-2474, Vol. 18, artikkel-id 138Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: For the treatment of calcific tendinitis of the shoulder a variety of treatment regimes exist. Commonly used treatment measures include medication with oral analgesics, corticosteroid injections, extracorporeal shockwave therapy, ultrasound guided needling and lavage, and surgical treatment. Earlier cohort studies suggest that patients may benefit from these treatments, but there are few randomized studies and conflicting evidence about the effectiveness of the various treatments. In the present study we aim to compare the effectiveness of ultrasound guided needling and lavage (barbotage) together with a steroid injection to sham barbotage with and without an additional steroid injection. Methods: The study will be performed in six secondary-care institutions in Norway and Sweden. It is designed as a pragmatic, randomized, three-arm, parallel group, double-blinded, sham-controlled clinical trial with a 2-year follow-up. It will be performed on 210 patients, aged 30 years or older, presenting with painful arc, positive impingement sign and a calcium deposit amp;gt; 5 mm. Randomization to one of the three treatment options will be performed by using an online central randomization system. The three treatment groups are barbotage together with a subacromial steroid injection (the barbotage group), sham barbotage together with a subacromial steroid injection (the steroid group) or sham barbotage without a subacromial steroid injection (the placebo group). In the placebo group the steroid injection will be replaced by a short-acting local anaesthetic. Standardized home-based post-treatment physiotherapy will be performed by all patients for 8 weeks. Follow-ups are at 2 and 6 weeks, 4, 8, 12 and 24 months after treatment was given and will be performed with the patients and the outcome assessors blinded for group assignment. Primary outcome will be the Oxford shoulder score at 4 month follow-up. Secondary outcome measures are the QuickDASH upper extremity score, the EQ-5D-5L general health score and visual analogue scales for pain at rest, during activity, and at night. Discussion: The scientific evidence from this placebo-controlled trial will be of importance for future treatment recommendations in patients with calcific tendinitis.

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  • 314.
    Mourad, Ghassan
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Strömberg, Anna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Jonsbu, Egil
    More and Romsdal Hospital Trust, Norway; Norwegian University of Science and Technology, Norway.
    Gustafsson, Mikael
    Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin.
    Johansson, Peter
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Jaarsma, Tiny
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Guided Internet-delivered cognitive behavioural therapy in patients with non-cardiac chest pain - a pilot randomized controlled study2016Inngår i: Trials, E-ISSN 1745-6215, Vol. 17, s. 1-12, artikkel-id 352Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Patients with recurrent episodes of non-cardiac chest pain may experience cardiac anxiety and avoidance behavior, leading to increased healthcare utilization. These patients might benefit from help and support to evaluate the perception and management of their chest pain. The purpose of this study was to test the feasibility of a short guided Internet-delivered cognitive behavioural therapy (CBT) program and explore the effects on cardiac anxiety, fear of body sensations, depressive symptoms, and chest pain in patients with non-cardiac chest pain, compared with usual care. Methods: A pilot randomized controlled study was conducted. Fifteen patients with non-cardiac chest pain with cardiac anxiety or fear of body sensations, aged 22-76 years, were randomized to intervention (n = 7) or control (n = 8) groups. The four-session CBT program contained psychoeducation, physical activity, and relaxation. The control group received usual care. Data were collected before and after intervention. Results: Five of seven patients in the intervention group completed the program, which was perceived as user-friendly with comprehensible language, adequate and varied content, and manageable homework assignments. Being guided and supported, patients were empowered and motivated to be active and complete the program. Patients in both intervention and control groups improved with regard to cardiac anxiety, fear of body sensations, and depressive symptoms, but no significant differences were found between the groups. Conclusions: The Internet-delivered CBT program seems feasible for patients with non-cardiac chest pain, but needs to be evaluated in larger groups and with a longer follow-up period.

    Fulltekst (pdf)
    fulltext
  • 315.
    Murnane, Andrew
    et al.
    Peter MacCallum Cancer Centre, Melbourne, Vic, Australia.
    Keogh, Justin
    Peter MacCallum Cancer Centre, Melbourne, Vic, Australia.
    Magat, Fiona
    Faculty of Health Science and Medicine, Bond University, Gold Coast, QLD, Australia.
    Imbesi, Sonya
    Faculty of Health Science and Medicine, Bond University, Gold Coast, QLD, Australia.
    Coulombe, Marie
    Peter MacCallum Cancer Centre, Melbourne, Vic, Australia.
    Patchell, Sharni
    Peter MacCallum Cancer Centre, Melbourne, Vic, Australia.
    Abbott, Allan
    Faculty of Health Science and Medicine, Bond University, Gold Coast, QLD, Australia.
    The impact of an inpatient hospital admission on patient’s physical functioning and quality of life rate in the oncology setting2014Inngår i: COSA’s 41st Annual Scientific Meeting: Poster Abstracts, Clinical Oncology Society of Australia , 2014, Vol. 10 (Suppl. 8), s. 204-204Konferansepaper (Annet vitenskapelig)
    Abstract [en]

    Introduction: Prolonged bed rest is often associated with acute inpatient hospital admissions, has been shown to significantly decrease patient’s physical function and health related quality of life (HRQoL). The aim of this study was to investigate the effects of hospitalisation and to describe the pattern and prevalence of functional decline in oncology patients over the course of their inpatient admission.

    Methods: This was a prospective observational study of 55 consenting inpatients recruited over a 10 week period.  Assessment measures were undertaken bi-weekly until discharge from hospital or they became too unwell to continue. Functional status and HRQoL data were collected using the, timed up and go test (TUG), 30-second chair sit to stand (STS), 30-second arm curl, isometric muscle strength testing, EORTC-C30 and SF-8.

    Results: 55 patients (28 male), median age 64 years (± SD 10.8) with an average length of stay of 18 days participated in the study. Reason for hospital admission included; symptom management (36%) or delivery of cancer treatment (35%). A number of subscales on the EORTC-C30 including physical functioning and functional assessments (TUG, STS and knee extension) showed a trend of weekly decline in performance but were not statistically significant. Compared to the general population 87% and 82% of the cohort scored below the norm in physical functioning and mental health respectively; 43% recorded TUG indicative of falls risks; 76% were below age matched norms for STS and 20% were below in upper limb strength.

    Conclusion: Despite non-significant declines in physical functioning and HRQoL during their hospital admission, participants demonstrated substantially reduced HRQoL and physical functioning at time of hospital admission and at discharge compared to healthy age-matched normative data. Despite this low level of function very few received rehabilitation follow-up. Screening programs using simple functional assessment measures (STS, TUG) could be useful in identifying patients at risk of deconditioning and those who require specialised input on discharge to prevent further declines in function and hospital re-admissions.

  • 316.
    Murtola, Sebastian
    Linköpings universitet, Institutionen för hälsa, medicin och vård.
    Begreppsvaliditet för 30 sekunder Chair Stand Test hos patienter med akut stroke2021Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Introduktion: Stroke kan vara ett mångfacetterat och komplext tillstånd. Uppresningar från stol speglar en fundamental aktivitet i det dagliga livet. Uppresningsförmågan är delvis avhängig en individs benstyrka, vilken i regel försämras med stigande ålder. Stroke drabbar oftast äldre individer, och påverkar ofta uppresningsförmågan negativt. Det är därför viktigt att kunna utvärdera uppresningsförmågan med valida och reliabla utvärderingsinstrument. Uppresningstestet 30 sekunder Chair Stand Test (30 CST) kan användas för detta, men har inte validitetstestats för populationen stroke.

    Syfte: Studiens syfte var att utföra en begreppsvalidering av 30 CST för patienter med akut stroke genom att undersöka hur testet korrelerar med greppstyrka, Timed up and go (TUG), Step test (ST) och Functional ambulation category (FAC).

    Metod: Tvåhundrasextioåtta individer med nytillkommen stroke inneliggande på tre olika slutenvårdsavdelningar i Sverige inkluderades i studien under 2016-2017. Studiedeltagarna utförde 30 CST, test av greppstyrka, TUG, ST och FAC. I syfte att begreppsvalidera 30 CST testades sambandet mellan 30 CST och de andra instrumenten med Spearmans rangkorrelation.

    Resultat: 30 CST korrelerade signifikant med greppstyrka (svagaste handen ρ=0,538, p<0,001, starkaste handen ρ=0,459, p<0,001), TUG (ρ=-0,705, p<0,001), ST (svagaste sidan ρ=0,875, p<0,001, starkaste sidan ρ=0,879, p<0,001) och FAC (ρ=0,772, p<0,001).

    Konklusion: Utvärderingsinstrumentet 30 CST begreppsvaliderades för patienter i akut fas efter stroke. 30 CST och ST samt 30 CST och FAC hade bra korrelation, medan 30 CST och TUG hade moderat korrelation. Greppstyrka hade dålig till måttlig korrelation med 30 CST. Utvärderingsinstrumenten utvärderar liknande kroppsliga förmågor, och där förmågorna är mer lika varandra, påträffades också högre korrelationskoefficienter.

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  • 317.
    Mäkimaa, Birgit
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi.
    Inspirationsmuskelträning för personer med idiopatisk lungfibros.: En experimentell fallstudie2017Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund: Vid idiopatisk lungfibros (IPF) är dyspné det dominerande symtomet, vilket påverkar gångsträckan. Andra patientkategorier har ökat gångsträckan och minskat dyspnén efter inspirationsmuskelträning (IMT). Endast två studier angående IMT för personer med IPF har hittats och ingen av dessa studier har IMT som enda studieintervention.

     

    Syfte: Syftet var att undersöka om IMT ökar andningsmuskelstyrkan (MIP), om gångsträcka och dyspné förändras efter träningen samt om det finns ett samband mellan MIP och gångsträcka, MIP och dyspné samt gångsträcka och dyspné.

     

    Metod: Single-subject experimentell design användes. Sex personer med IPF deltog. IMT genomfördes under åtta veckor. Under baslinje, intervention och cirka sex veckor efter interventionsslutet mättes MIP med Micro RPM® och gångsträcka med sex-minuters gångtest. Dyspnén skattades med Borg CR-10-skala och University of California San Diego Shortness of Breath Questionnaire (UCSD SOBQ).

     

    Resultat: Resultatet varierade mellan studiedeltagarna. Fyra deltagare ökade MIP. Fem studiedeltagare hade en kliniskt relevant ökning av gångsträcka. Fyra deltagare hade en kliniskt relevant minskad dyspné vid skattning med Borg CR-10 i vila eller UCSD SOBQ. Korrelationen mellan MIP och gångsträcka var signifikant för två studiedeltagare med rs 0,88 respektive 0,99.

     

    Konklusion: IMT kan öka MIP och ge kliniskt relevanta förbättringar av gångsträcka och dyspné. Alla studiedeltagare drar ej nytta av träningen. Fortsatta studier behövs för att undersöka vilka som har nytta av IMT och vilken träningsmängd som behövs för att uppnå förbättring.

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  • 318.
    Möller, Saffran
    et al.
    School of Health and Welfare, Jönköping University, Jönköping, Sweden.
    Hagberg, Kerstin
    Department of Prosthetics and Orthotics, Sahlgrenska University Hospital, Gothenburg, Sweden; dDepartment of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, SwedenAdvanced Reconstruction of Extremities, Sahlgrenska University Hospital, Gothenburg, Sweden .
    Samuelsson, Kersti
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Rehabiliteringsmedicinska kliniken.
    Ramstrand, Nerrolyn
    School of Health and Welfare, Jönköping University, Jönköping, Sweden.
    Perceived self-efficacy and specific self-reported outcomes in persons withlower-limb amputation using a non-microprocessor-controlled versus amicroprocessor-controlled prosthetic knee2018Inngår i: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 13, nr 3, s. 220-225Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: To measure self-efficacy in a group of individuals who have undergone a lower-limb amputationand investigate the relationship between self-efficacy and prosthetic-specific outcomes including prostheticuse, mobility, amputation-related problems and global health. A second purpose was to examine ifdifferences exist in outcomes based upon the type of prosthetic knee unit being used.Method: Cross-sectional study using the General Self-Efficacy (GSE) Scale and the Questionnaire forPersons with a Transfemoral Amputation (Q-TFA). Forty-two individuals participated in the study. Twentythreeused a non-microprocessor-controlled prosthetic knee joint (non-MPK) and 19 used a microprocessor-controlled prosthetic knee joint (MPK).Results: The study sample had quite high GSE scores (32/40). GSE scores were significantly correlated tothe Q-TFA prosthetic use, mobility and problem scores. High GSE scores were related to higher levels ofprosthetic use, mobility, global scores and negatively related to problem score. No significant differencewas observed between individuals using a non-MPK versus MPK joints.Conclusions: Individuals with high self-efficacy used their prosthesis to a higher degree and high self-efficacywas related to higher level of mobility, global scores and fewer problems related to the amputationin individuals who have undergone a lower-limb amputation and were using a non-MPK or MPK knee.

  • 319.
    Ng, Eunice
    et al.
    University of Queensland, Australia.
    Johnston, Venerina
    University of Queensland, Australia.
    Wibault, Johanna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Lofgren, Hakan
    Ryhov Hospital, Sweden.
    Dedering, Asa
    Karolinska University Hospital, Sweden; Karolinska Institute, Sweden.
    Öberg, Birgitta
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Zsigmond, Peter
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Region Östergötland, Sinnescentrum, Neurokirurgiska kliniken US. Linköpings universitet, Medicinska fakulteten. University of Queensland, Australia.
    Peolsson, Anneli
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. University of Queensland, Australia.
    Factors Associated With Work Ability in Patients Undergoing Surgery for Cervical Radiculopathy2015Inngår i: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 40, nr 16, s. 1270-1276Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Study Design. Cross-sectional study. Objective. To investigate the factors associated with work ability in patients undergoing surgery for cervical radiculopathy. Summary of Background Data. Surgery is a common treatment of cervical radiculopathy in people of working age. However, few studies have investigated the impact on the work ability of these patients. Methods. Patients undergoing surgery for cervical radiculopathy (n = 201) were recruited from spine centers in Sweden to complete a battery of questionnaires and physical measures the day before surgery. The associations between various individual, psychological, and work-related factors and self-reported work ability were investigated by Spearman rank correlation coefficient, multivariate linear regression, and forward stepwise regression analyses. Factors that were significant (P &lt; 0.05) in each statistical analysis were entered into the successive analysis to reveal the factors most related to work ability. Work ability was assessed using the Work Ability Index. Results. The mean Work Ability Index score was 28 (SD, 9.0). The forward stepwise regression analysis revealed 6 factors significantly associated with work ability, which explained 62% of the variance in the Work Ability Index. Factors highly correlated with greater work ability included greater self-efficacy in performing self-cares, lower physical load on the neck at work, greater self-reported chance of being able to work in 6 months time, greater use of active coping strategies, lower frequency of hand weakness, and higher health-related quality of life. Conclusion. Psychological, work-related and individual factors were significantly associated with work ability in patients undergoing surgery for cervical radiculopathy. High self-efficacy was most associated with greater work ability. Consideration of these factors by surgeons preoperatively may provide optimal return to work outcomes after surgery.

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    fulltext
  • 320.
    Nilsing Strid, Emma
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för sjukgymnastik. Linköpings universitet, Hälsouniversitetet.
    Söderberg, Elsy
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet.
    Öberg, Birgitta
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för sjukgymnastik. Linköpings universitet, Hälsouniversitetet.
    Sickness certificates: what information do they provide about rehabilitation?2014Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 36, nr 15, s. 1299-1304Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: To investigate whether patients are prescribed rehabilitation early in a new sick leave period, and whether this prescription is associated with age, sex, diagnosis, description of functioning, and affiliation of certifying physician.

    Methods: A cross-sectional study using data from sickness certificates issued during a total sick leave period, collected consecutively during 2 weeks in 2007 in Östergötland County, Sweden. Rehabilitation prescribed in the first certificate or within 28 days after the start of sick leave was defined as early rehabilitation.

    Results: Musculoskeletal diseases (MSD) were the largest diagnostic group, followed by mental disorders (MD). The mean certified duration of sick leave was 94 days (SD 139), longest for MD patients. Early rehabilitation was prescribed in 27% of all certificates and in 45% of certificates for MSD and MD diagnoses. Logistic regression analysis indicated that prescription of early rehabilitation was associated with certificates issued for MSD and MD, youngest patients, and certificates issued by primary health care physicians. The final model explained 29% of variation in the prescription of early rehabilitation.

    Conclusion: There is a modest prescription of early rehabilitation in sickness certificates, based on younger age and MSD or MD diagnosis. This indicates that patients’ rehabilitation needs may not have been identified.

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  • 321. Bestill onlineKjøp publikasjonen >>
    Nordqvist, Jenny
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten.
    Patients with subacromial pain in primary care: Assessment and efficacy of physiotherapy-guided exercise treatment2021Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Background: Shoulder pain is a common musculoskeletal disorder and 40-74% of the patients attending primary healthcare with a shoulder disorder are diagnosed with subacromial pain. Subacromial pain is characterized by restricted and painful movement of the arm that leads to difficulties in performing arm-related activities and often affects the quality of life profoundly, with respect to everyday function, work capacity, sleep quality and mental health. It is crucial that the measurements used to evaluate shoulder function and treatment response have acceptable psychometric properties and also that they are patients-specific and time-efficient to administer. For patients with subacromial pain, exercises are recommended as first-line treatment but consensus about which exercises and dosage to recommend has not been reached. The lack of evidence for one specific exercise model may be partly due to heterogeneity among this group of patients. 

    The overall aim of this thesis were to evaluate the efficacy of a previously tested exercise strategy for patients with subacromial pain in a primary care setting, to describe the heterogeneity with possible subcategories among patients with subacromial pain, and finally to validate and adjust the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire for more diagnosis-specific clinical assessment. 

    Methods: The four papers in this thesis are based on two clinical studies, one randomized controlled trial (RCT) and one clinical cohort. The participants in both studies were patients with subacromial pain attending physiotherapist (PT) in a primary care setting. Two of the papers are based on psychometric analyses, with evaluation of construct validity and responsiveness for the DASH when used to evaluate shoulder function in patients with subacromial pain, and also calculation of minimal important change (MIC) for a diagnosis-specific short version of DASH (DASH 7). A third paper describe clinical presentation in patients with subacromial pain, based on the components active range of motion (AROM), rotator cuff function and scapular kinematics and the fourth paper evaluated the efficacy of a 3-month specific exercise strategy in comparison to an active control strategy. 

    Results: Seven items from the original DASH were identified as being the most important in evaluating patients with subacromial pain (resulting in the DASH 7 questionnaire). The DASH 7 shows good responsiveness, can discriminate between patients who perceive themselves as improved and those who do not, and maintain a high level of internal consistency for the assessment of shoulder function in patients with subacromial pain, using only a quarter of the items of the original DASH. Based on clinical presentation, patients with subacromial pain in the primary care setting comprise a heterogeneous group. Rotator cuff dysfunction, defined as pain during resisted isometric muscle-testing, is very frequently present while limitation in active range of motion and scapular dyskinesia are less common. After three months of exercise, both groups in the RCT had significantly improved with no between group difference as measured with the primary CM-score. However, as measured with the DASH and the DASH 7, the patients in the specific exercise group was significantly more improved compared to those in the active control group. 

    Conclusions: The DASH 7 questionnaire is a short patient-reported outcome measurement (PROM) with good responsiveness, specific for patients with subacromial pain. Heterogeneity was confirmed with identified variability in AROM, rotator cuff function and scapular kinematics in clinical presentation which confirms that these components are important in the clinical examination of patients with subacromial pain. Shoulder function evaluated with the CM score did not improve to a significantly different degree between the two groups studied. The specific exercises might not be necessary for all patients in the primary care setting to achieve a clinically relevant improvement. However, the specific exercise strategy was significantly better when improvement was assessed by DASH and DASH 7, and this leads us to recommend this strategy, with its progressive loading of the rotator cuff muscles and scapula stabilizers, as first choice, provided that it is tolerated by the patient. 

    Delarbeid
    1. A short activity-related scale for measuring shoulder function in patients with subacromial pain: the DASH 7
    Åpne denne publikasjonen i ny fane eller vindu >>A short activity-related scale for measuring shoulder function in patients with subacromial pain: the DASH 7
    Vise andre…
    2017 (engelsk)Inngår i: JSES Open Access, ISSN 2468-6026, Vol. 1, nr 2, s. 113-118Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Background Subacromial pain is a common cause of shoulder dysfunction that negatively affects quality of life. Currently, most outcome measures for shoulder pain are applied to a heterogeneous group of patients. Of these measures, the Disabilities of the Arm, Shoulder, and Hand (DASH) is the most widely recognized test with which to assess patients with subacromial pain. The primary aim of this study was to assess the content validity of DASH for patients with subacromial pain, with a secondary aim to test responsiveness to a modified set of DASH items tailored to these patients. Methods There were 129 patients who reported activities in the Patient-Specific Functional Scale (PSFS). To assess validity, 5 independent physiotherapists matched PSFS activities to the most appropriate DASH item. DASH items identified as being of greatest importance to patients were those corresponding to the highest number of PSFS-matched activities. Calculations were made for responsiveness and internal consistency. Results Physiotherapists matched DASH items to 271 PSFS activities, reaching agreement for almost 80%. Seven DASH items (DASH 7) were identified as being particularly important. Effect size data (Cohen's d) were 0.93 for DASH 7, 0.92 for DASH 30, and 0.85 for QuickDASH; the corresponding Cronbach's α values (for DASH 7, DASH 30, and QuickDASH) were 0.84, 0.94, and 0.86, respectively. Conclusions DASH 7 is a short, patient-centered, and activity-related scale that can measure shoulder function in patients with subacromial pain using a quarter of the original DASH items. DASH 7 demonstrated responsiveness, with a satisfactory level of internal consistency.

    sted, utgiver, år, opplag, sider
    Elsevier, 2017
    Emneord
    Shoulder impingement syndrome, Patient outcome assessments, Human activity, Shoulder pain, Disabilities of the Arm, Shoulder, and Hand (DASH), Patient-Specific Functional Scale (PSFS)
    HSV kategori
    Identifikatorer
    urn:nbn:se:liu:diva-172379 (URN)10.1016/j.jses.2017.04.001 (DOI)30675551 (PubMedID)
    Tilgjengelig fra: 2021-01-08 Laget: 2021-01-08 Sist oppdatert: 2023-12-28bibliografisk kontrollert
    2. Heterogeneity among patients with subacromial pain – variabilities within clinical presentation and its impact on daily life
    Åpne denne publikasjonen i ny fane eller vindu >>Heterogeneity among patients with subacromial pain – variabilities within clinical presentation and its impact on daily life
    Vise andre…
    2021 (engelsk)Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 112, s. 113-120Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Objective: The primary aim was to describe the variability within clinical presentation of patients with subacromial pain in primary care, secondly to investigate associations between clinical presentation and self-reported pain intensity, shoulder function, level of anxiety and depression, and health-related quality of life. Design and setting A cross-sectional study based on data from two clinical studies in primary care, one randomized controlled trial and one implementation study. Three components: active range of motion (AROM), rotator cuff function and scapular kinematics were analyzed to describe variability within clinical presentation and patient-reported measurements were used to investigate the impact on daily life. Participants Patients aged 30-67 years, describing pain for more than two weeks, and positive signs for a minimum of three out of the following five clinical tests: impingement sign according to Neer, impingement test according to Hawkins-Kennedy, Pattes maneuver, Jobe’s test, and painful arc. Results Among the 164 patients included, 24% displayed dysfunction in one, 50% two and 24% in all three components. Limited AROM was seen in 46%, rotator cuff dysfunction in 91% and scapular dyskinesia in 57% of the patients. Conclusions These results reveal a heterogeneity among primary care patients with subacromial pain confirming a large variability regarding the components AROM, rotator cuff function and scapular kinematics. All three components appear unique (not significantly correlated) where a rotator cuff dysfunction is very frequent while limited AROM and scapular dyskinesia are more inconsistent. There are significant, but rather weak, associations between clinical presentation and impact on daily life.

    sted, utgiver, år, opplag, sider
    ELSEVIER SCI LTD, 2021
    Emneord
    Shoulder Impingement Syndrome, Clinical Presentation, Range of Motion Articular, Rotator Cuff, Scapular Dyskinesia, Primary Health Care
    HSV kategori
    Identifikatorer
    urn:nbn:se:liu:diva-172380 (URN)10.1016/j.physio.2020.10.001 (DOI)000687805600014 ()34058616 (PubMedID)
    Forskningsfinansiär
    Region ÖstergötlandLinköpings universitet
    Merknad

    Funding: Linkoping University, Sweden; County council of ostergotland

    Tilgjengelig fra: 2021-01-08 Laget: 2021-01-08 Sist oppdatert: 2023-12-28bibliografisk kontrollert
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  • 322.
    Nordqvist, Jenny
    et al.
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten.
    Holmgren, Theresa
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Avdelningen för kirurgi, ortopedi och onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Ortopedkliniken i Linköping.
    Adolfsson, Lars
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Avdelningen för kirurgi, ortopedi och onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Ortopedkliniken i Linköping.
    Öberg, Birgitta
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten.
    Johansson, Kajsa
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i östra Östergötland, Rehab Öst.
    The minimal important change for the seven-item disability of the arm, shoulder, and hand (DASH 7) questionnaire - Assessing shoulder function in patients with subacromial pain.2021Inngår i: JSES international, ISSN 2666-6383, Vol. 5, nr 3, s. 474-479Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The DASH 7 is a recently published activity-related 7-item short form of the disability of the arm, shoulder, and hand (DASH) questionnaire developed to assess shoulder function in patients with subacromial pain. Before implementation in both intervention studies and in clinical practice, it is essential to evaluate its responsiveness. The objective of this study was to determine the minimal important change (MIC) in the DASH 7 questionnaire for patients with subacromial pain after a 3 months exercise intervention in a primary care context.

    Methods: In this psychometric study the anchor-based MIC-distribution method was used to establish the MIC. The Patient Global Impression of Change (PGIC) was used as external criterion. Data from a clinical implementation study, aimed to implement a specific exercise strategy for patients with subacromial pain among physiotherapists in primary care, were used. Data from 70 patients were included in the analyses.

    Results: The correlation coefficient between Patient Global Impression of Change and the DASH 7 score change was 0.67 and the area under the curve was 0.94 (95% confidence interval: 0.88-1.0). The MICROC for improvement was detected at a mean change in 6.5 points with the sensitivity at 0.98 (98%) and the specificity at 0.78 (78%), and the MIC95% limit for improvement was detected at a mean change of 25.7 points. There were 77% of the patients who reached at least this MICROC and 51% who reached at least the MIC95% limit after 3 months of exercise intervention.

    Conclusion: The DASH 7 is responsive to change over time and can discriminate between patients considered to be improved and patients considered not improved. These MIC values for patients with subacromial pain in the primary care setting can be used in clinical practice and in intervention studies as an indication on the patients clinically important level of score change for improvement.

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  • 323.
    Nordqvist, Jenny
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Johansson, Kajsa
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Holmgren, Theresa
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten.
    Adolfsson, Lars
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten.
    Öberg, Birgitta
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    A short activity-related scale for measuring shoulder function in patients with subacromial pain: the DASH 72017Inngår i: JSES Open Access, ISSN 2468-6026, Vol. 1, nr 2, s. 113-118Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background Subacromial pain is a common cause of shoulder dysfunction that negatively affects quality of life. Currently, most outcome measures for shoulder pain are applied to a heterogeneous group of patients. Of these measures, the Disabilities of the Arm, Shoulder, and Hand (DASH) is the most widely recognized test with which to assess patients with subacromial pain. The primary aim of this study was to assess the content validity of DASH for patients with subacromial pain, with a secondary aim to test responsiveness to a modified set of DASH items tailored to these patients. Methods There were 129 patients who reported activities in the Patient-Specific Functional Scale (PSFS). To assess validity, 5 independent physiotherapists matched PSFS activities to the most appropriate DASH item. DASH items identified as being of greatest importance to patients were those corresponding to the highest number of PSFS-matched activities. Calculations were made for responsiveness and internal consistency. Results Physiotherapists matched DASH items to 271 PSFS activities, reaching agreement for almost 80%. Seven DASH items (DASH 7) were identified as being particularly important. Effect size data (Cohen's d) were 0.93 for DASH 7, 0.92 for DASH 30, and 0.85 for QuickDASH; the corresponding Cronbach's α values (for DASH 7, DASH 30, and QuickDASH) were 0.84, 0.94, and 0.86, respectively. Conclusions DASH 7 is a short, patient-centered, and activity-related scale that can measure shoulder function in patients with subacromial pain using a quarter of the original DASH items. DASH 7 demonstrated responsiveness, with a satisfactory level of internal consistency.

    Fulltekst (pdf)
    fulltext
  • 324.
    Nordqvist, Jenny
    et al.
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten.
    Öberg, Birgitta
    Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård.
    Adolfsson, Lars
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Avdelningen för kirurgi, ortopedi och onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Ortopedkliniken i Linköping.
    Holmgren, Theresa
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Ortopedkliniken i Linköping. Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Avdelningen för kirurgi, ortopedi och onkologi.
    Johansson, Kajsa
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i östra Östergötland, Rehab Öst.
    Heterogeneity among patients with subacromial pain – variabilities within clinical presentation and its impact on daily life2021Inngår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 112, s. 113-120Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: The primary aim was to describe the variability within clinical presentation of patients with subacromial pain in primary care, secondly to investigate associations between clinical presentation and self-reported pain intensity, shoulder function, level of anxiety and depression, and health-related quality of life. Design and setting A cross-sectional study based on data from two clinical studies in primary care, one randomized controlled trial and one implementation study. Three components: active range of motion (AROM), rotator cuff function and scapular kinematics were analyzed to describe variability within clinical presentation and patient-reported measurements were used to investigate the impact on daily life. Participants Patients aged 30-67 years, describing pain for more than two weeks, and positive signs for a minimum of three out of the following five clinical tests: impingement sign according to Neer, impingement test according to Hawkins-Kennedy, Pattes maneuver, Jobe’s test, and painful arc. Results Among the 164 patients included, 24% displayed dysfunction in one, 50% two and 24% in all three components. Limited AROM was seen in 46%, rotator cuff dysfunction in 91% and scapular dyskinesia in 57% of the patients. Conclusions These results reveal a heterogeneity among primary care patients with subacromial pain confirming a large variability regarding the components AROM, rotator cuff function and scapular kinematics. All three components appear unique (not significantly correlated) where a rotator cuff dysfunction is very frequent while limited AROM and scapular dyskinesia are more inconsistent. There are significant, but rather weak, associations between clinical presentation and impact on daily life.

  • 325.
    Nyström, Christine Delisle
    et al.
    Novum, Sweden; Childrens Hosp, Canada.
    Sandin, Sven
    Karolinska Inst, Sweden; Icahn Sch Med Mt Sinai, NY 10029 USA; Seaver Autism Ctr Res and Treatment Mt Sinai, NY 10029 USA.
    Henriksson, Pontus
    Novum, Karolinska Institutet, Sweden; PROFITH, University Granada, Spain.
    Henriksson, Hanna
    Univ Granada, Spain.
    Maddison, Ralph
    Deakin Univ, Australia.
    Löf, Marie
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Novum, Karolinska Institutet, Sweden.
    A 12-month follow-up of a mobile-based (mHealth) obesity prevention intervention in pre-school children: the MINISTOP randomized controlled trial2018Inngår i: BMC Public Health, E-ISSN 1471-2458, Vol. 18, artikkel-id 658Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: To date, few mobile health (mHealth) interventions aimed at changing lifestyle behaviors have measured long term effectiveness. At the 6-month follow-up the MINISTOP trial found a statistically significant intervention effect for a composite score comprised of fat mass index (FMI) as well as dietary and physical activity variables; however, no intervention effect was observed for FMI. Therefore, the aim of this study was to investigate if the MINISTOP intervention 12-months after baseline measurements: (i) improved FMI and (ii) had a maintained effect on a composite score comprised of FMI and dietary and physical activity variables. Methods: A two-arm parallel randomized controlled trial was conducted in 315 healthy 4.5 year old children between January 2014 and October 2015. Parents of the participating children either received the MINISTOP intervention or a basic pamphlet on dietary and physical activity behaviors (control group). After 6 months, participants did not have access to the intervention content and were measured again 6 months later (i.e. the 12-month follow-up). The Wilcoxon rank-sum test was then used to examine differences between the groups. Results: At the 12-month follow-up, no statistically significant difference was observed between the intervention and control groups for FMI (p = 0.57) and no maintained effect for the change in composite score was observed (mean +/- standard deviation for the intervention and control group: + 0.53 +/- 1.49 units and + 0.35 +/- 1.27 units respectively, p = 0.25 between groups). Conclusions: The intervention effect observed at the 6-month follow-up on the composite score was not maintained at the 12-month follow-up, with no effect on FMI being observed at either follow-up. Future studies using mHealth are needed to investigate how changes in obesity related markers in young children can be maintained over longer time periods.

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    fulltext
  • 326.
    Oldfors Engström, Lena
    Linköpings universitet, Institutionen för medicin och hälsa, Sjukgymnastik. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Primärvård: Vårdcentraler, Rörelse & Hälsa, LAH, Ungdomsmottagningen.
    Att förstå patienters bristande deltagande i individualiserat rehabiliteringsprogram2002Licentiatavhandling, monografi (Annet vitenskapelig)
    Abstract [en]

    The aim of this investigation was to elucidate and describe those patients who had discontinued their participation and/or paticipated infrequently in physiotherapy treatment based on their own activity and responsibility. The ambition was to understand the phenomenon of compliance/adherence from various perspectives in behavioural as well as social science.

    In study I the phenomenon compliance/adherence was studied in relation to Health Locus of Control and Health Belief variables. This study was based on a questionnaire that was answered by all patients before beginning of treatment. Questions concerning the patients´conceptions about both health locus of control and health beliefs were the focus.The definitions of compliance/adherence were completed treatment period and exercise frequency, respectively. Those patients who completed the treatment were also studied regarded exercise frequency.

    The results of study I showed that those who discontinued their treatment reported a higher perceived threat from their health condition (higher level of dysfunction (higher pain intensity) and a higher perceived severity of their health condition (higher level of dysfunction, worse general health) than those who completed treatment. The results also showed that those who exercised once a week or less often valued the significance of the caring situation as lower (HLC), perceived a higher threat from their health condition (higher pain intensity), a higher severity of their health condition (higher level of dysfunction, worse general health, greater distrution of impairment), more barriers to treatment (lower expectations), and had certain differences in demographic variables (younger individuals, more women) than those who exercised more often (HB).

    Study II investigated patients´descriptions of their reasons for discontinuing the treatment, whether those reasons varied, and if so how they varied. Sixteen patients who had discontinued their treatment were interviewed with open-ended questions. The inteviews began with a question about the background to the physiotherapy treatment. There were questions concerning carrying out the treatment as well as concerning what they thought about their impairment. The patients were also asked about their priotities in daily life, as these wre presumed to be anobstacle to the treatment over a shorter or longer period of time. The third domain concerned how they experiebced the patient/physiotherapist relationship. The interviews were anlysed qualitatively.

    Analysis of study II resulted in four different descriptions of reasons for treatment discontinuation. A) It was about time to end treatment and continue on alone. B) The treatment was not the most important activity to spend time on. C) An agreement with the physiothreapist to discontinue treatment due to lack of effect. D) No viewpoint as to why they discontinued the treatment. In further analysis of category D, this group appeared to experience varoius forms of powerlessness. They felt their trustworthiness was often questioned. They experienced frustration in their life situation as others made the important descisions and they themselves had little to say.They defended themselves by talking about their own conceptions of the reasons for their impairment and what should be done about them. In comparing category D with categories A, B, C it was found that those in the latter three categories experienced varying degrees of control in different situations, whereas those in category D did not experience a feeling of control.

    Conclusion: The concept of compliance in physiotherapy is ambiguous. The concept involves one part defining what will concern the other part. It is clear that the physiotherapist and the patient do not always agree about the aim of the treatment. Instead, we should develop the concept of concordance in encounters with the patients and abandon the reasoning of compliance.

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  • 327.
    Olsson, Line
    et al.
    Specialized Hosp Polio & Accid Victims, Denmark.
    Antepohl, Wolfram
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Rehabiliteringsmedicinska kliniken.
    Ravn, Sophie L.
    Specialized Hosp Polio & Accid Victims, Denmark; Univ Southern Denmark, Denmark.
    Active Conservative Management of Primary Spinal Syringomyelia: A Scoping Review and Perspectives for an Activity-based Clinical Approach2022Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 54, artikkel-id jrm00322Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Objective: This scoping review aimed to identify and synthesize existing research on active conservative management of primary spinal syringomyelia and associated symptoms and to discuss perspectives for clinical application using an activity-based approach. Methods: PubMed, Embase, Scopus, and Web of Science were systematically searched for empirical studies of conservative management or therapies of adults with primary spinal syringomyelia from inception to April 2021. In addition, abstracts from relevant conferences were searched. Study characteristics and key findings were extracted, and findings descriptively synthesized. Results: Of 1,186 studies screened, 7 studies met the eligibility criteria (4 single case studies and 3 cohort studies, a total of 90 individuals). The interventions were primarily physiotherapeutic, mostly by posture correction and exercises, and effects were alleviation of pain, improved physical function, improved activities of daily living and quality of life. Analysis of factors triggering symptoms and rationale for choice of intervention based upon these was limited. Conclusion: Evidence of active conservative management of primary spinal syringomyelia and associated symptoms is limited. Many variations and limitations in the existing research limit the conclusions. High-quality research is needed to enable healthcare professionals to apply evidence-based active conservative interventions.

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    fulltext
  • 328.
    Ortega, Francisco B.
    et al.
    Univ Granada, Spain; Univ Jyvaskyla, Finland; Karolinska Inst, Sweden.
    Mora-Gonzalez, Jose
    Univ Granada, Spain.
    Cadenas-Sanchez, Cristina
    Univ Granada, Spain.
    Esteban-Cornejo, Irene
    Univ Granada, Spain.
    Hidalgo Migueles, Jairo
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för samhälle och hälsa. Linköpings universitet, Medicinska fakulteten. Univ Granada, Spain; Karolinska Inst, Sweden.
    Solis-Urra, Patricio
    Univ Granada, Spain; Univ Andres Bello, Chile.
    Verdejo-Roman, Juan
    Univ Granada, Spain; Univ Granada, Spain; Ctr Biomed Technol CTB, Spain.
    Rodriguez-Ayllon, Maria
    Univ Granada, Spain; Erasmus MC Univ, Netherlands.
    Molina-Garcia, Pablo
    Univ Granada, Spain; Virgen Nieves Univ Hosp, Spain.
    Ruiz, Jonatan R.
    Univ Granada, Spain; Karolinska Inst, Sweden; IbsGranada, Spain.
    Martinez-Vizcaino, Vicente
    Univ Castilla La Mancha, Spain; Univ Autonoma Chile, Chile.
    Hillman, Charles H.
    Northeastern Univ, MA 02115 USA; Northeastern Univ, MA USA.
    Erickson, Kirk I
    Univ Granada, Spain; Univ Pittsburgh, PA 15260 USA; Murdoch Univ, Australia.
    Kramer, Arthur F.
    Northeastern Univ, MA 02115 USA; Univ Illinois, IL USA.
    Labayen, Idoia
    Univ Publ Navarra, Spain; Univ Publ Navarra, Spain; Navarra Inst Hlth Res, Spain.
    Catena, Andres
    Univ Granada, Spain.
    Effects of an Exercise Program on Brain Health Outcomes for Children With Overweight or Obesity The ActiveBrains Randomized Clinical Trial2022Inngår i: JAMA Network Open, E-ISSN 2574-3805, Vol. 5, nr 8, artikkel-id e2227893Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    IMPORTANCE Pediatric overweight and obesity are highly prevalent across the world, with implications for poorer cognitive and brain health. Exercise might potentially attenuate these adverse consequences. OBJECTIVES To investigate the effects of an exercise program on brain health indicators, including intelligence, executive function, academic performance, and brain outcomes, among children with overweight or obesity and to explore potential mediators and moderators of the main effects of exercise. DESIGN, SETTING, AND PARTICIPANTS All preexercise and postexercise data for this 20-week randomized clinical trial of 109 children aged 8 to 11 years with overweight or obesity were collected from November 21, 2014, to June 30, 2016, with neuroimaging data processing and analyses conducted between June 1, 2017, and December 20, 2021. All 109 children were included in the intention-to-treat analyses; 90 children (82.6%) completed the postexercise evaluation and attended 70% or more of the recommended exercise sessions and were included in per-protocol analyses. INTERVENTIONS All participants received lifestyle recommendations. The control group continued their usual routines, whereas the exercise group attended a minimum of 3 supervised 90-minute sessions per week in an out-of-school setting. MAIN OUTCOMES AND MEASURES Intelligence, executive function (cognitive flexibility, inhibition, and working memory), and academic performance were assessed with standardized tests, and hippocampal volume was measured with magnetic resonance imaging. RESULTS The 109 participants included 45 girls (41.3%); participants had a mean (SD) body mass index of 26.8 (3.6) and a mean (SD) age of 10.0 (1.1) years at baseline. In per-protocol analyses, the exercise intervention improved crystallized intelligence, with the exercise group improving from before exercise to after exercise (mean z score, 0.62 [95% CI, 0.44-0.80]) compared with the control group (mean z score, -0.10 [95% CI, -0.28 to 0.09]; difference between groups, 0.72 SDs [95% CI, 0.46-0.97]; P &lt; .001). Total intelligence also improved significantly more in the exercise group (mean z score, 0.69 [95% CI, 0.48-0.89]) than in the control group (mean z score, 0.07 [95% CI, -0.14 to 0.28]; difference between groups, 0.62 SDs [95% CI, 0.31-0.91]; P &lt; .001). Exercise also positively affected a composite score of cognitive flexibility (mean z score: exercise group, 0.25 [95% CI, 0.05-0.44]; control group, -0.17 [95% CI, -0.39 to 0.04]; difference between groups, 0.42 SDs [95% CI, 0.13-0.71]; P = .005). These main effects were consistent in intention-to-treat analyses and after multiple-testing correction. There was a positive, small-magnitude effect of exercise on total academic performance (mean z score: exercise group, 0.31 [95% CI, 0.18-0.44]; control group, 0.10 [95% CI, -0.04 to 0.24]; difference between groups, 0.21 SDs [95% CI, 0.01-0.40]; P = .03), which was partially mediated by cognitive flexibility. Inhibition, working memory, hippocampal volume, and other brain magnetic resonance imaging outcomes studied were not affected by the exercise program. The intervention increased cardiorespiratory fitness performance as indicated by longer treadmill time to exhaustion (mean z score: exercise group, 0.54 [95% CI, 0.27-0.82]; control group, 0.13 [95% CI, -0.16 to 0.41]; difference between groups, 0.42 SDs [95% CI, 0.01-0.82]; P = .04), and these changes in fitness mediated some of the effects (small percentage of mediation [approximately 10%-20%]). The effects of exercise were overall consistent across the moderators tested, except for larger improvements in intelligence among boys compared with girls. CONCLUSIONS AND RELEVANCE In this randomized clinical trial, exercise positively affected intelligence and cognitive flexibility during development among children with overweight or obesity. However, the structural and functional brain changes responsible for these improvements were not identified.

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  • 329.
    Oscarsson, Linnéa
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi.
    Påverkar fysioterapeutens neutrala versus positiva kommunikation individers grad av anspänning efter en behandlingssession med vila?: en randomiserad kontrollerad experimentell studie2017Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Inledning: Ospecifika behandlingskomponenter är marginellt studerade inom sjukvården. En kommunikationsmodell som påverkar behandlingseffekterpositivt, skulle kunna förbättra behandlade individers hälsa.

    Syfte: Att undersöka om kommunikationen(neutral/positiv) under en ”behandlingssession” med enbart vila påverkade personers behandlingstilltro, subjektiva (avslappning, muskelspänningar, stress) och objektiva (puls, blodtryck) grad av anspänning, samt om förändring i puls och grad av avslappning skiljde sig åt motpersoner från en tidigare nålbehandladreferenskohort.

    Metod: Randomiserad kontrollerad experimentell studie. Personer (>18 år) valdes med ett bekvämlighetsurval och randomiserades till positiv(n=60) eller neutral (n=60) kommunikation under en ”behandlingssession” av 30 min vila där behandlingstilltro, anspänningsnivå, puls och blodtryckmättes före och efter.

    Resultat: Positiva kommunikationsgruppen erhöll högre behandlingstilltro avseende avslappning, muskelspänningar och stress (md, 86, 83,84 mm på Visuell Analog Skala) än neutrala (md 75; p=0,023, 73; p=0,046,70; p=0,003), samt sänkte pulsen mer (m, -6,2 slag) än neutrala (m -3,2 slag; p=0,048). Båda grupperna minskade subjektiv anspänning (p<0,001), utan skillnader (ns) mellan grupperna. Sänkningen i puls, före jämfört med efter behandlingssessionen, var större än nålbehandlade kohortens, m -4,7 respektive m -2,8, (p=0,046).

    Konklusion: Studien belyser vikten av positiv kommunikation vad gäller tilltro till behandlingseffekter, för att öka dem. Tillsammans med tidigare forskning som visar att personers tilltro till behandlingseffekter gynnar dessa, indikerar det på att ospecifika behandlingskomponenter tycks vara en underutnyttjad potential inom vården som bör studeras vidare.

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  • 330.
    Oskarsson, Viktoria
    et al.
    Linköpings universitet, Institutionen för hälsa, medicin och vård.
    Herngren, Matilda
    Linköpings universitet, Institutionen för hälsa, medicin och vård.
    Yoga som behandling vid utmattningssyndrom: en systematisk kritisk litteraturgranskning2023Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund: Allt fler blir sjukskrivna på grund utav utmattningssyndom och det finns inga rekommendationer om huruvida träning så som yoga, kan vara en del av behandlingen. Bland tidigare studier har visats att yoga kan ha effekt som behandling vid utmattningssyndrom hos hälso- och sjukvårdspersonal. Det finns ingen systematisk litteraturgranskning från de senaste tio åren med det bredare perspektivet oavsett arbete.

    Syfte: Att sammanfatta och värdera det vetenskapliga underlaget och evidensen för yoga som behandling på sjukdomsgrad och hälsorelaterad livskvalitet vid utmattningssyndrom hos vuxna.

    Metod: En systematisk litteraturöversikt genomfördes där databaserna Cinahl, Pubmed och Pedro användes. Studierna granskades med stöd av Fowkes & Fultons granskningsmall samt bedömdes enligt GRADE för evidensvärdering. 

    Resultat: Studierna var heterogena utifrån yogainterventionens innehåll, dosering och längd samt utvärderingsinstrument. Nio av femton studier påvisade signifikanta resultat inom minst en komponent av sjukdomsgrad samt två av tre studier påvisade signifikanta resultat inom utfallsmåttet hälsorelaterad livskvalitet. Den metodologiska kvaliteten varierade med både mindre och större problem inom olika områden. Totalt bedömdes underlaget ha mycket låg tillförlitlighet i båda utfallsmåtten enligt GRADE.

    Konklusion: Det vetenskapliga underlaget för yoga som behandling vid utmattningssyndrom avseende att minska sjukdomsgrad och öka hälsorelaterad livskvalitet bedöms som låg. Främsta anledningen är det begränsade underlag av studier av god kvalitet samt heterogeniteten inom studierna. 

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  • 331.
    Overmeer, Thomas
    et al.
    Mälardalen University, Sweden; University of Örebro, Sweden.
    Peterson, Gunnel
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Uppsala University, Sweden.
    Landén Ludvigsson, Maria
    Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i västra Östergötland, Rehab Väst. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi.
    Peolsson, Anneli
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    The effect of neck-specific exercise with or without a behavioral approach on psychological factors in chronic whiplash-associated disorders: A randomized controlled trial with a 2-year follow-up2016Inngår i: Medicine, ISSN 0025-7974, E-ISSN 1536-5964, Vol. 95, nr 34, s. e4430-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background:To investigate the effect of neck-specific exercise with (NSEB) or without (NSE) a behavioural approach and prescribed physical activity (PPA) on general pain disability and psychological factors in chronic whiplash-associated disorders (WAD), grade 2 and 3, with a 2-year follow-up.Methods:A randomized controlled multi-centre study of 3 exercise interventions (NSE, NSEB or PPA) including a 2-year follow-up. A total of 216 volunteers with chronic WAD were recruited and 194 were analyzed, mean age 40.4 (Standard Deviation [SD] 11.4). Measures of general pain disability, pain catastrophizing, anxiety and depression, and kinesiophobia were evaluated at baseline, and 3, 6, 12 and 24 months with linear mixed models.Results:General pain disability decreased by 28% in the NSEB group from baseline to 3 months (Pamp;lt;0.001) and the improvements in disability were maintained over time (6, 12 and 24 months Pamp;lt;0.01) compared to the NSE (Pamp;gt;0.42) and PPA groups (Pamp;gt;0.43). Pain catastrophizing decreased in the NSE group from baseline to 6 and 12 months (Pamp;lt;0.01) and in the NSEB group from baseline to 3 and 24 months (Pamp;lt;0.01) compared to the PPA group (Pamp;gt;0.82) that showed no change over time. The NSE group improved in kinesiophobia over time from baseline to12 months (Pamp;lt;0.01) compared to the NSEB (P=0.052) and the PPA groups (Pamp;gt;0.74). Anxiety decreased over time from baseline to 12 and 24 months in the NSE group (Pamp;gt;0.02), but not in the NSEB (Pamp;gt;0.25) or the PPA (Pamp;gt;0.50) groups. The PPA had no effect on general disability or any of the measured psychological factors.Conclusion:This randomised controlled trial with a 2-year follow-up shows that physiotherapist-led neck-specific exercise with or without the addition of a behavioural approach had superior outcome on general disability and most psychological factors compared to the mere prescription of physical activity.

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  • 332.
    Pajediene, Evelina
    et al.
    Hosp Lithuanian Univ Hlth Sci, Lithuania.
    Bileviciute-Ljungar, Indre
    Linköpings universitet, Institutionen för medicin och hälsa. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum. Karolinska Institutet, Stockholm, Sweden; Danderyd Hospital, Stockholm, Sweden; .
    Friberg, Danielle
    Karolinska Univ Hosp, Sweden.
    Sleep patterns among patients with chronic fatigue: A polysomnography-based study2018Inngår i: Clinical Respiratory Journal, ISSN 1752-6981, E-ISSN 1752-699X, Vol. 12, nr 4, s. 1389-1397Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    ObjectivesThe purpose of this study was to detect treatable sleep disorders among patients complaining of chronic fatigue by using sleep questionnaires and polysomnography. MethodsPatients were referred to hospital for investigations and rehabilitation because of a suspected diagnosis of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). The criteria for further referral to full-night polysomnography (PSG) were symptoms of excessive daytime sleepiness and/or tiredness in the questionnaires. ResultsOf a total of 381 patients, 78 (20.5%) patients underwent PSG: 66 women and 12 men, mean age 48.6years, standard deviation 9.9years. On the basis of the PSG, 31 (40.3%) patients were diagnosed with obstructive sleep apnoea, 7 (8.9%) patients with periodic limb movement disorder, 32 (41.0%) patients with restless legs syndrome and 54 (69.3%) patients had one or more other sleep disorder. All patients were grouped into those who fulfilled the diagnostic criteria for ME/CFS (n=55, 70.5%) and those who did not (n=23, 29.5%). The latter group had significantly higher respiratory (P=.01) and total arousal (P=.009) indexes and a higher oxygen desaturation index (P=.009). ConclusionsMore than half of these chronic fatigue patients, who also have excessive daytime sleepiness and/or tiredness, were diagnosed with sleep disorders such as obstructive sleep apnoea, periodic limb movement disorder and/or restless legs syndrome. Patients with such complaints should undergo polysomnography, fill in questionnaires and be offered treatment for sleep disorders before the diagnose ME/CFS is set.

  • 333.
    Papp, Marian E.
    et al.
    Karolinska Inst, Sweden; Karolinska Inst, Sweden.
    Grahn Kronhed, Ann-Charlotte
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i västra Östergötland, Rehab Väst. Local Hlth Care Serv West Ostergotland, Sweden.
    Lundin, Hans Rauch
    Karolinska Inst, Sweden; Acad Primary Healthcare Ctr Stockholm, Sweden.
    Salminen, Helena
    Karolinska Inst, Sweden; Acad Primary Healthcare Ctr Stockholm, Sweden.
    Changes in physical activity levels and relationship to balance performance, gait speed, and self-rated health in older Swedish women: a longitudinal study2022Inngår i: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 34, nr 4, s. 775-783Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background and aim Physical activity levels in older people often decrease and may mean impaired physical functioning leading to an increased fall risk. The aim of this study was to investigate self-reported change in physical activity dose and deterioration in balance performance, gait speed, and self-rated health (SRH) in older women between two time points in a follow-up study. Methods A cohort of community-living women, aged 69-79 years (n = 351) were evaluated by questionnaire and clinical tests on balance, gait speed, and SRH at baseline. One hundred and eighty-six women were followed-up by these tests 8.5 years after inclusion. The non-parametric Wilcoxon signed-rank test and Mann-Whitney U test were used for the analysis. Results The greatest changes were seen in one-leg standing time (OLST) with eyes closed (- 60%) and eyes open (- 42%). The population was divided into high exercise (HE, n = 49) and low exercise (LE, n = 51) groups. At baseline the HE group had an OLST of 19 s with eyes open and 3 s with eyes closed. In the LE group, these values were 7.3 s and 2 s. At follow-up, differences between HE and LE concerning tandem walk forwards (steps) (HE = 8.5; LE = 2.5) and backwards (HE = 11; LE = 3.5) emerged. The HE group estimated SRH (VAS-scale) 30 mm higher at baseline and 17 mm higher at follow-up than the LE group. Conclusion Greater physical activity seems to be an important predictor for maintaining physical function and SRH in older women.

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  • 334.
    Pedersen, Britt Staevnsbo
    et al.
    Copenhagen Univ Hosp Amager & Hvidovre, Denmark.
    Kirk, Jeanette Wassar
    Copenhagen Univ Hosp Amager & Hvidovre, Denmark.
    Olesen, Maren Kathrine
    Copenhagen Univ Hosp, Denmark.
    Gronfeldt, Birk Mygind
    Copenhagen Univ Hosp Amager & Hvidovre, Denmark.
    Stefansdottir, Nina Thorny
    Copenhagen Univ Hosp Amager & Hvidovre, Denmark.
    Brodsgaard, Rasmus
    Copenhagen Univ Hosp Amager & Hvidovre, Denmark.
    Tjornhoj-Thomsen, Tine
    Univ Southern Denmark, Denmark.
    Nilsen, Per
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för samhälle och hälsa. Linköpings universitet, Medicinska fakulteten.
    Andersen, Ove
    Copenhagen Univ Hosp Amager & Hvidovre, Denmark; Copenhagen Univ Hosp, Denmark; Univ Copenhagen, Denmark.
    Bandholm, Thomas
    Copenhagen Univ Hosp Amager & Hvidovre, Denmark; Univ Copenhagen, Denmark; Copenhagen Univ Hosp, Denmark; Copenhagen Univ Hosp, Denmark.
    Pedersen, Mette Merete
    Copenhagen Univ Hosp Amager & Hvidovre, Denmark; Univ Copenhagen, Denmark.
    Feasibility and implementation fidelity of a co-designed intervention to promote in-hospital mobility among older medical patients - the WALK-Copenhagen project (WALK-Cph)2022Inngår i: Pilot and Feasibility Studies, E-ISSN 2055-5784, Vol. 8, nr 1, artikkel-id 80Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Mobility interventions can prevent functional decline among older patients, but implementation of such interventions may be complicated by barriers in the clinical setting. The WALK-Copenhagen project (WALK-Cph) is aimed at promoting a 24-h mobility among older medical patients during hospitalization. The WALK-Cph intervention was co-designed by researchers and stakeholders to tailor the intervention to the clinical context. The aim of this study was to investigate the feasibility and implementation fidelity of the WALK-Cph intervention before evaluating clinical effectiveness in a randomized controlled trial (ClinicalTrials.gov NCT03825497). Methods: The WALK-Cph intervention consisted of six components: a welcome folder explaining the importance of in-hospital activity, a WALK-plan prescribing up to three daily walking sessions during and after hospitalization, a WALK-path in the hallway that patients were motivated to use daily, exercise posters in the hallways and bedrooms, self-service on beverages and clothes, and discharge with a WALK-plan. The present study reports on phase 2 of WALK-Cph and consists of a feasibility and a fidelity component. The study was conducted at the two WALK-Cph intervention departments after the initiation of the WALK-Cph intervention. A cohort of older medical patients (+65) was recruited for the feasibility study to assess recruitment and data collection procedures and the method for assessment of activity. Simultaneously, implementation fidelity was assessed by observing clinical practice and intervention delivery at the intervention departments. Results: A feasibility cohort of 48 patients was included. Inclusion was considered feasible with recruitment rates between 62% and 70% of all eligible patients. Also, data collection was conducted without obstacles, and all patients accepted to wear activity monitors. The fidelity observations showed that three of the six intervention components were partially implemented as planned whereas three components were not implemented as planned. Conclusion: The WALK-Cph intervention was found feasible, and although the intervention was not implemented with fidelity, the level of fidelity was considered sufficient to continue with further testing of the WALK-Cph intervention in a large-scale trial.

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  • 335.
    Peolsson, Anneli
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Långvariga besvär efter whiplashtrauma: Muskuloskeletala mekanismer och fysioterapeutiska insatser2015Inngår i: Fysioterapi, ISSN 1653-5804, nr 7, s. 30-37Artikkel, forskningsoversikt (Annet vitenskapelig)
  • 336.
    Peolsson, Anneli
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    Karlsson, Anette
    Linköpings universitet, Institutionen för medicinsk teknik, Avdelningen för medicinsk teknik. Linköpings universitet, Tekniska fakulteten. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Ghafouri, Bijar
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Ebbers, Tino
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Fysiologiska kliniken US. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Engström, Maria
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för radiologiska vetenskaper. Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Jönsson, Margaretha
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Herrgardets Vardcentral, Sweden.
    Wåhlén, Karin
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Romu, Thobias
    Linköpings universitet, Institutionen för medicinsk teknik. Linköpings universitet, Tekniska fakulteten. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Borga, Magnus
    Linköpings universitet, Institutionen för medicinsk teknik, Avdelningen för medicinsk teknik. Linköpings universitet, Tekniska fakulteten. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Kristjansson, Eythor
    Univ Iceland, Iceland.
    Bahat, Hilla Sarig
    Univ Haifa, Israel.
    German, Dmitry
    Univ Haifa, Israel.
    Zsigmond, Peter
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Neurokirurgiska kliniken US.
    Peterson, Gunnel
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Uppsala Univ, Sweden.
    Pathophysiology behind prolonged whiplash associated disorders: study protocol for an experimental study2019Inngår i: BMC Musculoskeletal Disorders, E-ISSN 1471-2474, Vol. 20, artikkel-id 51Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BackgroundThere is insufficient knowledge of pathophysiological parameters to understand the mechanism behind prolonged whiplash associated disorders (WAD), and it is not known whether or not changes can be restored by rehabilitation. The aims of the projects are to investigate imaging and molecular biomarkers, cervical kinaesthesia, postural sway and the association with pain, disability and other outcomes in individuals with longstanding WAD, before and after a neck-specific exercise intervention. Another aim is to compare individuals with WAD with healthy controls.MethodsParticipants are a sub-group (n=30) of individuals recruited from an ongoing randomized controlled study (RCT). Measurements in this experimental prospective study will be carried out at baseline (before intervention) and at a three month follow-up (end of physiotherapy intervention), and will include muscle structure and inflammation using magnetic resonance imaging (MRI), brain structure and function related to pain using functional MRI (fMRI), muscle function using ultrasonography, biomarkers using samples of blood and saliva, cervical kinaesthesia using the butterfly test and static balance test using an iPhone app. Association with other measures (self-reported and clinical measures) obtained in the RCT (e.g. background data, pain, disability, satisfaction with care, work ability, quality of life) may be investigated. Healthy volunteers matched for age and gender will be recruited as controls (n=30).DiscussionThe study results may contribute to the development of improved diagnostics and improved rehabilitation methods for WAD.Trial registrationClinicaltrial.gov Protocol ID: NCT03664934, initial release 09/11/2018.

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  • 337.
    Peolsson, Anneli
    et al.
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV. Region Östergötland, Medicincentrum, Arbets- och miljömedicin.
    Karlsson, Anette
    Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Peterson, Gunnel
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Uppsala Univ, Sweden.
    Borén, Hanna
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten.
    Zsigmond, Peter
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Avdelningen för kirurgi, ortopedi och onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Neurokirurgiska kliniken US.
    Elliott, James M.
    Univ Sydney, Australia; Kolling Inst, Australia.
    Dahlqvist Leinhard, Olof
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för diagnostik och specialistmedicin. Linköpings universitet, Medicinska fakulteten.
    Morphology and composition of the ventral neck muscles in individuals with chronic whiplash related disorders compared to matched healthy controls: a cross-sectional case-control study2022Inngår i: BMC Musculoskeletal Disorders, E-ISSN 1471-2474, Vol. 23, nr 1, artikkel-id 867Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BackgroundObjective Studies of cross-sectional area (CSA) (morphology) and muscle fat infiltration (MFI) (composition) in ventral neck muscles is scarce in patients with chronic whiplash associated disorders (WAD), especially for men and those with severe WAD compared with matched healthy controls. The aim was to compare CSA and MFI of sternocleidomastoid (SCM), longus capitis (LCA) and longus colli (LCO) in patients with chronic right-sided dominant moderate (Neck Disability Index: NDI &lt; 40) or severe WAD (NDI &gt;= 40), compared to age- and sex-matched healthy controls. Methods Cross-sectional case-control study with blinded investigators. Thirty-one patients with chronic WAD (17 women and 14 men, mean age 40 years) (SD 12.6, range 20-62)) and 31 age- and sex-matched healthy controls underwent magnetic resonance imaging of ventral neck muscles segmental level C4. Results Unique to the severe group was a larger magnitude of MFI in right SCM (p = 0.02) compared with healthy controls. There was no significant difference between the groups with regards to the other muscles and measures. Conclusions Individuals with severe right-sided dominant WAD have a higher MFI in the right SCM compared to healthy controls. No other differences were found between the groups. The present study indicates that there are changes in the composition of muscles on the side of greatest pain.

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  • 338.
    Peolsson, Anneli
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    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.
    Peterson, Gunnel
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Uppsala University, Sweden.
    Neck-specific exercises with internet-based support compared to neck-specific exercises at a physiotherapy clinic for chronic whiplash-associated disorders: study protocol of a randomized controlled multicentre trial2017Inngår i: BMC Musculoskeletal Disorders, E-ISSN 1471-2474, Vol. 18, artikkel-id 524Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Globally, neck pain is the fourth most common condition associated with longer periods of living with disability. Annually, approximately 0.3% of the population of Western countries undergo whiplash trauma, and half of those individuals will develop chronic problems with high costs for the individual and society. Evidence for chronic whiplash-associated disorders (WAD) treatment is scarce, though neck-specific training at a physiotherapy clinic twice a week for 12 weeks has demonstrated good results. More efficient, flexible rehabilitation with reduced waiting times and lower costs is needed, ideally replacing lengthy on-site treatment series by healthcare providers. Internet-based care has been shown to be a viable alternative for a variety of diseases and interventions, but studies are lacking on Internet-based interventions for individuals with chronic neck problems. The aim of the trial described here is to compare the effects of an Internet-based neck-specific exercise programme to the same exercises performed at a physiotherapy clinic in regards to self-reported and clinical measures, as well as cost-effectiveness. Methods: This prospective, randomized controlled trial will involve 140 participants. Measurements will be made at baseline, 3 months (end of treatment), and 15 months (12 months after end of intervention) and will include ratings of pain, disability, satisfaction with care, work ability, quality of life, and cost-effectiveness. Discussion: The study results may contribute to the development of a more effective rehabilitation, flexible and equal care, shorter waiting times, increased availability, and lower costs for healthcare and society.

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  • 339.
    Peolsson, Anneli
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten.
    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.
    Tigerfors, Ann-Marie
    Previa Occupat Health Care AB, Sweden.
    Peterson, Gunnel
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Uppsala University, Sweden.
    Effects of Neck-Specific Exercises Compared to Waiting List for Individuals With Chronic Whiplash-Associated Disorders: A Prospective, Randomized Controlled Study2016Inngår i: Archives of Physical Medicine and Rehabilitation, ISSN 0003-9993, E-ISSN 1532-821X, Vol. 97, nr 2, s. 189-195Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To determine whether 3 months of neck-specific exercises (NSEs) could benefit individuals with chronic whiplash-associated disorder (WAD) who were on a waiting list (WL) for treatment. Design: A prospective, randomized controlled study. Setting: Primary health care. Participants: Individuals (N=41; 31 women, 10 men; mean age +/- SD, 38 +/- 11.2y) with chronic (6-36mo) WAD, grades 2 and 3, were analyzed. Interventions: Patients were randomly assigned to NSEs or no treatment for 3 months. Main Outcome Measures: Neck-specific disability (Neck Disability Index [NDI]), neck pain (visual analog scale), general pain-related disability (Pain Disability Index [PDI]), self-perceived performance ability (Self-Efficacy Scale [SES]), and health-related quality of life (EuroQol 5 dimensions [EQ-5D]) were measured. Results: NSEs significantly improved the NDI, SES, and EQ-5D compared with WL (P&lt;.01). There was significant improvement (P&lt;.0001) over time in all outcomes for NSEs, and apart from the PDI, significant worsening (P=.002-.0002) over time for the untreated group. Conclusions: NSEs were more beneficial than no intervention while on a WL for individuals with chronic WAD. (C) 2016 by the American Congress of Rehabilitation Medicine

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  • 340.
    Peolsson, Anneli
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för sjukgymnastik. Linköpings universitet, Hälsouniversitetet. University of Queensland, Brisbane, Australia.
    Landén Ludvigsson, Maria
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för sjukgymnastik. Linköpings universitet, Hälsouniversitetet. Region Östergötland, Närsjukvården i västra Östergötland, Rehab Väst.
    Wibault, Johanna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för sjukgymnastik. Linköpings universitet, Hälsouniversitetet.
    Dedering, Åsa
    Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
    Peterson, Gunnel
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Hälsouniversitetet. Uppsala University, Sweden.
    Function in Patients With Cervical Radiculopathy or Chronic Whiplash-Associated Disorders Compared With Healthy Volunteers2014Inngår i: Journal of Manipulative and Physiological Therapeutics, ISSN 0161-4754, E-ISSN 1532-6586, Vol. 37, nr 4, s. 211-218Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective

    The purposes of this study were to examine whether any differences in function and health exist between patients with cervical radiculopathy (CR) due to disk disease scheduled for surgery and patients with chronic whiplash-associated disorders (WADs) and to compare measures of patients' physical function with those obtained from healthy volunteers.

    Methods

    This is a cross-sectional study of patients with CR (n = 198) and patients with chronic WAD (n = 215). Patient data were compared with raw data previously obtained from healthy people. Physical measures included cervical active range of motion, neck muscle endurance, and hand grip strength. Self-rated measures included pain intensity (visual analog scale), neck disability (Neck Disability Index), self-efficacy (Self-Efficacy Scale), and health-related quality of life (EuroQol 5-dimensional self-classifier).

    Results

    Patient groups exhibited significantly lower performance than the healthy group in all physical measures (P < .0005) except for neck muscle endurance in flexion for women (P > .09). There was a general trend toward worse results in the CR group than the WAD group, with significant differences in neck active range of motion, left hand strength for women, pain intensity, Neck Disability Index, EuroQol 5-dimensional self-classifier, and Self-Efficacy Scale (P < .0001).

    Conclusions

    Patients had worse values than healthy individuals in almost all physical measures. There was a trend toward worse results for CR than WAD patients.

    Fulltekst (pdf)
    fulltext
  • 341.
    Peolsson, Anneli
    et al.
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Medicincentrum, Arbets- och miljömedicin.
    Löfgren, Håkan
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Avdelningen för kirurgi, ortopedi och onkologi. Linköpings universitet, Medicinska fakulteten. Neuro Orthoped Ctr, Sweden.
    Dedering, Asa
    Karolinska Inst, Sweden.
    Kristedal, Mattias
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Rörelse och Hälsa.
    Öberg, Birgitta
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten.
    Zsigmond, Peter
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Avdelningen för kirurgi, ortopedi och onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Neurokirurgiska kliniken US.
    Wibault, Johanna
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Rörelse och Hälsa.
    Neurological outcomes after surgery and postoperative rehabilitation for cervical radiculopathy due to disc disease: a 2-year-follow-up of a randomized clinical trial2023Inngår i: Scientific Reports, E-ISSN 2045-2322, Vol. 13, nr 1, artikkel-id 3830Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Reports on neurological outcomes in patients with cervical radiculopathy (CR) undergoing surgery and postoperative rehabilitation are important to inform prognosis. This 2-year-follow-up of a randomized clinical trial aimed to compare secondary neurological outcomes between structured postoperative rehabilitation and a standard approach after surgery for CR. A secondary aim was to increase knowledge about recovery of neurological impairments in relation to patient-reported neck disability. Neurological outcomes included assessment of sensibility, motor function, arm reflexes and the Spurling test. A total of 153 and 135 participants (&gt;70% response rate) completed the clinical examination. Between-group differences, changes over time, and associations between persistent neurological impairments and the Neck Disability Index were investigated. No between-group differences were reported (p&gt;0.07), and neurological impairments in sensibility, motor function, and a positive Spurling test decreased over time in both groups (p&lt;0.04). Persistent impairments in sensibility and reflex arm were most frequent at follow-up, whereas, a persistent positive Spurling test, and impairments in motor function were associated with higher NDI score. Neurological outcomes improved over time in patients undergoing surgery for CR with no between-group differences., However, persistent neurological impairments were common, and associated with poorer outcome for patient-reported neck disability.Clinical registration: clinicaltrial.gov NCT01547611, 08/03/2012, Title: Outcome of physiotherapy after surgery for cervical disc disease: a prospective multi-centre trial.

    Fulltekst (pdf)
    fulltext
  • 342.
    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 disorders2016Inngår i: Scientific Reports, E-ISSN 2045-2322, Vol. 6, artikkel-id 30415Artikkel i tidsskrift (Fagfellevurdert)
    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.

    Fulltekst (pdf)
    fulltext
  • 343.
    Peolsson, Anneli
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för sjukgymnastik. Linköpings universitet, Hälsouniversitetet.
    Öberg, Birgitta
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för sjukgymnastik. Linköpings universitet, Hälsouniversitetet.
    Wibault, Johanna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för sjukgymnastik. Linköpings universitet, Hälsouniversitetet.
    Dedering, Åsa
    Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.
    Zsigmond, Peter
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neurovetenskap. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Neurokirurgiska kliniken US.
    Bernfort, Lars
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för hälso- och sjukvårdsanalys. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Allergicentrum US.
    Kammerlind, Ann-Sofi
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för sjukgymnastik. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Öron- näsa- och halskliniken US. Futurum, County Council Jönköping, Sweden .
    Persson, Liselott
    Lunds University, Sweden.
    Löfgren, Håkan
    Ryhov Hospital, Jönköping, Sweden .
    Outcome of physiotherapy after surgery for cervical disc disease: a prospective randomised multi-centre trial2014Inngår i: BMC Musculoskeletal Disorders, E-ISSN 1471-2474, Vol. 15, nr 34Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND:

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

    METHODS/DESIGN:

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

    DISCUSSION:

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

    Fulltekst (pdf)
    fulltext
  • 344.
    Peters, Madelon L.
    et al.
    Maastricht University, Netherlands.
    Smeets, Elke
    Maastricht University, Netherlands.
    Feijge, Marion
    Maastricht University, Netherlands.
    van Breukelen, Gerard
    Maastricht University, Netherlands.
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Karolinska Institute, Sweden.
    Buhrman, Monica
    Uppsala University, Sweden.
    Linton, Steven J.
    Örebro University, Sweden.
    Happy Despite Pain A Randomized Controlled Trial of an 8-Week Internet-delivered Positive Psychology Intervention for Enhancing Well-being in Patients With Chronic Pain2017Inngår i: The Clinical Journal of Pain, ISSN 0749-8047, E-ISSN 1536-5409, Vol. 33, nr 11, s. 962-975Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: There is preliminary evidence for the efficacy of positive psychology interventions for pain management. The current study examined the effects of an internet-based positive psychology self-help program for patients with chronic musculoskeletal pain and compared it with an internet-based cognitive-behavioral program. Materials and Methods: A randomized controlled trial was carried out with 3 conditions: an internet-delivered positive psychology program, an internet-delivered cognitive-behavioral program and waitlist control. A total of 276 patients were randomized to 1 of the 3 conditions and posttreatment data were obtained from 206 patients. Primary outcomes were happiness, depression, and physical impairments at posttreatment and at 6-month follow-up. Intention-to-treat analyses were carried out using mixed regression analyses. Results: Both treatments led to significant increases in happiness and decreases in depression. Physical impairments did not significantly decrease compared with waitlist. Improvements in happiness and depression were maintained until 6-month follow-up. There were no overall differences in the efficacy of the 2 active interventions but effects seemed to be moderated by education. Patients with a higher level of education profited slightly more from the positive psychology intervention than from the cognitive-behavioral program. Discussion: The results suggest that an internet-based positive psychology and cognitive-behavioral self-help interventions for the management of chronic pain are clinically useful. Because the self-help exercises as used in the current program do not require therapist involvement, dissemination potential is large. Further studies should examine whether it can best be used as stand-alone or add-on treatment combined with established pain treatment programs.

  • 345. Bestill onlineKjøp publikasjonen >>
    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 injury2016Doktoravhandling, med artikler (Annet vitenskapelig)
    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.

    Delarbeid
    1. THE EFFECT OF 3 DIFFERENT EXERCISE APPROACHES ON NECK MUSCLE ENDURANCE, KINESIOPHOBIA, EXERCISE COMPLIANCE, AND PATIENT SATISFACTION IN CHRONIC WHIPLASH
    Åpne denne publikasjonen i ny fane eller vindu >>THE EFFECT OF 3 DIFFERENT EXERCISE APPROACHES ON NECK MUSCLE ENDURANCE, KINESIOPHOBIA, EXERCISE COMPLIANCE, AND PATIENT SATISFACTION IN CHRONIC WHIPLASH
    Vise andre…
    2015 (engelsk)Inngår i: Journal of Manipulative and Physiological Therapeutics, ISSN 0161-4754, E-ISSN 1532-6586, Vol. 38, nr 7, s. 465-746.e4Artikkel i tidsskrift (Fagfellevurdert) 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.

    sted, utgiver, år, opplag, sider
    MOSBY-ELSEVIER, 2015
    Emneord
    Exercise Therapy; Neck Pain; Whiplash Injuries; Rehabilitation
    HSV kategori
    Identifikatorer
    urn:nbn:se:liu:diva-122438 (URN)10.1016/j.jmpt.2015.06.011 (DOI)000362450700003 ()26387858 (PubMedID)
    Merknad

    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

    Tilgjengelig fra: 2015-11-03 Laget: 2015-11-02 Sist oppdatert: 2017-12-01
    2. Altered ventral neck muscle deformation for individuals with whiplash associated disorder compared to healthy controls: A case-control ultrasound study
    Åpne denne publikasjonen i ny fane eller vindu >>Altered ventral neck muscle deformation for individuals with whiplash associated disorder compared to healthy controls: A case-control ultrasound study
    Vise andre…
    2015 (engelsk)Inngår i: Manual Therapy, ISSN 1356-689X, E-ISSN 1532-2769, Vol. 20, nr 2, s. 319-327Artikkel i tidsskrift (Fagfellevurdert) 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.

    HSV kategori
    Identifikatorer
    urn:nbn:se:liu:diva-115920 (URN)10.1016/j.math.2014.10.006 (DOI)000352769200013 ()25454684 (PubMedID)
    Tilgjengelig fra: 2015-03-24 Laget: 2015-03-24 Sist oppdatert: 2017-12-04
    3. CHANGES IN DORSAL NECK MUSCLE FUNCTION IN INDIVIDUALS WITH CHRONIC WHIPLASH-ASSOCIATED DISORDERS: A REAL-TIME ULTRASOUND CASE-CONTROL STUDY
    Åpne denne publikasjonen i ny fane eller vindu >>CHANGES IN DORSAL NECK MUSCLE FUNCTION IN INDIVIDUALS WITH CHRONIC WHIPLASH-ASSOCIATED DISORDERS: A REAL-TIME ULTRASOUND CASE-CONTROL STUDY
    Vise andre…
    2016 (engelsk)Inngår i: Ultrasound in Medicine and Biology, ISSN 0301-5629, E-ISSN 1879-291X, Vol. 42, nr 5, s. 1090-1102Artikkel i tidsskrift (Fagfellevurdert) 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.

    sted, utgiver, år, opplag, sider
    ELSEVIER SCIENCE INC, 2016
    Emneord
    Whiplash injury; Ultrasonography; Neck muscles; Spine
    HSV kategori
    Identifikatorer
    urn:nbn:se:liu:diva-127550 (URN)10.1016/j.ultrasmedbio.2015.12.022 (DOI)000373385300008 ()26921149 (PubMedID)
    Merknad

    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

    Tilgjengelig fra: 2016-05-04 Laget: 2016-05-03 Sist oppdatert: 2018-03-27
    4. Novel insights into the interplay between ventral neck muscles in individuals with whiplash-associated disorders
    Åpne denne publikasjonen i ny fane eller vindu >>Novel insights into the interplay between ventral neck muscles in individuals with whiplash-associated disorders
    Vise andre…
    2015 (engelsk)Inngår i: Scientific Reports, E-ISSN 2045-2322, Vol. 5, nr 15289Artikkel i tidsskrift (Fagfellevurdert) 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.

    sted, utgiver, år, opplag, sider
    NATURE PUBLISHING GROUP, 2015
    HSV kategori
    Identifikatorer
    urn:nbn:se:liu:diva-122524 (URN)10.1038/srep15289 (DOI)000362884300001 ()26472599 (PubMedID)
    Merknad

    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

    Tilgjengelig fra: 2015-11-09 Laget: 2015-11-06 Sist oppdatert: 2022-09-15
    Fulltekst (pdf)
    Neck muscle function in individuals with persistent pain and disability after whiplash injury
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  • 346.
    Peterson, Gunnel
    et al.
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Uppsala Univ, Sweden.
    Carlfjord, Siw
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för samhälle och hälsa. Linköpings universitet, Medicinska fakulteten.
    Strid, Emma Nilsing
    Örebro Univ, Sweden.
    Ask, Sofia
    Cty Council Västmanland, Sweden.
    Jönsson, Margaretha
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten.
    Peolsson, Anneli
    Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Medicincentrum, Arbets- och miljömedicin.
    Evaluation of implementation and effectiveness of neck-specific exercise for persistent disability and pain after whiplash injury: study protocol for a randomized controlled study using a hybrid 2 design2022Inngår i: BMC Musculoskeletal Disorders, E-ISSN 1471-2474, Vol. 23, nr 1, artikkel-id 516Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Persistent pain and disability in whiplash-associated disorders (WAD) grades II and III are common. In two randomized controlled trials (RCTs) of neck-specific exercises (NSE), we have seen promising results in chronic WAD, with a sustained clinically important reduction in pain and disability. NSE can also be delivered through internet support (NSEIT) and a few visits to a physiotherapist, saving time and cost for both patients and providers. NSE have been shown to have positive effects in other neck pain disorders and we will evaluate the diffusion of the exercises to other patients. The aims of the proposed study are to evaluate an implementation strategy for NSEIT and NSE in primary health care and to evaluate the effectiveness of NSEIT and NSE in clinical practice.

    Methods: The proposed study is a prospective cluster-randomized mixed-design study with hybrid 2 trial design. Reg. physiotherapists working in twenty physiotherapy clinics will be included. The primary implementation outcome is proportion of patients with neck pain receiving neck-specific exercise. Secondary outcomes are; physiotherapists attitudes to implementation of evidence-based practice, their self-efficacy and confidence in performing NSEIT/NSE, number of patients visits, and use of additional or other exercises or treatment. To further evaluate the implementation strategy, two qualitative studies will be performed with a sample of the physiotherapists. The primary outcome in the patient effectiveness evaluation is self-reported neck disability according to the Neck Disability Index (NDI). Secondary outcomes are pain intensity in the neck, arm, and head; dizziness; work- and health-related issues; and patients improvement or deterioration over time. All measurements will be conducted at baseline and at 3 and 12 months. Physiotherapists self-efficacy and confidence in diagnosing and treating patients with neck pain will also be evaluated directly after their instruction in NSEIT/NSE.

    Discussion: This trial will evaluate the implementation strategy in terms of adoption of and adherence to NSEIT and NSE in clinical primary health care, and measure diffusion of the method to other patients. In parallel, the effectiveness of the method will be evaluated. The results may guide physiotherapists and health care providers to sustainable an effective implementation of effective exercise programs.

  • 347.
    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 study2015Inngår i: Manual Therapy, ISSN 1356-689X, E-ISSN 1532-2769, Vol. 20, nr 2, s. 319-327Artikkel i tidsskrift (Fagfellevurdert)
    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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  • 348.
    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 WHIPLASH2015Inngår i: Journal of Manipulative and Physiological Therapeutics, ISSN 0161-4754, E-ISSN 1532-6586, Vol. 38, nr 7, s. 465-746.e4Artikkel i tidsskrift (Fagfellevurdert)
    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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    fulltext
  • 349.
    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 disorders2015Inngår i: Scientific Reports, E-ISSN 2045-2322, Vol. 5, nr 15289Artikkel i tidsskrift (Fagfellevurdert)
    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.

    Fulltekst (pdf)
    fulltext
  • 350.
    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 study2018Inngår i: Scientific Reports, E-ISSN 2045-2322, Vol. 8, artikkel-id 9649Artikkel i tidsskrift (Fagfellevurdert)
    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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    fulltext
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