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  • 101.
    Blomqvist, Sven
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wester, Anita
    Skolverket.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Postural muscle responses and adaptations to backward platform perturbations in young people with and without intellectual disability2014In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 39, no 3, p. 904-908Article in journal (Refereed)
    Abstract [en]

    This study examines postural muscle responses to backward perturbations in young people with and without intellectual disability (ID). The study included 56 young people with ID and 43 age-matched without ID volunteers. The subjects stood on a platform that was moved backwards in a surface translation. Lower and upper leg muscles and lower back spine muscles were recorded with surface electromyography (EMG). Muscle onset latency, time to peak amplitude (EMG), adaption of muscle responses to repeated perturbations (using IEMG for epochs), and synergies and strategies were assessed. The result showed no differences between the two groups in muscle onset latency, time to peak amplitude, synergies, and strategies. However, young people with ID tended to adapt their IEMG less compared to the controls. These findings suggest that young people with ID have limited ability to adapt their postural muscle responses to repeated perturbations.

  • 102.
    Blomqvist, Sven
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wester, Anita
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Test-retest reliability, smallest real difference and concurrent validity of six different balance tests on young people with mild to moderate intellectual disability2012In: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 98, no 4, p. 313-319Article in journal (Refereed)
    Abstract [en]

    Objectives Some studies have reported that people with intellectual disability may have reduced balance ability compared with the population in general. However, none of these studies involved adolescents, and the reliability and validity of balance tests in this population are not known. The purpose of this study was to examine the reliability of six different balance tests and to investigate their concurrent validity.

    Design Test-retest reliability assessment.

    Settings All subjects were recruited from a special school for people with intellectual disability in Bollnas, Sweden.

    Participants Eighty-nine adolescents (35 females and 54 males) with mild to moderate intellectual disability with a mean age of 18 years (range 16 to 20 years).

    Interventions All subjects followed the same test protocol on two occasions within an 11-day period.

    Main outcomes Balance test performances.

    Results Intraclass correlation coefficients greater than 0.80 were achieved for four of the balance tests: Extended Timed Up and Go Test, Modified Functional Reach Test, One-leg Stance Test and Force Platform Test. The smallest real differences ranged from 12% to 40%; less than 20% is considered to be low. Concurrent validity among these balance tests varied between no and low correlation.

    Conclusion The results indicate that these tests could be used to evaluate changes in balance ability over time in people with mild to moderate intellectual disability. The low concurrent validity illustrates the importance of knowing more about the influence of various sensory subsystems that are significant for balance among adolescents with intellectual disability.

    (C) 2011 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  • 103.
    Bocké, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Uppfattningar efter total höftledsplastik hos patienter som inte är nöjda med resultatet efter operationen: En kvalitativ innehällsanalys.2013Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Bakgrund

    För patienter med höftledsartros och som genomgått primär höftprotesoperation i Sverige, är implantatöverlevnaden nästan 100% efter ett år. Trots detta är nöjdheten hos patienterna knappt 90%. Genom patientrapporterat utfall har Svenska höftprotesregistret identifierat personer som angett att de är osäkra och missnöjda vid ett ärsuppföljningen.

    Syfte

    Syftet med studien var att belysa uppfattningar om resultatet ett år efter höftprotesoperation hos patienter som inte är nöjda trots avsaknad av registrerad komplikation.

    Metod

    Deltagare rekryterades frän Svenska höftprotesregistrets databas. Semistrukturerade intervjuer genomfördes med tjugotvå personer (femton kvinnor och sju män) i åldern 49-85 är om sina erfarenheter och uppfattningar av resultet efter total höftprotesoperation. Intervjuerna analyserades med kvalitativ innehållsanalys.

    Resultat

    Deltagarna hade en önskan om en gedigen och förlängd support och vägledning när livet var begränsat av funktionshinder. Analysen resulterade i fyra kategorier: Ett liv begränsat av funktionshinder, Negativ inverkan på det dagliga livet, Upplevelse av otillräckligt stöd och bemötande, Sjukvärdspersonalens begränsade tillgänglighet.

    Konklusion

    Patienters uppfattningar om nöjdhet med resultatet efter total höftprotesoperation är komplext och innefattar många av livets områden. Ingen av deltagarnas förväntningar var helt uppfyllda. Vägledning och stöd från hälso- och sjukvården är viktiga för patienten även om ortopedkliniken anser att interventionen är uppfylld.

  • 104.
    Bohman, Peter
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Upplevelser av hur fysisk aktivitet på recept - FaR - påverkar den fysiska och mentala hälsan hos patienter inom primärvården: En intervjustudie2016Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Otillräcklig fysisk aktivitet är idag ett stort problem på både individ- och samhällsnivå. Fysisk aktivitet på recept, FaR, har på senare år blivit ett vanligt verktyg för att behandla och förebygga sjukdomar hos patienter inom primärvården. Det råder idag en brist på information om patienternas upplevelser av FaR. Syftet med studien var därför att undersöka hur patienter, som har blivit ordinerade FaR, upplever att receptet har påverkat den fysiska och mentala hälsan.

    Metod: I processen har en kvalitativ, beskrivande forskningsdesign använts. Studien bygger på intervjuer med 10 personer och individuella intervjuer med ett semistrukturerat frågeformulär användes. Intervjuerna transkriberades och analyserades med hjälp av kvalitativ innehållsanalys. Målet med den induktiva, kvalitativa innehållsanalysen var att ge en ökad kunskap och förståelse inom det undersökta området.

    Resultat: Resultatet av innehållsanalysen visade på upplevelser av bland annat ökat fysiskt och psykosomatiskt välbefinnande samt ökad fysisk uthållighet och styrka .

    Slutsats: Studien visar på ett antal olika upplevelser hos patienter inom primärvården som har ökat sin fysiska aktivitetsnivå via FaR. Upplevelser som kan tas tillvara på av sjukgymnaster/fysioterapeuter i det kliniska arbetet för att stödja patienter i deras strävan till ett mer aktivt liv. Fortsatt forskning inom området premieras förhoppningsvis i framtiden för att ytterligare öka förståelsen kring upplevelser av FaR samt för att öka förståelsen kring vilka motivationsfaktorer som kan vara avgörande för en ökad fysisk aktivitet.

  • 105. Bohman, Tony
    et al.
    Bottai, Matteo
    Björklund, Martin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation. Department of Occupational Health Sciences and Psychology, University of Gävle, Gävle, Sweden.
    Predictive models for short-term and long-term improvement in women under physiotherapy for chronic disabling neck pain: a longitudinal cohort study2019In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 4, article id e024557Article in journal (Refereed)
    Abstract [en]

    Objectives: To develop predictive models for short-term and long-term clinically important improvement in women with non-specific chronic disabling neck pain during the clinical course of physiotherapy.

    Design: Longitudinal cohort study based on data from a randomised controlled trial evaluating short-term and long-term effects on sensorimotor function over 11 weeks of physiotherapy.

    Participants and settings: Eighty-nine women aged 31–65 years with non-specific chronic disabling neck pain from Gävle, Sweden.

    Measures: The outcome, clinically important improvement, was measured with the Patient Global Impression of Change Scale (PGICS) and the Neck Disability Index (NDI), assessed by self-administered questionnaires at 3, 9 and 15 months from the start of the interventions (baseline). Twelve baseline prognostic factors were considered in the analyses. The predictive models were built using random-effects logistic regression. The predictive ability of the models was measured by the area under the receiver operating characteristic curve (AUC). Internal validity was assessed with cross-validation using the bootstrap resampling technique.

    Results: Factors included in the final PGICS model were neck disability and age, and in the NDI model, neck disability, depression and catastrophising. In both models, the odds for short-term and long-term improvement increased with higher baseline neck disability, while the odds decreased with increasing age (PGICS model), and with increasing level of depression (NDI model). In the NDI model, higher baseline levels of catastrophising indicated increased odds for short-term improvement and decreased odds for long-term improvement. Both models showed acceptable predictive validity with an AUC of 0.64 (95% CI 0.55 to 0.73) and 0.67 (95% CI 0.59 to 0.75), respectively.

    Conclusion: Age, neck disability and psychological factors seem to be important predictors of improvement, and may inform clinical decisions about physiotherapy in women with chronic neck pain. Before using the developed predictive models in clinical practice, however, they should be validated in other populations and tested in clinical settings.

  • 106. Bohman, Tony
    et al.
    Tegern, Matthias
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation. Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.
    Halvarsson, Alexandra
    Broman, Lisbet
    Larsson, Helena
    Concurrent validity of an isokinetic lift test used for admission to the Swedish Armed Forces2018In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 11, article id e0207054Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to assess the concurrent validity of the IsoKai isokinetic lift test peak force (IsoKai(Peak))1 in comparison to a submaximal 5-1ORM deadlift test (5-10RM(DL)), and to develop an equation for converting the IsoKai(Peak) in Newton (N) to an estimated 1 RM (1 RMest) deadlift load in kilograms (kg). The participants included 28 males and 16 female employees in the Swedish Armed Forces (20-59 years). Each participant conducted the IsoKai lift test, followed by the 5-1ORM(DL) test at one occasion. The Pearson's correlation coefficient, with a 95% confidence interval was calculated to evaluate the validity between the IsoKai(peak) and the 1 RMest deadlift load derived from the 5-10RM(DL) test. Univariate and multivariable linear regressions were used to derive the equation for calculating the 1 RMest deadlift load based on the IsoKai(Peak)- The IsoKai(p)(eak) showed good- to-excellent correlation with the 1 RMest deadlift weight with a correlation coefficient of 0.84 (0.72-0.91) for the total sample, and 0.65 (0.37-0.83) and 0.81 (0.53-0.93) in males and females, respectively. The final equation, 1 RMest deadlift weight (kg) = -51.63 + (0.08 x IsoKai(Peak))1+ (2.28 x BMI), explained 72% (adjusted R-2 = 0.72) of the total variance in the 1 RMest, and had a standard error of the estimate (SEE) of 16.57 kg. In conclusion, the IsoKai isokinetic lift test could be considered a highly valid measure of maximal dynamic muscular strength in comparison to the 5-10RM(DL). The equation can be used to convert the IsoKai lift test (N) results to an 1 RMest deadlift load (kg), but with consideration of the relative large SEE.

  • 107.
    Bolin, Jonas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    En motorisk 5 års-uppföljning av underburna barn på Sundsvalls Sjukhus2016Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Sammanfattning:  Syfte: Att beskriva perinatala bakgrundsfaktorers betydelse avseende motorisk utveckling vid fem års ålder hos barn födda före vecka 32+0 GA, vårdade vid länsverksamheten Barn och Ungdom, Sundsvalls sjukhus mellan åren 2006-2009. Ett annat syfte var att se vilken motorisk förmåga denna grupp underburna barn hade vid fem års ålder jämfört med normalpopulationen.

    Metod: En retrospektiv longitudinell journalstudie där journaldata för 43 barn födda före vecka 32+0 GA vid Sundsvall sjukhus, avseende bakgrundsfaktorer som födelsevikt, födelselängd, huvudomfång samt om barnen initialt vårdats i respirator jämfördes med resultat från ett motoriskt test vid fem års ålder (Movement ABC) Resultatet vid den motoriska uppföljningen vid fem års ålder analyserades även mot normativa data från Movement ABC.

    Resultat: Gruppen barn (n=43) födda före vecka 32+0 GA visade signifikant större motoriska funktionsnedsättningar än normalpopulationen p<0,0001. Av dessa hamnade 23,3 % i kategorin avvikande motorisk förmåga (under percentil 5). Ingen skillnad noterades mellan de mycket underburna och de extremt underburna barnen (<vecka 28+0 GA). Födelselängd, födelsevikt samt hur många dygn barnen legat i respirator initialt inverkade inte på det motoriska resultatet vid femårsuppföljningen. Barn med större huvudomfång (≥+1SD) vid födseln uppvisade större motoriska svårigheter vid uppföljningen (p=0,035). En tendens sågs även mot att flickor klarade sig bättre än pojkarna motoriskt men skillnaden var inte signifikant (p=0,06).

    Slutsats: Gruppen mycket och extremt underburna får oftare än fullgångna barn motoriska svårigheter. Därför är det viktigt att denna grupp följs upp så att barn som behöver extra stöd snabbt kan få detta. Stor försiktighet bör iakttas vid tolkning av perinatala bakgrundsfaktorers påverkan då studiepopulationen var mycket liten.

  • 108.
    Borg, Tina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Smärtvariabilitet hos tandläkarstudenter med nackbesvär.: En longitudinell studie.2014Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Syftet var att beskriva smärtfrekvens och smärtvariabilitet med avseende på nacksmärta hos en grupp tandläkarstudenter under klinisk utbildning. Ytterligare ett syfte var att redogöra för faktorer som predicerar smärtvariabilitet.

     

    Metod: Designen var en longitudinell kohortstudie. Sjutton tandläkarstudenter med nackbesvär fick besvara frågor om smärta, symptom, funktion, stress, fysisk aktivitet, hälsorelaterad livskvalitet och medicinering samt genomgå en funktionsundersökning. Därefter skattades smärtintensiteten under 4 veckor med numerical rating scale (NRS). Variabiliteten beräknades genom den intraindividuella standardavvikelsen av samtliga smärtskattningar. Multipel linjär regression användes för att undersöka predicerande faktorer.

     

    Resultat: Samtliga upplevde återkommande besvär, 53 % angav besvär ibland/då och då, 24 % flera gånger i veckan och 24 % dagligen. Medelvärdet för smärtvariabiliteten var 1,2 (variationsvidd 0-3). Att ha besvär utan diagnos predicerade ökad variabilitet (2,2 skalsteg på NRS). En diagnos på cervikalgi eller trapeziusmyalgi predicerade en minskning av variabiliteten (1,8 resp. 1,2 skalsteg på NRS).

     

    Slutsats: Tandläkarstudenter med nackbesvär upplever återkommande nackbesvär. Smärtan uppvisar variabilitet i intensitet för de allra flesta och variabiliteten motsvarar en klinisk relevant skillnad för över två tredjedelar. Att inte ha en funktionsdiagnos predicerar hög variabilitet och att ha en diagnos på trapeziusmyalgi eller cervikalgi predicerar låg variabilitet. Urvalet var litet så resultatet bör tolkas med försiktighet.

     

  • 109.
    Boström, Gustaf
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Depression in older people with and without dementia: non-pharmacological interventions and associations between psychotropic drugs and mortality2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim of this thesis was to investigate associations between psychotropic drug use and death, associations between functional capacity, dependency in ADL and depression, and to evaluate a non-pharmacological intervention to reduce depressive symptoms, among older people with and without dementia.

    There is limited knowledge about the risk of death associated with psychotropic drug use among those aged ≥85 years, those with dementia, or those living in residential care facilities; groups that have a higher intake of psychotropic drugs and who are also more prone to adverse drug reactions. In a representative sample of people ≥85 years (n = 992), baseline antidepressant use was not associated with an increased 5-year mortality risk when adjusting for confounding factors. A significant interaction between gender and antidepressant use was found, with a higher mortality risk in women, than in men.  When analyzing men and women separately, no significant associations were found. In a sample of older people (i.e. ≥65 years) with dementia (n = 1037), there was a significant gender difference in 2-year mortality associated with the baseline use of antidepressant drugs, with a lower mortality risk in men, than in women. In men, the mortality risk was significantly reduced with antidepressant use, while there was no significant association in women. The association between baseline use of benzodiazepines and mortality had a tendency toward an increased risk during the first year of follow-up, although this became non-significant after adjustments. In this time period, the interaction term for sex was significant, with a higher mortality risk among men than women. When the sexes were analyzed separately, no significant associations were found. No significant associations were found between baseline use of antipsychotic drugs and mortality.

    Drug treatment for depression seems to have a limited effect in older people and may have no effect in people with dementia. In order to find alternative ways of treating or preventing depression in older age, it is important to increase our knowledge about factors associated with this condition. Functional capacity and dependency in activities of daily living (ADL) are associated with depression in community-dwelling older people. However, it is uncertain whether the same associations are to be found in very old people (i.e. ≥80 years), including those with severe cognitive or physical impairments. In a heterogeneous sample (n = 392) with a high mean age, a large range of cognitive and functional capacity, a wide spectrum of dependency in ADL, and a high prevalence of comorbidities, depressive symptoms were significantly associated with functional balance capacity, but not with overall dependency in ADL. Among individual ADL tasks, dependency in transfer and dressing were associated with depressive symptoms.

    Physical exercise has shown effect sizes similar to those of antidepressants in reducing depressive symptoms among older people without dementia, with moderate–high-intensity exercise being more effective than low-intensity exercise. However, these effects are unclear among older people with dementia. Care-facility residents with dementia (n = 186) were cluster-randomized to a high-intensity functional exercise program or a non-exercise control activity conducted for 45 minutes every other weekday for 4 months. No significant difference between the exercise and control activity was found in depressive symptoms at 4 or 7 months. Among participants with high levels of depressive symptoms, reductions were observed in both the exercise and control groups at 4 and 7 months.

    In conclusion, ongoing treatment at baseline with any of the three psychotropic drug classes antidepressants, antipsychotics and benzodiazepines did not increase the risk of mortality in older people with dementia.  Neither did antidepressant drugs in very old people. In both samples, gender differences were found in the mortality risk due to antidepressant use. In those with dementia, the mortality risk due to benzodiazepine use also differed by gender. The potential risk from initial treatment and gender differences regarding mortality risk require further investigation in randomized controlled trials or in large cohort studies properly controlled for confounding factors. In older people, living in community and residential care facilities, functional capacity seems to be independently associated with depressive symptoms whereas overall ADL performance may not be associated. Dependency in the individual ADL tasks of transfer and dressing appear to be independently associated with depressive symptoms and may be an important focus for future interdisciplinary multifactorial intervention studies. Among older people with dementia living in residential care facilities, a 4-month high-intensity functional exercise program has no superior effect on depressive symptoms than a control activity. Both exercise and non-exercise group activities may reduce high levels of depressive symptoms. However, this finding must be confirmed in three-armed randomized controlled trials including control groups receiving standard care.

  • 110.
    Boström, Gustaf
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Conradsson, Mia
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Hörnsten, Carl
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Rosendahl, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Lindelöf, Nina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Holmberg, Henrik
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Nordström, Peter
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Littbrand, Håkan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Effects of a high-intensity functional exercise program on depressive symptoms among people with dementia in residential care: a randomized controlled trial2016In: International Journal of Geriatric Psychiatry, ISSN 0885-6230, E-ISSN 1099-1166, Vol. 31, no 8, p. 868-878Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The aim of this study is to evaluate the effect of a high-intensity functional exercise program on depressive symptoms among older care facility residents with dementia.

    METHODS: Residents (n = 186) with a diagnosis of dementia, age ≥ 65 years, Mini-Mental State Examination score ≥ 10, and dependence in activities of daily living were included. Participants were randomized to a high-intensity functional exercise program or a non-exercise control activity conducted 45 min every other weekday for 4 months. The 15-item Geriatric Depression Scale (GDS) and the Montgomery-Åsberg Depression Rating Scale (MADRS) were administered by blinded assessors at baseline, 4, and 7 months.

    RESULTS: No difference between the exercise and control activity was found in GDS or MADRS score at 4 or 7 months. Among participants with GDS scores ≥ 5, reductions in GDS score were observed in the exercise and control groups at 4 months (-1.58, P = 0.001 and -1.54, P = 0.004) and 7 months (-1.25, P = 0.01 and -1.45, P = 0.007). Among participants with MADRS scores ≥ 7, a reduction in MADRS score was observed at 4 months in the control group (-2.80, P = 0.009) and at 7 months in the exercise and control groups (-3.17, P = 0.003 and -3.34, P = 0.002).

    CONCLUSIONS: A 4-month high-intensity functional exercise program has no superior effect on depressive symptoms relative to a control activity among older people with dementia living in residential care facilities. Exercise and non-exercise group activities may reduce high levels of depressive symptoms.

  • 111.
    Brinckmann, Paula
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sjöberg, Anna
    Time to stabilization during a single-leg hop is less variabe in participants with anterior cruciate ligament reconstruction than in controls2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Objective: The purpose of this study was to compare time to stabilization (TTS) and standard deviation (SD) during a single-leg hop of individuals with anterior cruciate ligament reconstruction (ACLR) to healthy controls, and between the reconstructed and the contralateral uninjured sides.

    Design: Cross-sectional study with two groups.

    Participants: A total number of 62 participants (36 ACLR and 26 Controls).

    Main Outcome Measure: Participants performed five trials of horizontal single-leg hops for each side onto a force plate, and TTS were calculated for the landing phase. Main outcome measures were: mean TTS mediolateral direction, mean TTS anteroposterior direction, SD TTS mediolateral direction and standard deviation TTS anteroposterior direction. General linear models repeated measures analyses of variance were conducted to analyze between-group and with-in group differences (2 x 2, group x side). If significant effects or interactions were found, post-hoc analyses with Bonferroni corrections were performed (P≤0.05).

    Results: No significant group or side effects or interactions were found for mean TTS or for SD TTS in the anteroposterior direction. However, significant group effect and group x side interaction was found for SD TTS in mediolateral direction. SD TTS in the mediolateral direction was significantly lower on the ACLR injured side compared to controls (P=0.031).

    Conclusions: The results indicate that the ACLR group had a less varied movement pattern during a single-leg hop compared to the control group, as reflected by TTS.

  • 112.
    Broman, Karolina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    "Den svåra balansgången": Pedagogers upplevelse av att arbeta med barn med motoriska svårigheter: En kvalitativ studie2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Prevalensen av barn med fördröjd utveckling är nästan ett av var sjätte barn, och eftersom barns första åtta år är en viktig period för tillväxt och utveckling som kan påverka barnets fortsatta liv, bör barnen tidigt erhålla ett gott stöd.

    Syfte: Syftet med uppsatsen är att nå ökad kunskap om hur pedagoger upplever sitt arbete med barn med motoriska svårigheter, och vilket stöd de upplever att de får av en fysioterapeut.

    Metod: Kvalitativ studie grundad på semistrukturerade intervjuer med fem pedagoger som arbetar med barn som har motoriska svårigheter. Barnens ålder är 1-9 år. Intervjuerna analyserades med hjälp av the grounded theory, och för att öka trovärdigheten i datamaterialet genomfördes en triangulering av materialet med totalt tre personer.

    Resultat: En huvudkategori: ”Den svåra balansgången” och fem kategorier: ”Områden som skapar osäkerhet hos pedagogen”,Stöd för pedagogen”, ”Varför en diagnos? ”, ”Målet: ett självständigt barn” och ”Respekt” identifierades. Huvudkategorin, ”Den svåra balansgången”, representerar pedagogernas strävan att nå balans i sitt arbete med barn som har motoriska svårigheter medan kategorierna visar delar som påverkar balansen.

    Slutsats: Pedagogerna upplever att deras arbete är en ständig balansgång där olika delar i arbetet måste avvägas mot varandra i en kontinuerlig strävan efter jämnvikt.

  • 113.
    Brännlund, Anton
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sahlström, Robin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Trapezius pain pressure threshold as a predictor for neck muscle functions and cervical range of motion: A comparison of female chronic neck pain patients with or without traumatic background2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Neck pain is one of the most common causes of disability with a lifetime prevalence of approximately 50%. Few previous studies have investigated the correlation between pain and muscle functions and they’ve all used subjective self-estimated pain-rating scales as pain measurements. Pain pressure threshold (PPT) as a pain measurement gives a definite value of the pain which could be clinically useful for therapists.

    Purpose: The primary purpose of this study is to examine if Trapezius PPT can predict muscle functions and cervical range of motion (CROM) in women with chronic neck pain. Other purposes are to examine differences between patients with whiplash associated disorders (WAD) and idiopathic neck pain (INP) as well as if central sensitization affects the examined variables.

    Method: The subjects were devided into three groups; healthy controls (n=29), WAD (n=28) and INP (n=36). PPTs, neck muscle strengths, neuromuscular controll, muscle endurance and CROM were measured and regression analysis as well as difference tests were performed.

    Result: The results show several significant differences between the WAD and INP patients. The regression analysis shows that Trapezius PPT might be used for predicting muscle functions and CROM in the WAD group. The results also show that central sensitization negatively affects the examined variables.

    Conclusion: There are major differences between chronic WAD and INP patients. One might suggest to separate these groups in future studies. The clinical usability of Trapezius PPT as a single predictor for neck muscle functions and CROM needs to be further examined.

  • 114.
    Brännström, Johan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Teamsamarbete i företagshälsovården: En kartläggning i fyra svenska län2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion

    Teamsamarbete mellan professioner inom företagshälsovård kan förbättra arbetets kvalité, resultat och säkerhet.Vidare kan teamsamarbete främja teamets interna hälsa och teamets rehabiliteringsfokus kan vara avgörande för patientens arbetsåtergång.

     

    Syfte

    -Att kartlägga hur teamsamarbetet fungerar inom företagshälsovård.

    -Att undersöka skillnader mellan respondenter som upplevde sällan respektive oftast välfungerande team vad gäller arbetstillfredställelse, självskattad hälsa samt syn på rehabilitering avseende hälsa och arbetsåtergång

     

    Metod

    Enkäten Assessment of Interprofessional Team Collaboration Scale – Svensk version (AITCS-s), med subskalorna partnerskap/delat beslutsfattande, samarbete och koordination användes vid kartläggningen av teamsamarbetet utifrån en femgradig skala. Frågor kring självskattad hälsa, arbetstillfredställelse samt syn på patientrehabilitering avseende hälsa och arbetsåtergång bifogades enkäten.och den tredje 168 personer vid 14 företagshälsovårdsenheter erbjöds deltagande varav 73 personer ingick i studien.

     

    Resultat

    Respondenterna skattade sitt teamsamarbete som välfungerande inom subskalorna partnerskap/delat beslutsfattande (4,11 poäng, SD 0,59) och samarbete (4,13 poäng, SD 0,56). Subskalan koordination skattades lägre (3,88 poäng, SD 0,63). Ingen skillnad mellan respondenter som upplevde sällan respektive oftast välfungerande team noterades för arbetstillfredställelse (p=0,058), självskattad hälsa (p=0,31) eller syn på rehabilitering (hälsa: p=1,00 och arbetsåtergång: p=0,20)

     

    Konklusion

    Teamsamarbetet bedömdes vara välfungerande vilket indikerar effektiv rehabilitering avseende arbetsåtergång. Ingen skillnad mellan sällan respektive oftast välfungerande team noterades för arbetstillfredställelse, självskattad hälsa eller syn på rehabilitering. 

  • 115.
    Buck, Sebastian
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Development of a new functional test targeting proprioceptive ability following anterior cruciate ligament injury2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Movement control is critically dependent on exteroceptive and proprioceptive information. Reduced proprioception of the knee has been demonstrated after injury of the anterior cruciate ligament (ACL). Various test have been proposed in research, but their implementation and evaluation still represent clinical challenges. There is thus a pronounced need for improved clinical discriminative knee function tests related to proprioceptive ability.

    Aim: Our main aim of this pilot study was to develop and evaluate a new functional proprioception test, and secondly evaluate if our test could discriminate ACL injured from controls.

    Method: We developed a test in which participants step repeatedly over an obstacle, with downward vision occluded. Kinematics were collected in 3D motion laboratory from participants with ACL injury (n=8) and healthy controls (n=10). Coefficient of variation were calculated for the following variables: foot clearance, knee flexion angle and step length and compared between legs within group and between groups.

     

    Results: For between-group comparison larger variability of step length on the trailing leg of both legs were found in the ACL group. No other significant differences were found between the groups and within group differences were also nonsignificant.  

    Conclusion: Our test, so far in a small population, did not discriminate between legs within ACL injured persons or between ACL injured persons and healthy controls. This test needs to be further developed to determine whether it can discriminate between ACL injured and controls. If so, obstacle task may provide a valuable functional test of sensorimotor control following an ACL injury.

  • 116.
    Bugge Jakobsen, Knut Erling
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wilén, Catarina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    ”Tejpen ger mig liksom en trygghet”: - tävlingsidrottares upplevelse av att använda Kinesiotape®2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Kinesiotape® är ett populärt verktyg vid både rehabilitering och prevention av idrottsskador inom idrotten, dess påvisade effekt är dock ännu osäker. Ingen kvalitativ studie är tidigare gjord på upplevelsen av att använda Kinesiotape®.

    Syfte: Syftet med studien var att utforska tävlingsidrottares upplevelser av att använda Kinesiotape® vid rehabilitering av idrottsskador eller som prevention.

    Metod: I denna studie användes semistrukturerade intervjuer som analyserades med kvalitativ innehållsanalys enligt Graneheim och Lundman. Totalt fem tävlingsidrottare deltog i intervjuerna; två från Sverige och tre från Norge.

    Resultat: Analysen resulterade i de tre kategorierna Läkande effekt, Trygghetskänsla och Smärtlindring. Informanterna uttryckte bland annat att Kinesiotape® hade påskyndat läkning av inflammation, ökat blodcirkulation verkat smärtlindrande och fungerat som psykiskt stöd. Tejpen användes enskilt eller i kombination med andra metoder. Effekterna kom tydligt fram i flera intervjuer, dock fanns även upplevelser av att tejpen inte hade gett någon effekt alls.

    Konklusion: Resultatet visade att Kinesiotape® hade bidragit till flera positiva effekter. Tolkning av intervjuerna antyder även att det kan vara ett enkelt och säkert verktyg att använda för fysioterapeuter, då möjligtvis som ett komplement till andra behandlingsmetoder.

  • 117. Bui, Kim-Ly
    et al.
    Nyberg, Andre
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Rabinovich, Roberto
    Saey, Didier
    Maltais, François
    The Relevance of Limb Muscle Dysfunction in Chronic Obstructive Pulmonary Disease: A Review For Clinicians2019In: Clinics in Chest Medicine, ISSN 0272-5231, E-ISSN 1557-8216, Vol. 40, no 2, p. 367-383Article in journal (Refereed)
    Abstract [en]

    "Chronic obstructive pulmonary disease (COPD) is often accompanied by extrapulmonary manifestations such as limb muscle dysfunction. This term encompasses several features, including atrophy, weakness, and reduced oxidative capacity. Clinicians should become accustomed with this manifestation of COPD because of its relevance for important outcomes such as exercise tolerance and survival. Measuring muscle strength and mass can be performed with simple and valid tools that could be implemented in clinical practice. One identified, limb muscle dysfunction is amenable to therapy such as exercise training that has been repeatedly shown to improve muscle mass, strength, and oxidative capacity in COPD."

  • 118. Bui, Kim-Ly
    et al.
    Nyberg, André
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Maltais, François
    Saey, Didier
    Functional tests in chronic obstructive pulmonary disease part 1: clinical relevance and links to the International classification of functioning, disability and health2017In: Annals of the American Thoracic Society, ISSN 2329-6933, E-ISSN 2325-6621, Vol. 14, no 5, p. 778-784Article in journal (Refereed)
    Abstract [en]

    Chronic obstructive pulmonary disease is a major cause of morbidity and mortality worldwide and an important cause of disability. A thorough patient-centered outcome assessment, including not only measures of lung function, exercise capacity and health-related quality of life, but also of functional capacity and performance in activities of daily life, is imperative for a comprehensive management of chronic obstructive pulmonary disease. This American Thoracic Society Seminar Series is devoted to help clinicians substantiate their choice of functional outcome measures in this population. In Part 1 of this two-part Seminar Series, we aim to describe the various domains of functional status, to elucidate terms and key concepts intertwined with functioning, and to demonstrate the clinical relevance of assessing functional capacity in the context of activities of daily living, in agreement with the International Classification of Functioning, Disability and Health. We hope that a better understanding of the various defining components of functional status will be instrumental to healthcare providers to optimize chronic obstructive pulmonary disease evaluation and management, ultimately leading to improved quality of life of patients afflicted by this condition. This first paper also serves as an introduction to Part 2 of this Seminar Series, where the main functional tests available to assess upper and lower body functional capacity of these patients will be discussed.

  • 119. Bui, Kim-Ly
    et al.
    Nyberg, André
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Maltais, François
    Saey, Didier
    Functional tests in chronic obstructive pulmonary disease part 2: measurement properties2017In: Annals of the American Thoracic Society, ISSN 2329-6933, E-ISSN 2325-6621, Vol. 14, no 5, p. 785-794Article in journal (Refereed)
    Abstract [en]

    Chronic obstructive pulmonary disease is a major cause of morbidity and mortality worldwide and an important cause of disability and handicap. For a thorough patient-centered outcome assessment and comprehensive management of the disease, measures of lung function, exercise capacity and health-related quality of life, but also of functional capacity in activities of daily life are necessary. In Part 2 of this Seminar Series, we will discuss the main functional tests to assess upper and lower body functional capacity in patients with COPD, to help clinicians substantiate their choice of functional outcome measures in COPD. In agreement with the International Classification of Functioning, Disability and Health to assess functional capacity representative of daily life activities, this review focuses on functional tests that include components such as changing and maintaining body positions, walking, moving and climbing, as well as carrying, moving and handling objects. We will review the validity, reliability and responsiveness of these tests. With 11 links to the International Classification of Functioning, Disability and Health framework addressing several upper and lower body components of functional activities, the Glittre Activities of Daily Life test seems to be the most promising and comprehensive test to evaluate functional capacity in activities of daily life. The links between functional capacity tests and real participation in daily life, as well as with important clinical outcomes such as morbidity and mortality, need further investigation. More studies are also recommended to document minimal detectable changes, minimal clinically important differences and normative values for these functional tests.

  • 120.
    Bylund, Nils
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lundberg, Michael
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Polisstudenters fysiska kapacitet i förhållande till normal fysisk förmåga2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Polisyrket innehåller varierande arbetsuppgifter och är stundvis fysiskt krävande. För att antas till polisutbildningen ska sökanden inneha god hälsa och normal fysisk förmåga. Studier har undersökt polisstudenters fysiska förmågor vid utbildningens början, inga har dock jämfört resultaten med normalvärden.

    Syfte: Syftet med den här studien var att beskriva fysisk kapacitet hos polisstudenter i början av sin utbildning samt eventuella skillnader mellan kvinnor och män. Ytterligare syften var att jämföra resultaten med normalvärden där det är möjligt samt undersöka sambandet mellan explosivitetstester i nedre och övre extremitet.

    Metod: 64 polisstudenter utförde tester som mätte kondition, greppstyrka, bålstabilitet, explosivitet i nedre och övre extremitet. Alla polisstudenter deltog inte i samtliga tester.

    Resultat: Polisstudenterna presterade signifikant högre resultat än normalvärden gällande maximalt syreupptag och greppstyrka. De manliga polisstudenterna hade en signifikant högre kapacitet än de kvinnliga i samtliga test utom bålstabilitetstestet. Ett signifikant samband fanns mellan explosivitet i nedre och övre extremitet.

    Slutsats: I början på sin utbildning är polisstudenterna en grupp med fysiska kapaciteter som överstiger normal fysisk förmåga. Det finns även signifikanta skillnader mellan de manliga och kvinnliga studenternas fysiska kapaciteter. Dessa resultat pekar på att antagningskraven rimligtvis bör justeras för att göra de mer rättvisa. Alternativt att en fysisk kravprofil för polisyrket arbetas fram om antagningskraven ska behållas lika för alla.

  • 121.
    Byman, Emelie
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wahlberg, Jenny
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Tankar kring bemötande och behandling av gravida kvinnors bäcken- och ländryggssmärta: En kvalitativ intervjustudie med fem barnmorskor2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Graviditetsrelaterad bäcken- och ländryggssmärta är en komplikation som drabbar närmare 50 % av alla gravida. Det är dock inte fastställt varför bara vissa kvinnor drabbas. Om de drabbade kvinnorna däremot identifieras redan vid inskrivning på mödravårdscentralen kan symtomen lindras om tidiga åtgärder sätts in.

     

    Syfte: Att undersöka barnmorskors tankar och upplevelser kring graviditetsrelaterad bäcken- och ländryggssmärta utifrån ett interprofessionellt samarbete med fysioterapeuter.

     

    Metod: Studien bygger på semistrukturerade intervjuer med fem barnmorskor. Datamaterialet genomgick en kvalitativ innehållsanalys i enlighet med Graneheim och Lundman.

     

    Resultat: Analysen resulterade i fem kategorier som berör områdena: Bemötande, diagnostisering, behandlingsalternativ, individanpassning och prevention samt interprofessionellt samarbete. Ett antal subkategorier skapades.

     

    Slutsats: Denna studie visar på att barnmorskor har stor erfarenhet och kunskap om hur graviditetsrelaterad bäcken- och ländryggssmärta diagnostiseras, tack vare deras kliniska erfarenhet. Barnmorskorna vittnar även om en viss tveksamhet i sin syn på hur dessa smärtproblem ska behandlas, vilket vittnar om behovet av att utveckla ett bättre samarbete med fysioterapeuter. I framtiden skulle de båda yrkesgrupperna i så fall kunna erbjuda dessa kvinnor bättre och mer effektiv behandling. Ökad information gällande kvinnohälsa och graviditetsrelaterad bäcken- och ländryggssmärta på bådas respektive grundutbildningar borde förbättras enligt författarna och informanterna, för att öka kunskapen och intresset för detta folkhälsoproblem.  

  • 122.
    Bäcklund, Catharina
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Promoting physical activity among overweight and obese children: Effects of a family-based lifestyle intervention on physical activity and metabolic markers2010Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background Overweight and obesity in childhood is associated with physical, psychological and social consequences. Physical inactivity is regarded as one of the main factors that have contributed to the increase in childhood obesity through out the world. Overweight and obesity as well as physical activity level are shown to track from childhood to adolescence and adulthood, thereby influencing not only the current health status but also long-term health. The general purpose of this thesis was to evaluate the effect of a 2-year family-based lifestyle intervention on physical activity and metabolic health among children with overweight and obesity.

    Methods Children with overweight or obesity living in northern Sweden were recruited to the study. In total 105 children, mean age 10.5 years (SD±1.09), were randomized into either an intervention or a control group. The intervention group was offered as a 2-year family-based lifestyle intervention; the 1st year consisted of 14 group sessions and during the 2nd year the intervention was web-based. The control group did not participate in any intervention sessions, but performed all measurements. Physical activity was measured in all children using SenseWear Pro2 Armband (SWA) during 4 consecutive days before, in the middle and after the intervention, data regarding anthropometrics and blood values were collected in the same periods. Twenty-two of the children wore SWA during 14 days before the intervention in order to validate energy expenditure (EE) estimated by SWA against EE measured with double labelled water.

    Results The SWA, together with software version 5.1, proved to be a valid device to accurately estimate EE at group level of overweight and obese children. There were no statistically significant differences between the groups neither before nor after the intervention regarding physical activity and screen-time. All children significantly decreased their time being active ≥3 METs during the study period. After the study period, significantly fewer in the control group achieved the national physical activity recommendation, and they had significantly increased their screen-time. However, these changes were not seen within the intervention group. The intervention group had a significantly lower apolipoprotein B/A1 compared to the control group at 1-year measurement; no other significant differences were found regarding metabolic markers. No statistical difference was found between the groups regarding body mass index after the 2-year study period.

    Conclusion Even though a comprehensive program, the 2-year family-based lifestyle intervention had limited effects on physical activity and metabolic health in overweight and obese children. SWA is a device that can be used in future studies to measure energy expenditure among free-living overweight or obese children.

  • 123.
    Bäcklund, Catharina
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Larsson, Christel
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Effect of a 1-year lifestyle intervention on physical activity in overweight and obese children2011In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 13, no 3, p. 87-96Article in journal (Refereed)
    Abstract [en]

    This study evaluated the effect of a family-based multifactor intervention programme on physical activity among overweight or obese children. Children (n = 105, mean age 10.6 ± 1.07 years) with overweight or obesity were randomized into an intervention or control group. The intervention group participated in a 1-year programme aiming at lifestyle changes regarding food habits and physical activity. All children's physical activity was measured using SenseWear Armband at baseline and after 1 year. The children in both groups had a physical activity level (PAL) of 1.67 (0.27) at baseline. When comparing the intervention and control groups, no significant differences were found in physical activity outcome variables after 1 year of intervention. Contrarily to the hypotheses, both groups decreased their energy expenditure and time spent at >3 MET, and there was no change in steps and screen time after 1 year. Despite extensive efforts, the intervention showed no significant positive effect on overweight and obese children's PAL. Further studies are needed to obtain more knowledge on how to maintain or increase the PAL successfully among overweight and obese children.

    Read More: http://informahealthcare.com/doi/abs/10.3109/14038196.2011.566353

  • 124.
    Bäcklund, Catharina
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Larsson, Christel
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Effects on physical activity of a 2-year lifestyle intervention in overweight and obese children2011In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 13, no 3, p. 97-109Article in journal (Refereed)
    Abstract [en]

    The aim was to examine the effect on physical activity of a 2-year family-based lifestyle intervention among overweight and obese Swedish children 8–12 years of age; 105 children were randomized to either intervention or control group. The intervention group was offered a 2-year lifestyle programme. Physical activity was measured using SenseWear Pro2 Armband during 4 consecutive days before and after the intervention. When comparing the intervention and control groups, no significant differences were found in the physical activity outcome variables after 2 years of intervention. However, the intervention group decreased their number of steps per day by 13%, p = 0.003 but had an unchanged screen time, whereas the control group had an unchanged number of steps but increased their screen time by 15%, p = 0.02, from baseline to 2-year measurement. There were no significant change in the intervention group, whereas significantly fewer children in the control group achieved the physical activity recommendations at 2-year measurement (88%) compared with at baseline (98%), p = 0.007. Future interventions regarding physical activity among overweight and obese children are of great importance even though the present one showed limited effects. In the continuing work, a greater effect may be received with an extended and more intense intervention regarding physical activity, focusing on reducing sedentary time rather than increasing the physical activity level.

    Read More: http://informahealthcare.com/doi/abs/10.3109/14038196.2011.562540

  • 125.
    Bäckman, Pernilla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Validering av självtest för balans och funktionell styrka med mobiltelefon för äldre personer2018Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Att testa balans och styrka med hjälp av en mobiltelefon skulle kunna göra det möjligt för äldre att själva utföra enklare balans- och styrketest i hemmiljö. En prototyp av ett sådant test har tagits fram och som en del i utvecklingen av prototypen ska testresultat jämföras mot kliniskt validerade test. Syfte: Undersöka den samtidiga validiteten mellan kliniska test och rörelsevariabler insamlade samt beräknade med en prototyp av en mobil applikation. Metod: 21 personer (medelålder 78år) inkluderades. Korrelation mellan mobiltelefonens registreringar under 4- stage balance test samt en maximal uppresning och resultatet för sju kliniska test (five times sit to stand, 1 repetitions maximum i benpress, 30 sekunders uppresningstest, MiniBESTest, functional reach, modifierat stepping test och 4-stage balance test) beräknades. Resultat: De variabler som beräknats från mobiltelefonens registreringar under maximalt uppresningstest korrelerade samtliga signifikant med resultatet på 30 sekunders uppresningstest. För balanstesten sågs en korrelation mellan mobiltelefonens registreringar av svaj i den svåraste fotpositionen deltagarna klarat och den totala tiden deltagarna balanserat i 4-stage balance test. I övrigt fanns inga signifikanta korrelationer. Slutsats: Mätningar med en mobiltelefon under en maximal uppresning skulle kunna kvantifiera äldres funktionella benstyrka i likhet med 30 sekunders uppresningstest. En mobiltelefons mätningar verkar inte kunna kvantifiera äldre personers balans på liknande sätt som kliniska balanstest

  • 126.
    Bäckström Andersson, Solveig
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Vårdvetenskapligt forskningscentrum, Örebro läns landsting.
    Medicinsk yoga för personer med multipel skleros: En feasibility studie2015Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Summary

    Background and objective: Physical activity affects people with Multiple sclerosis (PwMS) in a positive way. The number of studies that shows if yoga is a suitable activity with positive effects for PwMS is still inadequate. The attention with this study was to examine the feasibility of a tutorled groupyoga with 2 sessions per week for 8 weeks combine with homepractice  and the feasibility as well as relevance of choosen measurements and assessments to detect change in fatigue, balance, walking ability and quality of life for PwMS.

     

    Method: A feasibilitystudy of an intervention with measurements taken before and after was conducted. 15 people from two clinics in Stockholm were invited and 12(80%) accepted. Timed Up and Go (TUG), postural stability and reaching ability with swajmeter were selected for function. Patientrelated assessments were Activities-specific Balance Confidence scale (ABC), MS Walking Scale (MSWS-12), The Fatigue Scale for Motor and Cognitive Functions (FMCF), Euroqual EQ-5D and Multiple Sclerosis Impact Scale (MSIS-29). Compliance to anticipation as well as prospective falls were measured and by the attendents noted in a logbook. After completed intervention the attendants described the experiance with tutorled groupyoga vs homepractice, possible effects, future interest in attending medical yoga, the study´s design and the extention of measurements and intervention.

     

    Results: All of the attendants completed the intervention and the compliance in the groupled yoga was good with 88% attendance. The compliance of homepractice varied greatly from one to several times per week. No falls were rapported. The yoga practice was highly appreciated, all of the attendants wished to continue to yoga and recommended PwMS to try. Most of the choosen methods and assessments including the loggbook were found to be doable both by the attendants and the assistant. Some parts of the postural stability tests were found to be too difficult for this group, as well as ABC. Even though the intervention included few attendants, small improvements were noted in functional balance through TUG (p=0.006) and patient reported level of psycological and physical function through MSIS-29 (p=0.01).

     

     

     

    Conclusion: The feasibility and compliance of an 8-week tutorled groupyoga was good but the compliance of home practice varied amongst the attendants. To evaluate the effects of medical yoga for this group of patients the tutorled yoga is adequate. TUG and parts of the postural stability seem to be relevant. The amount of patientrelated assessments need to be reduced. MSWS and MSIS-29 tend to be sensitive for change in this study. Other assessments for fatigue and quality of life should be considered.

  • 127.
    Caiman, Lisa
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Dryselius, Alice
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Group exercise as a fall prevention intervention for people with intellectual disability: A feasibility case study2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: People with intellectual disability (ID) have an increased risk of falling and of falls related injuries. During a 12 month period approximately 30 percent of people with ID experience at least one fall. In the older population fall prevention programmes and exercise interventions have been established and used successfully, but for people with ID evidence is currently lacking.

    Purpose: The aim of this case-study was to evaluate the feasibility of a group exercise program based on the Otago Exercise Programme (OEP) in people with ID.

    Method: Four individuals with mild-moderate ID participated in this study. A mixed method approach was used: before-after evaluation and a qualitative interview evaluation of the group class. Balance, gait and participation were assessed at baseline and 8 weeks later, with 7 standardized measures. The qualitative interview was analysed using content analysis method.

    Result: A consistent, positive change was found across all participants on measure Video Based Balance Scale for ID (BSID). The qualitative interview resulted in one theme; The group exercise class was enjoyable, suitable and stimulating. One fall was recorded during the intervention period.

    Conclusion: The exercise programme resulted in some improvements in gait and balance, however beneficial psychosocial effects were found in this group. The OEP could be feasible for people with ID, thus further studies are needed. 

  • 128.
    Camilla, Sandberg
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Pomeroy, Jeremy
    Thilén, Ulf
    Gradmark, Anna
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Wadell, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Johansson, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Habitual Physical Activity in Adults with Congenital Heart Disease Compared with Age- and Sex- Matched Controls2016In: Canadian Journal of Cardiology, ISSN 0828-282X, E-ISSN 1916-7075, Vol. 32, no 4, p. 547-553Article in journal (Refereed)
    Abstract [en]

    Background: Most adult patients with congenital heart disease (CHD) have reduced aerobic exercise capacity. Their habitual physical activity (PA) level is, however, less well studied. In this study habitual PA level in a cohort of adults with CHD compared to healthy age and gender matched controls was investigated.

    Methods: Eighty adults with CHD, classed as either “complex” (n=40) or “simple” (n=40), and 42 healthy controls were studied with a combined uniaxial accelerometer and heart rate monitor worn during 4 consecutive days. We analysed 1) the time spent during ≥ moderate/vigorous PA, 2) accelerometer counts/day and 3) to what extent the World Health Organization recommendations on PA were reached.

    Results: Patients with simple lesions had higher total accelerometer counts/day compared to both patients with complex lesions and controls (simple lesions; median (IQR) 107.7(63.4) vs. complex lesions; 72.8(53.5) and controls; 78.3(49.6), p≤0.001 and p=0.002). Furthermore, no differences in time spent during ≥ moderate-to-vigorous PA was found between patients and controls. In addition 46% of the patients with simple lesions, 55% of the patients with complex lesions and 44% of the controls did not reach the W.H.O.-recommended level of daily PA, but no significant differences between groups were found. There were no differences in achieving recommended PA level between patients in NYHA I vs. NYHA II+III.

    Conclusions: Patients with CHD follow the same PA-level pattern as the general population. Broad strategies promoting an active lifestyle are needed across the population and especially for patients with complex CHD and impaired NYHA class.

  • 129.
    Carlson, Victor
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hedberg, Joel
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Validering av Självskattningsskalan C-SMIT30 vid högintensiv intervallträning på cykel: en pilotstudie2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte Syftet med denna pilotstudie är att utvärdera ifall självskattning med C-smit30-skalan är valid för att mäta upplevd ansträngning vid högintensiv intervallträning på cykel för yngre och tränade individer.

    Metod Totalt 12 träningsvana testpersoner, 6 kvinnor och 6 män i åldrarna 20-30 år utförde sammanlagt 6 olika tester. Ingen av testdeltagarna var elitidrottare och samtliga såg sig själva som friska under testtillfället. Testdeltagarna cyklade på olika motstånd och självskattade upplevd ansträngning enligt Borg’s RPE-skala. För att validera C-SMIT30-skalan användes ett test där testpersonerna fick cykla tre stycken 30-sekundersintervaller då de sedan fick skatta upplevd ansträngning enligt Borg’s RPE-skala samt den nya C-SMIT30-skalan. Ytterligare ett test utfördes för samtliga testpersoner där de fick göra ett test för att se hur länge de faktiskt kunde fortsätta cykla på den satta effekten. Samtliga cykeltest utfördes på en spinningcykel med en kadens på 85 Rounds Per Minute (RPM).

    Resultat Tre av testpersonerna (25%) cyklade kortare tid än vad de uppskattade, fyra (33%) cyklade längre än vad de uppskattade och fem (42%) cyklade lika länge som de hade skattat. Fyra av testpersonerna var inom fyra sekunder från att skatta rätt. Korrelationen av självskattningen kontra det faktiskta resultatet var +0,860 och testet var signifikant (p<0,01).

    Slutsats C-SMIT30-skalan kan användas som självskattningskala för att utvärdera om individer tränar på rätt motstånd vid högintensiv intervallträning på cykel. Vidare forskning av ämnet behövs.

  • 130.
    Carlsson, Carl
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Effekten av muskeltrötthet på avvikande rörelsemönster- screeningtester för elit-herrjuniorer i fotboll.2016Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
  • 131.
    Carlsson, Elin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Medin, Frida
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Feedback och dess effekter på resultatet vid utförande av The Functional Movement Screen (FMS)2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Abstrakt

     

    Introduktion Testning av kroppsfunktioner kan vara viktigt för att upptäcka nedsättningar som kan leda till skador. The Functional Movement Screen (FMS) är ett testbatteri med sju grundläggande rörelsetester som undersöker asymmetrier som nedsatt styrka och rörlighet. FMS används numera i hela världen men har ifrågasatts när det gäller testernas tillförlitlighet och validitet.

     Syfte

    Syftet med den här studien är att undersöka om feedback påverkar resultatet av The Functional Movement Screen.

     Metod

    I studien deltog 19 Fysioterapeutstudenter från Umeå Universitet. Deltagarna delades in i två randomiserade grupper, en kontrollgrupp (n=10) och en interventionsgrupp (n=9).  Samtliga blev bedömda i FMS vid två tillfällen, interventionsgruppen fick inför andra testtillfället feedback på deras utförande från första tillfället.

     

    Resultat

    Kontrollgruppen visade inte på några signifikanta skillnader mellan försöken. Interventionsgruppen visade på signifikanta skillnader i DS (p=0,046), ASLR (p=0,025) samt i  totalpoängen (p=0,011).  Mellangruppsjämförelsen visade signifikanta skillnader i delmomenten DS (p=0,017),  ASLR (p=0,008) samt i totalpoängen (p=0,001).

    Konklusion

    Denna studie visar att feedback kan förbättra resultatet av The Functional Movement Screen. Detta innebär i förlängningen att delmomenten i FMS kanske inte speglar den verkliga kroppsfunktionen hos de som testas utan om och hur det förstått instruktionerna samt vilka bedömningskriterierna för de sju testerna är. Ytterligare studier krävs inom ämnet med ett högre deltagarantal.

  • 132.
    Carlsson, Maine
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Littbrand, Håkan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lindelöf, Nina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Rosendahl, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Håglin, Lena
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Effects of high-intensity exercise and protein supplement on muscle mass in ADL dependent older people with and without malnutrition: a randomized controlled trial2011In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 15, no 7, p. 554-560Article in journal (Refereed)
    Abstract [en]

    Background  Loss of muscle mass is common among old people living in institutions but trials that evaluate interventions aimed at increasing the muscle mass are lacking.

    Objective, participants and intervention  This randomized controlled trial was performed to evaluate the effect of a high-intensity functional exercise program and a timed protein-enriched drink on muscle mass in 177 people aged 65 to 99 with severe physical or cognitive impairments, and living in residential care facilities.

    Design  Three-month high-intensity exercise was compared with a control activity and a protein-enriched drink was compared with a placebo drink. A bioelectrical impedance spectrometer (BIS) was used in the evaluation. The amount of muscle mass and body weight (BW) were followed-up at three and six months and analyzed in a 2 × 2 factorial ANCOVA, using the intention to treat principle, and controlling for baseline values.

    Results  At 3-month follow-up there were no differences in muscle mass and BW between the exercise and the control group or between the protein and the placebo group. No interaction effects were seen between the exercise and nutritional intervention. Long-term negative effects on muscle mass and BW was seen in the exercise group at the 6-month follow-up.

    Conclusion  A three month high-intensity functional exercise program did not increase the amount of muscle mass and an intake of a protein-enriched drink immediately after the exercise did not induce any additional effect on muscle mass. There were negative long-term effects on muscle mass and BW, indicating that it is probably necessary to compensate for an increased energy demand when offering a high-intensity exercise program.

  • 133.
    Carlsson, Pernilla
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Antfolk, Amanda
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rörelserädsla och tvångsmässig träning hos personer med utmattningssyndrom2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Psykisk ohälsa ökar i Sverige och andelen drabbade kvinnor är nästan dubbelt så stor som andelen män. Utmattningssyndrom är en diagnos som tillhör psykisk ohälsa och vanliga symtom är fysisk trötthet, ångest, nedstämdhet och även kognitiva symtom är vanligt. Fysisk aktivitet har positiva effekter vid ångest, depression och utmattningssyndrom men det finns bristfällig evidens på vad personer med utmattningssyndrom har för inställning till fysisk aktivitet och om det eventuellt förekommer rörelserädsla eller tvångsmässig träning hos den här patientgruppen. Syfte: Syftet med denna studie är att undersöka förekomsten av rörelserädsla och tvångsmässig träning hos personer med utmattningssyndrom, samt dess samband med utmattning, ångest, depression och fysisk aktivitet. Metod: 42 deltagare med en medelålder på 45,5 i ett multimodalt rehabiliteringsprogram svarade på en enkät angående rörelserädsla, tvångsmässig träning, utmattning, ångest, depression och fysisk aktivitet. Resultat: Rörelserädsla förekom hos 50% av deltagarna och det fanns tendenser till tvångsmässig träning hos drygt hälften av deltagarna. Rörelserädsla och tendenser till tvångsmässig träning var vanligare bland kvinnor än bland män. Det fanns ett signifikant samband (r=0,378) mellan rörelserädsla och utmattningssyndrom. Det fanns också ett svagt negativt samband (r=-195) mellan tvångsmässig träning och fysisk aktivitet, samt ett svagt samband (r=0,224) mellan ångest och rörelserädsla. Konklusion: Resultatet i studien visar att det förekommer rörelserädsla hos personer med utmattningssyndrom samt att det förekommer tendenser till tvångsmässig träning. Få studier har studerat sambandet mellan dessa variabler därför krävs mer forskning inom området.

  • 134.
    Carlström, Sara
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Muskuloskeletala besvär i överkroppen och belastningsexponering hos svetsare och förskolepersonal: - En jämförelse2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion Arbetsrelaterade muskuloskeletala besvär (WMSD) är vanligt förekommande inom manuellt arbete, varav besvär i nacke och överkropp är vanligt. Tunga statiska och tunga dynamiska exponeringar för nack- och skuldermuskulatur har visat samband med besvär i nacke/axlar. Att arbeta som svetsare innebär tungt statiskt arbete och vid arbete i förskola utsätts personalen för ett tungt varierande arbete.

    Syftet är att jämföra svetsare och förskolepersonal med avseende på muskuloskeletala besvär och fysisk belastningsexponering i överkroppen.

    Metod Med MEBA undersöktes prevalensen av muskuloskeletala besvär i överkroppen och med QEC undersöktes belastningsexponeringen. Totalt deltog 25 personer, 15 svetsare (Md 44 år) och 10 personer (Md 50 år) som arbetade inom förskola.

    Resultat Inga signifikanta skillnader fanns mellan grupperna med avseende på besvärsförekomst eller belastningsexponering. Hög prevalens av nackbesvär rapporterades inom båda yrkesgrupperna. Svetsarna hade också stor andel besvär i axlar, armbågar/underarmar som i handleder/händer, medan förskolepersonalen hade stor andel besvär i axlar och handleder/händer. Belastningsexponeringen vid svetsning bedömdes som mycket hög för nacken och mellanhög för resten av överkroppen. För arbete på förskola bedömdes exponeringen som mellan för alla delar av överkroppen.  

    Konklusion Det var en hög besvärsförekomst inom båda yrken, nackbesvär stod ut som det mest förekommande besväret. 

  • 135.
    Carlström, Sara
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Israelsson, Rebecka
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Nack- och ryggpatienters kinesiofobi och tilltro till sin förmåga: vid sjukgymnastbesök2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 136.
    Conradsson, Mia
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Physical exercise and mental health among older people: measurement methods and exercise effects focusing on people living in residential care facilities2012Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim of this thesis was to study the effects of exercise on mental health among older people living in residential care facilities. The aim was also to study the reliability of an assessment scale for balance function and the usefulness of an assessment scale for depressive symptoms among older people, including people with cognitive impairments.

     

    The Berg Balance Scale (BBS) is frequently used to assess balance in older people, but knowledge is lacking about its absolute reliability. The BBS (0-56 points) was assessed twice among older people living in residential care facilities by the same assessor, at approximately the same time of day, and with 1-3 days in between. The absolute reliability was calculated as being 7.7 points, using 95% confidence level, and the Intra Class Correlation coefficient (ICC) was calculated to 0.97.

     

    Depression is common among older people and is often not detected and not treated adequately. The Geriatric Depression Scale 15-item version (GDS-15) was designed to assess depressive symptoms among older people, but there is limited knowledge about the usefulness of the scale among people with varying degree of cognitive impairment. A sample of people aged 85 years and over was divided into groups according to cognitive function using their Mini-Mental State Examination (MMSE) scores; 0-4, 5-9, 10-14, 15-19, 20-24, 25-27, and 28-30. In total, 650 (78%) of the 834 participants completed the GDS-15. The lower the cognitive function, the smaller the proportion who completed the GDS-15 assessment; for the two MMSE groups with scores of < 10, the proportions who completed the GDS-15 were 1% and 42%, respectively, compared to 64–95% in people with MMSE scores of ≥ 10. The level of correlation between the GDS-15 and a scale of psychological wellbeing, the Philadelphia Geriatric Center Morale Scale (PGCMS), did not differ between MMSE groups with scores of ≥5 compared to people in the group with the highest scores (MMSE 28–30).

     

    Exercise has been suggested as effective in influencing mental health among community-dwelling older people, but there is a need for a well-designed study to establish the effects among older people living in residential care facilities. A high-intensity functional exercise programme was evaluated for effects on depressive symptoms and psychological wellbeing among older people dependent in activities of daily living (ADL) and living in residential care facilities. The study was a cluster-randomised controlled study. Participants were randomised to either a high-intensity functional weight-bearing exercise program (HIFE Program) or a control activity. Sessions were held in groups, for approximately 45 minutes, five times over each two-week period for three months, a total of 29 times. The outcome measures, the GDS-15 and the PGCMS, were blindly assessed at baseline, 3- and 6-month follow-up.  There were no differences between the groups at the 3- or 6-month follow-ups in the total sample. However, sub-groups analyses showed a difference in PGCMS scores in favor of the exercise group among people with dementia at the 3-month follow-up.

     

    Regarding older people living in residential care facilities, including people with cognitive impairments, there is a lack of evidence showing that exercise has a positive influence on mental health. This may either be due to a lack of effect, or an insufficient amount of effect of exercise on physical capacity or dependence in ADL, which could be two important mediating factors for influencing mental health. The association between changes in physical capacity (BBS) or dependence in ADL (Barthel ADL Index) and changes in mental health (GDS-15 and PGCMS) was evaluated. The results showed no significant associations between change in physical capacity or dependence in ADL, and change in depressive symptoms or psychological well-being. Further, interaction analyses showed no moderating effects for dementia disorder.

     

    In conclusion, despite a high ICC value, the result of the absolute reliability evaluation shows that a change of 8 BBS points is required to reveal a genuine change in function among older people who are dependent in ADL and living in residential care facilities. This knowledge is important in the clinical setting when evaluations are made of an individual’s change in balance function over time in this group of older people. The GDS-15 seems useful in assessing depressive symptoms among very old people with MMSE scores of ten or above. More studies are needed to strengthen the validity among people with MMSE scores of 10-14, and for people with lower MMSE scores than ten there may be a need to develop and validate other measurements. Furthermore, a high-intensity exercise programme offered 2-3 times/week seems not to generally influence mental health among older people living in residential care facilities. However, the exercise programme may have a short-term effect on well-being among people with dementia. A change in physical capacity or dependence in ADL does not appear to be associated with a change in depressive symptoms or psychological well-being among older people who are living in residential care facilities. These results may explain why studies of using exercise to influence mental health have not shown effects in this group of older people. In future research, there is a need for studies that evaluate whether exercise offered more frequently, or interventions that aim to increase the level of physical activity in daily life, can influence mental health among older people living in residential care facilities.

  • 137.
    Conradsson, Mia
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Littbrand, Håkan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Boström, Gustaf
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Lindelöf, Nina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Rosendahl, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Is a change in physical capacity or dependence in ADL associated with a change in mental health among older people living in residential care facilities?Manuscript (preprint) (Other academic)
  • 138.
    Conradsson, Mia
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Littbrand, Håkan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Lindelöf, Nina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Rosendahl, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Effects of a high-intensity functional exercise programme on depressive symptoms and psychological well-being among older people living in residential care facilities: a cluster-randomized controlled trial2010In: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 14, no 5, p. 565-576Article in journal (Refereed)
    Abstract [en]

    Objectives: To evaluate the effects of a high-intensity functional exercise programme on depressive symptoms and psychological well-being among older people dependent in activities of daily living (ADL) and living in residential care facilities.

    Method: Cluster-randomized controlled study. Participants were 191 older people, aged 65–100, dependent in ADL and with Mini Mental State Examination scores between 10 and 30. One-hundred (52%) of the participants had a diagnosed dementia disorder. A high-intensity functional weight-bearing exercise programme and a control activity were performed in groups. Sessions were held five times over each two week period for three months, a total of 29 times. The outcome measures, Geriatric Depression Scale (GDS-15) and Philadelphia Geriatric Center Morale Scale (PGCMS) were blindly assessed at baseline, three and six months.

    Results: At baseline, mean ± SD (range) for GDS was 4.4 ± 3.2 (0–14), and for PGCMS 11.0 ± 3.5 (2–17). There were no significant differences in GDS or PGCMS between the exercise and the control group at the three and six month follow-ups in the total sample. Among people with dementia, there was a between-group difference at three months in PGCMS scores in favour of the exercise group.

    Conclusion: A high-intensity functional exercise programme seems generally not to influence depressive symptoms or psychological well-being among older people dependent in ADL and living in residential care facilities. An individualized and multifactorial intervention may be needed in this group. However, an exercise programme as a single intervention may have a short-term effect on well-being among people with dementia.

  • 139.
    Conradsson, Mia
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Lundin-Olsson, Lillernor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lindelöf, Nina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Littbrand, Håkan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Malmqvist, Lisa
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Rosendahl, Erik
    Physiotherapy Unit, Department of Health Sciences, Luleå University of Technology.
    Berg balance scale: intrarater test-retest reliability among older people dependent in activities of daily living and living in residential care facilities2007In: Physical Therapy, ISSN 0031-9023, E-ISSN 1538-6724, Vol. 87, no 9, p. 1155-1163Article in journal (Refereed)
    Abstract [en]

    Background and Purpose: The Berg Balance Scale (BBS) is frequently used to assess balance in older people, but knowledge is lacking about the absolute reliability of BBS scores. The aim of this study was to investigate the absolute and relative intrarater test-retest reliability of data obtained with the BBS when it is used among older people who are dependent in activities of daily living and living in residential care facilities.

    Subjects: The participants were 45 older people (36 women and 9 men) who were living in 3 residential care facilities. Their mean age was 82.3 years (SD=6.6, range=68-96), and their mean score on the Mini Mental State Examination was 17.5 (SD=6.3, range=4-30).

    Methods: The BBS was assessed twice by the same assessor. The intrarater test-retest reliability assessments were made at approximately the same time of day and with 1 to 3 days in between assessments. Absolute reliability was calculated using an analysis of variance with a 95% confidence level, as suggested by Bland and Altman. Relative reliability was calculated using the intraclass correlation coefficient (ICC). Results The mean score was 30.1 points (SD=15.9, range=3-53) for the first BBS test and 30.6 points (SD=15.6, range=4-54) for the retest. The mean absolute difference between the 2 tests was 2.8 points (SD=2.7, range=0-11). The absolute reliability was calculated as being 7.7 points, and the ICC was calculated to .97.

    Discussion and Conclusion: Despite a high ICC value, the absolute reliability showed that a change of 8 BBS points is required to reveal a genuine change in function among older people who are dependent in activities of daily living and living in residential care facilities. This knowledge is important in the clinical setting when evaluating an individual's change in balance function over time in this group of older people.

  • 140.
    Conradsson, Mia
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Rosendahl, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Littbrand, Håkan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Olofsson, Birgitta
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lövheim, Hugo
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Usefulness of the Geriatric Depression Scale 15-item version among very old people with and without cognitive impairment2013In: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 17, no 5, p. 81p. 638-645Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of this population-based study was to investigate the usefulness of the Geriatric Depression Scale 15-item version (GDS-15) to assess depressive symptoms among very old people with differing levels of cognitive function.

    Methods: The 834 participants were aged 85 and over. Feasibility of GDS-15 was evaluated as the proportion of people who completed the scale. Concurrent criterion validity was evaluated by calculating correlations between GDS-15 and Philadelphia Geriatric Center Morale Scale (PGCMS). PGCMS measures psychological wellbeing which is closely related with depressive symptoms. Correlations were calculated within groups according to cognitive function assessed with Mini-Mental State Examination (MMSE); 0-4, 5-9, 10-14, 15-19, 20-24, 25-27, and 28-30, using Pearson's two-sided correlation and compared using Fisher r-to-z transformation. Internal consistency of the GDS-15 was evaluated by calculating Cronbach's in each group.

    Results: In total, 651 (78%) of the 834 participants completed the GDS-15. For the two MMSE-groups with scores of <10, the proportion who completed GDS-15 were 1% and 42%, respectively, compared to 65-95% in the MMSE-groups with scores of 10. Cronbach's in each MMSE-group ranged from 0.636 (MMSE 28-30) to 0.821 (MMSE 5-9). The level of correlation between GDS-15 and PGCMS did not significantly differ between MMSE-groups with scores of 5-27 compared to the MMSE-group with scores of 28-30.

    Conclusions: The GDS-15 seems to have an overall usefulness to assess depressive symptoms among very old people with an MMSE score of 10 or more. More studies are needed to strengthen the validity of GDS-15 among older people with MMSE scores of 10-14. For older people with MMSE scores lower than 10, there is a need to develop and validate other measurements.

  • 141. Crea, Simona
    et al.
    Edin, Benoni B.
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB).
    Knaepen, Kristel
    Meeusen, Romain
    Vitiello, Nicola
    Time-Discrete Vibrotactile Feedback Contributes to Improved Gait Symmetry in Patients With Lower Limb Amputations: Case Series2017In: Physical Therapy, ISSN 0031-9023, E-ISSN 1538-6724, Vol. 97, no 2, p. 198-207Article in journal (Refereed)
    Abstract [en]

    Background. Reduced sensory feedback from lower leg prostheses results in harmful gait patterns and entails a significant cognitive burden because users have to visually monitor their locomotion. Objectives. The purpose of this study was to validate a sensory feedback device designed to help elderly patients with transfemoral amputation to improve their temporal gait symmetry after a training program aimed at associating the vibrotactile patterns with symmetrical walking. Design. This was a prospective quasi-experimental study including 3 elderly patients walking with lower leg prostheses. Methods. During training sessions, participants walked on a treadmill equipped with feedback device that controlled vibrotactile stimulators based on signals from a sensorized insole while provided with visual feedback about temporal gait symmetry. The vibrotactile stimulators delivered short-lasting, low-intensity vibrations synchronously with certain gait phase transitions. During pretraining and posttraining sessions, participants walked without visual feedback about gait symmetry under 4 conditions: with or without vibrotactile feedback while performing or not performing a secondary cognitive task. The primary outcome measure was temporal gait symmetry. Results. with <= 52 hours of training,the participants improved their temporal gait symmetry from 0.82 to 0.84 during the pretraining evaluation session to 0.98 to 1.02 during the follow-up session across all conditions. Following training, participants were able to maintain good temporal gait synmsetry, without any evidence of an increased cognitive burden. Limitations. The small sample size and short follow-up time do not allow straightforward extrapolations to larger populations or extended time periods. Conclusions. Low-cost, gait phase-specific vibrotactile feedback after training combined with visual feedback may improve the temporal gait synmsetry in patients with transfemoral amputation without representing an additional cognitive burden.

  • 142.
    Dahlgren, Gunilla
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Carlsson, Daniel
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Moorhead, Anne
    Health and Rehabilitation Sciences Research Institute, School of Health Sciences, University of Ulster, Co. Antrim, Northern Ireland, United Kingdom.
    Häger-Ross, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    McDonough, Suzanne M
    Health and Rehabilitation Sciences Research Institute, School of Health Sciences, University of Ulster, Co. Antrim, Northern Ireland, United Kingdom.
    Test-retest reliability of step counts with the ActivPAL™ device in common daily activities.2010In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 32, no 3, p. 386-90Article in journal (Refereed)
    Abstract [en]

    The ActivPAL device is a well-established physical activity monitor for assessment of physical activity. AIM: To investigate test-retest reliability of step counts and establish minimal detectable changes (MDC) in step count to account for intra device error over time in various physical activities. METHODS: Healthy participants (n=24, age range, 19-28 years) performed activities on two occasions, 1 week apart, in a laboratory setting; self-paced floor walking, treadmill walking at three different speeds (3.2 km/h, 4.5 km/h and 4.5 km/h with incline), treadmill jogging (8.0 km/h), stair walking and cycling on an exercise bike at three speeds (45 rpm, 60 rpm and 75 rpm). Relative reliability was calculated using intraclass correlation coefficient (ICC) and Spearman correlation. Absolute reliability was assessed using standard error of measurement (SEM) and coefficient of repeatability (CR). RESULTS: The ActivPAL showed high to very high relative reliability for treadmill walking at all speeds and stair walking, while self-paced normal floor walking showed moderate reliability. The absolute reliability was the best for treadmill walking activities, slightly increased for self-paced walking, followed by stair walking and jogging. The use of activity monitors during cycling has been questioned and our results confirm a low absolute and relative reliability. MDC values varied according to the type of activity e.g. treadmill walking 4.5 km/h (10 steps), walking on the floor (45 steps). Data loss in this study (10-13%) was higher than previously reported. CONCLUSIONS: The ActivPAL is reliable for treadmill walking, jogging and self-paced walking. MCD varies according to the activity and should be considered when establishing true change over time.

  • 143.
    Dahlqvist, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lundblad, Maria
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    "Lagom är bäst": Elitsatsande hockeykillars syn på träning, kropp och hälsa – en kvalitativ intervjustudie2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Kropps- och träningsideal sprids globalt med hjälp av bland annat sociala medier. Många ungdomar strävar efter en viss idealkropp, vilket i vissa fall resulterar i ätstörningar och negativa träningsbeteenden. Tidigare forskning är främst gjord på tjejer men det har visat sig att även killar drabbas. Elitsatsande ungdomar inom olika idrotter kan utgöra en riskgrupp.

     

    Syfte: Att undersöka unga elitsatsande hockeykillars syn på träning, kropp och hälsa i relation till sociala medier och rådande kropps- och träningsideal.

     

    Metod: En kvalitativ studiedesign valdes där semistrukturerade intervjuer genomfördes med nio spelare från en elitsatsande klubb i åldrarna tretton till sexton år. Intervjuerna analyserades enligt Grounded Theory.

     

    Resultat: Intervjuerna resulterade i kärnkategorin ”Sunt hälsotänk – lagom är bäst” som innefattar fyra kategorier med underkategorier. Kategorierna är Målmedvetenhet med en sund inställning, Fysisk aktivitet är bra för alla, men mängden är upp till var och en, Medvetna men uttrycker sig vara opåverkade av sociala medier och Stödjande omgivning. Slutligen skapades en modell, det vill säga en mindre teori.

     

    Konklusion: Spelarna beskrev ett sunt hälsotänk där de uttryckte att de inte påverkades av yttre faktorer. De var medvetna om att mycket på sociala medier handlar om träning och kost, men påverkades inte negativt av det och tyckte att tränings- och kostvanor inte ska gå till en överdrift. Orsaken till detta kan vara att de har ett bra stödnät och att vara en spelare i ett elitsatsande hockeylag kan ha en skyddande effekt. En ökad kunskap inom fysioterapin om ungdomars syn på träning, kropp och hälsa skulle kunna bidra till att negativa beteenden upptäcks i god tid. Mer forskning krävs som stödjer detta.

  • 144.
    Dahlström, Stina
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Remmets, Cilla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Balanstest med mobiltelefon: Hur fungerar det i praktiken? En pilotstudie2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Fallolyckor bland äldre innebär stora samhällskostnader och lidande för individen. Träning av balansförmågan kan minska fallrisken men tillförlitliga och lättanvända metoder för att utvärdering av sådan träning behövs. Accelerometer är ett enkelt instrument validerat för att mäta balansförmåga och sådana finns idag inbyggda i de flesta mobiltelefoner. En applikation för självtest av balans i hemmiljö skulle vara ett hjälpmedel vid fallpreventiv träning.

    Syftet med denna studie är att utvärdera applikationen “Balansera” som är under utveckling för att äldre personer ska kunna testa sin balans med hjälp av en mobiltelefon eller surfplatta.

    Metod: Under ett användartest observerades 14 deltagare när de använde applikationen. Validiteten testades genom att applikationens tidtagningsförmåga jämfördes statistiskt med manuell tidtagning och utifrån accelerometerdata.

    Resultat: Under användartesterna uppvisade de äldre deltagarna en rad svårigheter med att genomföra självtestet med hjälp av applikationen. Den statistiskt beräknade korrelationen mellan applikationens tidtagning och den manuella tidtagningen gav ett r2-värde på 0,904 samt ett p-värde på 0,000.

    Slutsats: Denna studie visar att applikationen ”Balansera” på ett tillförlitligt sätt kan mäta balansförmåga med hjälp av tidtagning. För att applikationen ska bli tillförlitlig som självtest för hemmabruk måste den vidareutvecklas så att användaren utför testet korrekt.

  • 145.
    Danvind-Malm, Linda
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Johnels, Maria
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Ridterapi som lustfylld drivkraft till träning vid cerebral pares: en kvalitativ intervjustudie ur ryttares och instruktörs perspektiv2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund

    Ridterapi är en hästbaserad behandlingsform som har visat sig ge många olika fysiska förbättringar för personer med cerebral pares. Ridterapi använts i vissa fall av fysioterapeuter som ett alternativ till behandling för dessa personer. Fortfarande finns få kvalitativa studier av hur ridterapi upplevs kroppsligen av ryttarna samt vilka intentioner som finns.

    Syfte

    Syftet med denna studie var att utifrån ryttares och instruktörs perspektiv belysa intentioner och upplevelser i samband med ridterapi som behandling vid cerebral pares.

    Metod

    Kvalitativ intervjustudie med fyra kropps- och upplevelseorienterade intervjuer samt en avslutande member check som utfördes med deltagarna, en ryttare och en instruktör, i nära anslutning till ridterapisessionerna. Studien genomfördes enligt Grounded theory.

    Resultat

    Resultatet presenteras i sju kategorier “Hästen och naturen som träningsredskap”, “Stärkt motivation genom omgivning och utveckling”, “Trygghet - viktig faktor inom ridterapin”, “Utmaningar på hästryggen”, “Från mental frånvaro till mental närvaro”, “Stärkande upplevelser” och “Gemensamma mål”. De sju kategorierna mynnade ut i en huvudkategori “Ridterapi som lustfylld drivkraft att möta kroppsliga och mentala utmaningar” samt en teoretisk modell.

    Konklusion

    Ridterapi påverkar kroppen likväl som det mentala. Det kan bidra till ökad närvaro samt höjd motivation till fortsatt träning. Ridterapin kan bidra till upplevelser av kompetens, samhörighet och autonomi.

  • 146.
    Darwén, Anna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Besvärsförekomst och datoranvändning bland gymnasieungdomar: En pilotstudie av besvärsförekomst i rörelse- och  stödjeorganen, datorvanor samt riskbedömning av datorarbete2012Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 147.
    Degerstedt, Frida
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Fysioterapeutiska interventioner och fysisk aktivitet för barn med cerebral pares i norra Sverige: en registerstudie ur rättvise- och genusperspektiv2015Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Unga personer med funktionsnedsättning, rörelsehinder i synnerhet, skattar lägre hälsa än andra. Ohälsan kommer dels av funktionsnedsättningen i sig men också av påverkbara orsaker som låg grad av fysisk aktivitet och diskriminering.

    Syfte: Att utifrån ett rättvise- och genusperspektiv kartlägga hur de fysioterapeutiska interventionerna samt fysisk aktivitet fördelas för barn upp till 18 år med Cerebral Pares (CP) i de fem norra landstingen i Sverige 2013 utifrån grovmotorisk funktionsnivå och ålder. Syftet var också att undersöka samband mellan behandlingar som Botulinumtoxin (botox), spasticitetsreducerande medicinering, operationer och ortoser och mängden fysioterapi och fysisk aktivitet.

    Metod: Studien är en registerstudie utifrån ett nationellt kvalitetsregister, CPUP. Data innefattande 313 barn 0-18 år med CP från de fem nordliga länen i Sverige år 2013. Studien behandlar den första mätningen för året i de fall flera gjorts.

    Resultat:  Inom tre landsting fick pojkarna fler eller mer frekventa fysioterapeutiska interventioner. Skillnader mellan landsting sågs gällande om, hur ofta och i vilket syfte fysioterpeutiska interventioner givits (p>0,001). Fysioterapeuten (FT) medverkade oftare för barn med lägre grovmotorisk funktionsnivå och oftare för barn som inte hade fysisk fritidsaktivitet. Barn med lägre funktionsnivå deltog i lägre grad i fritidsaktivitet (p>0,001). Pojkar deltog i högre grad i skolidrott jmf med flickor (p=0,028). Det fanns samband mellan övriga behandlingar och fysioterapeutiska interventioner samt närvaro av FT.

    Slutsats: Förliggande studie tyder på skillnader i fysioterapeutiska insatser avseende på kön och landstingstillhörighet. Det fanns samband mellan grovmotorisk nivå och deltagande i fysisk fritidsaktivitet samt mellan kön deltagandet i skolidrott.

  • 148.
    Degerstedt, Frida
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wiklund, Maria
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Enberg, Birgit
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Physiotherapeutic interventions and physical activity for children in Northern Sweden with cerebral palsy: a register study from equity and gender perspectives2017In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 10, article id 1272236Article in journal (Refereed)
    Abstract [en]

    Background: Young people with disabilities, especially physical disabilities, report worse health than others. This may be because of the disability, lower levels of physical activity, and discrimination. For children with cerebral palsy, access to physiotherapy and physical activity is a crucial prerequisite for good health and function. To date, there is limited knowledge regarding potential gender bias and inequity in habilitation services.

    Objectives: To map how physiotherapeutic interventions (PTI), physical leisure activity, and physical education are allocated for children with cerebral palsy regarding sex, age, level of gross motor function, and county council affiliation. This was done from a gender and equity perspective.

    Methods: A register study using data from the Cerebral Palsy follow-Up Program (CPUP). Data included 313 children ≤18 years with cerebral palsy from the five northern counties in Sweden during 2013. Motor impairment of the children was classified according to the expanded and revised Gross Motor Function Classification System (GMFCS).

    Results: In three county councils, boys received more physiotherapy interventions and received them more frequently than girls did. Differences between county councils were seen for frequency and reasons for physiotherapy interventions (p < 0.001). The physiotherapist was involved more often with children who had lower motor function and with children who had low physical leisure activity. Children with lower motor function level participated in physical leisure activity less often than children with less motor impairment (p < 0.001). Boys participated more frequently in physical education than did girls (p = 0.028).

    Conclusion: Gender and county council affiliation affect the distribution of physiotherapy interventions for children with cerebral palsy, and there are associations between gender and physical activity. Thus, the intervention is not always determined by the needs of the child or the degree of impairment. A gender-bias is indicated. Further studies are needed to ensure fair interventions.

  • 149.
    Denisson, Stina
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Israelsson, Matilda
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    "Intelligent rollator, den tar mig dit jag ska": En intervjustudie om hur personer som haft stroke upplever Intelligent rollator2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Stroke medför såväl fysiska som kognitiva konsekvenser för den drabbade vilket kan påverka förmågan till säker förflyttning. Personer med funktionsnedsättning kan erbjudas olika typer av hjälpmedel och rollatorn är det mest använda förflyttningshjälpmedlet. Forskare vid Umeå Universitet utvecklar en Intelligent rollator utrustad med sensorer som kan detektera hinder och automatiska bromsar som kan korrigera körriktningen.

     

    Syfte: Att undersöka hur personer som haft stroke upplever det att gå med Intelligent rollator inomhus samt ta reda på deras åsikter om rollatorns funktion och användbarhet.

     

    Metod: Fem personer (två kvinnor och tre män) som haft stroke fick testa att gå med Intelligent rollator inomhus. För att undersöka deltagarnas upplevelser och åsikter genomfördes semistrukturerade intervjuer som analyserades med hjälp av kvalitativ innehållsananlys.

     

    Resultat: Analysen av intervjuerna resulterade i de tre kategorierna ”Intelligent rollator väcker många tankar och frågor”, ”En hjälp i många situationer och för många personer” och ”Intelligent rollator ger feedback”. Efterhand växte det övergripande temat ”Intelligent rollator hejdar framfarten men styr i rätt riktning” fram, som beskriver deltagarnas positiva och negativa upplevelser av rollatorn.

     

    Slutsats: Deltagarna i den här studien var positiva till Intelligent rollator men ansåg att sensorerna var för känsliga och reagerade på för långt avstånd till de hinder som fanns.

     

  • 150.
    Djurfors, Erik
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gaasvik, Lovisa
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Förekomst av muskuloskeletala besvär och belastningsergonomisk riskbedömning bland bagare och konditorer2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Arbetet har en stor betydelse gällande uppkomst av belastningsbesvär. Var femte yrkesverksam uppskattas ha av besvär till följd av arbetet. Det finns begränsad yrkesspecifik statistik och få studier på yrkena bagare/konditorer gällande den ergonomiska arbetsmiljön eller arbetsrelaterade muskuloskeletala besvär.

     

    Syftet med studien var att kartlägga förekomsten av muskuloskeletala besvär samt genomföra en belastningsergonomisk riskbedömning av vanligt förekommande arbetsmoment bland bagare och konditorer. Studiepopulationen är bagare och konditorer på mindre och medelstora företag.  Totalt svarade 69 stycken (30 män och 39 kvinnor) på enkäten Nordic Musculoskeletal Questionnaire (NMQ) och 15 stycken deltog i den belastningsergonomisk riskbedömning, Quick Exposure Checklist (QEC).

     

    Kartläggningen visar att ungefär tre fjärdedelar av deltagarna har haft smärta i någon kroppsregion de senaste tolv månaderna. Högst andel besvär rapporteras i kroppsregionerna nacke, skuldror och ryggens nedre del. Den belastningsergonomiska riskbedömningen visar att det är högst risk att utveckla besvär i rygg, hand/handled och nacke. Nacke är den kroppsregion där deltagare har bedömts som mycket hög risk. Stress är ett observandum då tolv av femton deltagare har uppgett en mellanexponering. Resultatet indikerar att det finns arbetsuppgifter som bör undersökas vidare. Ytterligare kartläggningar där besvärsförekomst tydligare relateras till arbetet rekommenderas. Även belastningsergonomiska analyser är av vikt för att vidare utreda vilka riskexponeringar som föreligger yrkena i dagsläget.

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