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  • 151.
    Geithner, Christina A.
    et al.
    Department of Organizational Leadership, Gonzaga University.
    Molenaar, Claire E.
    The School of Physical Therapy, Regis University.
    Henriksson, Tommy
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gilenstam, Kajsa
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Relative Age Effects in Women’s Ice Hockey: Contributions of Body Size and Maturity Status2018In: Women in Sport & Physical Activity Journal, ISSN 1063-6161, E-ISSN 1938-1581, Vol. 26, no 2, p. 124-133Article in journal (Refereed)
    Abstract [en]

    Research on relative age effects (RAEs) in women’s ice hockey is lacking data on participant characteristics, particularly body size and maturity status. The purposes of our study were to investigate RAEs in women’s ice hockey players from two countries, and to determine whether RAE patterns could be explained by chronological age, body size, and maturity status. Participants were 54 Swedish elite and 63 Canadian university players. Birthdates were coded by quartiles (Q1–Q4). Weight and height were obtained, and body mass index and chronological age were calculated for each player. Players recalled age at menarche, and maturity status was classified as early, average, or late relative to population-specific means. Chi-square (χ2), odds ratios (OR), 95% confidence intervals (CI) and effect sizes (Cohen’s w) were calculated using population data across quartiles and for pairwise comparisons between quartiles. Descriptive statistics and MANOVAs were run by quartile and by country. Significant RAEs were found for Canadian players across quartiles (p < .05), along with a Q2 phenomenon (Q2: Q3, Q2: Q4, p < .05). Swedish players were overrepresented in Q3 (Q3: Q4, p < .05). Q4 was significantly underrepresented in both countries (p < .05). The oldest, earliest maturing, and shortest players in both countries were clustered in Q2, whereas the next oldest and latest maturing Swedish players were found in Q3. Age, physical factors, and interactions may contribute to overrepresentations in Q2 and Q3. These findings do not suggest the same bias for greater relative age and maturity found in male ice hockey.

  • 152. Gephine, Sarah
    et al.
    Frykholm, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Nyberg, Andre
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Bui, Kim-Ly
    Maltais, Francois
    Saey, Didier
    Relationship between functional capacity, dynamic and static muscle function assessments in people with Chronic Obstructive Pulmonary Disease (COPD)2018In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 52Article in journal (Other academic)
    Abstract [en]

    Introduction: In addition to impaired lung function, patients with COPD often exhibit limb muscle dysfunction and impaired functional status, negatively impacting quality of life. However, whether and how these two components related to each other remains to be established. The objective of this study was to examine relationships between quadriceps muscle function and functional capacity in patients with COPD.

    Methods: Forty participants (age :69±7 years, FEV1 :57±18 % predicted) were evaluated. Quadriceps strength was measured during isometric and isokinetic knee extension while quadriceps endurance was evaluated using isometric, isokinetic and isotonic knee extension protocols. Functional capacity was assessed with a battery of test including the 6 minute walking test (6MWT), the ADL Glittre test, the 1 minute Sit to Stand (1STS) and the Short Physical Performance Battery test (SPPB). Univariate correlation analyses between indices of muscle strength and endurance and functional tests were performed.

    Results: Pearson correlations coefficients between functional capacity and quadriceps function are provided in the table.

    Conclusion: Several indices of muscle function moderately correlate with functional capacity in patients with COPD, with stronger correlations noted for the dynamic contraction protocols (isokinetic, isotonic).

  • 153. Gerdle, Bjorn
    et al.
    Molander, Peter
    Stenberg, Gunilla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Stalnacke, Britt-Marie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Enthoven, Paul
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine. Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, SE-581 85 Linköping, Sweden.
    Weak outcome predictors of multimodal rehabilitation at one-year follow-up in patients with chronic pain: a practice based evidence study from two SQRP centres2016In: BMC Musculoskeletal Disorders, E-ISSN 1471-2474, Vol. 17, article id 490Article in journal (Refereed)
    Abstract [en]

    Background: For patients with chronic pain, the heterogeneity of clinical presentations makes it difficult to identify patients who would benefit from multimodal rehabilitation programs (MMRP). Yet, there is limited knowledge regarding the predictors of MMRP’s outcomes. This study identifies predictors of outcome of MMRPs at a 12-month follow-up (FU-12) based on data from the Swedish Quality Registry for Pain Rehabilitation (SQRP).

    Methods: Patients with chronic pain from two clinical departments in Sweden completed the SQRP questionnaires—background, pain characteristics, psychological symptoms, function, activity/participation, health and quality of life—on three occasions: 1) during their first visit; 2) immediately after the completion of their MMRP; and 3) 12 months after completing the MMRP (n = 227). During the FU-12, the patients also retrospectively reported their global impressions of any changes in their perception of pain and their ability to handle their life situation in general.

    Results: Significant improvements were found for pain, psychological symptoms, activity/participation, health, and quality of life aspects with low/medium strong effects.

    A general pattern was observed from the analyses of the changes from baseline to FU-12; the largest improvements in outcomes were significantly associated with poor situations according to their respective baseline scores. Although significant regressors of the investigated outcomes were found, the significant predictors were weak and explained a minor part of the variation in outcomes (15–25%). At the FU-12, 53.6% of the patients reported that their pain had decreased and 80.1% reported that their life situation in general had improved. These improvements were associated with high education, low pain intensity, high health level, and work importance (only pain perception). The explained variations were low (9–11%).

    Conclusions: Representing patients in real-world clinical settings, this study confirmed systematic reviews that outcomes of MMRP are associated with broad positive effects. A mix of background and baseline variables influenced the outcomes investigated, but the explained variations in outcomes were low. There is still a need to develop standardized and relatively simple outcomes that can be used to evaluate MMRP in trials, in clinical evaluations at group level, and for individual patients.

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  • 154.
    Goicolea, Isabel
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Carson, Dean
    Umeå University, Arctic Research Centre at Umeå University. Demography and Growth Planning, Northern Institute, Charles Darwin University, Darwin, Australia; Centre for Rural Medicine, Storuman, Sweden.
    San Sebastian, Miguel
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Christianson, Monica
    Umeå University, Faculty of Medicine, Department of Nursing.
    Wiklund, Maria
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hurtig, Anna-Karin
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Health care access for rural youth on equal terms?: A mixed methods study protocol in northern Sweden2018In: International Journal for Equity in Health, E-ISSN 1475-9276, Vol. 17, article id 6Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The purpose of this paper is to propose a protocol for researching the impact of rural youth health service strategies on health care access. There has been no published comprehensive assessment of the effectiveness of youth health strategies in rural areas, and there is no clearly articulated model of how such assessments might be conducted. The protocol described here aims to gather information to; i) Assess rural youth access to health care according to their needs, ii) Identify and understand the strategies developed in rural areas to promote youth access to health care, and iii) Propose actions for further improvement. The protocol is described with particular reference to research being undertaken in the four northernmost counties of Sweden, which contain a widely dispersed and diverse youth population.

    METHODS: The protocol proposes qualitative and quantitative methodologies sequentially in four phases. First, to map youth access to health care according to their health care needs, including assessing horizontal equity (equal use of health care for equivalent health needs,) and vertical equity (people with greater health needs should receive more health care than those with lesser needs). Second, a multiple case study design investigates strategies developed across the region (youth clinics, internet applications, public health programs) to improve youth access to health care. Third, qualitative comparative analysis of the 24 rural municipalities in the region identifies the best combination of conditions leading to high youth access to health care. Fourth, a concept mapping study involving rural stakeholders, care providers and youth provides recommended actions to improve rural youth access to health care.

    DISCUSSION: The implementation of this research protocol will contribute to 1) generating knowledge that could contribute to strengthening rural youth access to health care, as well as to 2) advancing the application of mixed methods to explore access to health care.

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  • 155.
    Goicolea, Isabel
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Hultstrand Ahlin, Cecilia
    Umeå University, Faculty of Medicine, Department of Nursing.
    Waenerlund, Anna-Karin
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Marchal, Bruno
    Christianson, Monica
    Umeå University, Faculty of Medicine, Department of Nursing.
    Wiklund, Maria
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hurtig, Anna-Karin
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    San Sebastian, Miguel
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Accessibility and factors associated with utilization of mental health services in youth health centers: a qualitative comparative analysis in northern Sweden2018In: International Journal of Mental Health Systems, E-ISSN 1752-4458, Vol. 12, article id 69Article in journal (Refereed)
    Abstract [en]

    Background: Youth-friendly health care services can facilitate young people's access to health care services and promote their health, including their mental health. In Sweden, a network of youth health centers exist since the 1970s, incorporated within the public health system. Even if such centers take a holistic approach to youth health, the focus has been in sexual and reproductive health care, and the extent of integrating mental health care services is less developed though it varies notably between different centers. This study aims to analyse the various conditions that are sufficient and/or necessary to make Swedish youth health centers accessible for mental and psychosocial health.

    Methods: Multiple case study design, using qualitative comparative analysis to assess the various conditions that makes a youth health center accessible for mental and psychosocial issues and mental health. The cases included 18 youth health centers (from a total of 22) in the four northern counties of Sweden.

    Results: In order to enhance accessibility for mental health services, youth health centers need to be trusted by young people. Trust was necessary but not sufficient, meaning that it had to be combined with other conditions: either having a team with a variety of professions represented in the youth health center, or being a youth health center that is both easy to contact and well-staffed with mental health professionals.

    Conclusions: Differentiated, first-line services for youth can play an important role in promoting youth mental health if certain conditions are fulfilled. Trust is necessary, but has to be combined with either multidisciplinary teams, or expertise on mental health and easy accessibility.

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  • 156. Gold, Judith E.
    et al.
    Hallman, David M.
    Hellström, Fredrik
    Björklund, Martin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, Gävle, Sweden.
    Crenshaw, Albert G.
    Djupsjobacka, Mats
    Heiden, Marina
    Mathiassen, Svend Erik
    Piligian, George
    Barbe, Mary F.
    Systematic review of biochemical biomarkers for neck and upper-extremity musculoskeletal disorders2016In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 42, no 2, p. 103-124Article, review/survey (Refereed)
    Abstract [en]

    Objective This study systematically summarizes biochemical biomarker research in non-traumatic musculoskeletal disorders (MSD). Two research questions guided the review: (i) Are there biochemical markers associated with neck and upper-extremity MSD? and (ii) Are there biochemical markers associated with the severity of neck and upper-extremity MSD?

    Methods A literature search was conducted in PubMed and SCOPUS, and 87 studies met primary inclusion criteria. Following a quality screen, data were extracted from 44 articles of sufficient quality.

    Results Most of the 87 studies were cross-sectional and utilized convenience samples of patients as both cases and controls. A response rate was explicitly stated in only 11 (13%) studies. Less than half of the studies controlled for potential confounding through restriction or in the analysis. Most sufficient-quality studies were conducted in older populations (mean age in one or more analysis group >50 years). In sufficient-quality articles, 82% demonstrated at least one statistically significant association between the MSD and biomarker(s) studied. Evidence suggested that: (i) the collagen-repair marker TIMP-1 is decreased in fibroproliferative disorders, (ii) 5-HT (serotonin) is increased in trapezius myalgia, and (iii) triglycerides are increased in a variety of MSD. Only 5 studies showed an association between a biochemical marker and MSD severity.

    Conclusion While some MSD biomarkers were identified, limitations in the articles examined included possible selection bias, confounding, spectrum effect (potentially heterogeneous biomarker associations in populations according to symptom severity or duration), and insufficient attention to comorbid conditions. A list of recommendations for future studies is provided.

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  • 157. Gold, Judith E.
    et al.
    Hallman, David M.
    Hellström, Fredrik
    Björklund, Martin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Univ Gävle, Ctr Musculoskeletal Res, Dept Occupat & Publ Hlth Sci, Gävle, Sweden.
    Crenshaw, Albert G.
    Mathiassen, Svend Erik
    Barbe, Mary F.
    Ali, Sayed
    Systematic review of quantitative imaging biomarkers for neck and shoulder musculoskeletal disorders2017In: BMC Musculoskeletal Disorders, E-ISSN 1471-2474, Vol. 18, article id 395Article, review/survey (Refereed)
    Abstract [en]

    Background: This study systematically summarizes quantitative imaging biomarker research in non-traumatic neck and shoulder musculoskeletal disorders (MSDs). There were two research questions: 1) Are there quantitative imaging biomarkers associated with the presence of neck and shoulder MSDs?, 2) Are there quantitative imaging biomarkers associated with the severity of neck and shoulder MSDs?

    Methods: PubMed and SCOPUS were used for the literature search. One hundred and twenty-five studies met primary inclusion criteria. Data were extracted from 49 sufficient quality studies.

    Results: Most of the 125 studies were cross-sectional and utilized convenience samples of patients as both cases and controls. Only half controlled for potential confounders via exclusion or in the analysis. Approximately one-third reported response rates. In sufficient quality articles, 82% demonstrated at least one statistically significant association between the MSD(s) and biomarker(s) studied. The literature synthesis suggested that neck muscle size may be decreased in neck pain, and trapezius myalgia and neck/shoulder pain may be associated with reduced vascularity in the trapezius and reduced trapezius oxygen saturation at rest and in response to upper extremity tasks. Reduced vascularity in the supraspinatus tendon may also be a feature in rotator cuff tears. Five of eight studies showed an association between a quantitative imaging marker and MSD severity.

    Conclusions: Although research on quantitative imaging biomarkers is still in a nascent stage, some MSD biomarkers were identified. There are limitations in the articles examined, including possible selection bias and inattention to potentially confounding factors. Recommendations for future studies are provided.

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  • 158.
    Gonzalez, Manuel
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Commonwealth Scientific Research and Industrial Organisation (CSIRO), Brisbane, Australia.
    Sjölin, Ingela
    Bäck, Maria
    Ögmundsdottir Michelsen, Halldora
    Tanha, Tina
    Sandberg, Camilla
    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.
    Schiopu, Alexandru
    Leosdottir, Margret
    Effect of a lifestyle-focused electronic patient support application for improving risk factor management, self-rated health, and prognosis in post-myocardial infarction patients: study protocol for a multi-center randomized controlled trial2019In: Trials, E-ISSN 1745-6215, Vol. 20, article id 76Article in journal (Refereed)
    Abstract [en]

    Background: Cardiac rehabilitation (CR) programs addressing risk factor management, educational interventions, and exercise contribute to reduce mortality after myocardial infarction (MI). However, the fulfillment of guideline-recommended CR targets is currently unsatisfactory. eHealth, i.e., the use of electronic communication for healthcare, including the use of mobile smartphone applications combined with different sensors and interactive computerized programs, offers a new array of possibilities to provide clinical care. The present study aims to assess the efficacy of a web-based application (app) designed to support persons in adhering to lifestyle advice and medication as a complement to traditional CR programs for improvement of risk factors and clinical outcomes in patients with MI compared with usual care.

    Methods/design: An open-label multi-center randomized controlled trial is being conducted at different CR centers from three Swedish University Hospitals. The aim is to include 150 patients with MI < 75 years of age who are confident smartphone and/or Internet users. In addition to participation in CR programs according to the usual routine at each center, patients randomized to the intervention arm will receive access to the web-based app. A CR nurse reviews the patients’ self-reported data twice weekly through a medical interface at the clinic. The primary outcome of the study will be change in submaximal exercise capacity (in watts) between 2 and 4 weeks after discharge and when the patient has completed his/her exercise program at the CR center, usually around 3–6 months post-discharge. Secondary outcomes include changes in self-reported physical activity, objectively assessed physical activity by accelerometry, self-rated health, dietary, and smoking habits, body mass index, blood pressure, blood lipids, and glucose/HbA1c levels between inclusion and follow-up visits during the first year post-MI. Additionally, we will assess uptake and adherence to the application, the number of CR staff contacts, and the incidence of cardiovascular events at 1 and 3 years after the MI. Patient recruitment started in 2016, and the first study results are expected in the beginning of 2019.

    Discussion: The present study will add evidence to whether electronic communication can be used to improve traditional CR programs for patients after MI.

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  • 159.
    Gothilander, Jennifer
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Widmark, Sara
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Testprotokoll för tävlande styrkelyftare med och utan ländryggssmärta: En genomförbarhetsstudie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Inledning

    Styrkelyft är en kraftsport där det är vanligt att utveckla ländryggsbesvär. Det föreslås finnas ett optimalt rörelsemönster för att fördela belastning på kroppens leder, men det kan se olika ut beroende på antropometri, ledrörlighet, muskelrekrytering och rörelsekontroll.

    Syfte och metod

    Uppsatsens syfte var att undersöka om ett testprotokoll innehållande rörelsekontroll, ledrörlighet, muskelrekrytering och antropometri, är genomförbart i populationen styrkelyftare. Åtta manliga styrkelyftare, i åldrarna 31 – 48 år, deltog. De hade tävlat mellan 7 - 24 år och var fortfarande tävlingsaktiva. Av de åtta hade fyra haft ländryggssmärta under minst 12 månader tillbaka, som hämmat träningen, och de resterande fyra hade inte ländryggssmärta. Testprotokollet genomfördes under individuella testtillfällen och efteråt fick styrkelyftare och testledare värdera olika påståenden om upplevelsen av genomförandet, via ett frågeformulär.

    Resultat och slutsats

    Testprotokollet är genomförbart i populationen styrkelyftare. Styrkelyftarna upplevde inte genomförandet av testprotokollet obehagligt och testledarna upplevde inga problem med genomförandet av testerna. Alla delar av testprotokollet gav analyserbara data, och i frågeformulären framkom inga hinder för genomförbarhet. En ny föreslagen testordning för testprotokollet finns i Bilaga 4.

  • 160.
    Goude Öhgren, Elin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Unspecific gynecological pelvic pain: is there an added value for this patient group with a multimodal treatment method?: A blinded randomized controlled trial.2014Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet med den här studien var att undersöka om kvinnor med ospecificerad bäckensmärta fick effektivare smärlindring med gynekologisk behandling i kombination med multimodal behandling enligt ”STAYAC – metoden” än gynekologisk behandling ensamt.

    Metod: Studien som var utformad som en pragmatisk , randomiserad interventions studie. Deltagarna var kvinnor mellan 18-65 år som hade ospecifik bäckensmärta, med misstänkt gynekologisk orsak. Block randomisering användes. Patienterna randomiserades till både gynekologisk behandling och multimodal behandling eller gynekologisk behandling. Datainsamling skedde vid baslinjen och efter fem veckor och fyra , tolv och tjugofyra månader.  Effektmåtten var genomsnittlig smärta under de senaste 24 timmarna och genomsnittlig smärta under de senaste tre veckorna .

    Resultat: Förändring av smärta över tiden mellan grupperna var inte signifikant  vid mätning från baslinjen och för alla fyra uppföljningar (p=0.093 och p=0.071) eller vid förändring från baslinjen till 24 månader (p=0.070 och p=0.088).

    Slutsats: Det fanns ingen signifikant skillnad vid jämförelse mellan de två grupperna. Detta visar att det inte fanns något mervärde för kvinnor med ospecifik bäckensmärta med en multimodal behandling enligt ”STAYAC – metoden”.

  • 161.
    Gougeon, Marie-Madeline
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Caught in a foxtrap: Working single mothers´experiences of barriers, facilitators and wishes for support for physical activity.2018Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Introduction: Working single mothers is a growing group in Sweden that has higher risk of poorer health and disabilities. They do not engage in enough physical activity (PA) to achieve health benefits.   Studies among American parents and single mothers show common barriers to PA such as lack of time, lack of social support and not overcoming putting children’s needs before their own. Little is known about Swedish working single mothers´ experiences of barriers, facilitators and wishes for support for PA.

     

    Aim: Explore swedish working single mothers experiences of barriers, facilitators and wishes for support for PA.

     

    Method: Eight participants with lower PA level than the World Health Organisation (WHO) recommendations ,were interviewed. The material was transcribed and analyzed with qualitative content analysis according to Graneheim and Lundman.

     

    Results: One theme emerged: “Prioritizing many other responsibilities while needing more support for physical activity”. Participants experienced difficulties finding time, energy, economy and opportunities for PA alone and with children. They put other responsibilities and others ‘needs before PA. They experienced a lack of support for PA from their social network and environment and wished for more support to make PA possible to do.

    Conclusion:  A socially oriented approch is needed to raise PA level in this group who seem to still struggle with economical and social disavantages. They seem to not benefit from workplaces fitness and wellness plans. Future research should investigate the relationship between their PA level and their access to fitness and wellness plans at their workplace.

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  • 162.
    Granberg, Anna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Upplevelser av kroppsmedvetenhet hos yogautövande individer: en kvalitativ intervjustudie2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion:  Kroppsmedvetandeträning används för att öka en individs kontakt med sig själv genom att förstärka medvetenheten i kroppen. Eftersom yoga innefattar både kroppsliga rörelser och medveten närvaro så liknar det annan kroppsmedvetandeträning. I nuläget saknas kvalitativ forskning på hur kroppsmedvetenheten påverkas av regelbundet yogautövande.

    Syfte: Syftet med studien var att undersöka upplevelser av kroppsmedvetenhet vid regelbundet yogautövande samt vad ökad kroppsmedvetenhet i förlängningen kan ge en individ.

    Metod: Kvalitativ metod med en induktiv ansats användes i denna studie. Fyra semistrukturerade intervjuer genomfördes med personer som utövar yoga regelbundet minst två gånger i veckan. Det insamlade materialet analyserades sedan genom kvalitativ innehållsanalys.

    Resultat: Temat som framkom i studien lyder ”Medvetenhet och välmående från yogan ut i livet” och utformades utifrån fyra kategorier: ”En räddning när livet är körigt”, ”Medvetenhet genom närvaro och närvaro genom medvetenhet”, ”Från yttre till inre fokus” och ”Från mikroperspektiv till helhetssyn”. I resultatet skildras hur yogan gett en ökad kroppsmedvetenhet genom framför allt en ökad närvaro i sig själv och i sin kropp, med en acceptans kring det som upplevs. Det beskrivs även ett fokus på att ta hand om sig själv framför att prestera. Detta finns även med i informantens vardag.

    Konklusion: Studiens resultat visar på att yoga kan påverka kroppsmedvetenheten och ge ökad kontakt med utövarens inre genom en starkare koppling psyke och kropp. Yoga skulle därför kunna användas som komplement till annan kroppsmedvetandeträning eller som egenträning efter avslutad fysioterapi. Det behövs dock ytterligare forskning som undersöker vilken yogaform som ger störst kroppsmedvetenhet.

  • 163.
    Granholm, David
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Åsing, Caroline
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Inter- och intrabedömarreliabilitet gällande ryggradens kurvatur med analysprogrammet Kinovea och visuell bedömning2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    En avvikande kroppshållning kan leda till flertalet muskuloskeletala besvär och i klinisk verksamhet är patienter med ryggsmärta vanligt förekommande hos fysioterapeuter. Idag finns kostnadsfria analysprogram utvecklade för att möjliggöra komplexa analyser av ryggradens kurvatur. Få studier har dock studerat deras reliabilitet.

    Syfte:

    Syftet med denna studie var att utvärdera samstämmigheten mellan och inom bedömare vid analys av ryggradens kurvatur i stående med hjälp av videoanalysprogrammet Kinovea och vid visuell bedömning.

    Metod:

    Deltagare i studien var 6 män och 7 kvinnor (medelålder 23,5 år). Studien innefattade två mättillfällen av ryggradens kurvatur och utfördes med två veckors mellanrum.  Varje mättillfälle innefattade en analys i Kinovea där en vinkelmätning av kurvaturen mellan specifika referenspunkter utfördes, samt en visuell analys. Vid det första mättillfället gjordes analyserna av båda bedömarna och vid det andra mättillfället gjordes analyserna av en av bedömarna för att möjliggöra en bedömning av intrabedömarreliabiliteten. Medelavvikelse uppmätt i grader, procentuell överensstämmelse och korrelationsanalys med Pearsons´s bivariata korrelation analyserades därefter.

    Resultat:

    I Kinovea mellan bedömare beräknades Pearson´s bivariata korrelation till mellan r=0,69-0,91 i ländrygg, bröstrygg och halsrygg och inom bedömare till mellan r=0,65-0,72. Samtliga resultat var signifikanta under p<0,05. Den lägsta medelavvikelsen mellan bedömare vid vinkelmätningen uppmättes i bröstryggen till 2 grader och den högsta i halsryggen till 6 grader. Inom bedömare 1 uppmättes den lägsta medelavvikelsen i ländryggen till 2 grader och den högsta i halsryggen till 5 grader. Procentuell överensstämmelse visuellt mellan bedömare var mellan 85-100 %. Inom bedömare 1 var den procentuella överenstämmelsen något högre (92-100 %).

    Konklusion:

    Baserat på resultatet från denna studie tycks Kinovea kunna användas som ett hjälpmedel vid analyser av ryggradens kurvatur. Studier som bedömt Kinoveas tillförlitlighet är få till antalet vilket talar för att ytterligare studier av Kinovea krävs för att fastställa dess reliabilitet för detta ändamål.

  • 164.
    Granström, Niklas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Skadeprofil hos tennisspelare. En prospektiv tvä-ärs studie.2014Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Introduktion:Tennis är en av de populäraste sporterna i världen. Det spelas av många olika människor i olika åldrar. Likt mänga andra sporter finns en uttalad skaderisk.

    Syfte:Syftet med denna studie var att prospektivt undersöka skador hos seniorspelare i tennis.

    Metod: 122 tennisspelare följdes under två år.Alla tennisrelaterade skador

    registrerades under denna period. När spelarna skadades undersöktes spelarna kliniskt och ett skadeformulär fylldes i av en registrerad idrottssjukgymnast.

    Resultat:62 spelare (38 män och 24 kvinnor) ådrog sig 89 skador. Män fick 64% av skadorna och kvinnorna 36%. Skadeincidensen totalt var 3.75 skador per 1000 spelade timmar. Etilologin på skadorna var jämt fördelade med 52 (58%)

    överbelastningsskador samt 37 (42%) akuta skador. Knät var den mest skadade kroppsdelen (n=17) följt av nedre delen av benet/hälsena (n=t6) och armbåge (n=16). Konklusion: Nedre extremitet drabbades mer än övre extremitet. Skador på muskler och senor var den vanligaste typen av skada. Största andelen av skadorna definierades som allvarliga. Inga könsskillnader påvisades .

  • 165.
    Granås, Marie
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Tronarp, Rebecca
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    OfficeBiking® in sedentary office workers whilst still performing their usual desk work: - A controlled pilot field study2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund och syfte

    Kontorsarbetaretillbringarstörstadelenavarbetstidenstillasittande.Nutidaforskningvisarpåattävenom Världshälsoorganisationensrekommendationerförfysiskaktivitetuppfyllshardettastillasittandebeteende negativahälsoeffekter.Syftetmeddennastudie varattundersökagenomförbarhetenavintegreringav fysiskaktivitet påarbetsplatsengenomattanvändaenspecialanpassadcykelergometer(OfficeBike™)vid kontorsarbetsplatsensamtidigtsomdet vanliga arbetetutförs,samtinterventionenseventuella påverkan påenergiförbrukningochmuskuloskeletalsmärta.

    Metod

    Deltagarna (interventionsgruppn=10,kontrollgruppn=10)i dennaicke randomiserade,kontrollerade pilotstudierekryteradesfrånenkontorsarbetsplatsiUmeå,Sverige.Deltagarnaiinterventionsgruppenfick tillgångtillvarsinOfficeBike™ vidsinkontorsarbetsplatsunderenperiodavtreveckor,medankontrollerna instrueradesattleva somvanligt.Förattundersökaeffekterna avinterventionenanvändesenfysisk aktivitetsmonitorförattmätaenergiförbrukningen ochden fysiskaaktivitetsnivån.Muskuloskeletala besvärutvärderadesgenomsmärtritningsamtsmärtskattning.UpplevelsenavOfficeBiking® samthurdet påverkade arbetet undersöktes medhjälpav ettintervjuformulär.

    Resultat

    OfficeBike™ användes11(median)arbetsdagarav15möjliga.Självrapporteradsmärtaminskadehosåttaav tioindivideriinterventionsgruppen.Detfanns ingen signifikantskillnadienergiförbrukning mellan grupperna.OfficeBiking® påverkade inte arbetskapaciteten ochnioavtiouppgavattde skullevilja ha tillgång till enOfficeBike™ i sitt dagliga arbete.

    Slutsats

    OfficeBiking® verkar vara ett genomförbart koncept för integrering av fysisk aktivitet på en kontorsarbetsplats.

  • 166.
    Grenehed, Joel
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Fhärm, Josefin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Finger movement control in persons who have suffered a stroke: - A Pilot Study2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

  • 167.
    Grip, Helena
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences. Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).
    Johansson, Anna-Maria
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).
    Selling, Jonas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).
    Rönnqvist, Louise
    Umeå University, Faculty of Social Sciences, Department of Psychology. Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).
    Boraxbekk, Carl-Johan
    Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR). Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI). Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).
    Three dimensional kinematic analyses of finger movement control and association to brain activity responses: A pilot study on healthy individuals2017In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 57, p. 355-Article in journal (Refereed)
    Abstract [en]

    Introduction: An increased knowledge of how the brain control finger movements give us keys to understand the recovery of motor function after a brain injury. This knowledge is crucial for the development of reliable and valid assessment methods in the clinical evaluation of hand function.

    Research question: How are individual finger movements represented in the brain? Investigating the associations between kinematics and brain activity responses in healthy individuals.

    Methods: Keeping the others still. Finger movements were performed lying in the MR scanner in order to register brain activity response during the task. Optoelectronic cameras simultaneously monitored the positions of reflective markers affixed to each finger. The marker position data were used to calculate each finger's movement frequency (MF),  movement independence (“Individuation Index”, II), stationary ability (Stationarity Index, SI)[1][1]. fMRI data was analyzed by contrasting the finger movements against its active rest.

    Results: Preliminary analyses showed that (1) the finger movements primarily activate sensorimotor areas in the contralateral hemisphere (Fig. 1A), (2) that use of kinematic parameters in the fMRI analyses improved spatial specificity and (3) II engage a number of cortical areas, while MF engage fewer areas (Fig. 1B–D). Further analyses will further explore activations maps for each individual finger.

    Discussion: The inclusion of movement parameters in the fMRI analyses improves the specificity in the derived activation map, increasing the interpretability of the neural correlates of movement control. This advancement carries the promise for the development of better assessment methods of the recovery of function post-stroke with usability in rehabilitation practices.

  • 168.
    Grip, Helena
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Tengman, Eva
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Dynamic knee stability as estimated by finite helical axis methods during drop landing twenty years after anterior cruciate ligament injury2015In: Journal of Biomechanics, ISSN 0021-9290, E-ISSN 1873-2380, Vol. 48, no 10, p. 1906-1914Article in journal (Refereed)
    Abstract [en]

    Finite helical axis (FHA) measures of the knee joint during weight-bearing tasks may capture dynamic knee stability following Anterior Cruciate Ligament (ACL) injury. The aim was to investigate dynamic knee stability during two-leg squat (TLS) and one-leg side hop (SH) in a long-term follow-up of ACL injury, and to examine correlations with knee laxity (KT-1000), osteoarthritis (OA, Kellgren–Lawrence) and knee function (Lysholm score). Participants were injured 17–28 years ago and then treated with surgery (n=33, ACLR) or physiotherapy only (n=37, ACLPT) and healthy-knee controls (n=33) were tested. Movements were registered with an optical motion capture system. We computed three FHA inclination angles, its' Anterior–Posterior (A–P) position, and an index quantifying directional changes (DI), during stepwise knee flexion intervals of ∼15°. Injured knees were less stable compared to healthy controls' and to contralateral non-injured knees, regardless of treatment: the A–P intersection was more anterior (indicating a more anterior positioning of tibia relative to femur) positively correlating with high laxity/low knee function, and during SH, the FHA was more inclined relative to the flexion–extension axis, possibly due to reduced rotational stability. During the TLS, A–P intersection was more anterior in the non-injured knee than the injured, and DI was higher, probably related to higher load on the non-injured knee. ACLR had less anterior A–P intersection than ACLPT, suggesting that surgery enhanced stability, although rotational stability may remain reduced. More anterior A–P intersection and greater inclination between the FHA and the knee flexion–extension axis best revealed reduced dynamic stability ∼23 years post-injury.

  • 169.
    Grip, Helena
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Tengman, Eva
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Quantifying motor control of the knee during side hops - healthy subjects and subjects ~20 years after anterior cruciate ligament injury2012Conference paper (Other academic)
  • 170.
    Grip, Helena
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Tengman, Eva
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Häger, Charlotte K
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Dynamic knee stability estimated by finite helical axis methods during functional performance approximately twenty years after anterior cruciate ligament injury2015In: Journal of Biomechanics, ISSN 0021-9290, E-ISSN 1873-2380, Vol. 48, no 10, p. 1906-1914Article in journal (Refereed)
    Abstract [en]

    Finite helical axis (FHA) measures of the knee joint during weight-bearing tasks may capture dynamic knee stability following Anterior Cruciate Ligament (ACL) injury. The aim was to investigate dynamic knee stability during two-leg squat (TLS) and one-leg side hop (SH) in a long-term follow-up of ACL injury, and to examine correlations with knee laxity (KT-1000), osteoarthritis (OA, Kellgren-Lawrence) and knee function (Lysholm score). Participants were injured 17-28 years ago and then treated with surgery (n=33, ACL(R)) or physiotherapy only (n=37, ACL(PT)) and healthy-knee controls (n=33) were tested. Movements were registered with an optical motion capture system. We computed three FHA inclination angles, its' Anterior-Posterior (A-P) position, and an index quantifying directional changes (DI), during stepwise knee flexion intervals of similar to 15 degrees. Injured knees were less stable compared to healthy controls' and to contralateral non-injured knees, regardless of treatment: the A-P intersection was more anterior (indicating a more anterior positioning of tibia relative to femur) positively correlating with high laxity/low knee function, and during SH, the FHA was more inclined relative to the flexion-extension axis, possibly due to reduced rotational stability. During the TLS, A-P intersection was more anterior in the non-injured knee than the injured, and DI was higher, probably related to higher load on the non-injured knee. ACL(R) had less anterior A-P intersection than ACL(PT), suggesting that surgery enhanced stability, although rotational stability may remain reduced. More anterior A-P intersection and greater inclination between the FHA and the knee flexion-extension axis best revealed reduced dynamic stability similar to 23 years post-injury.

  • 171.
    Guerreiro Semedo, Bruno
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Experiences from multimodal pain rehabilitation in primary healthcare in Sweden: A qualitative study among a group of immigrant women from Somalia.2016Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Introduction: Chronic pain is one of the most disabling and costly afflictions in the world. There is strong scientific evidence that multimodal rehabilitation (MMR) can be more effective than separate interventions to reduce the pain, increase the return to work and to an active life and shorten the sick leaves. Aim: The aim of this study was to obtain the experiences of a group of women from Somalia who took part in a multimodal rehabilitation program in primary healthcare in Northern Sweden. Methods: Seven of the MMR participants were individually interviewed a few months after the end of the program. Five participants gathered for a focus group discussion one year after the program. Grounded theory was used for the data analysis. Results: The analysis resulted in one core category, “regained life”. Two categories emerged, “panic” and “connection”. The participants reported that they had opened their minds; got new ideas and knowledge; got help to improve their adaptation and integration in the society; understood that they were not alone and that there was more to gain when a group of people share their experiences and feelings. Conclusions: The study provided insight about the experiences from agroup of women as participants in a MMR program. These participants pointed out that their experiences were very positive and that the program triggered positive changes in their lives. They attained knowledge about pain, diet and how to exercise, became capable to take care of themselves and improved their self confidence and health.

  • 172.
    Guerrero, Esteban
    et al.
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Nieves, Juan Carlos
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Sandlund, Marlene
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lindgren, Helena
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Activity qualifiers in an argumentation framework as instruments for agents when evaluating human activity2016In: Advances in Practical Applications of Scalable Multi-agent Systems. The PAAMS Collection: 14th International Conference, PAAMS 2016, Sevilla, Spain, June 1-3, 2016, Proceedings / [ed] Yves Demazeau, Takayuki Ito, Javier Bajo, Maria José Escalona, Springer, 2016, Vol. 9662, p. 133-144Conference paper (Other academic)
    Abstract [en]

    Theoretical frameworks have been developed for enabling software agents to evaluate simple activities such as walking and sitting. However, such frameworks typically do not include methods for how practically dealing with uncertain sensor information. We developed an argument-based method for evaluating complex goal-based activities by adapting two qualifiers: Performance and Capacity defined in the health domain. The first one evaluates what a person does, and the second one how "well" or "bad" an activity is executed. Our aim is to deal with uncertainty and inconsistent information; generate consistent hypotheses about the activity execution; and resemble an expert therapist judgment, where an initial hypothesis assessment can be retracted under new evidence. We conducted a pilot test in order to evaluate our approach using a Physiotherapy assessment test as a goal-based activity. Results show that skeptic argumentation semantics are may be useful for discriminating individuals without physical issues by considering Performance and Capacity; conversely, credulous semantics may be suitable for obtaining information in the evaluation of activity, which an intelligent agent may use for providing personalized assistance in an ambient assisted living environment.

  • 173.
    Guerrero, Esteban
    et al.
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Nieves, Juan Carlos
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Sandlund, Marlene
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lindgren, Helena
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Activity qualifiers using an argument-based construction2018In: Knowledge and Information Systems, ISSN 0219-1377, E-ISSN 0219-3116, Vol. 54, no 3, p. 633-658Article in journal (Refereed)
    Abstract [en]

    Based on an argumentation theory approach, we present a novel method for evaluating complex goal-based activities by generalizing a notion of qualifier defined in the health domain. Three instances of the general qualifier are proposed: Performance, Actuation and Capacity; the first one evaluates what a person does, the second how an individual follows an action plan, and the third one how "well" or "bad" an activity is executed. Qualifiers are intended to be used by autonomous systems for evaluating human activity. We exemplify our approach using a health domain assessment protocol. Main results of this test show a partial correlation between ambiguities assessed by experts and our argument-based approach; and a multi-dimensional perspective how an activity is executed when a combined evaluation of qualifiers is used. This last outcome was interesting for some therapists consulted. Results also show differences between values of qualifiers using different argumentation semantics; two scenarios were proposed by therapist for using different semantics: preliminary activity screening and time-span follow-up evaluation.

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  • 174.
    Guevara, Balder
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    En utvärdering av samstämmighet och intrabedömarreliabilitet  avseende bedömningar av postural hållning och rörelser med ett 2-dimensionellt rörelseanalysprogram2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Avvikande rörelsemönster och dålig hållning medför en risk för muskuloskeletala besvär. De senaste åren har flera videoanalysprogram utvecklats som kan användas för att bedöma rörelser och hållning. Det finns dock i dagsläget få studier som har undersökt reliabiliteten och validiteten för sådana rörelseanalysprogram.

     

    Syfte

    Syftet med denna undersökning var att undersöka samstämmigheten mellan analyser av videoinspelningar och visuella analyser gjorda live. Syftet var också att utvärdera intrabedömarreliabiliteten för rörelseanalysprogrammet Kinovea.

     

    Metod

    Deltagarna i studien var 15 studenter vid Umeå Universitet (medelålder 24 år) varav sju män och åtta kvinnor. Samtliga fick utföra en teströrelse, Deep Squat, som bedömdes och spelades in med kamera. Deltagarna fick också sin posturala hållning bedömd och inspelad med kamera. Därefter gjordes bedömningar av den inspelade rörelsen och hållningen för varje deltagare med hjälp av datorprogrammet Kinovea. Bedömningarna på plats jämfördes med bedömningarna med Kinovea och sambandet mellan bedömningarna analyserades. Dessutom gjordes ytterligare två bedömningar av postural hållning i datorprogrammet Kinovea med hjälp av vinkelmätning som sedan analyserades.

     

    Resultat

    Den procentuella överensstämmelsen mellan visuella bedömningen av Deep Squat live och den första bedömningen i Kinovea är 80%. Sambandet mellan den visuella bedömningen av Deep Squat live och den sista bedömningen med Kinovea är 60%. Den procentuella överensstämmelsen mellan den subjektiva bedömningen av postural hållning live och den subjektiva bedömningen av postural hållning med Kinovea var 73% i nacken, 80% i bröstryggen och 87% i ländryggen. Bedömningarna med vinkelmätning för postural hållning som gjordes i Kinovea visade på pearson korrelationskoefficienter mellan 07-0,9.

     

    Konklusion

    Intrabedömarreliabiliteten för vinkelmätningar i Kinovea är relativt hög. Resultaten från bedömningar med Kinovea kunde dock skilja sig markant från bedömningar på plats. Detta tolkas som att bedömningar med videoanalysprogram är mer noggrant utförda och kan ge mer precisa resultat än enbart visuella bedömningar. Man kan således vara hjälpt av videoanalysprogram för att förebygga skador som kan uppstå på grund av avvikande rörelser eller hållning.

  • 175.
    Gustafsson, Johanna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Kunskap och individuellt stöd – en bra grund för beteendeförändringar vid rygg- och nacksmärta.: En intervjustudie.2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Arbetsrelaterade besvär är vanligt förekommande i Sverige. Muskuloskeletala besvär står för en stor del av sjukskrivningarna i Sverige och anställda inom vård- och serviceyrken är bland de hårdast drabbade. Brister i både psykosocial och fysisk arbetsmiljö var vanliga på förskolor. Träning var en viktig behandlingsmetod vid smärta från rygg och nacke och tilltron till den egna förmågan har visat sig viktig vid hantering av smärta. Trotts kunskap om riskfaktorer och effektiva behandlingsmetoder besväras många förskollärare av smärta från nacke och rygg.

    Syftet med denna intervjubaserade studie var att undersöka förskollärares upplevelse av en intervention i form av en rygg- och nackgrupp. För att få svar på det genomfördes 4 individuella intervjuer med kvalitativ design. Kunskap och individuellt stöd visade sig vara en bra grund för beteendeförändingar. Vidare identifierades kategorierna: Förändrat beteende gav minskade besvär, ökad tilltro till den egna förmågan, interventionen gav insikt om faktorer som stöttade en förändring och interventionen gav insikt om faktorer som försvårade en förändring. Intervjuerna skapade en förståelse för vilka faktorer som kan vara viktiga för att minska smärta från rygg och nacke samt stödja en beteendeförändring bland förskollärare. Resultatet kan ge företagshälsovården kunskap om förskollärares arbetssituation och hur de på bästa sätt stöttas till en bättre hälsa på arbete.     

  • 176.
    Gustavsson, Elias
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Håkansson, Simon
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    The why and how of social connectedness: People with multiple LTCs in Christchurch New Zealand2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: The prevalence of multiple LTCs is increasing in New Zealand as it is globally. Low attendance and completion rates at referred rehabilitation programs suggest a need for new rehabilitation approaches for people with LTCs. One of the potential benefits of attending a group program is the opportunity it provides individuals to experience and develop social connections with others who understand and are living with similar issues. Social connection is important for people and it is associated with improved health and well-being. People with LTCs and especially those with multiple LTCs have been shown to have low social connectedness. Aim: The aim of this study was therefore to explore how and why people with multiple LTCs experience and perceive social connectedness as it pertains to them in their everyday lives. Method: This qualitative study used interviews to collect data through a semi-structured predetermined set of questions. Seventeen participants were recruited through a purposive selection of people with multiple LTCs who lived in the east electoral area in Christchurch New Zealand. Results: Analysis of the data resulted in three themes, Community connectedness and ‘neighborhoodness’, Yearning, and Disconnection. Conclusions: Participants perceived and experienced social connectedness through families, friends, work, activities, and in their immediate neighbourhoods. Feelings of isolation and loneliness was experienced by some of our participants and the catalyst for becoming socially isolated and lonely was a major change in their life circumstances. Healthcare professionals need to be cognizant of the effect of major change on the lives of people with LTCs and be ready to explore and assist development of new social connections with them.

  • 177.
    Gustavsson, Linnéa
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    THE IMPORTANCE OF TIME TO RETURN TO SPORT AND MUSCLE FUNCTION ON SUBSEQUENT ANTERIOR CRUCIATE LIGAMENT INJURIES2018Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Abstract:   

    Introduktion:Patienter yngre än 25 år vid en primär rekonstruktion av främre korsbandet (ACL) och som deltar i knäkrävande idrott, representerar en högriskgrupp för att ådra sig en efterföljande ACL skada. Tidig återgång till idrott (RTS) och återgång innan uppnådda specifika rehabiliterings kriterier ökar risken för en efterföljande ACL skada. Mer kunskap behövs om faktorer som påverkar risken för att drabbas av en efterföljande ACL skada hos unga idrottare. 

    Syfte: Att undersöka relationen mellan en efterföljande ACL skada och tid till återgång till idrott, återställande av muskelfunktionen i anslutning till RTS och patientdemografiska faktorer hos unga idrottare. 

    Metod: Detta var en prospektiv observationsstudie som baseras på ett rehabiliterings register. Data från fem muskelfunktionstester (knäflexion/-extension styrka, enbensupphopp, enbens längdhopp, enbens sidohopp) extraherades från registret. Ett frågeformulär skickades ut till 359 personer gällande frågor om tid till RTS och antal ACL skador. En univariabel logistisk regression användes för att analysera samband mellan risken att drabbas av en efterföljande ACL skada och oberoendevariablerna.

    Resultat: Av de tillgängliga patienterna, inkluderades 75 (47 kvinnor) med en medelålder på 21.9±4.5 år. Elva patienter (9 kvinnor) ådrog sig en efterföljande ACL skada. Ingen signifikant skillnad fanns mellan de som drabbades av en efterföljande ACL skada och någon av de oberoende variablerna. 

    Konklusion: Tid till RTS, muskelfunktion i anslutning till RTS och patientdemografi verkar ej ha någon effekt på risken att drabbas av en efterföljande ACL skada hos unga idrottare. Emellertid skall resultatet från denna studie inte ändra rekommendationer från andra studier. Fler studier med större population behövs. 

  • 178.
    Hadrevi, Jenny
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine.
    Bjorklund, Martin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Kosek, E.
    Hallgren, Solveig
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Professionell Development.
    Antti, Henrik
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Fahlstrom, Martin
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Professionell Development.
    Hellstrom, F.
    Systemic differences in serum metabolome: a cross sectional comparison of women with localised and widespread pain and controls2015In: Scientific Reports, E-ISSN 2045-2322, Vol. 5, article id 15925Article in journal (Refereed)
    Abstract [en]

    Chronic musculoskeletal pain exists either as localised to a single region or as widespread to multiple sites in several quadrants of the body. Prospective studies indicate that widespread pain could act as a far end of a continuum of musculoskeletal pain that started with chronic localised pain. The mechanism by which the transition from localised pain to widespread occurs is not clear, although many studies suggest it to be an altered metabolism. In this study, systemic metabolic differences between women with chronic localised neck-shoulder pain (NP), women with chronic widespread pain (CWP) and women who were healthy (CON) were assessed. Blood samples were analysed taking a metabolomics approach using gas chromatography mass spectrometry (GC-MS) and orthogonal partial least square discriminant analysis (OPLS-DA). The metabolomics analysis showed a clear systematic difference in the metabolic profiles between the subjects with NP and the CON but only a weak systematic difference between the subjects with CWP and the CON. This most likely reflects a difference in the portion of the metabolome influenced by the two pain conditions. In the NP group, the overall metabolic profile suggests that processes related to energy utilisation and lipid metabolism could be central aspects of mechanisms maintaining disorder.

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  • 179.
    Hakola, Susanne
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wiljeskén, Sanna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Muskuloskelettala- och generella hälsoproblem hos sångare2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Musiker löper likt andra yrkesgrupper en stor risk att drabbas av muskuloskelettala besvär. Förutom fysiska påfrestningar i samband med arbetet utsätts musiker och däribland sångare även för höga psykosociala krav som kan bidra till andra hälsoproblem. Ett flertal studier har belyst muskuloskelettala besvär hos musiker, men få studier fokuserar på sångares besvär.

    Syfte: Att undersöka muskeloskelettala och generella hälsorelaterade besvär hos sångare och jämföra med övriga musiker.

    Metod: I denna tvärsnittsstudie ingick ett urval av 349 musiker med sång som huvudinstrument (33% män och 67% kvinnor), mellan 15 - 62 år, från enkätundersökningen University of North Texas Musician Health Survey. Antalet övriga musiker var 3668. Demografiska variabler innefattade ålder, kön, år av utbildning, år som professionell musiker, antal övningstimmar/dag, besvärsduration och besvärsgrad av muskuloskelettala besvär, samt generella hälsoproblem.

    Resultat: Sångare har lägre grad av självrapporterade muskuloskelettala besvär än övriga musiker, men signifikant mer generella hälsoproblem. Muskuloskelettala problem hos sångarna var huvudsakligen lokaliserade till den övre kroppshalvan (48%). Vanligast var besvär i händerna. De mest rapporterade generella hälsoproblemen hos sångare var trötthet (60%), huvudvärk (52%) och depression (44%). Inga signifikanta skillnader påvisades mellan manliga och kvinnliga sångare gällande muskuloskelettala besvär. Kvinnor uppgav däremot mer generella hälsoproblem.

    Slutsats: Sångare har mindre muskuloskelettala besvär än andra musiker, men mer generella hälsoproblem. Mer forskning behövs för att styrka resultaten i denna undersökning.

  • 180. Halvarsson, Alexandra
    et al.
    Hagman, Ingela
    Tegern, Matthias
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Huddinge, Sweden.
    Broman, Lisbet
    Larsson, Helena
    Self-reported musculoskeletal complaints and injuries and exposure of physical workload in Swedish soldiers serving in Afghanistan2018In: PLOS ONE, E-ISSN 1932-6203, Vol. 13, no 4, article id e0195548Article in journal (Refereed)
    Abstract [en]

    Background: Musculoskeletal complaints and injuries (MSCI) are common in military populations. However, only a limited number of studies have followed soldiers during international deployments and investigated the prevalence of MSCI during and at the end of their deployment. The aim was to describe the prevalence of MSCI in different military occupational specialties and categorise their most common tasks in terms of exposures to physical workloads during a six-month long international deployment in Afghanistan. Methods: Cross-sectional survey, including 325 soldiers (300 men), aged 20-62 participating in an international deployment in Afghanistan during the spring of 2012. Soldiers were clustered into different military occupational specialties: Infantry, Administration, Logistics, Logistics/Camp, Medical and Other. Data were collected through the use of the Musculoskeletal Screening Protocol at the end of the international mission. Results: Forty-seven percent reported MSCI during deployment, with 28% at the end. The most common locations of MSCI during the mission were lower back, knee, shoulders, upper back, neck and foot, while the knee and lower back prevailed at the end of the mission. Almost half of the soldiers who had MSCI reported affected work ability. The most common duties during the mission were vehicle patrolling, staff duties, guard/security duties, foot patrols and transportation. Soldiers reported that vehicle patrolling, staff duties and transportation were demanding with respect to endurance strength, guard/security duties challenged both maximum and endurance strength while foot patrolling challenged maximum and endurance strength, aerobic and anaerobic endurance and speed. Conclusions: MSCI during international deployment are common among Swedish soldiers. The results indicate the need to further develop strategies focusing on matching the soldiers' capacity to the job requirements, with relevant and fair physical selection-tests during the recruitment process and proactive interventions targeting MSCI before and during deployment, in order to enhance soldiers' readiness and promote operational readiness.

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  • 181.
    Hammarström, Anne
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS). Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lindahl, Bernt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Larsson, Christel
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition. Department of Food and Nutrition, and Sport Science, University of Gothenburg, Sweden.
    Ahlgren, Christina
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS). Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Experiences of barriers and facilitators to weight-loss in a diet intervention: a qualitative study of women in Northern Sweden2014In: BMC Women's Health, E-ISSN 1472-6874, Vol. 14, p. 59-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: There is a lack of research about the experiences of participating in weight-reducing interventions. The aim of this study was to explore barriers and facilitators to weight-loss experienced by participants in a diet intervention for middle-aged to older women in the general population in Northern Sweden.

    METHOD: In the intervention the women were randomised to eat either a Palaeolithic-type diet or a diet according to Nordic Nutrition recommendations for 24 months. A strategic selection was made of women from the two intervention groups as well as from the drop-outs in relation to social class, civil status and age. Thematic structured interviews were performed with twelve women and analysed with qualitative content analyses.

    RESULTS: The results showed that the women in the dietary intervention experienced two main barriers - struggling with self (related to difficulties in changing food habits, health problems, lack of self-control and insecurity) and struggling with implementing the diet (related to social relations and project-related difficulties) - and two main facilitators- striving for self-determination (related to having clear goals) and receiving support (from family/friends as well as from the project) - for weight-loss. There was a greater emphasis on barriers than on facilitators.

    CONCLUSION: It is important to also include drop-outs from diet interventions in order to fully understand barriers to weight-loss. A gender-relational approach can bring new insights into understanding experiences of barriers to weight-loss.

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  • 182.
    Hammarström, Anne
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Haukenes, Inger
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Fjellman Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lehti, Arja
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation. Umeå University, Faculty of Medicine, Department of Clinical Sciences, Professionell Development.
    Wiklund, Maria
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Evengard, Birgitta
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Infectious Diseases.
    Stålnacke, Britt-Marie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Low-Educated Women with Chronic Pain Were Less Often Selected to Multidisciplinary Rehabilitation Programs2014In: PLOS ONE, E-ISSN 1932-6203, Vol. 9, no 5, article id e97134Article in journal (Refereed)
    Abstract [en]

    Background: There is a lack of research about a potential education-related bias in assessment of patients with chronic pain. The aim of this study was to analyze whether low-educated men and women with chronic pain were less often selected to multidisciplinary rehabilitation than those with high education. Methods: The population consisted of consecutive patients (n = 595 women, 266 men) referred during a three-year period from mainly primary health care centers for a multidisciplinary team assessment at a pain rehabilitation clinic at a university hospital in Northern Sweden. Patient data were collected from the Swedish Quality Registry for Pain Rehabilitation National Pain Register. The outcome variable was being selected by the multidisciplinary team assessment to a multidisciplinary rehabilitation program. The independent variables were: sex, age, born outside Sweden, education, pain severity as well as the hospital, anxiety and depression scale (HADS). Results: Low-educated women were less often selected to multidisciplinary rehabilitation programs than high-educated women (OR 0.55, CI 0.30-0.98), even after control for age, being born outside Sweden, pain intensity and HADS. No significant findings were found when comparing the results between high-and low-educated men. Conclusion: Our findings can be interpreted as possible discrimination against low-educated women with chronic pain in hospital referrals to pain rehabilitation. There is a need for more gender-theoretical research emphasizing the importance of taking several power dimensions into account when analyzing possible bias in health care.

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  • 183.
    Hammarström, Anne
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Socialmedicin.
    Lundman, Berit
    Umeå University, Faculty of Medicine, Department of Nursing.
    Ahlgren, Christina
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Socialmedicin.
    Wiklund, Maria
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Health and masculinities shaped by agency within structures among young unemployed men in a northern Swedish context2015In: PLOS ONE, E-ISSN 1932-6203, Vol. 10, no 5, p. 1-18, article id e0124785Article in journal (Refereed)
    Abstract [en]

    The aim of our paper was to explore expressions of life choices and life chances (aspects of agency within structures) related to power and experiences of health among early unemployed adolescent young men during the transition period to adulthood. These expressions of agency within structure were interpreted in the light of Cockerham’s Health Lifestyles Theory. Furthermore, social constructions of masculinities were addressed in our analysis.

    Repeated interviews with ten young men in a cohort of school leavers were analyzed with qualitative content analysis.

    Cockerham’s model was useful for interpreting our findings and we found disposition to act to be a crucial theoretical tool to capture the will and intentions of participants in relation to health. We developed the model in the following ways: structure and socialization were visualized as surrounding the whole model. Analyses of what enhances or restricts power are important. In addition to practices of health lifestyles, we added experiences of health as outcome as well as emotional aspects in disposition to act. We interpret our findings as constructions of masculinities within certain structures, in relation to choices, habitus and practices.

    Qualitative research could contribute to develop the understanding of the agency within structure relationships. Future studies need to pay attention to experiences of health among young people at the margin of the labor market in various milieus – and to analyze these in relation to gender constructions and within the frame-work of agency within structure.

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  • 184.
    Hammarström, Anne
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Social medicine.
    Wiklund, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Social medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Stålnacke, Britt-Marie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Lehti, Arja
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Professionell Development.
    Haukenes, Inger
    Department of Public Mental Health, Division of Mental Health, Norwegian Institute of Public Health; Research Unit for General Practice, Uni Research Health, Kalfarveien 31, Bergen, Norway.
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Developing a Tool for Increasing the Awareness about Gendered and Intersectional Processes in the Clinical Assessment of Patients: A Study of Pain Rehabilitation2016In: PLOS ONE, E-ISSN 1932-6203, Vol. 11, no 4, article id e0152735Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: There is a need for tools addressing gender inequality in the everyday clinical work in health care. The aim of our paper was to develop a tool for increasing the awareness of gendered and intersectional processes in clinical assessment of patients, based on a study of pain rehabilitation.

    METHODS: In the overarching project named "Equal care in rehabilitation" we used multiple methods (both quantitative and qualitative) in five sub studies. With a novel approach we used Grounded Theory in order to synthesize the results from our sub studies, in order to develop the gender equality tool. The gender equality tool described and developed in this article is thus based on results from sub studies about the processes of assessment and selection of patients in pain rehabilitation. Inspired by some questions in earlier tools, we posed open ended questions and inductively searched for findings and concepts relating to gendered and social selection processes in pain rehabilitation, in each of our sub studies. Through this process, the actual gender equality tool was developed as 15 questions about the process of assessing and selecting patients to pain rehabilitation. As a more comprehensive way of understanding the tool, we performed a final step of the GT analyses. Here we synthesized the results of the tool into a comprehensive model with two dimensions in relation to several possible discrimination axes.

    RESULTS: The process of assessing and selecting patients was visualized as a funnel, a top down process governed by gendered attitudes, rules and structures. We found that the clinicians judged inner and outer characteristics and status of patients in a gendered and intersectional way in the process of clinical decision-making which thus can be regarded as (potentially) biased with regard to gender, socio-economic status, ethnicity and age.

    IMPLICATIONS: The clinical implications of our tool are that the tool can be included in the systematic routine of clinical assessment of patients for both awareness raising and as a base for avoiding gender bias in clinical decision-making. The tool could also be used in team education for health professionals as an instrument for critical reflection on gender bias.

    CONCLUSIONS: Thus, tools for clinical assessment can be developed from empirical studies in various clinical settings. However, such a micro-level approach must be understood from a broader societal perspective including gender relations on both the macro- and the meso-level.

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  • 185.
    Hedlund, Jessie
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Ullberg, William
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Betydelse av undersökningsmetod vid utvärdering av lårmuskeluthållighet hos personer med kroniskt obstruktiv lungsjukdom: En kontrollerad tvärsnittsstudie2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Sammanfattning: För personer med kroniskt obstruktiv lungsjukdom (KOL) är nedsatt styrka och/eller uthållighet i lårmuskulaturen en av de vanligaste extrapulmonella konsekvenserna av sjukdomen vilket även har stor betydelse för livskvalitet och framtida prognos för den enskilda individen. Rekommendationen är att muskelstyrka utvärderas med isometrisk (statisk) mätning men det finns dock ingen konsensus om hur utvärderingen ska genomföras avseende muskeluthållighet.

    Syfte: Syftet var att undersöka och jämföra om val av utvärderingsmetod är av betydelse för att upptäcka eventuella skillnader i lårmuskeluthållighet hos personer med KOL jämfört med friska ålders- och könsmatchade kontroller.

    Metod: Tvärsnittsstudie bestående av tio personer med KOL och tio ålders- och könsmatchade friska individer. Dessa genomförde tre tester av muskeluthållighet, (isokinetiskt, isometriskt och isotoniskt), i en stationär dynamometer. Jämförelse mellan testerna gjordes genom beräkning av effektstorlek (ES) som graderades enligt en standardiserad skala.

    Resultat: Jämförelse av lårmuskeluthållighet mellan personer med KOL och friska ålders- och könsmatchade kontroller visar att ES var större vid dynamiska tester (medelstor ES vid både isokinetisk ES=0.71 och isotoniska ES=o.68) jämfört med det statiska testet (isometriska ES=0.16 som är en liten ES). Detta till trots fanns ingen signifikant skillnad i lårmuskeluthållighet mellan grupperna (p>0.05).

    Slutsats: De dynamiska testernas ES indikerar på att dessa är känsligare för att mäta skillnader i lårmuskelfunktion vid KOL än det statiska testet. Den oväntade avsaknaden av statistiskt signifikant skillnad mellan grupperna i lårmuskeluthållighet skulle kunna förklaras av att kontrollgruppen inte var representativ.

  • 186.
    Hedlund, Mattias
    et al.
    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, Physiotherapy.
    Johansson, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Boraxbekk, Carl-Johan
    Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR). Danish Research Center for Magnetic Resonance, Center for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, Hvidovre, Denmark.
    Rosendahl, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Development and Feasibility of a Regulated, Supramaximal High-Intensity Training Program Adapted for Older Individuals2019In: Frontiers in Physiology, E-ISSN 1664-042X, Vol. 10, article id 590Article in journal (Refereed)
    Abstract [en]

    Background: High-intensity training (HIT) with extremely short intervals (designated here as supramaximal HIT) is a time-efficient training method for health and performance. However, a protocol for regulation and control of intensity is missing, impeding implementation in various groups, such as older individuals.

    Methods: This study presents the development and characteristics of a novel training protocol with regulated and controlled supramaximal intervals adapted for older people. Using both quantitative and qualitative analyses, we explored the feasibility of the program, performed in a group training setting, with physically active older individuals (aged 65–75, n = 7; five women). The developed supramaximal HIT program consisted of 10 × 6 s cycle sprint intervals with ∼1 min of active recovery with the following key characteristics: (1) an individual target power output was reached and maintained during all intervals and regulated and expressed as the percentage of the estimated maximum mean power output for the duration of the interval (i.e., 6 s); (2) pedaling cadence was standardized for all participants, while resistance was individualized; and (3) the protocol enabled controlled and systematic adjustments of training intensity following standardized escalation criteria.

    Aim: Our aim was to test the feasibility of a novel training regimen with regulated and controlled supramaximal HIT, adapted for older people. The feasibility criteria for the program were to support participants in reaching a supramaximal intensity (i.e., power output > 100% of estimated VO2 max), avoid inducing a negative affective response, and have participants perceive it as feasible and acceptable.

    Results: All feasibility criteria were met. The standardized escalation procedure provided safe escalation of training load up to a supramaximal intensity (around three times the power output at estimated VO2 max). The participants never reported negative affective responses, and they perceived the program as fun and feasible.

    Conclusion: This novel program offers a usable methodology for further studies on supramaximal HIT among older individuals with different levels of physical capacity. Future research should explore the effects of the program in various populations of older people and their experiences and long-term adherence compared with other forms of training.

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  • 187.
    Hekmatara, Nadja
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sandberg, Julia
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Unga kvinnors drivkrafter och erfarenheter bakom ett deltagande i Bikini fitness - en kvalitativ intervjustudie2017Independent thesis Basic level (university diploma), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Bikini fitness är en disciplin inom Bodybuilding som introducerades år 2011. Det som utmärker disciplinen gentemot andra är att den lägger mer tonvikt på det feminina utseendet och mindre på mängden muskelmassa. Deltagandet kan vara förenat med både positiva och negativa upplevelser. Högriskbeteenden gällande strikta kost- och träningsvanor som kan innebära kompromisser för hälsan är vanligt förekommande inom sporten. Kunskap om deltagarnas drivkrafter och erfarenheter av ett deltagande kan underlätta bemötande och förebyggande insatser.

    Syfte: Syftet med denna studie var att utforska unga kvinnors drivkrafter och erfarenheter bakom ett deltagande i Bikini fitness.

    Metod: Kvalitativ studie som baserades på semistrukturerade intervjuer med fem deltagare som nyligen hade ställt upp i tävlingen och var geografiskt spridda i Sverige. Data analyserades genom kvalitativ innehållsanalys.

    Resultat: Utifrån de två domänerna Drivkrafter och Erfarenheter resulterade analys av data i sex kategorier; Träning som en del av identiteten, En stimulerande social gemenskap, Att vara vältränad men ändå kvinnlig, Empowerment genom sporrande utmaningar, Påfrestande socialt, mentalt och fysiskt samt Kämpig tid efter tävling.

    Konklusion: Det framkom att den största drivkraften till att delta i Bikini fitness är grundad i en stark bakomliggande önskan efter att utmana och bekräfta sig själv. Deltagandet är förenat med positiva men även negativa erfarenheter då det föreligger en risk att erfara depressionsliknande symptom eller ohälsosamma förhållanden till mat efter träningsperioden. En lyhördhet och uppmärksamhet från omgivningens sida krävs för att fånga upp och förebygga dessa beteendemönster i tid.

  • 188.
    Hellberg, Jessica
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Redeborn, Tova
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Samband mellan fysisk aktivitet och självskattad hälsa: En enkätstudie bland svenska ungdomar i årskurs 92018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Fysisk aktivitet (FA) rekommenderas 60 minuter dagligen på måttlig och/eller hög intensitet för barn och unga baserat på många hälsoeffekter som forskning har påvisat. Majoriteten av de svenska ungdomarna kommer inte upp i rekommendationen för FA. Samtidigt konstateras det att allt fler unga har psykosomatisk och psykisk ohälsa. Tidigare forskning visar att FA kan påverka upplevd hälsa hos en individ.

    Syfte: Att undersöka sambandet mellan självskattade fysiska aktivitet och självskattade hälsa i ett urval av ungdomar i årskurs 9

    Metod: Kvantitativ enkätstudie bestående av svenska ungdomar i årskurs 9 (n=58). FA mättes med IPAQ Short Form och självskattad hälsa mättes med frågor hämtade från SF-36 Hälsoenkät.

    Resultat: N=27 (50%) nådde upp till rekommendationerna för FA. Majoriteten, n=44 (77,2%), av ungdomarna skattade sin hälsa som God till Utmärkt. Ett svagt samband sågs mellan minuter FA i veckan av måttlig och hög intensitet och självskattad hälsa, r=0,492. Ett svagt samband sågs mellan minuter av måttlig FA och självskattad hälsa, r= 0,332, och minuter högintensiv FA och självskattad hälsa, r=,0,411. Av de 27 deltagare som inte kom upp i rekommendationerna för FA mådde n=12 (44%) dåligt. Alla deltagarna som kom upp i rekommendationerna för FA mådde n=27 (100%) bra.

    Diskussion: Majoriteten av ungdomarna som deltog i studien upplever att de mår bra samtidigt som hälften når upp till rekommendationen för FA. Urvalsgruppen var liten och homogen vilket kan ha påverkat resultatet. Resultatet motsäger större delen av tidigare forskning som visat att ett starkt samband finns mellan FA och självskattad hälsa.

  • 189.
    Hellgren, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Åhlander, Anna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Fysioterapeutstudenters uppfattningar om psykisk ohälsa hos unga och interventioner via e-hälsa2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Psykisk ohälsa hos unga är ett utbrett folkhälsoproblem, samtidigt som det för hälso- och sjukvården är en utmaning att nå ut till denna grupp. Fysioterapi är verksamt vid psykisk ohälsa, men huruvida fysioterapeutiska interventioner för unga med psykisk ohälsa kan förmedlas via e-hälsa behöver utforskas vidare.

    Syfte: Syftet med studien var att utforska fysioterapeutstudenters uppfattningar om 1) psykisk ohälsa hos unga samt 2) e-hälsa som en väg att förmedla fysioterapi till unga med psykisk ohälsa.

    Metod: I denna studie tillämpades kvalitativ metod och resultatet baserades på sju semistrukturerade individuella intervjuer med fysioterapeutstudenter. Intervjuerna analyserades med vägledning av metoden socialkonstruktivistisk GT. 

    Resultat: Analysen av resultatet mynnade ut i kärnkategorin Verktyg men ingen väg för ohälsan som inte syns, samt fyra kategorier med tillhörande subkategorier. Resultatet presenterar fysioterapeutstudenters uppfattningar om hur psykisk ohälsa hos unga är mer utbrett än vad det till synes verkar. Fysioterapi uppfattas vara verksamt för att hjälpa unga med psykisk ohälsa, samtidigt som fysioterapeuten har svårt att nå unga. E-hälsa diskuteras som en potentiell väg att förmedla fysioterapeutiska interventioner vid psykisk ohälsa.

    Konklusion: Av resultatet framkom att psykisk ohälsa hos unga uppfattas vara vanligt och att fysioterapeuten har en viktig roll både i preventivt och behandlande arbete med unga. Samtidigt som det upplevs vara svårt för fysioterapeuten att nå ut till unga, kan en dualistisk syn på hälsa försvåra implementering av fysioterapeutiska interventioner för unga med psykisk ohälsa. E-hälsa kan fungera som ett komplement för att nå ut med fysioterapeutiska interventioner till unga med psykisk ohälsa.

  • 190.
    Hellgren, Susanne
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sundqvist, Camilla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Muskuloskeletala besvär, upplevd hälsa och krav/kontroll hos Load Haul Dump-förare i malmgruva2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion:

    Syftet var att undersöka förekomst av muskuloskeletala besvär, hälsa, upplevd krav/kontroll i arbetet och upplevelse av förarmiljö hos Load Haul Dump-förare, samt undersöka skillnader mellan de som kör el- respektive dieseldriven Load Haul Dump-maskin.

     

    Metod:

    Ett kvantitativt frågeformulär rörande förekomst av muskuloskeletala besvär (Nordic Musculosceletal Questionnaire - NMQ), hälsa, krav/kontroll (Demand Control Questionnaire - DCQ) och förarmiljö besvarades av LHD-förarna. 104 (12 kvinnor, 90 män, 2 uppgav ej kön) av totalt 138 raslastare deltog i studien. Bortfallet var 25 %.

     

    Resultat:

    79 % hade upplevt muskuloskeletala besvär senaste året. Nacke, ländrygg och

    skuldra/axel var vanligaste besvärsområdena. Besvärsfrekvensen var högre hos de som körde dieseldriven maskin. 79,6 % upplevde hälsan som god. Endast 27,7 % upplevde högra krav och låg kontroll i arbetet.

     

    Konklusion:

    Hög besvärsförekomsten kan ha orsakats av helkroppsvibrationer kombinerat med ogynnsamma kroppsställningar, maskinens skick samt förarstolens inställningsmöjligheter. Dieselmaskinens stol hade mindre rotation och stolinställning samt maskinskick upplevdes i högre grad som sämre, vilket kan vara en anledning till att dieselförarna uppgett mer besvär. Maskinens skick och utformning har stor betydelse varför fortsatta ergonomiska interventioner är viktiga.

  • 191.
    Hellqvist, Jonas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Can Kinesiophobia, Disability and Pain Intensity Discriminate Between Different Patterns of Control Impairment in Patients With Persistent Low Back Pain?2010Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Introduction

    Inconsistent results regarding the efficacy of different treatment modalities for non-specific low back pain (NSLBP) indicate a need for a deeper understanding of what characterise different sub-groups of LBP patients.

    Aim

    To investigate whether kinesiophobia, disability and pain intensity can discriminate between different movement control impairment patterns in patients with NSLBP, and further, to investigate if there are any existing differences between men and women in these variables.

    Design

    Cross-sectional design.

    Method

    A total of 71 patients (33 men, 38 women, mean age of 42.2±10.1) with movement control impairment were classified into five sub-groups based on their direction of control impairment, i.e. flexion-, flexion/lateral shifting-, active extension-, passive extension- or multidirectional pattern, in the low back and analysed for in between group differences in kinesiophobia (Tampa Scale of Kinesiophobia), disability (Roland and Morris Disability Questionnaire) and pain intensity (Visual Analogue Scale). Further, a multiple discriminant analysis (MDA) was executed in order to investigate whether these variables discriminate between these patterns of impairment.

    Result

    The MDA produced no significant functions that could discriminate between different control impairment patterns and therefore no in between group differences were found. A wide distribution within the different patterns exist. Men had a significantly higher level of kinesiophobia compared to women.

    Conclusion

    Kinesiophobia, disability and pain intensity do not discriminate between movement control impairment patterns in NSLBP. Further research is needed to find whether there are other anticipatoryfactors than the direction of the patients control impairment that characterise these sub-groups. Finally, the wide distribution in kinesiophobia, disability and pain intensity within the different patterns of impairment indicate the importance of an individual focus in examining these factors in every patient.

  • 192.
    Henriksson, Tommy
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gilenstam, Kajsa
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine.
    Correlation between Off-ice Strength and Power Variables and Skating Performance in Women's Ice Hockey2015In: Medicine & Science in Sports & Exercise, ISSN 0195-9131, E-ISSN 1530-0315, Vol. 47, no 5S, p. 962-962Article in journal (Refereed)
    Abstract [en]

    The relationship between off-ice tests and skating performance has not been previously investigated in elite women ice hockey players (WIHP).

    PURPOSE: The aim of this study was to investigate the relationship between off-ice strength-, and power- variables and different components of skating performance in Elite WIHP. 

    METHODS: Elite WIHP (n=32) age: 18.3±2.1 years, were evaluated via physiological tests of; Vertical power (squat jump (SJ) and countermovement jump (CMJ)); Horizontal power (standing long jump on two legs (SLJ) on one leg (SLJR) and 20m linear sprinting); Strength (isometric leg pull, squat and isokinetic leg extension on 90° and 210° (Iso90, Iso210)). Right leg measurements were selected for the isokinetic leg extension and SLJ(R). Skating performance was assessed on-ice via three agility tests; S-cornering agility skate (SCAS), Transition agility skate (TAS), Cone agility skate (CAS), and anaerobic endurance test; Modified repeat sprint skate (MRSS). Pearson ́s bivariate correlations were used to investigate the associations between physical variables and on-ice variables. Statistical significance was set to p<.05.

    RESULTS: SLJR, SLJ, Iso90, Iso210, isometric leg-pull and 20m sprint were correlated with TAS, r = .698 (p.001), r = .509 (p.026), r = -.514 (p.050), r = -.529 (p.043), -.479 (p.038) and r = .631 (p.007) respectively. SLJR and Iso90 was correlated with SCAS, r = -.619 (p.005) and r = -.520 (p.047). SLJR, SLJ, CMJ and Iso210 were correlated to MRSS, r = -.588 (p.01), r = -.539 (p.021), r = -.482 (p.037) and r = -.544 (p.04) respectively. CAS was not significantly correlated with any of the physiological tests.

    CONCLUSIONS: Off-ice power and strength tests were significantly correlated to skating performance in elite WIHP. 

  • 193.
    Henriksson, Tommy
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine. The National Graduate School of Gender Studies.
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gilenstam, Kajsa
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine.
    Running a team is like laying a puzzle: Elite coaches' perspective on women's ice hockey2013Conference paper (Refereed)
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  • 194.
    Henriksson, Tommy
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Gilenstam, Kajsa
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Running a team is like laying a puzzle: elite coaches' experiences of women's ice hockeyManuscript (preprint) (Other academic)
    Abstract [en]

    Purpose: The aim of the study was to explore aspects important for sport development and performance in women’s ice hockey, and to reflect on the conditions in Sweden and in North America.

    Method: Data were collected using individual interviews analyzed by qualitative content analysis. The sample including eight ice hockey coaches, two women and six men from being active coaches for female teams on the highest national level.

    Result: The analysis resulted in the theme “Coaching with a holistic approach” and three categories; “Individually oriented and humane leadership”, “Insight and understanding of performance requirements”, and “Necessary conditions for sport development”. The results displayed the complex task of managing a top-level team. In order to coordinate available preconditions into a beneficial environment for the players to develop and perform, the coached had adopted a holistic approach to coaching. A holistic approach to coaching was considered necessary to promote human-, as well as athletic-development in WIH.

    Conclusion: This study suggests that leadership, conditions and requirement of the game, are interrelated and all has to be considered to meet the requirements of the sport and provide opportunities for development. Furthermore, we suggest WIH would benefit from being treated as its own unique experience, instead of being compared to MIH.

  • 195.
    Henriksson, Tommy
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports Medicine. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Vescovi, Jason D.
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gilenstam, Kajsa
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports Medicine.
    Laboratory- and field-based testing as predictors of skating performance in competetive-level female ice hockey2016In: Open Access Journal of Sports Medicine, E-ISSN 1179-1543, Vol. 7, p. 81-88Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The purpose of this study was to examine whether field-based and/or laboratory-based assessments are valid tools for predicting key performance characteristics of skating in competitive-level female hockey players.

    DESIGN: Cross-sectional study.

    METHODS: Twenty-three female ice hockey players aged 15-25 years (body mass: 66.1±6.3 kg; height: 169.5±5.5 cm), with 10.6±3.2 years playing experience volunteered to participate in the study. The field-based assessments included 20 m sprint, squat jump, countermovement jump, 30-second repeated jump test, standing long jump, single-leg standing long jump, 20 m shuttle run test, isometric leg pull, one-repetition maximum bench press, and one-repetition maximum squats. The laboratory-based assessments included body composition (dual energy X-ray absorptiometry), maximal aerobic power, and isokinetic strength (Biodex). The on-ice tests included agility cornering s-turn, cone agility skate, transition agility skate, and modified repeat skate sprint. Data were analyzed using stepwise multivariate linear regression analysis. Linear regression analysis was used to establish the relationship between key performance characteristics of skating and the predictor variables.

    RESULTS: Regression models (adj R2) for the on-ice variables ranged from 0.244 to 0.663 for the field-based assessments and from 0.136 to 0.420 for the laboratory-based assessments. Single-leg tests were the strongest predictors for key performance characteristics of skating. Single leg standing long jump alone explained 57.1%, 38.1%, and 29.1% of the variance in skating time during transition agility skate, agility cornering s-turn, and modified repeat skate sprint, respectively. Isokinetic peak torque in the quadriceps at 90° explained 42.0% and 32.2% of the variance in skating time during agility cornering s-turn and modified repeat skate sprint, respectively.

    CONCLUSION: Field-based assessments, particularly single-leg tests, are an adequate substitute to more expensive and time-consuming laboratory assessments if the purpose is to gain knowledge about key performance characteristics of skating.

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  • 196.
    Henriksson, Tommy
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Vescovi, Jason D.
    Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada..
    Geithner, Christina A.
    Department of Organizational Leadership, Gonzaga University.
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gilenstam, Kajsa
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Performance profiling of female ice hockey players by country and positionManuscript (preprint) (Other academic)
    Abstract [en]

    Purpose: The purposes of this study were to determine whether physiological qualities and on- ice skating performance differ by country and by position in women’s ice hockey.

    Design: Cross-sectional study.

    Methods: A total of 109 female ice hockey players volunteered for the study: 45 players from Sweden (19.38 ± 2.56 years; body mass 69.43 ± 7.05 kg: height 169.83 ± 5.03 cm) and 64 players from Canada (19.84 ± 1.62 years; body mass 68.28 ± 7.72 kg: height 166.14 ± 13.67 cm). Anthropometric assessments included estimated body composition using skinfold measurements. Physiological assessments included tests for acceleration, strength, power and aerobic endurance. Performance assessments included on-ice agility and anaerobic tests. Data were analyzed for mean differences by country and position using a two-way ANOVA.

    Results: The Swedish players had less body fat (p=.007), more lean mass (p=.005), and higher Beep test scores (p=.001). The Canadian players performed better on leg strength (p=.026), acceleration (p=.001), single leg standing long jumps (right leg p=.002, left leg p=.030) and the modified repeat sprint skate (MRSS) (p=.029). Positional comparisons between forwards (F) and defenders (D) showed no significant differences. F and D performed better than goalies (G) on the beep test (p=.002 and p=.002, respectively).

    Conclusion: The findings showed that the physiological profile for the female ice hockey players in this sample differed by country. The results indicate that the Canadian profile may be better adapted for on-ice performance. No performance differences were found between F and D. G are subjected to completely different requirements, due to variation in equipment and movement patterns, and should not be compared to F and D.

  • 197.
    Hermiz, Nawar
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Thorsson, Nils
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Physical health of support worker in the aged care sector: – A cross-sectional study2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: En växande och åldrande befolkning sätter ökade krav på äldrevården. Tillräckligt med arbetskraft och att vårdgivarna förblir friska kommer därför att vara viktigt för att möta den åldrande befolkningens behov.

     

    Syfte: Att undersöka den fysiska hälsan hos vårdgivare inom äldreomsorgen och att jämföra hälsan hos personal ifrån hemtjänsten med dem i särskilda boenden samt att se hur de förhåller sig mot en normal befolkning.

     

    Metod: Tjugoen stycken vårdgivare inom äldreomsorgen deltog frivilligt i denna studie. Varje deltagare fyllde i tre olika frågeformulär och genomgick en hälsoundersökning. Blodtryck, puls, vikt, längd och midjemått registrerades. Deltagarna fick även utföra tre fysiska tester; Grip Strength, 30 Second Chair Stands Test och Six Minute Walk Test. Medel, standardavvikelse och spridning beräknades och medelvärden analyserades deskriptivt i jämförelse mot normativa data. De i hemtjänsten jämfördes med de ifrån särskilda boenden med hjälp av Two-Sample T-test: Assuming Unequal Variances.

     

    Resultat: Alla som deltog i studien var kvinnor med en medelålder på 50.5 (SD 10.3) år, blodtryck på 125.8 (SD 14.2)/81.2 (SD 10.8) mmHG, vilopuls på 73.2 (SD 8.5) bpm, längd 162.0 (SD 8.4) cm, vikt 83.8 (SD 21.8) kg, BMI 31.8 (SD 7.6), midjemått på 93.5 (SD 14.8) cm, waist to height ratio (WtHR) 0.6 (SD 0.1). Exercise Self-Efficacy Scale (ESES) 7.3 (SD 1.15), handstyrka L/R 31.8 (SD 7.2)/34.7 (SD 7.4) kg, chair stands test 13.4 (SD 3.3) reps och sex minuters gångdistans (6MWD) 554.8 (SD 57.7) meter. BMI, midjemått, WHtR och greppstyrka visade alla högre värden än den normativa datan. 30s Sit to Stand och 6MWD visade liknande resultat som den normativa datan. Ingen signifikant skillnad visade sig mellan grupperna förutom högre värden för hemtjänstpersonal i WtHR  (p=0.04)

     

    Konklusion: Denna studie visar på att vårdgivarna som deltog var överlag hälsosamma förutom att de var feta. Resultatet var överlag liknande den normativa datan förutom BMI, midjemått och WHtR.  Ingen signifikant skillnad sågs när grupperna jämfördes förutom vid en varibel, WtHR. Lågt deltagarantal försvårar studiens resultat att gälla för en generell befolkning. Fortsatt forskning är nödvändig och bör fokusera på att rekrytera fler manliga deltagare och fler deltagare ifrån både hemtjänsten och ifrån särskilda boenden.

  • 198.
    Hertzberg, Andreas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Långvarig smärta och utmattningssyndrom – Olika diagnoser, liknande besvär?2015Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Abstract: Chronic pain and exhaustion disorder are included in the choice of care "Rehabilitation of chronic pain with or without comorbidity and exhaustion disorder". The choice of care aims to offer patients specialized multimodal rehabilitation. To be included in the choice of care, patients with chronic pain should score ≥50 on the short version of the self-assessment form Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ Short). To be included in the choice of care, patients with exhaustion disorder should score ≥4,0 on the self-assessment form Shirom-Melamed Burnout Measure (SMBM).

    Aims: To evaluate whether there were similarities/differences between patients with chronic pain with or without comorbidity and patients with exhaustion disorder who were referred to a specialist clinic based on the inclusion criteria stipulated in the choice of care "Rehabilitation of chronic pain with or without comorbidity and exhaustion disorder".

    Method: Evaluation of 136 patients' responses to self-assessment forms; Personal characteristics, ÖMPSQ Short and SMBM.

    Results: Patients with exhaustion disorder could be included in the choice of care for rehabilitation of pain in 51.5% of cases, based on their responses to ÖMPSQ Short. Patients with chronic pain could be included in the choice of care for rehabilitation of exhaustion disorder in 85.7% of cases, based on their responses to SMBM. Patients with exhaustion disorder had higher education than patients with chronic pain. Patients with chronic pain were overweight or were obese and had pain in a greater proportion of the cases and a higher pain intensity compared to patients with exhaustion disorder.

    Conclusion: Most importantly to note is that patients with chronic pain also exhibit exhaustion symptoms and that patients with exhaustion disorder in the majority of cases also have pain.

  • 199.
    Hesselman Borg, Johanna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Den longitudinella svenska studien om fysisk aktivitet och kondition (SPAF 1958):: Vilka faktorer är relaterade till utveckling av besvär från nacke/skuldra vid 52 års ålder?2014Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
  • 200.
    Hesselman Borg, Johanna
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Westerståhl, Maria
    Institutionen för laboratoriemedicin, Karolinska institutet.
    Lundell, Sara
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Madison, Guy
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Longitudinal study exploring factors associated with neck/shoulder pain at 52 years of age2016In: Journal of Pain Research, E-ISSN 1178-7090, Vol. 9, p. 303-310Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To investigate the ability of work-related measurements, body composition, physical activity, and fitness levels to predict neck/shoulder pain (upper body pain, UBP) at the age of 52 years. Another aim was to investigate the cross-sectional relationships between UBP, work-related factors, and individual factors at the age of 52 years.

    METHODS: We followed a randomly selected cohort of 429 adolescents that was recruited in 1974 (baseline), when they were 16 years old. The participants completed physical fitness tests, questions about sociodemographic and lifestyle factors at 16, 34, and 52 years of age, and questions about work-related factors and pain in the follow-ups. Logistic regression analyses were used to examine the associations between UBP and the other variables.

    RESULTS: Univariate logistic regression analyses showed that high body mass index and the work-related factors, low control, and low social support at the age of 34 years were related to UBP at the age of 52 years. For social support, there was an interaction between men and women where the relationship between low social support and the experience of pain was more evident for women. Among women, body mass index and social support remained significantly related in the multivariate analyses. For men, social support remained significantly related. Cross-sectional relationships at the age of 52 differed from the longitudinal in the sense that measures of joint flexibility and work posture were also significantly associated with UBP.

    CONCLUSION: The fact that the cross-sectional differed from the longitudinal relationships strengthens the importance of performing longitudinal studies when studying factors that might influence the initiation of pain. UBP preventative measures might need to include both lifestyle (such as dietary habits and physical activity to ensure that the individuals are not becoming overweight) and work-related factors such as social support.

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