umu.sePublications
Change search
Refine search result
1234567 151 - 200 of 2721
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the Create feeds function.
  • 151. Barreto, Philipe de Souto
    et al.
    Morley, John E.
    Chodzko-Zajko, Wojtek
    Pitkala, Kaisu H.
    Weening-Djiksterhuis, Elizabeth
    Rodriguez-Manas, Leocadio
    Barbagallo, Mario
    Rosendahl, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sinclair, Alan
    Landi, Francesco
    Izquierdo, Mikel
    Vellas, Bruno
    Rolland, Yves
    Recommendations on Physical Activity and Exercise for Older Adults Living in Long-Term Care Facilities: A Taskforce Report2016In: Journal of the American Medical Directors Association, ISSN 1525-8610, E-ISSN 1538-9375, Vol. 17, no 5, p. 381-392Article in journal (Refereed)
    Abstract [en]

    A taskforce, under the auspices of The International Association of Gerontology and Geriatrics-Global Aging Research Network (IAGG-GARN) and the IAGG European Region Clinical Section, composed of experts from the fields of exercise science and geriatrics, met in Toulouse, in December 2015, with the aim of establishing recommendations of physical activity and exercise for older adults living in long-term care facilities (LTCFs). Due to the high heterogeneity in terms of functional ability and cognitive function that characterizes older adults living in LTCFs, taskforce members established 2 sets of recommendations: recommendations for reducing sedentary behaviors for all LTCF residents and recommendations for defining specific, evidence-based guidelines for exercise training for subgroups of LTCF residents. To promote a successful implementation of recommendations, taskforce experts highlighted the importance of promoting residents' motivation and pleasure, the key factors that can be increased when taking into account residents' desires, preferences, beliefs, and attitudes toward physical activity and exercise. The importance of organizational factors related to LTCFs and health care systems were recognized by the experts. In conclusion, this taskforce report proposes standards for the elaboration of strategies to increase physical activity as well as to prescribe exercise programs for older adults living in LTCFs. This report should be used as a guide for professionals working in LTCF settings.

  • 152.
    Baskar, Jayalakshmi
    et al.
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Janols, Rebecka
    Umeå University, Faculty of Science and Technology, Department of Computing Science. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Guerrero, Esteban
    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.
    Lindgren, Helena
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    A Multipurpose Goal Model for Personalised Digital Coaching2017In: Agents and Multi-Agent Systems for Health Care: 10th International Workshop, A2HC 2017, São Paulo, Brazil, May 8, 2017, and International Workshop, A-HEALTH 2017, Porto, Portugal, June 21, 2017, Revised and Extended Selected Papers, Springer, 2017, Vol. 10685, p. 94-116Conference paper (Refereed)
    Abstract [en]

    Supporting human actors in daily living activities for improving health and wellbeing is a fundamental goal for assistive technology. The personalisation of the support provided by assistive technology in the form of digital coaching requires user models that handle potentially conflicting goals and motives. The aim of this research is to extend a motivational model implemented in an assistive technology, into a multipurpose motivational model for the human actor who is to be supported, which can be translated into a multipurpose goal model for a team of assistive agents. A team of assistive agents is outlined with supplementary goals following the human’s different properties. A method for generating multipurpose arguments relating to different motives were developed, and implemented in a human-agent dialogue system. The results are exemplified based on a use case from an earlier pilot user study of the assistive technology. Future work includes user studies to validate the model.

  • 153.
    Baxter, Rebecca
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lövheim, Hugo
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Björk, Sabine
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Sköldunger, Anders
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lindkvist, Marie
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Sjögren, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sandman, Per-Olof
    Umeå University, Faculty of Medicine, Department of Nursing. Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden.
    Bergland, Ådel
    Winblad, Bengt
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing. School of Nursing & Midwifery, La Trobe University, Melbourne, Australia.
    The Thriving of Older People Assessment Scale: Psychometric evaluation and short‐form development2019In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648Article in journal (Refereed)
    Abstract [en]

    Aim: To evaluate the psychometric properties and performance of the 32‐item Thriving of Older People Assessment Scale (TOPAS) and to explore reduction into a short‐form.

    Background: The 32‐item TOPAS has been used in studies of place‐related well‐being as a positive measure in long‐term care to assess nursing home resident thriving; however, item redundancy has not previously been explored.

    Design: Cross‐sectional.

    Method: Staff members completed the 32‐item TOPAS as proxy‐raters for a random sample of Swedish nursing home residents (N = 4,831) between November 2013 and September 2014. Reliability analysis, exploratory factor analysis and item response theory‐based analysis were undertaken. Items were systematically identified for reduction using statistical and theoretical analysis. Correlation testing, means comparison and model fit evaluation confirmed scale equivalence.

    Results: Psychometric properties of the 32‐item TOPAS were satisfactory and several items were identified for scale reduction. The proposed short‐form TOPAS exhibited a high level of internal consistency (α=0.90) and strong correlation (r=0.98) to the original scale, while also retaining diversity among items in terms of factor structure and item difficulties.

    Conclusion: The 32‐item and short‐form TOPAS' indicated sound validity and reliability to measure resident thriving in the nursing home context.

    Impact: There is a lack of positive life‐world measures for use in nursing homes. The short‐form TOPAS indicated sound validity and reliability to measure resident thriving, providing a feasible measure with enhanced functionality for use in aged care research, assessments and care planning for health promoting purposes in nursing homes.

  • 154.
    Bay, Annika
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Dellborg, Mikael
    Berghammer, Malin
    Sandberg, Camilla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Engström, Gunnar
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Moons, Philip
    Johansson, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Patient reported outcomes are associated with physical activity level in adults with congenital heart disease2017In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 243, p. 174-179Article in journal (Refereed)
    Abstract [en]

    Background: In general, adults with congenital heart disease (CHD) have impaired exercise capacity, and approximately 50% do not reach current recommendations on physical activity. Herein we analysed factors associated with physical activity level (PAL) in adults with CHD by using patient-reported outcomes (PRO). Methods: Patients with CHD (n = 471) were randomly selected from the national register on CHD and categorized according to complexity of lesions -simple (n = 172, 39.1 +/- 14.6 years), moderate (n = 212, 39 +/- 14.1 years), and severe (n = 87, 31.7 +/- 10.7 years). Participants completed a standardized questionnaire measuring PRO-domains including PAL. Variables associated with PAL were tested in multivariate logistic regression. Results: PAL was categorized into high (>= 3 METs = 2.5 h/week, n = 192) and low (>= 3 METs <2.5 h/week, n = 279). Patients with low PAL were older (42.6 vs. 35.8 years, p = 0.001), had more prescribed medications (51% vs. 39%, p = 0.009), more symptoms (25% vs. 16%, p = 0.02) and comorbidity (45% vs. 34% p= 0.02). Patients with low PAL rated a lower quality of life (76.6 vs. 83.4, p < 0.001), satisfaction with life (25.6 vs. 27.3, p = 0.003), a lower Physical Component Summary score (PCS) (78.1 vs. 90.5, p < 0.001) andMental Component Summary score (MCS) (73.5 vs. 79.5, p < 0.001). Complexity of heart lesion was not associated with PAL. The included PROs-separately tested in the model, together with age were associated with PAL. Conclusions: PCS and MCS are stronger associated with PAL than age and medical factors. The use of these PROs could therefore provide valuable information of benefit for individualized advice regarding physical activity to patients with CHD.

  • 155.
    Bay, Annika
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Lämås, Kristina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Berghammer, Malin
    Sandberg, Camilla
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Johansson, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Enablers and barriers for physical activity in adults with congenital heart disease2019Conference paper (Refereed)
  • 156.
    Bay, Annika
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Sandberg, Camilla
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Thilen, U.
    Wadell, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Johansson, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Exercise self-efficacy (ESE) in adults with congential heart disease2017In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 38, no Suppl. 1, article id ehx501.P618Article in journal (Refereed)
    Abstract [en]

    Background: Many adults with congenital heart disease (CHD) have reduced aerobic exercise capacity and impaired muscle function. However, it is largely unknown which factors have influence on the confidence to perform exercise training, i.e. Exercise Self-Efficacy (ESE).

    Aims: To identify factors related to low ESE, and thus identify potential targets for rehabilitation and thereby enhance the potential for being physically active.

    Methods: Seventy-nine adults with CHD; simple lesions n=38 (women n=16), complex lesions n=41 (women n=17) (mean age 36.7±14.6 years) and 42 age and sex matched controls were recruited. All participants completed questionnaires on ESE, quality of life (EQ-5D), and physical activity (international physical activity questionnaire, IPAQ), and performed muscle endurance tests.

    Results: ESE was categorised into low (<26 points, n=24) and high (≥26 points, n=55). Patients with low ESE were older (45.2±15.4 vs. 32.6±12.5 years, p=0.002), more often had prescribed medication (67% vs. 44%, p=0.06), higher New York Heart Association functional class (NYHA) (≥ III) (25% vs. 7%, p=0.03) and performed fewer shoulder flexions (30.9±16.1 vs. 45.9±23.9, p=0.01) compared with those with high ESE. In the high ESE group, ESE did not differ from controls (33.8±3.9 vs. 33.4±6.1, p=0.74). In linear multivariate analysis age (B;-0.18, 95% CI -0.28- -0.08), smoking (B;-3.73, 95% CI -7.17- -0.28), EQ-5Dindex <1 (B;-3.33, 95% CI -6.08- -0.57) and number of shoulder flexions (B; 0.09, 95% CI 0.03–0.16) were independently associated with ESE.

    Conclusion: Many adults with CHD have low ESE. Rehabilitation targeting quality of life, smoking cessation and muscle training may improve ESE, and thus enhance the potential for being physically active in this population.

  • 157.
    Bay, Annika
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Sandberg, Camilla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Thilén, Ulf
    Wadell, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Johansson, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Exercise self-efficacy in adults with congenital heart disease2018In: International Journal of Cardiology: Heart and vasculature, E-ISSN 2352-9067, Vol. 18, p. 7-11Article in journal (Refereed)
    Abstract [en]

    Background: Physical activity improves health, exercise tolerance and quality of life in adults with congenital heart disease (CHD), and exercise training is in most patients a high-benefit low risk intervention. However, factors that influence the confidence to perform exercise training, i.e. exercise self-efficacy (ESE), in CHD patients are virtually unknown. We aimed to identify factors related to low ESE in adults with CHD, and potential strategies for being physically active.

    Methods: Seventy-nine adults with CHD; 38 with simple lesions (16 women) and 41 with complex lesions (17 women) with mean age 36.7 ± 14.6 years and 42 matched controls were recruited. All participants completed questionnaires on ESE and quality of life, carried an activity monitor (Actiheart) during four consecutive days and performed muscle endurance tests.

    Results: ESE in patients was categorised into low, based on the lowest quartile within controls, (≤ 29 points, n = 34) and high (> 29 points, n = 45). Patients with low ESE were older (42.9 ± 15.1 vs. 32.0 ± 12.4 years, p = 0.001), had more complex lesions (65% vs. 42%, p = 0.05) more often had New York Heart Association functional class III (24% vs. 4%, p = 0.01) and performed fewer shoulder flexions (32.5 ± 15.5 vs. 47.7 ± 25.0, p = 0.001) compared with those with high ESE. In a logistic multivariate model age (OR; 1.06, 95% CI 1.02-1.10), and number of shoulder flexions (OR; 0.96, 95% CI 0.93-0.99) were associated with ESE.

    Conclusion: In this study we show that many adults with CHD have low ESE. Age is an important predictor of low ESE and should, therefore, be considered in counselling patients with CHD. In addition, muscle endurance training may improve ESE, and thus enhance the potential for being physically active in this population.

  • 158. Bellelli, Giuseppe
    et al.
    Mazzola, Paolo
    Morandi, Alessandro
    Bruni, Adriana
    Carnevali, Lucio
    Corsi, Maurizio
    Zatti, Giovanni
    Zambon, Antonella
    Corrao, Giovanni
    Olofsson, Birgitta
    Umeå University, Faculty of Medicine, Department of Nursing.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Annoni, Giorgio
    Duration of Postoperative Delirium Is an Independent Predictor of 6-Month Mortality in Older Adults After Hip Fracture2014In: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 62, no 7, p. 1335-1340Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To evaluate the association between number of days with delirium and 6-month mortality in elderly adults after hip fracture surgery. DESIGN: Prospective cohort study with 6-month follow-up. SETTING: Orthogeriatric Unit (OGU). PARTICIPANTS: Individuals (mean age = 84.3 +/- 6.4) admitted to the OGU between October 2011 and April 2013 with hip fracture (N = 199). MEASUREMENTS: Postoperative delirium (POD) was assessed daily using the Confusion Assessment Method algorithm and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, criteria. Multivariable Cox regression models were used to evaluate the association between POD of and 6-month mortality after surgery, after adjustment for covariates including age, prefracture residence, Katz activity of daily living score, New Mobility score, diagnosis of prefracture dementia, American Society of Anesthesiologists score, albumin serum levels, Charlson Comorbidity Index, and length of OGU stay. RESULTS: Fifty-seven participants (28.6%) developed POD. In the 6-month period after surgery, 35 (17.6%) participants died: 16 of 57 (28.1%) with POD and 19 / of 142 (13.4%) with no POD. The average duration of POD was 2.0 +/- 3.2 days for participants who died and 0.7 +/- 1.8 days for those who survived (P < .001). After adjusting for covariates, each day of POD in the OGU increased the hazard of dying at 6 months by 17% (hazard ratio = 1.17, 95% confidence interval = 1.07-1.28). CONCLUSION: In older adults undergoing hip fracture surgery, duration of POD is an important prognostic factor for 6-month mortality. Efforts to reduce duration of POD are therefore crucial for these individuals.

  • 159. Benetou, V.
    et al.
    Orfanos, P.
    Feskanich, D.
    Michaëlsson, K.
    Pettersson-Kymmer, Ulrika
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Byberg, L.
    Eriksson, Sture
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Grodstein, F.
    Wolk, A.
    Jankovic, N.
    de Groot, L. C. P. G. M.
    Boffetta, P.
    Trichopoulou, A.
    Mediterranean diet and hip fracture incidence among older adults: the CHANCES project2018In: Osteoporosis International, ISSN 0937-941X, E-ISSN 1433-2965, Vol. 29, no 7, p. 1591-1599Article in journal (Refereed)
    Abstract [en]

    The association between adherence to Mediterranean diet (MD) and hip fracture incidence is not yet established. In a diverse population of elderly, increased adherence to MD was associated with lower hip fracture incidence. Except preventing major chronic diseases, adhering to MD might have additional benefits in lowering hip fracture risk.

    INTRODUCTION: Hip fractures constitute a major public health problem among older adults. Latest evidence links adherence to Mediterranean diet (MD) with reduced hip fracture risk, but still more research is needed to elucidate this relationship. The potential association of adherence to MD with hip fracture incidence was explored among older adults.

    METHODS: A total of 140,775 adults (116,176 women, 24,599 men) 60 years and older, from five cohorts from Europe and the USA, were followed-up for 1,896,219 person-years experiencing 5454 hip fractures. Diet was assessed at baseline by validated, cohort-specific, food-frequency questionnaires, and hip fractures were ascertained through patient registers or telephone interviews/questionnaires. Adherence to MD was evaluated by a scoring system on a 10-point scale modified to be applied also to non-Mediterranean populations. In order to evaluate the association between MD and hip fracture incidence, cohort-specific hazard ratios (HR), adjusted for potential confounders, were estimated using Cox proportional-hazards regression and pooled estimates were subsequently derived implementing random-effects meta-analysis.

    RESULTS: A two-point increase in the score was associated with a significant 4% decrease in hip fracture risk (pooled adjusted HR 0.96; 95% confidence interval (95% CI) 0.92-0.99, pheterogeneity = 0.446). In categorical analyses, hip fracture risk was lower among men and women with moderate (HR 0.93; 95% CI 0.87-0.99) and high (HR 0.94; 95% CI 0.87-1.01) adherence to the score compared with those with low adherence.

    CONCLUSIONS: In this large sample of older adults from Europe and the USA, increased adherence to MD was associated with lower hip fracture incidence.

  • 160. Benetou, Vassiliki
    et al.
    Orfanos, Philippos
    Feskanich, Diane
    Michaëlsson, Karl
    Pettersson-Kymmer, Ulrika
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Eriksson, Sture
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Grodstein, Francine
    Wolk, Alicja
    Bellavia, Andrea
    Ahmed, Luai A
    Boffeta, Paolo
    Trichopoulou, Antonia
    Fruit and Vegetable Intake and Hip Fracture Incidence in Older Men and Women: The CHANCES Project2016In: Journal of Bone and Mineral Research, ISSN 0884-0431, E-ISSN 1523-4681, Vol. 31, no 9, p. 1743-1752Article in journal (Refereed)
    Abstract [en]

    The role of fruit and vegetable intake in relation to fracture prevention during adulthood and beyond is not adequately understood. We investigated the potential association between fruit and vegetable intake and hip fracture incidence in a large sample of elderly from Europe and United States. A total of 142,018 individuals (among which 116,509 women), aged ≥60 years old, from five cohorts, were followed-up prospectively for 1,911,482 person-years accumulating 5,552 hip fractures. Fruit and vegetable intake was assessed by validated, cohort-specific, food-frequency questionnaires. Ηip fractures were ascertained through national patient registers or telephone interviews/questionnaires. Adjusted hazard ratios (HR) derived by Cox proportional-hazards regression were estimated for each cohort and subsequently pooled using random-effects meta-analysis. Intake of ≤ 1 servings/day of fruit and vegetables combined was associated with 39% higher hip fracture risk [pooled adjusted HR:1.39, 95% Confidence Intervals (CIs): 1.20, 1.58] in comparison to moderate intake (>3 and ≤5 servings/day) (pfor heterogeneity  = 0.505), whereas higher intakes (>5 servings/day) were not associated with lower risk in comparison to the same reference. Associations were more evident among women. We concluded that a daily intake of one or less servings of fruits and vegetables was associated with increased hip fracture risk in relation to moderate daily intakes. Older adults with such low fruit and vegetable consumption may benefit from raising their intakes to moderate amounts in order to reduce their hip fracture risk. 

  • 161.
    Bengs, Carita
    et al.
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Wiklund, Maria
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Kropp och hälsa2015In: Feministiskt tänkande och sociologi: teorier, begrepp och tillämpningar / [ed] Anna Hedenus, Sofia Björk, Oksana Shmulyar Gréen, Lund: Studentlitteratur AB, 2015, p. 151-167Chapter in book (Refereed)
  • 162.
    Bengtsson, Karolin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Lindholm, Malin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Gymnasieelevers erfarenheter av att arbeta med elevcoach: En nätbaserad kvantitativ enkätundersökning2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    En till två elever i varje klass inom grundskolan har någon form av neuropsykiatrisk funktionsnedsättning och upplever skolan som en stor kamp. För att stödja elever inom gymnasieskolan startades projektet Pusselbiten där elevhälsan kompletterades med elevcoacher, bestående av arbetsterapeuter och beteendevetare. Elevcoacherna fokuserade sina interventioner inte enbart på skolsituationen, utan även på elevens hela vardagssituation då detta påverkar deras prestation i skolan. Syftet med denna studie var att beskriva elevernas erfarenheter av särskilda stödinsatser från elevcoach i gymnasieskolan. Utvärderingen gjordes genom en nätbaserad kvantitativ enkätundersökning och data bearbetades genom en deskriptiv analys. Resultatet visade att alla elever ansåg att de fick den hjälp de behövde av elevcoacherna i skolan. De vanligaste insatserna elevcoacherna fick hjälpa eleverna med, var att hitta struktur i vardagen och att komma igång med skoluppgifter. I denna studie framstår elevernas erfarenheter av projektet som positiva men det behövs fler studier inom området för att på ett vetenskapligt sätt kunna utvärdera effekten av elevcoachernas interventioner.Sökord: Elevcoach i skolan, arbetsterapi i skolan, coach, neuropsykiatriska funktionshinder och webbenkät.

  • 163.
    Bengtsson, Patricia
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Larsson, Angelica
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Upplevelser av balans i vardagslivet: En kvalitativ studie om unga vuxna med reumatisk sjukdom2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Inom aktivitetsvetenskap har människans dagliga mönster av aktiviteter länge ansetts vara av betydelse för hälsan. Unga vuxna kan ha många förväntningar att leva upp till och att dessutom vara sjuk kan göra vardagen svår att hålla samman. Enligt tidigare forskning finns ett behov av att fokusera på unga vuxna med reumatisk sjukdom för att få större inblick i deras vardag. Därför genomfördes denna studie i syfte att belysa hur unga vuxna med reumatisk sjukdom upplever balans i vardagen och vad som kan påverka denna. Studien hade en kvalitativ ansats där sju personer i åldern 21-33 år intervjuades. Data bearbetades genom kvalitativ innehållsanalys. Upplevelsen av balans skildrades genom huvudkategorierna; i relation till dygnets tid, i ett socialt sammanhang, att känna sig frisk eller sjuk, med känslan av kontroll, att få vara aktiv och göra det som är viktigt samt att befinna sig på en lagom nivå. Viljan att vara aktiv var centralt och ett perspektiv på aktivitet och hälsa kunde urskiljas. Personliga faktorer och omgivningsfaktorer, däribland anpassningsförmåga, känslor, smärta, trötthet och social omgivning visade sig vara möjliggörande eller hindrande för känslan av balans. En helhetsbild och förståelse för samspelet mellan person, aktivitet och miljö är viktigt för att vid eventuell obalans kunna erbjuda stöd för att främja en balanserad vardag.

  • 164.
    Bengtsson, Patrik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Postoperativ knäsvullnad efter främre korsbandsrekonstruktion: - en jämförelse mellan standard- och accelererad rehabilitering.2013Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Nu för tiden är det vanligt att använda sig av så kallad accelererad rehabilitering efter främre korsbandsrekonstruktion. Den accelererade rehabiliterings påverkan på uttöjning av det nya korsbandsgraftet och lårmuskelstyrka är väl kända. Däremot är kunskapen om hur accelererad rehabilitering påverkar svullnad i knäleden mer begränsad.

    Syfte: Att undersöka om det finns någon skillnad avseende knäledssvullnad efter främre korsbandsrekonstruktion vid ett standard- och ett accelererat rehabiliteringsprogram.

    Studiedesign: Sekundäranalys av randomiserad kontrollerad studie.

    Material och metod: Etthundra sextioen främre korsbandsrekonstruerade patienter med patellar- eller hamstringssena randomiserades till standard- och ett accelererat rehabiliteringsprogram. Nittio patienter, standard rehabilitering (n=29) och accelererad rehabilitering (n=61) inkluderades för beräkning av svullnad, vid baseline, 1 vecka postoperativt. Svullnad definierades som skillnad i omkrets mätt med måttband av icke opererat knä jämfört med opererat knä. Svullnad beräknades vid vecka 1 och månad 1, 2, 3 och 4 postoperativt.

    Resultat: Det var ingen signifikant skillnad avseende knäsvullnad vid jämförelse  mellan standard- och ett accelererat rehabiliteringsprogram vid något av uppföljningstillfällena.

    Slutsats: Denna studie visar att träning enligt ett accelererat rehabiliteringsprogram efter främre korsbandrekonstruktion inte ökar knäsvullnad signifikant jämfört med ett standard rehabiliteringsprogram. Gruppen som tränat enligt ett accelererat rehabiliteringsprogram uppvisade dock en något större knäsvullnad suprapatellärt.

  • 165.
    Bengtsson, Samuel
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Comorbidity of psychological distress in patients with chronic pain, with focus on burnout, a pilot study2018Independent thesis Basic level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • 166.
    Bengtsson, Victor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    The three-dimensional movement patterns in the thoracolumbar and lumbopelvic spine during the deadlift exercise2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Marklyft är en vanlig styrketräningsövning. Det saknas emellertid studier av ryggradens rörelsemönster under utförandet av marklyft. Syftet med den här studien var att kvantifiera ryggradens tredimensionella rörelsemönster under utförandet av marklyft och vid vanehållning i de thorakolumbala och lumbosakrala regionerna samt studera inverkan av kön.

    Tjugofyra tävlande lyftare, 14 män och 10 kvinnor med 1 repetition maximum (1RM) i marklyft på 162.5 ± 55.5 kg, utförde tre repetitioner av tunga marklyft. Ryggens tredimensionella rörelsemönster, rörelseomfång (ROM) och kurvatur i thorakolumbala (T11-L2) och lumbosakrala (L2-S2) regionerna mättes med rörelsesensorer.

    Resultatet visade att rörelser sker i sagittal-, frontal- och horizontalplanet i thorakolumbala (ROM = 11.8 ± 7.6, 4.3 ± 2.8, and 3.4 ± 1.6 degrees) och lumbosakrala regionerna (ROM = 21.7 ± 6.5, 2.8 ± 1.7, och 2.8 ± 1.4 grader) under marklyftsutförandet. I jämförelse med vanehållningen ändrades ryggens kurvatur i start- och stoppläget mot ett mer flekterat läge. Signifikanta skillnader hittades mellan könen avseende vanehållning, startläge och ROM.

    Sammanfattningsvis ändras ryggens kurvatur under utförandet av tunga marklyft i sagittalplanet samt att vanehållningen och rörelsemönster skiljer sig mellan män och kvinnor.

  • 167.
    Bengtsson, Victor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    The three-dimensional thoracolumbar and lumbopelvic spinal alignment during the squat exercise: a comparison between powerlifters and weightlifters2018Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Introduction: The squat is a common strength training exercise used by athletes for injury-reduction, rehabilitation, muscle hypertrophy, and performance-enhancement. Aims: To quantify the three-dimensional spinal alignment in the thoracolumbar and lumbopelvic spine during the squat exercise, compare the alignment during the squat to the alignment during habitual posture, determine whether powerlifters and weightlifters differ in these aspects, and to examine the absolute and relative intrarater test-retest reliability of the spinal alignment during the squat exercise. Methods: Twenty-three competitive lifters: 13 powerlifters and 10 weightlifters were included. They performed the squat exercise with three repetitions at 70% of one-repetition maximum. Three-dimensional thoracolumbar (T11-L2) and lumbopelvic (L2-S2) spinal alignment and range of motion (ROM) were measured using inertial measurement units. Absolute reliability was estimated with minimal detectable change (MDC). Relative reliability was calculated using the intraclass correlation coefficient (ICC). Results: No statistically significant group*time interaction was found for thoracolumbar or lumbopelvic spinal alignment in neither dimension. However, statistically significant interactions for time was found in all three dimensions in thoracolumbar and lumbopelvic spinal alignment. During the squat, adjustments were made in all three dimensions in both the thoracolumbar and lumbopelvic spinal alignment. The MDC ranged between 3.4-27.4° and ICC between 0.91-1.00. Conclusion: These findings suggest that that powerlifters and weightlifters assumes a less lordotic thoracolumbar spinal alignment when the loaded barbell is placed on the upper back and that further adjustments are made in the thoracolumbar and lumbopelvic spinal alignment during the squat. Despite high relative reliability, the MDC was considered high.

  • 168.
    Bengtsson, Victor
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Berglund, Lars
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Social Sciences, Umeå Sport Sciences Center.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Social Sciences, Umeå Sport Sciences Center. Medfit, Primary Care Rehabilitation and Fitness Centre, Stockholm, Sweden.
    Narrative review of injuries in powerlifting with special reference to their association to the squat, bench press and deadlift2018In: BMJ Open Sport & Exercise Medicine, E-ISSN 2055-7647, Vol. 4, article id e000382Article in journal (Refereed)
    Abstract [en]

    Pain and injuries are considered a common problem among elite athletes and recreational lifters performing the squat, bench press and deadlift. Since all three lifts engage multiple joints and expose the lifters' bodies to high physical demands often several times a week, it has been suggested that their injuries might be related to the excessively heavy loads, the large range of motion during the exercises, insufficient resting times between training sessions and/or faulty lifting technique. However, no previous article has summarised what is known about specific injuries and the injury aetiology associated with the three lifts. Thus, the aim of this narrative review was to summarise what is known about the relationships between the powerlifting exercises and the specific injuries or movement impairments that are common among lifters and recreationally active individuals.

  • 169.
    Bengtsson, Victor
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine.
    Yu, Ji-Guo
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine.
    Gilenstam, Kajsa
    Could the negative effects of static stretching in warm-up be restored by sport specific exercise?2018In: Journal of Sports Medicine and Physical Fitness, ISSN 0022-4707, E-ISSN 1827-1928, ISSN 0022-4707, Vol. 58, no 9, p. 1185-1189Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Static stretching (SS) is widely used in warm-up as it is generally believed to increase mobility and reduce the risk of injury; however, SS has been shown to induce transient negative effects on subsequent muscle performance. Interestingly, recent studies have shown that sport specific exercise could restore SS-induced negative effects on certain sports, especially of explosive muscular performance. Whether sport specific exercise could restore SS-induced negative effects on isokinetic muscle performance remains unclear.

    METHODS: The present study conducted two different warm-ups: 2-component warm-up and 3-component warm-up on 15 university students. Both protocols contained low intensity aerobic exercise and sport specific exercise, whereas the 3-component warm-up also contained SS which has been previously proven to induce negative effects on subsequent muscle performance. After the warm-ups, the subjects performed an isokinetic test on a Biodex. To make the sport specific exercise mimic the subsequent test, both included concentric isokinetic knee extension. During the tests, muscle performance of peak torque, mean power, and total work was recorded. Comparison of the measurements on each parameter between the two warm-ups was performed using paired t test.

    RESULTS: The comparisons did not reveal any significant difference in the measurement of any parameter between the two different warm-up protocols, and calculation of Cohen's revealed small effect sizes on all of the three variables.

    CONCLUSIONS: On basis of the present results and that the SS could induce transient negative effects on subsequent muscle performance, we concluded that the negative effects of the SS on the variables were restored by the isokinetic contractions.

  • 170.
    Benjamin, Tornblad
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Andersson, Christian
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Erfarenheter av sömnsvårigheter och dess inverkan på aktivitet hos unga vuxna med diagnosen ADHD2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Aktivitet beskrivs som ett görande och är viktigt för alla individer. Sömnsvårigheter kan påverka aktiviteters utförande och göra att utförandet blir otillfredsställande. Syftet med denna studie var att beskriva erfarenheter av sömnsvårigheter och dess inverkan på aktivitet hos unga vuxna med diagnosen ADHD. Studien utfördes med en kvalitativ ansats. Personer med sömnsvårigheter och diagnosen ADHD intervjuades med stöd av intervjuguide. Materialet analyserades sedan med stöd av innehållsanalys. Intervjuerna resulterade i fyra kategorier, som visade att personer med en ADHD diagnos upplevde att sömnsvårigheter påverkade deras förmåga att utföra vardagliga aktiviteter. ADHD ansågs vara en bidragande faktor till sömnsvårigheterna och att kunna somna upplevdes som en utmaning. Det var tydligt att miljön hade inverkan både på god och bristande sömnkvalitet. Olika strategier som hjälpmedel och fasta rutiner för att skapa struktur användes för att öka möjligheten att kunna somna. Det saknas forskning om verksamma arbetsterapeutiska interventioner riktade mot personer med ADHD och sömnsvårigheter. Det är därför viktigt att mer forskning utförs på det området.

     

    Sökord: sömnkvalitet, arbetsterapi, neuropsykiatriskt funktions- hinder, aktivitetsutförande

  • 171.
    Bentzer, Linda
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hedlund, Linnea
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Functional movement screen, skadeförekomst och träningsmängd hos kvinnliga innebandyspelare2012Student thesis
  • 172.
    Bergdahl, Ellinor
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation.
    Depression among the very old2007Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Emotional suffering in old age is largely caused by various psychiatric conditions, of which depression is the most common. Depression is associated with a decline in both well-being and daily functioning and reduces both morale and social capacity among the very old, which may produce high health and social costs for society.

    The overall aim of the thesis was to study the prevalence of depression among the very old, to identify factors associated with depression and to evaluate the prognosis of depression among the very old.

    In total, 363 people were evaluated for depression, 242 from an urban municipality in the year 2000 and 121 from five rural municipalities in 2002. In 2005, those still alive in the urban municipality were asked to participate again, and were therefore re-evaluated. The prevalence of depression was 27% in the urban municipality, 34% in the rural municipalities and 29% in the total sample. Of those depressed, about 67% were receiving antidepressive treatment, and of those, approximately 50% had responded to treatment. In the rural municipality, the depressed were less often treated with Selective Serotonin Re-uptake Inhibitor medications, receiving instead Tri-Cyclic Antidepressants. In the rural municipalities, only 38% of the depressed had responded to treatment. A higher proportion of women were diagnosed as depressed, 33% vs. 19%, p=0.006, although the response rate was the same for men and women. Depression was twice as common among those with dementia, 44% vs. 23%. There were discrepancies concerning associated factors between the depressed participants with dementia and those without.

    Experiencing the death of a child during the preceding ten years was associated with depression and independently associated with depression among men and participants with dementia. In all the studies, the depressed were less often able to go outside independently and to visit others. They also received fewer visits from others and often experienced loneliness.

    The great majority of those who were depressed in 2000 died during the subsequent five years, only 13 out of 65, 22%, were still alive in 2005, compared to 41% of those who were not depressed, p=0.003. Of 13 who survived, only two had recovered. Twenty-four out of 70 non-depressed people, 34%, had developed depression during the five years (2000-2005), and the total prevalence in year 2005 was 42% (35 out of 83 participants). Ten out of the 24 who had developed depression were prescribed antidepressants. Of those ten, four were regarded as responders. In the group with persistent depression, nine out of eleven were receiving antidepressants and 67% were responders.

    In conclusion, a large proportion of the very old suffer from under-diagnosed and undertreated depression. The response rate to treatment seems to be low, and the quality of treatment and follow-up also seems to be poor. The mortality rate among the depressed was high. The spectrum of factors associated with depression in people with dementia is different from that associated with depression among non-demented. Depression among the very old clearly emerges as a common and serious public health problem, with probably the most serious impact on quality of life. More efforts have to be made to improve the quality of assessments, treatment and research regarding depression among the very old.

  • 173.
    Bergdahl, Ellinor
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Allard, Per
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Aléx, Lena
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lundman, Berit
    Umeå University, Faculty of Medicine, Department of Nursing.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Gender differences in depression among the very old2007In: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 19, no 6, p. 1125-1140Article in journal (Refereed)
  • 174.
    Bergdahl, Ellinor
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Allard, Per
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Depression among the very old with dementia2011In: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 23, no 5, p. 756-763Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of this study was to investigate the prevalence of depression among very old individuals with dementia compared to those without dementia and to examine if there were any differences regarding associated factors between people with or without depression in these conditions.

    Methods: In a population-based study in Sweden, 363 participants aged 85 years and above, were evaluated for depression and dementia.

    Results: The prevalence of depression was significantly higher among the people with dementia than without dementia, 43% vs. 24% (p < 0.001). Approximately 2/3 of the depressed in both groups used antidepressants and of those, approximately 50% had responded. Depression in the group without dementia was, among other factors, associated with higher total number of medication, the use of significant more analgesics and benzodiazepines, loneliness, inability of going outside and recent loss of child. The loss of a child was the only factor that was independently associated with depression in those with dementia.

    Conclusions: The present study confirms that in the very old, depression is more common among people with dementia than without dementia. A large proportion, both with and without dementia, are under-diagnosed and untreated, and in addition many subjects in both groups studied were non-responders to treatment. Many of the factors associated with depression among people without dementia in this study were not associated with depression among those with dementia, thus supporting the theory that the spectrum of associated factors for depression in dementia seems to be different from that for depression in people without dementia.

  • 175.
    Bergdahl, Ellinor
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Allard, Per
    Gustafson, Yngve
    Outcome of depression among the very old: a five-year follow-up studyManuscript (preprint) (Other (popular science, discussion, etc.))
  • 176.
    Bergdahl, Ellinor
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Allard, Per
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Lundman, Berit
    Umeå University, Faculty of Medicine, Department of Nursing.
    Gustafson, Yngve
    Depression in the oldest old in urban and rural municipalities2007In: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 11, no 5, p. 570-578Article in journal (Refereed)
  • 177.
    Bergdahl, Ellinor
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Geriatrik.
    Gustavsson, Janna M C
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Geriatrik.
    Kallin, Kristina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Geriatrik.
    von Heideken Wågert, Petra
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Geriatrik.
    Lundman, Berit
    Umeå University, Faculty of Medicine, Department of Nursing.
    Bucht, Gösta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Geriatrik.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Geriatrik.
    Depression among the oldest old: the Umeå 85+ study2005In: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 17, no 4, p. 557-575Article in journal (Refereed)
  • 178.
    Berggren, Ingrid
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Kognitiv funktion, upplevd ADL, hälsorelaterad livskvalitet och livstillfredsställelse pre- och postoperativt hos persorner med meningiom.: En pilotstudie2014Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Aim: The purpose of this pilot study was to describe and examine cognitive functioning, perceived ability in activities of daily living (ADL), health-related quality of life and life satisfaction of people with meningiomas on two occasions, preoperatively and at follow-up postoperatively for three to five months. A second objective was to examine how well the assessment instruments fit this diagnosis group.

    Method: A pilot study with 15 participants over 18 years old and diagnosed meningioma were recruited from a neurosurgical clinic during December 2013-January 2016. The cognitive function was measured with The Montreal Cognitive Assessment (MOCA), the perceived ADL ability was assessed using ADL taxonomy and independence in ADL with Karnofsky Performance Status scale (KPS). Participants answered two different questionnaires, the EQ-5D health-related quality of life and Life Satisfaction Checklist (LisaT-11) to life satisfaction. All assessments were performed pre- and postoperatively for three to five months.

    The result: The participants experienced a significant improvement in cognition postoperatively, but otherwise there were no significant changes. Participants experienced good ADL, and independence in ADL, both before and after surgery.

    Conclusion: Significant changes were only seen in the cognitions that could be partly explained by that the chosen instruments were not sensitive enough or not applicable for the participants in this study.

  • 179.
    Berggren, Monica
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Karlsson, Åsa
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Lindelöf, Nina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Englund, Undis
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Olofsson, Birgitta
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics. Umeå University, Faculty of Medicine, Department of Nursing.
    Nordstöm, Peter
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Stenvall, Michael
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Effects of geriatric interdisciplinary home rehabilitation on complications and readmissions after hip fracture: a randomized controlled trial2019In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 33, no 1, p. 64-73Article in journal (Refereed)
    Abstract [en]

    Objective: This pre-planned secondary analysis of geriatric interdisciplinary home rehabilitation, which was initially found to shorten the postoperative length of stay in hospital for older individuals following hip fracture, investigated whether such rehabilitation reduced the numbers of complications, readmissions, and total days spent in hospital after discharge during a 12-month follow-up period compared with conventional geriatric care and rehabilitation.

    Design: Randomized controlled trial.

    Setting: Geriatric department, participants' residential care facilities, and ordinary housing.

    Subjects: Individuals aged ⩾70 years with acute hip fracture (n = 205) were included.

    Intervention: Geriatric interdisciplinary home rehabilitation was individually designed and aimed at early discharge with the intention to prevent, detect, and treat complications after discharge.

    Main measures: Complications, readmissions, and days spent in hospital were registered from patients' digital records and interviews conducted during hospitalization and at 3- and 12-month follow-up visits.

    Results: No significant difference in outcomes was observed. Between discharge and the 12-month follow-up, among participants in the geriatric interdisciplinary home rehabilitation group (n = 106) and control group (n = 93), 57 (53.8%) and 44 (47.3%) had complications (P = 0.443), 46 (43.4%) and 38 (40.9%) fell (P = 0.828), and 38 (35.8%) and 27 (29.0%) were readmitted to hospital (P = 0.383); the median total days spent in hospital were 11.5 and 11.0 (P = 0.353), respectively.

    Conclusion: Geriatric interdisciplinary home rehabilitation for older individuals following hip fracture resulted in similar proportions of complications, readmissions, and total days spent in hospital after discharge compared with conventional geriatric care and rehabilitation.

  • 180.
    Berggren, Monica
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Stenvall, Michael
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Englund, Undis
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Olofsson, Birgitta
    Umeå University, Faculty of Medicine, Department of Nursing.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Co-morbidities, complications and causes of death among people with femoral neck fracture: a three-year follow-up study2016In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 16, article id 120Article in journal (Refereed)
    Abstract [en]

    Background: The poor outcome after a hip fracture is not fully understood. The aim of the study was to describe the prevalence of co-morbidities, complications and causes of death and to investigate factors that are able to predict mortality in old people with femoral neck fracture. Methods: Data was obtained from a randomized, controlled trial with a 3-year follow-up at Umea University Hospital, Sweden, which included 199 consecutive patients with femoral neck fracture, aged >= 70 years. The participants were assessed during hospitalization and in their homes 4, 12 and 36 months after surgery. Medical records and death certificates were analysed. Results: Multivariate analysis revealed that cancer, dependence in P-ADL (Personal Activities of Daily Living), cardiovascular disease, dementia at baseline or pulmonary emboli or cardiac failure during hospitalization were all independent predictors of 3-year mortality. Seventy-nine out of 199 participants (40 %) died within 3 years. Cardiovascular events (24 %), dementia (23 %), hip-fracture (19 %) and cancer (13 %) were the most common primary causes of death. In total, 136 participants suffered at least one urinary tract infection; 114 suffered 542 falls and 37 sustained 56 new fractures, including 13 hip fractures, during follow-up. Conclusion: Old people with femoral neck fracture have multiple co-morbidities and suffer numerous complications. Thus randomized intervention studies should focus on prevention of complications that might be avoidable such as infections, heart diseases, falls and fractures.

  • 181.
    Berggren, Monica
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Stenvall, Michael
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Olofsson, Birgitta
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Evaluation of a fall-prevention program in older people after femoral neck fracture: a one-year follow-up2008In: Osteoporosis International, ISSN 0937-941X, E-ISSN 1433-2965, Vol. 19, no 6, p. 801-809Article in journal (Refereed)
    Abstract [en]

    A randomized, controlled fall-prevention study including 199 patients operated on for femoral neck fracture reduced inpatient falls and injuries. No statistically significant effects of the intervention program could be detected after discharge. It seems that fall-prevention must be part of everyday life in fall-prone old people. Introduction This study evaluates whether a postoperative multidisciplinary, multifactorial fall-prevention program performed by a geriatric team that reduced inpatient falls and injuries had any continuing effect after discharge. The intervention consisted of staff education, systematic assessment and treatment of fall risk factors and vitamin D and calcium supplementation. Methods The randomized, controlled trial with a one-year follow-up at Umea University Hospital, Sweden, included 199 patients operated on for femoral neck fracture, aged >= 70 years. Results After one year 44 participants had fallen 138 times in the intervention group compared with 55 participants and 191 falls in the control group. The crude postoperative fall incidence was 4.16/1,000 days in the intervention group vs. 6.43/1,000 days in the control group. The incidence rate ratio was 0.64 (95% CI: 0.40-1.02, p = 0.063). Seven new fractures occurred in the intervention group and 11 in the control group. Conclusion A team applying comprehensive geriatric assessment and rehabilitation, including prevention and treatment of fall-risk factors, reduced inpatient falls and injuries, but no statistically significant effects of the program could be detected after discharge. It seems that fall-prevention must be part of everyday life in fall-prone elderly.

  • 182.
    Berggren, Sara
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Einemo, Tina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Rehabiliteringsinsatser för barn och ungdomar med juvenil artrit: – engagemanget i vardagliga aktiviteter och dess hälsoeffekt2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Juvenil artrit även kallad barnreumatism är en ledgångssjukdom som kan påverka barnets och ungdomens förmåga att delta i en aktivitet. Syftet med litteraturstudien är att belysa om rehabiliteringsinsatser kan hjälpa barn och ungdomar med juvenil artrit till att känna mer engagemang i aktiviteter, samt hur barnen och ungdomarna upplever hälsoeffekter av insatserna. En elektronisk och manuell sökning gjordes för att söka artiklar som kunde besvara frågeställningarna. Insatserna som identifierats i de utvalda artiklarna var ledskonande principer, träningsprogram och förberedande till vardagsaktiviteter. Deltagarna i de inkluderade artiklarna tyckte att deras möjlighet att vara mer engagerad i aktiviteter hade ökat och därmed deras livskvalitet. Alla insatser för barn och ungdomar med juvenil artrit hade en positiv inverkan, men vissa insatser visade även på negativa effekter. Deltagarna från alla inkluderade artiklar blev mer engagerade i vardagliga aktiviteter och upplevde ett ökat välmående.

  • 183.
    Berggren, Therese
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Ingmar, Annette
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Förändringar i aktivitetsutförande hos långtidssjukskrivna personer2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 184. Bergh, Anna
    et al.
    Nordlöf, H
    Essén-Gustavsson, B
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Evaluation of neuromuscular electrical stimulation on fibre characteristics and oxidative capacity in equine skeletal muscles2010In: Equine Veterinary Journal, ISSN 0425-1644, E-ISSN 2042-3306, Vol. 42, no Suppl 38, p. 671-675Article in journal (Refereed)
    Abstract [en]

    Reasons for performing study: Neuromuscular electrical stimulation (NMES) is used to increase or maintain muscle strength during rehabilitation. Human studies investigating different protocols show that some treatments induce changes in muscle characteristics. Despite the frequent use of NMES in horses, no studies have been published describing its efficacy.

    Objectives: To investigate the effects of a NMES protocol on equine fibre types and areas, glycogen concentrations and enzyme activities.

    Methods: NMES was administrated to m. gluteus medius and m. longissimus dorsi, on one side of 6 healthy Standardbred horses. The contralateral side of each muscle served as a nonstimulated control. The horses were stimulated at 50 Hz a day, with 21-39 mA, for 45-60 min, 5 days a week for 4 weeks. Needle biopsies were obtained from the muscles on both sides before and after the experimental period. Muscle samples were analysed for fibre type proportions and area using histochemical methods and for glycogen and enzyme activities (citrate synthase, 3-OH-acyl CoA dehydrogenase, hexokinase and lactate dehydrogenase) using biochemical methods. Muscle contractions at the location and depth of the muscle biopsy were confirmed by diagnostic ultrasound. Nonparametric tests (Mann-Whitney, Wilcoxon sign-rank) were used for statistical analysis. Results: No significant differences were observed in the percentage of types I, IIA or IIX fibres, fibre areas, glycogen levels or enzyme activities either when comparing stimulated and nonstimulated muscles before and after the NMES treatment, or when comparing the left and right muscle samples.

    Conclusions: The NMES treatment was well tolerated by the horses, but the present protocol did not induce significant muscle adaptations. Further studies are needed to describe the effect of more intense and/or prolonged NMES treatment protocols on muscles of healthy horses, and to describe if stimulation protocols induce positive changes in atrophied muscles.

  • 185.
    Berginström, Nils
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Fatigue after traumatic brain injury: exploring novel methods for diagnosis and treatment2019Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Traumatic brain injury (TBI) is one of the most common causes of disability and mortality. While some patients recover quickly, especially at the mild side of the injury severity continuum, many will experience symptoms for years to come. In this chronic phase, patients report a wide array of symptoms, where fatigue is one the most common. This fatigue makes huge impact in several areas of these patients’ lives. Despite the prevalence of fatigue after TBI, the underlying mechanisms are unclear. Further, there are no standardized way for assessment and diagnosis, and there are no treatments with satisfying empirical support. The aim of this thesis was to examine the effects of the novel compound OSU6162 on fatigue in patients with TBI, and to explore functional and structural brain imaging correlates of fatigue after TBI.

    Methods: Studies I and III were based on a placebo-controlled, double-blinded clinical trial examining the effects of the monoaminergic stabilizer OSU6162 on fatigue in patients in the chronic phase of traumatic brain injury. In study I, self-assessment scales of fatigue and neuropsychological tests were used as outcomes, while functional magnetic resonance imaging (fMRI) blood-oxygen-level dependent (BOLD) signal was the primary outcome in study III. Studies II and IV used cross-sectional designs, comparing patients with TBI with age- and gender matched healthy controls. Study II examined whether fMRI BOLD signal could be used to detect and diagnose fatigue in patients with TBI, and study IV whether white matter hyperintensities (WMH) contribute to lower cognitive functioning and presence of fatigue after TBI.

    Results: Study I revealed no effects of OSU6162 during 28 days of treatment at maximum doses of 15 mg twice daily on measures of fatigue or any other outcome. The results from study II indicated that fatigue after TBI is linked to alterations in striato-thalamic-cortical loops, and suggested that fMRI could be a promising technique to use in the diagnosis of fatigue after TBI. In study III the results revealed effects of treatment in the right occipitotemporal and orbitofrontal cortex. In these areas, the BOLD response was normalized in the OSU6162 group as compared to healthy controls, while the placebo group showed a steady low activity in these areas. The regional effects were located outside the network shown to be linked to fatigue in study II, which might explain why there were no effects on fatigue after treatment with OSU6162 in study I. Study IV showed that WMH lesions increased with increased TBI severity, but the presence and extent of lesions did not explain lower neuropsychological functioning or fatigue in subjects with previous TBI.

    Conclusions: In summary, although no effects on fatigue after treatment with OSU6162 were seen, the results provide support to the theory that fatigue after TBI is linked to alterations in striato-thalamic-cortical loops, and on how fatigue after TBI could be assessed or diagnosed using fMRI. Structural damage within white matter was however not related to fatigue.

  • 186.
    Berginström, Nils
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Johansson, Jonas
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Nordström, Peter
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Nordström, Anna
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Attention in Older Adults: A Normative Study of the Integrated Visual and Auditory Continuous Performance Test for Persons Aged 70 Years2015In: Clinical Neuropsychologist (Neuropsychology, Development and Cognition: Section D), ISSN 1385-4046, E-ISSN 1744-4144, Vol. 29, no 5, p. 595-610Article in journal (Refereed)
    Abstract [en]

    Objective: Our objective was to present normative data from 70-year-olds on the Integrated Visual and Auditory Continuous Performance Test (IVA), a computerized measure of attention and response control. Method: 640 participants (330 men and 310 women), all aged 70years, completed the IVA, as well as the Mini-Mental State Examination and the Geriatric Depression Scale. Results: Data were stratified by education and gender. Education differences were found in 11 of 22 IVA scales. Minor gender differences were found in six scales for the high-education group, and two scales for the low-education group. Comparisons of healthy participants and participants with stroke, myocardial infarction, or diabetes showed only minor differences. Correlations among IVA scales were strong (all r > .34, p < .001), and those with the widely used Mini-Mental State Examination were weaker (all r < .21, p < .05). Skewed distributions of normative data from primary IVA scales measuring response inhibition (Prudence) and inattention (Vigilance) represent a weakness of this test. Conclusions: This study provides IVA norms for 70-year-olds stratified by education and gender, increasing the usability of this instrument when testing persons near this age. The data presented here show some major differences from original IVA norms, and explanations for these differences are discussed. Explanations include the broad age-range used in the original IVA norms (66-99years of age) and the passage of 15years since the original norms were collected.

  • 187.
    Berginström, Nils
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Nordström, Peter
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Ekman, Urban
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Physiology. Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI). Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    Eriksson, Johan
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Physiology. Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI).
    Andersson, Micael
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Physiology. Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI).
    Nyberg, Lars
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Physiology. Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI).
    Nordström, Anna
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Fatigue after traumatic brain injury is linked to altered striato-thalamic-cortical functioning2017In: Brain Injury: Accepted Abstracts from the International Brain Injury Association’s 12th World Congress on Brain Injury, 2017, Vol. 31, p. 755-755Conference paper (Refereed)
    Abstract [en]

    Mental fatigue is a common symptom in the chronic phase of traumatic brain injury. Despite its high prevalence, no treatmentis available for this disabling symptom, and the mechanisms underlying fatigue are poorly understood. Some studies have suggested that fatigue in traumatic brain injury and other neurological disorders might reflect dysfunction within striato-thalamic-cortical loops. In the present study, we investigated whether functional magnetic resonance imaging(fMRI) can be used to detect chronic fatigue after traumatic brain injury (TBI), with emphasis on the striato-thalamic cortical-loops. We included patients who had suffered traumatic brain injury (n = 57, age range 20–64 years) and experienced mental fatigue > 1 year post injury (mean = 8.79 years, SD = 7.35), and age- and sex-matched healthycontrols (n = 27, age range 25–65 years). All participants completed self-assessment scales of fatigue and other symptoms, underwent an extensive neuropsychological test battery and performed a fatiguing 27-minute attention task (the modified Symbol Digit Modalities Test) during fMRI. Accuracy did not differ between groups, but reaction times were slower in the traumatic brain injury group (p < 0.001). Patients showed a greater increase in fatigue than controls from before to after task completion (p < 0.001). Patients showed less fMRI blood oxygen level–dependent activity in several a priori hypothesized regions (family-wise error corrected,p < 0.05), including the bilateral caudate, thalamus and anterior insula. Using the left caudate as a region of interest and testing for sensitivity and specificity, we identified 91% of patients and 81% of controls. As expected, controls showed decreased activation over time in regions of interest—the bilateral caudate and anterior thalamus (p < 0.002, uncorrected)—whereas patients showed no corresponding activity decrease. These results suggest that chronic fatigue after TBI is linked to altered striato-thalamic-cortical functioning. The high precision of fMRI for the detection of fatigue is of great clinical interest, given the lack of objective measures for the diagnosis of fatigue.

  • 188.
    Berginström, Nils
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Nordström, Peter
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Ekman, Urban
    Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI). Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Physiology. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    Eriksson, Johan
    Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI). Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Physiology.
    Andersson, Micael
    Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI). Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Physiology.
    Nyberg, Lars
    Umeå University, Faculty of Medicine, Department of Radiation Sciences. Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI). Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Physiology.
    Nordström, Anna
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Using Functional Magnetic Resonance Imaging to Detect Chronic Fatigue in Patients With Previous Traumatic Brain Injury: changes linked to altered Striato-Thalamic-Cortical Functioning2018In: The journal of head trauma rehabilitation, ISSN 0885-9701, E-ISSN 1550-509X, Vol. 33, no 4, p. 266-274Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate whether functional magnetic resonance imaging (fMRI) can be used to detect fatigue after traumatic brain injury (TBI).

    Setting: Neurorehabilitation clinic.

    Participants: Patients with TBI (n = 57) and self-experienced fatigue more than 1 year postinjury, and age- and gender-matched healthy controls (n = 27).

    Main Measures: Self-assessment scales of fatigue, a neuropsychological test battery, and fMRI scanning during performance of a fatiguing 27-minute attention task.

    Results: During testing within the fMRI scanner, patients showed a higher increase in self-reported fatigue than controls from before to after completing the task (P < .001).The patients also showed lower activity in several regions, including bilateral caudate, thalamus, and anterior insula (all P < .05). Furthermore, the patients failed to display decreased activation over time in regions of interest: the bilateral caudate and anterior thalamus (all P < .01). Left caudate activity correctly identified 91% of patients and 81% of controls, resulting in a positive predictive value of 91%.

    Conclusion: The results suggest that chronic fatigue after TBI is associated with altered striato-thalamic-cortical functioning. It would be of interest to study whether fMRI can be used to support the diagnosis of chronic fatigue in future studies.

  • 189.
    Berginström, Nils
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Nordström, Peter
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. School of Sport Sciences, The Arctic University of Norway, Tromsø, Norway Medicine.
    Ekman, Urban
    Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI). Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Eriksson, Johan
    Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI).
    Nyberg, Lars
    Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI). Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Nordström, Anna
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health. School of Sport Sciences, The Arctic University of Norway, Tromsø, Norway.
    Pharmaco-fMRI in Patients With Traumatic Brain Injury: A Randomized Controlled Trial With the Monoaminergic Stabilizer (-)-OSU61622019In: The journal of head trauma rehabilitation, ISSN 0885-9701, E-ISSN 1550-509X, Vol. 34, no 3, p. 189-198Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To examine the effects of monoaminergic stabilizer (-)-OSU6162 on brain activity, as measured by blood-oxygen-level-dependent (BOLD) functional magnetic resonance imaging (fMRI), in patients in the chronic phase of traumatic brain injury suffering from fatigue.

    SETTING: Neurorehabilitation clinic.

    PARTICIPANTS: Patients with traumatic brain injury received either placebo (n = 24) or active treatment (n = 28). Healthy controls (n = 27) went through fMRI examination at one point and were used in sensitivity analysis on normalization of BOLD response.

    DESIGN: Randomized, double-blinded, placebo-controlled design.

    MAIN MEASURES: Effects on BOLD signal changes from before to after treatment during performance of a fatiguing attention task.

    RESULTS: The fMRI results revealed treatment effects within the right occipitotemporal cortex and the right orbitofrontal cortex. In these regions, the BOLD response was normalized relative to healthy controls at the postintervention fMRI session. No effects were seen in regions in which we previously observed activity differences between patients and healthy controls while performing this fMRI task, such as the striatum.

    CONCLUSION: (-)-OSU6162 treatment had influences on functional brain activity, although the normalized regional BOLD response was observed in regions that were not a priori hypothesized to be sensitive to this particular treatment, and was not accompanied by any effects on in-scanner test performance or on fatigue.

  • 190.
    Berginström, Nils
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Nordström, Peter
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Nyberg, Lars
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Physiology.
    Nordström, Anna
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    White matter hyperintensities increases with traumatic brain injuryseverity: associations to neuropsychological performance and fatigueManuscript (preprint) (Other academic)
    Abstract [en]

    Objective: To examine the prevalence of white matter hyperintensities (WMHs) in patients with traumatic brain injury (TBI) as compared to healthy controls, and to investigate whether there is an association between WMH lesion burden and performance on neuropsychological tests in patients with TBI.

    Methods: A total of 59 patients with TBI and 27 age- and gender- matched healthy controls underwent thorough neuropsychological testing and magnetic resonance imaging. The quantification of WMH lesions was performed using the fully automated Lesion Segmentation Tool.

    Results: WMH lesions were more common in patients with TBI than in healthy controls (p = 0.032), and increased with higher TBI severity (p = 0.025). Linear regressions showed that WMH lesions in patients with TBI were not related to performance on any neuropsychological tests (p > 0.05 for all). However, a negative relationship between number of WMH lesions in patients with TBI and self-assessed fatigue was found (r = –0.33, p = 0.026).

    Conclusion: WMH lesions are more common in patients with TBI than in healthy controls, and WMH lesions burden increases with TBI severity. However, these lesions do not seem to explain the decreased cognitive functioning or the increased fatigue in patients with TBI.

  • 191.
    Berginström, Nils
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Nordström, Peter
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Schuit, Robert
    Nordström, Anna
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    The effects of (-)-OSU6162 on chronic fatigue in patients with traumatic brain injury: a randomized controlled trial2017In: The journal of head trauma rehabilitation, ISSN 0885-9701, E-ISSN 1550-509X, Vol. 32, no 2, p. E46-E54Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To examine the effects of the monoaminergic stabilizer (-)-OSU6162 on mental fatigue in patients with traumatic brain injury.

    SETTING: Single-center Neurorehabilitation Clinic.

    DESIGN: Randomized, double-blind, placebo-controlled trial.

    PARTICIPANTS: Sixty-four subjects with traumatic brain injury were randomized to treatment (n = 33) and placebo (n = 31).

    MAIN MEASURES: The effects of (-)-OSU6162 at a dose of 15 mg twice a day were evaluated using self-assessment scales and neuropsychological tests measuring mental fatigue.

    RESULTS: No difference between groups was observed on any scale at baseline. At follow-up, both groups showed significant improvement on the Fatigue Severity Scale and the Mental Fatigue Scale (both Ps < .01). Similarly, the performance of both groups increased significantly on many neuropsychological tests. However, no significant between-group difference in changes on these scales was observed before or after adjustment for confounders except for one neuropsychological test favoring the control group. Sensitivity analyses showed significantly greater changes in levels of prolactin and folic acid and heart rate (all Ps < .05) in the treatment group. The mean plasma concentration after 4 weeks of treatment was 0.14 (range, 0.01-0.32) μM, which was lower than expected.

    INTERPRETATION: Treatment with (-)-OSU6162 had no significant effect on mental fatigue in patients with traumatic brain injury compared with placebo.

  • 192.
    Berglin, Johannes
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy.
    Carlsson, Filip
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy.
    Vuxnas erfarenheter av rullstol med ståfunktion: En kvalitativ studie2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Det finns idag forskning av brukares erfarenheter av rullstolsanvändning och hur ståhjälpmedel kan motverka negativa komplikationer till följd av långvarigt sittande. Men det finns begränsad forskning av brukares erfarenheter av rullstol med ståfunktion. Syftet med denna studie var att undersöka vuxnas erfarenheter av att använda rullstol med ståfunktion och dess betydelse för delaktighet i personens dagliga aktiviteter. Sex deltagare intervjuades och intervjuerna analyserades utifrån metoden kvalitativ innehållsanalys. Resultat visade att ståfunktionen varit betydelsefull i vardagen för exempelvis ökad delaktighet i deltagarens dagliga aktiviteter och för att motverka kroppsliga komplikationer som ett långvarigt sittande kan medföra. Slutsatsen är att ståfunktionen i helhet haft en positiv inverkan utifrån flera olika aspekter. Men det råder bristande fysisk tillgänglighet vilket försvårar användandet och skapar ett behov av ytterligare utveckling av rullstol inklusive ståfunktion vilket kan främja deltagande i dagliga aktiviteter.

  • 193.
    Berglund, Jon
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Inter-rater reliabilityfor visual assessment of six movement qualities during supervised musicexercise performance2013Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Visuella bedömningar är vanligt förekommande i det dagliga arbetet bland sjukgymnaster, personliga tränare och gym instruktörer. Med målet att optimera rörelser och minimera risken för skada läggs förtroende till den visuella bedömning som grund för korrigering av rörelser. Det saknas dock vetenskapligt underlag för den visuella bedömningen av rörelsekvalitéer genom att titta på videoinspelningar av deltagares utförande under ledd träning till musik.

     Syfte: Syftet med denna studie var att undersöka inter-bedömar reliabiliteten för visuell bedömning av rörelsekvalitéerna timing, kvickhet, likhet, initiering, kraft och generell koordination genom att titta på videoinspelningar av deltagares utförande av dem under ledd träning till musik.

     Metod: För att undersöka inter-bedömar reliabiliteten så fick fyra bedömare visuellt bedöma videoinspelningar av 85 deltagare avseende deras utförande av ledd träning till musik genom skattning av sex olika rörelsekvalitéer. För varje deltagare fanns tre videosekvenser att bedöma.

     Resultat: Analyser med linjärt viktad kappa (k) utfördes för att bedöma likheten mellan bedömarna vilket gav medianvärdet för k = 0,206.

     Slutsats: På grund av brister i metoden kan inga säkra slutsatser dras avseende inter-bedömar reliabilteten för visuell bedömning av sex rörelsekvalitéer genom att titta på videoinspelningar av deltagares utförande av dem under ledd träning till musik.

  • 194.
    Berglund, Julia
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Bahrami, Soma
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Användbarheten av digitala aktivitetsscheman och dess effekter på aktivitetsutförande för barn och unga med autism: – en litteraturstudie2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    En litteraturstudie genomfördes för att beskriva användbarhet av digitala aktivitetsscheman (DAS) och dess effekter på aktivitetsutförande för barn och unga med autism. Systematisk sökning i elektroniska databaser utfördes och tolv studier identifierades som uppnådde inklusionskriterierna. Deltagarna i de inkluderade studierna var mellan 3-18 år. Resultatet visade på användbarhet i olika kontexter och för olika aktiviteter inom aktiviteter i dagliga livet och fritid. DAS kan innehålla fotografier, bilder, text, video, ljud samt dialoger och kan vara tillgängligt på mobil, surfplatta, dator eller handdator. Oavsett vilket innehåll eller format DAS har visar det effekt på engagemang i uppgifter, övergångar inom och mellan aktiviteter, samt effekt på utförande av nya och kända aktiviteter. Implikationer och förslag för framtida forskning om DAS för att bidra till delaktighet i aktivitet diskuteras.

  • 195.
    Berglund, Lars
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Deadlift training for patients with mechanical low back pain: a comparison of the effects of a high-load lifting exercise and individualized low-load motor control exercises2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Disability due to low back pain is common. While evidence exist that exercise is effective in reducing pain and disability, it is still largely undetermined which kind of exercises that are most effective. The overall aim of this thesis was to evaluate and compare the effects of a high-load lifting exercise and individualized low-load motor control exercises for patients with nociceptive mechanical low back pain. A secondary aim was to evaluate which patients benefit from training with a high-load lifting exercise.

    All four papers in this thesis were based on a randomized controlled trial including 70 participants with nociceptive mechanical low back pain as their dominating pain pattern. Participants were randomized into training with either a high-load lifting exercise (HLL), the deadlift, (n=35) or individualized low-load motor control exercises (LMC) (n=35). Both interventions included aspects of pain education. All participants were offered twelve sessions during an eight week period. The effects of the interventions were evaluated directly after and twelve months after the end of the intervention period. Outcome measures were pain intensity, activity, disability, physical performance, lumbo-pelvic alignment and lumbar multifidus muscle thickness.

    There was a significant between-group effect in favour of the LMC intervention regarding improvements in activity, movement control tests and some tests of trunk muscle endurance. For pain intensity there were no significant differences between groups. A majority of participants in both intervention groups showed clinically meaningful improvements from baseline to two and twelve month follow-up regarding pain intensity and activity. There were no significant differences between HLL and LMC regarding the effect on lumbo-pelvic alignment or lumbar multifidus thickness. The participants who benefit the most from the HLL intervention were those with a low pain intensity and high performance in the Biering-Sørensen test at baseline.

    The results of this thesis showed that the HLL intervention was not more effective than the LMC intervention. The LMC was in fact more effective in improving activity, performance in movement control tests and some tests of trunk muscle endurance, compared to the HLL intervention.

    The results imply that the deadlift, when combined with education, could be considered as an exercise to produce clinically relevant improvements on pain intensity in patients who prefer a high-load exercise. However, before considering deadlift training, the results suggest that pain intensity and performance in the Biering-Sørensen test should be evaluated.

  • 196.
    Berglund, Lars
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Which patients with persistent mechanical low back pain will respond to highload motor control training?2010Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Introduction

    A previous pilot study has shown that high load motor control training with the conventional deadlift exercise can reduce pain intensity and activity limitation in patients with persistent low back pain. However, it is still unknown which variables characterize the ideal patient for this exercise.

    Aim

    The aim of this study was to explore variables influencing success or failure of eight weeks of high loadmotor control training with the conventional deadlift exercise for patients with persistent mechanical low back pain.

    Method

    The study design was a prospective cohort study of patients with persistent mechanical low back pain(n=35). The intervention consisted of eight weeks of training with the conventional deadlift exercise. Possible predictive variables were collected at baseline. To discriminate patients with a successful or failed outcome of treatment, change in the patient-specific functional scale was used and a cut-off at 50 %improvement was set. Of the 35 patients, 15 were categorized as treatment success (≥50 % improvement) and 20 patients as treatment failure (<50 % improvement).

    Results

    No variables at baseline were recognized as possible predictors of successful or failed treatment.

    Conclusion

    From the results of this study it appears that none of the variables in this study could influence success or failure of high load motor control training with the conventional deadlift exercise. However, the conventional deadlift could be considered a potent exercise when administered by a PT well experienced in resistance training and analyzing movement patterns.

  • 197.
    Berglund, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Aasa, Björn
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Michaelson, Peter
    Luleå Tekniska Universitet, Institutionen för hälsovetenskap, Avdelningen för hälsa och rehabilitering, Fysioterapi.
    Styrketräning som behandling vid långvariga ländryggsbesvär2017In: Fysioterapi, ISSN 1653-5804, no 4, p. 8p. 28-33Article, review/survey (Other academic)
    Abstract [sv]

    Fysisk träning är viktigt för en god hälsa och fungerar även som behandlingsform vid många sjukdomar, så även ländryggsbesvär. Styrketräning har visat sig vara en mer effektiv träningsform än till exempel aerob träning vid behandling av långvariga ländryggsbesvär. I dagsläget finns det ingen konsensus kring vilket det mest effektiva styrketräningsupplägget kan vara. Den vanligaste designen av styrketräningsprogram vid ländryggsbesvär tycks vara ett upplägg med syftet att förbättra styrkan/uthålligheten av ryggsträckarmuskulaturen och därigenom uppnå smärtlindring och funktionsförbättring. I en studie från Umeå universitet och Luleå tekniska universitet har träning av marklyft för patienter med långvariga ländryggsbesvär utvärderats. Marklyftsträningen förväntades öka deltagarnas bålstyrka samtidigt som den fokuserade på förbättring av rörelsekontroll kring såväl höft som ländrygg. När den åtta veckor långa träningsperioden var slut, visade det sig att gruppen som tränat marklyft hade ökat sin bålstyrka, minskat smärta, ökat funktionsförmåga och hälsorelaterad livskvalitet i samma omfattning som gruppen som tränade individanpassad träning av rörelsekontroll. Men de hade inte förbättrats lika mycket gällande rörelsekontroll eller vardagsfunktion. Vidare forskning pågår vid Umeå universitet om skador i samband med tung styrketräning samt lyftteknikens betydelse för skador och besvär vid tung styrketräning.

  • 198.
    Berglund, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Aasa, Björn
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Hellqvist, Jonas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Michaelson, Peter
    Luleå Tekniska Universitet, Institutionen för hälsovetenskap, Avdelningen för hälsa och rehabilitering, Fysioterapi .
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Which patients with low back pain benefit from deadlift training?2015In: Journal of Strength and Conditioning Research, ISSN 1064-8011, E-ISSN 1533-4287, Vol. 29, no 7, p. 1803-1811Article in journal (Refereed)
    Abstract [en]

    Recent studies have indicated that the deadlift exercise may be effective in decreasing pain intensity and increasing activity for most, but not all, patients with a dominating mechanical low back pain pattern. This study aimed to evaluate which individual factors measured at baseline could predict activity, disability, and pain intensity in patients with mechanical low back pain after an 8-week training period involving the deadlift as a rehabilitative exercise. Thirty-five participants performed deadlift training under the supervision of a physical therapist with powerlifting experience. Measures of pain-related fear of movement, hip and trunk muscle endurance and lumbopelvic movement control were collected at baseline. Measures of activity, disability and pain intensity were collected at baseline and at follow-up. Linear regression analyses were used to create models to predict activity, disability and pain intensity at follow-up. Results showed that participants with less disability, less pain intensity and higher performance on the Biering-Sørensen test, which tests the endurance of hip and back extensor muscles, at baseline benefit from deadlift training. The Biering-Sørensen test was the strongest predictor since it was included in all predictive models. Pain intensity was the next best predictor as it was included in two predictive models. Thus, for strength and conditioning professionals who use the deadlift as a rehabilitative exercise for individuals with mechanical low back pain, it is important to ensure that clients have sufficient back extensor strength and endurance and a sufficiently low pain intensity level to benefit from training involving the deadlift exercise.

  • 199.
    Berglund, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
    Aasa, Björn
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics. Norrlandskliniken Hlth Care Ctr, Umea, Sweden.
    Michaelson, Peter
    Luleå Tekniska Universitet, Institutionen för hälsovetenskap, Avdelningen för hälsa och rehabilitering, Fysioterapi .
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine.
    Effects of Low-Load Motor Control Exercises and a High-Load Lifting Exercise on Lumbar Multifidus Thickness: A Randomized Controlled Trial2017In: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 42, no 15, p. E876-E882Article in journal (Refereed)
    Abstract [en]

    Study Design. Randomized controlled trial.Objective. The aim of this study was to compare the effects of low-load motor control (LMC) exercises and a high-load lifting (HLL) exercise, on lumbar multifidus (LM) thickness on either side of the spine and whether the effects were affected by pain intensity or change in pain intensity. Summary of Background Data. There is evidence that patients with low back pain (LBP) may have a decreased size of the LM muscles with an asymmetry between sides in the lower back. It has also been shown that LMC training can affect this asymmetry. It is, however, not known whether a high-load exercise has the same effect. Methods. Sixty-five participants diagnosed with nociceptive mechanical LBP were included and randomized into LMC exercises or a HLL exercise, the deadlift. The LM thickness was measured using rehabilitative ultrasound imaging (RUSI), at baseline and after a 2-month training period. Results. There were no differences between interventions regarding effect on LM muscle thickness. However, the analysis showed a significant effect for asymmetry. The thickness of the LM muscle on the small side increased significantly compared with the large side in both intervention groups, without influence of pain at baseline, or change in pain intensity.Conclusion. At baseline, there was a difference in thickness of the LM muscles between sides. It seems that exercises focusing on spinal alignment may increase the thickness of the LM muscles on the small side, irrespective of exercise load. The increase in LM thickness does not appear to be mediated by either current pain intensity or the magnitude of change in pain intensity.

  • 200.
    Berglund, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Social Sciences, Umeå Sport Sciences Center.
    Aasa, Björn
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics. Norrlandskliniken Health Care Centre, Umeå, Sweden.
    Michaelson, Peter
    Luleå Tekniska Universitet, Institutionen för hälsovetenskap, Avdelningen för hälsa och rehabilitering, Fysioterapi .
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Social Sciences, Umeå Sport Sciences Center.
    Sagittal lumbopelvic alignment in patients with low back pain and the effects of a high-load lifting exercise and individualized low-load motor control exercises: a randomized controlled trial2018In: The spine journal, ISSN 1529-9430, E-ISSN 1878-1632, Vol. 18, no 3, p. 399-406Article in journal (Refereed)
    Abstract [en]

    Background Context Assessment of posture and lumbopelvic alignment is often the main focus in the classification and treatment of patients with low back pain (LBP). However, little is known regarding the effects of motor control interventions on objective measures of lumbopelvic alignment.

    Purpose The primary aim of this study was to describe the variation of sagittal lumbopelvic alignment in patients with nociceptive mechanical LBP. The secondary aim was to compare the effects of a high-load lifting exercise (HLL) and low-load motor control exercises (LMC) on the change in lumbopelvic alignment with a special emphasis on patients with high and low degrees of lumbar lordosis (lu) and sacral angle (sa).

    Study Design This study is a secondary analysis of a randomized controlled trial evaluating the effects of HLL and LMC.

    Patient Sample Patients from the primary study, that is, patients categorized with nociceptive mechanical LBP, who agreed to participate in the radiographic examination were included (n=66).

    Outcome Measures Lateral plain radiographic images were used to evaluate lumbopelvic alignment regarding the lumbar lordosis and the sacral angle as outcomes, with posterior bend as an explanatory variable.

    Materials and Methods The participants were recruited to the study from two occupational health-care facilities. They were randomized to either the HLL or the LMC intervention group and offered 12 supervised exercise sessions. Outcome measures were collected at baseline and following the end of intervention period 2 months after baseline. Between- and within-group analyses of intervention groups and subgroups based on the distribution of the baseline values for the lumbar lordosis and the sacral angle, respectively (LOW, MID, and HIGH), were performed using both parametric and non-parametric statistics.

    Results The ranges of values for the present sample were 26.9–91.6° (M=59.0°, standard deviation [SD]=11.5°) for the lumbar lordosis and 18.2–72.1° (M=42.0°, SD=9.6°) for the sacral angle. There were no significant differences between the intervention groups in the percent change of eitheroutcome measure. Neither did any outcome change significantly over time within the intervention groups. In the subgroups, based on the distribution of respective baseline values, LOWlu showed a significantly increased lumbar lordosis, whereas HIGHsa showed a significantly decreased sacral angle following intervention.

    Conclusions This study describes the wide distribution of values for lumbopelvic alignment for patients with nociceptive mechanical LBP. Further research is needed to investigate subgroups of other types of LBP and contrast findings to those presented in this study. Our results also suggest that retraining of the lumbopelvic alignment could be possible for patients with LBP.

1234567 151 - 200 of 2721
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf