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  • 201. Ferreira, Mariana Cândido
    et al.
    Björklund, Martin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences. Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden.
    Dach, Fabiola
    Chaves, Thais Cristina
    Cross-Cultural Adaptation of the Profile Fitness Mapping Neck Questionnaire to Brazilian Portuguese: Internal Consistency, Reliability, and Construct and Structural Validity2017In: Journal of Manipulative and Physiological Therapeutics, ISSN 0161-4754, E-ISSN 1532-6586, Vol. 40, no 3, p. 176-186Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The purpose of this study was to adapt and evaluate the psychometric properties of the ProFitMap-neck to Brazilian Portuguese.

    METHODS: The cross-cultural adaptation consisted of 5 stages, and 180 female patients with chronic neck pain participated in the study. A subsample (n = 30) answered the pretest, and another subsample (n = 100) answered the questionnaire a second time. Internal consistency, test-retest reliability, and construct validity (hypothesis testing and structural validity) were estimated. For construct validity, the scores of the questionnaire were correlated with the Neck Disability Index (NDI), and the Hospital Anxiety and Depression Scale (HADS), the Tampa Scale of Kinesiophobia (TSK), and the 36-item Short-Form Health Survey (SF-36).

    RESULTS: Internal consistency was determined by adequate Cronbach's α values (α > 0.70). Strong reliability was identified by high intraclass correlation coefficients (ICC > 0.75). Construct validity was identified by moderate and strong correlations of the Br-ProFitMap-neck with total NDI score (-0.56 <R < -0.71) and with the SF-36, HADS-anxiety, HADS-depression, and TSK (-0.32 <R < -0.82). Exploratory factor analysis revealed 2 factors for the Symptom scale: intensity index and the Function scale. Symptom scale-frequency index identified 1 factor. Structural validity was determined by percentage of cumulative variance >50%, Kaiser-Meyer-Olkin index > 0.50, eigenvalue > 1, and factor loadings > 0.2.

    CONCLUSION: Br-ProFitMap-neck had adequate psychometric properties and can be used in clinical settings, as well as research, in patients with chronic neck pain.

  • 202.
    Ferry, Tomas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Familial predisposition for ligament injuries in relation to physical activity level in persons with Anterior Cruciate Ligament injury compared to healthy controls.2014Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Introduktion: Föreliggande undersökning avhandlar eventuell familjär predisposition för främre korsbandsskada och andra ligamentsskador, samt hur detta relaterar till individens fysiska aktivitetsnivå, som kan spela roll för risken att skadas.

    Metod: En enkät med frågor om respondenterna har släktingar som drabbats av främre korsbandsskada, eller andra ligamentsskador, fysisk aktivitetsnivå etc. skickades ut till 334 personer som drabbats av främre korsbandsskada. De tillfrågade kommer från norra Sverige. Enkäten delades även ut till icke korsbandsskadade kontroller.

    Resultat: Etthundratio personer med främre korsbandsskada besvarade enkäten (33%). Det var 52 män och 58 kvinnor i åldrarna 19-65 år, som skadat sig mellan 1 – 45 år. Bland dessa är 82% opererade med korsbandsrekonstruktion.  Svaren jämfördes sedan med en grupp av 117 kontrollpersoner. Frekvensen av släktingar med främre korsbandsskada var högre bland korsbandsskadade; (23%) bland försökspersonerna jämfört med (16%) bland kontrollpersonerna. Denna skillnad var dock inte statistisk signifikant. Personer med främre korsbandsskada uppgav att de hade släktingar som drabbats av någon form av ligamentsskada i 74 % av fallen, medan motsvarande siffra bland kontrollpersonerna var 59 %. Skillnaderna mellan grupperna var signifikanta. Bland män med främre korsbandsskada var det signifikant vanligare att de drabbats av någon annan form av ligamentsskada än korsbandsskada jämfört med männen i kontrollgruppen. Innan skadan uppgav 64 % i gruppen med korsbandsskada att de utövat någon form av lag bollsport, den siffran sjönk dock till 23 % efter skada. Trettiosju (43%) bland gruppen med främre korsbandsskada uppgav att de på något sätt  var begränsade i sin fysiska aktivitet medan motsvarande siffror bland kontrollpersonerna var 4 (4%).

    Konklusion: Föreliggande studie stödjer antagandet att det kan finnas en familjär predisposition för ligamentsskador; vi kunde se att det förekom signifikant fler ligamentsskador hos släktingar till personer med främre korsbandsskador jämfört med kontrollgruppen. Gruppen med främre korsbandsskada var mest aktiv inom lagbollsporter innan skadan, men deltagandet i sådana aktiviteter minskade efter skada då många av dem får funktionsnedsättningar som försvårar deltagande i liknande aktiviteter. Forskningsområdet kring främre korsbandsskada och genetik är ännu inte väl utforskat, men resultaten från föreliggande studie tillsammans med undersökningar om genetik kan visa sig ha betydelse för personer som löper ökad risk för främre korsbandsskada.  

  • 203.
    Fisher, Anne G.
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Griswold, Lou Ann
    Munkholm, Michaela
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Kottorp, Anders
    Evaluating domains of everyday functioning in people with developmental disabilities2017In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 24, no 1, p. 1-9Article in journal (Refereed)
    Abstract [en]

    Objective: To examine the relationship among (a) quality of activities of daily living (ADL) task performance, (b) quality of social interaction, and (c) the extent of discrepancy between the person's and the occupational therapist's perspectives; and explore patterns of strengths and challenges among people with developmental disabilities (DD). Methods: Fifty-eight adults with different types of DD, living in northern Sweden, were evaluated using the Assessment of Motor and Process Skills (AMPS), the Evaluation of Social Interaction (ESI) and the Assessment of Compared Qualities -Occupational Performance (ACQ-OP) and Assessment of Compared Qualities -Social Interaction (ACQ-SI). The relationships among assessments were analysed using Pearson correlation analyses. Cluster analysis was used to group participants based on their evaluation results. Results The quality of ADL task performance and the quality of social interaction demonstrated weak to moderate positive relationships while the ACQ-OP and ACQ-SI demonstrated a strong positive relationship. The cluster analysis resulted in identifying three distinct groups that differed significantly from one another. Conclusion: The findings support the clinical use of multiple assessment tools, including observation and self-report, to evaluate different aspects of occupational performance. Comprehensive and relevant evaluation supports collaborative goal setting and intervention planning.

  • 204.
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Musicianship and teaching: aspects of musculoskeletal disorders, physical and psychosocial work factors in musicians with focus on music teachers2003Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Musculoskeletal disorders are common among musicians at all levels of performance. Since music teachers train our future musicians it is important to understand their work environment. By creating good examples of a healthy work environment, they can teach their students how to stay healthy and to prevent pain. The aim of this thesis was to study the work environment of music teachers at municipal music schools, with regard to physical and psychosocial factors and musculoskeletal disorders with the focus on neck and shoulder disorders. An additional aim was to investigate the variability of the playing technique in string players and to investigate if they could play with greater variation in the trapezius muscle activity pattern after a training intervention program.

    In a cross-sectional study at 23 municipal music schools, 171 out of the 208 (82%) music teachers reported that they had experienced work related musculoskeletal disorders (WMSDs) during the previous year. Women reported significantly more symptoms in the neck, the shoulders and the upper back compared to men. Both physical and psychosocial work factors were associated with neck and shoulder disorders. For women “high mental work demands” and “teaching at many schools” could be seen as risk factors and for men “lifting”, “playing the guitar” and “low social support at work” were risk factors.

    The occurrence of WMSDs was also investigated, over an eight-year period, in music teachers at one music school. The result showed that neck, shoulder and lower back disorders were common and tended to be of long duration and to increase over the years.

    In an interview study, nine music teachers focused on what they perceived to be important for their health and well-being. Replenishing and using up energy was found to be the core category. Creativity in the music and working with other musicians were perceived as sources of energy, while the goals of the organisation were experienced as stressful and used up energy. Whether the work was regarded as pedagogical or musical could affect the perception of health and the strategies for dealing with the strains of work.

    In two studies using electromyography, the variation in the trapezius muscle activity pattern in string musicians was investigated. The results suggested that each musician could repeat their muscular activity pattern in a similar way between two playing sessions. No difference was found in the trapezius muscle activity between five violinists who trained basic Body Awareness Therapy (BAT), a technique having its roots in Tai Chi Chuan tradition, compared to a reference group of nine violinists who did not take part in any training. However, the training group perceived positive changes in breathing, muscular tension, postural control and concentration during practice sessions.

    Neck and shoulder disorders were associated with physical and psychosocial factors at work. A process of replenishing and using up energy was important for music teachers’ health. The playing technique in string musicians seemed to be repeatable but difficult to affect over a short-term period. For future musicians it is crucial to learn good working technique at an early age. In the learning process the music teacher is a vital role model.

  • 205.
    Fjellman-Wiklund, Anncristine
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Brulin, Christine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Physical and psychosocial work-related risk factors associated with neck-shoulder discomfort in male and female music teachers.2003In: Medical problems of performing artists, ISSN 0885-1158, E-ISSN 1938-2766, Vol. 18, no 1, p. 33-41Article in journal (Other academic)
  • 206.
    Fjellman-Wiklund, Anncristine
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Nordin, Ellinor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Skelton, Dawn A.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. School of Health and Life Sciences, Institute of Applied Health Research, Glasgow Caledonian University, Glasgow, United Kingdom.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Reach the Person behind the Dementia Physical Therapists' Reflections and Strategies when Composing Physical Training2016In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 12, article id e0166686Article in journal (Refereed)
    Abstract [en]

    Dementia is a disease characterized by cognitive impairment and physical decline that worsens over time. Exercise is one lifestyle factor that has been identified as a potential means of reducing or delaying progression of the symptoms of dementia, maximizing function and independence. The purpose of this study was to explore physical therapists' (PTs) experiences and reflections on facilitating high-intensity functional exercise with older people living with dementia, in residential care home settings. The study used a qualitative design based on interviews, individually or in small groups, with seven PTs engaged as leaders in the training of older people with dementia. The interviews were analyzed with a modified Grounded Theory method with focus on constant comparisons. To increase trustworthiness the study used triangulation within investigators and member checking. The core category "Discover and act in the moment-learn over time" reflects how the PTs continuously developed their own learning in an iterative process. They built on previous knowledge to communicate with residents and staff and to tailor the high intensity training in relation to each individual at that time point. The category "Be on your toes" highlights how the PTs searched for sufficient information about each individual, before and during training, by eliciting the person's current status from staff and by interpreting the person's body language. The category "Build a bond with a palette of strategies" describes the importance of confirmation to build up trust and the use of group members and the room to create an interplay between exercise and social interaction. These findings highlight the continuous iterative process of building on existing knowledge, sharing and reflecting, being alert to any alterations needed for individuals that day, communication skills (both with residents and staff) and building a relationship and trust with residents in the effective delivery of high intensity functional exercise to older people living with dementia in care settings.

  • 207.
    Fjellman-Wiklund, Anncristine
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Stenlund, Therese
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Steinholtz, Katarina
    The Stress Clinic, University Hospital of Umeå.
    Ahlgren, Christina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Take charge: Patients' experiences during participation in a rehabilitation programme for burnout2010In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 42, no 5, p. 475-481Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study was to explore the experiences of patients with burnout during a rehabilitation programme.

    Patients and methods: Eighteen patients with burnout were interviewed at the end of a one-year rehabilitation programme. The programme consisted of 2 groups, one with a focus on cognitively-oriented behavioural rehabilitation and Qigong and 1 with a focus on Qigong alone. The interviews were analysed using the grounded theory method.

    Results: One core category, Take Charge, and 6 categories emerged. The core category represents a beneficial recovery process that helped the patients to take control of their lives. The common starting point for the process is presented in the 3 categories of Good encounters, Affirmation and Group cohesiveness. The categories were basic conditions for continuing development during rehabilitation. In the categories Get to know myself, How can I be the one I want to be? and Choice of track, the more group-specific tools are included, through which the patients adopted a new way of behaving.

    Conclusion: Patients in both groups experienced group participation as being beneficial for recovery and regaining control of their lives, although in somewhat different way. An experience of affirmation and support from health professionals and group participants is of importance for behavioural change

  • 208.
    Fjellman-Wiklund, Anncristine
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Musculoskeletal discomfort of music teachers: an eight-year perspective and psychosocial work factors1998In: International journal of occupational and environmental health, ISSN 1077-3525, E-ISSN 2049-3967, Vol. 4, no 2, p. 89-98Article in journal (Refereed)
    Abstract [en]

    Musicians at all levels of performance, especially string players, are known to have a high prevalence of work-related musculoskeletal disorders. The disorders seem to be most common in the neck, shoulders and low back. In 1988, a survey of the work-related musculoskeletal disorders of 36 music teachers was carried out at a music school in northern Sweden. In 1996, the teachers were reinvestigated. The study also included an investigation of the psychosocial work environment according to the Karasek demand-control theory, as well as measurements of upper-arm elevation during a working day in five violin teachers. The results showed that music teachers, like other professional musicians, often experience discomfort in the neck, shoulders, and low back. The discomfort tended to be of long duration, increasing over the years. The psychosocial work environment was characterized by high psychological demands and low authority over decisions. This was compensated for through good social support. The work required skill and creativity but was monotonous. The measurements of upper-arm elevation indicated considerable variations in shoulder positions between teachers. There were also differences in the work done with the right and left arms, with repetitive motions more commonly involving the right arm. Approximately a fourth of the working day was spent with the arm elevated 30-90 degrees. The relationships between upper-arm movements and ratings of discomfort were moderate.

  • 209.
    Fjellman-Wiklund, Anncristine
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Brulin, Christine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Musicianship and teaching: positive health factors in music teachers2002In: Medical problems of performing artists, ISSN 0885-1158, E-ISSN 1938-2766, Vol. 17, no 1, p. 3-10Article in journal (Other academic)
  • 210.
    Fjällberg, Amanda
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Tjernqvist, Sara
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Vad motiverar elitidrottare och motionärer under och till träning?2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion:Motivation är en viktig faktor vid träningssammanhang dels under själva genomförandet men även för att upprätthålla fysisk aktivitet på lång sikt. Elitidrottare och motionärer är två typer av idrottare med olika typer av träningsmängd och syn på träning. Det är värdefullt att som fysioterapeut att ha kunskap om detta för att kunna ge en bra behandling. Därför är det intressant att fördjupa sig i detta ämne och undersöka vad som motiverar elitidrottare och motionärer till att träna genom denna studie.

    Syfte:Syftet med vår studie var att genom en kvalitativ metod undersöka hur elitidrottare respektive motionärer motiverades till träning samt under träning.

    Metod:Studien genomfördes via sex semistrukturerade intervjuer, tre motionärer samt tre elitidrottare. Informanterna fick svara på frågor om känslor, tankar och strategier före, under och efter träning. Materialet sammanställdes enligt innehållsanalys.

    Resultat: Utifrån innehållsanalysen framkom sex kategorier; Träningen ger fysiska och mentala vinster, Formar en positiv identitet, Utvecklar strategier, Sätter mål, Social gemenskap, Hantera barriärer.

    Konklusion: Något olika faktorer var betydelsefulla vad gällde motivation för motionärer respektive elitidrottare. Elitidrottarna i studien motiverades främst av individuella mål och att uppnå resultat. Vad gällde motionärer var social gemenskap och att må bra viktiga faktorer för att uppnå motivation.

  • 211.
    Flatholm, Emil
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Larsson, Björn
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Kvantitativ innehållsanalys av undervisnings- och examinationscase vid arbetsterapeut- och fysioterapeututbildningar i Sverige: Patientbeskrivande faktorer och könsskillnader2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Casemetodik (CM) och Problembaserat lärande (PBL) är två metoder som skiljer sig från de traditionella inlärningsmetoderna. Syftet med CM och PBL är att stimulera studenternas förmåga att analysera, diskutera och bedöma för att hitta kopplingen mellan kunskap, fakta och problem. Det är viktigt att tillräckligt med information finns i casen. Syfte: Syftet med denna studie var att undersöka hur patienter beskrivs i examinations- och undervisningscase utifrån releventa faktorer vid rehabilitering. Metod: Kvantitativ innehållsanalys användes. Alla grundbildningar inom fysioterapi och arbetsterapi i Sverige ombads vara med i studien. Slutmaterialet bestod av 91 case från fem utbildningar som kodades och analyserades. Resultat: Resultatet visade att det ofta saknades viktig information om patienterna i casen. Det fanns inte heller några samband mellan kön och de faktorer som beskrevs i casen. Slutsats: Studien visar att många av de faktorer som ansetts som relevanta vid rehabilitering sällan beskrevs i casen. Studien har inte visat på några signifikanta samband mellan de undersökta faktorerna och kön i casen. Trots detta har det varit möjligt att urskilja en viss likhet mellan hur kvinnor och män framställs i casen gällande yrken inom Administration och kundtjänst/service-, omsorg- och försäljningsarbete, farmakologisk behandling och vårat samhälle. Där kvinnor i större utsträckning jobbar inom denna yrkeskategori samt tillhandahålls mer farmakologisk behandling än män. I framtiden behövs fler studier som undersöker hur patienter beskrivs i examinations- och undervisningscase vid arbetsterpeut- och fysioterapeututbildningar i Sverige.

  • 212.
    Forsberg, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Associations of neck–shoulder muscle strength gain, self-rated pain and disability in women with nonspecific neck pain2016Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Aim: to investigate the association between changes in neck-shoulder muscle strength and changes in self-rated pain and disability, for women with nonspecific neck pain after a neck-shoulder strength training intervention. 

     

    Methods: Observational longitudinal correlation study based on an experimental study. Data was retrieved from an RCT with neck-shoulder exercise intervention. 45 women, age 20-64, with nonspecific neck-shoulder pain were divided into three groups based on type of exercise they received. Craniocervical flexion training (CCF)-group n=15; cervicothoracic training (CTH)-group n=18; craniocervical flexion training and cervicothoracic training (CCF+CTH)-group n=12. Spearman’s correlation coefficient (rs) was used for statistical analyses of correlations between changes in neck-shoulder strength, self-rated pain and disability. Change values from baseline to follow up one week after intervention period for CCF-strength, CTH-strength, Numeric Rating Scale (NRS) and Neck Disability Index (NDI) were used for the correlation analyses.

     

    Results: Correlations between neck strength changes and changes in pain and disability were overall low or very low. An improvement in CTH-extension showed a moderate correlation with an increase in disability in the CCF+CTH-group. For all other correlation analyses, CCF-strength and CTH-strength showed low (rs 0,3-0,5) or very low (rs 0,0-0,3) correlations with both NRS and NDI.

     

    Conclusion:  The results from this study give no support for neck-shoulder muscle strength gain being the explaining mechanism behind reduced neck pain and disability in women with non-specific neck pain after neck-shoulder strength training intervention. The results give indications of the complexity around neck pain and exercise. Future research should further investigate mechanisms related to neck-shoulder exercise, pain and disability.

  • 213.
    Forsgren, Josefin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Ivansson, Ida
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Fysisk aktivitet i sjukgymnastutbildningen på Umeå universitet och Kilimanjaro Christian Medical College, Tanzania: En jämförelse mellan sjukgymnaststudenternas upplevelser.2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion:Fysisk aktivitet har alltid varit en stor del i en människas vardag, men det har förändrats med tiden och utvecklingen har de senaste hundra åren gått mot en allt mer stillasittande livsstil. Inaktivitet är idag ett stort och växande problem och för att få kontroll över det har det blivit allt vanligare att som sjukgymnast förskriva fysisk aktivitet som behandling av folkhälsosjukdomar. Syfte: Syftet med den här studien är att jämföra hur sjukgymnaststudenterna på Umeå universitet (Umu) och på Kilimanjaro Christian Medical College (KCMC) ser på fysisk aktivitet, fysisk aktivitet som sjukdomsförebyggande och som sjukdomsbehandling samt undersöka eventuella samband med utbildningarnas kursplaner. Metod: En egenutformad enkät delades ut till svenska (n=77) och tanzaniska (n=34) sjukgymnaststudenter. En kvantitativ innehållsanalys gjordes av utbildningarnas kursplaner där vi räknade hur många gånger fysisk aktivitet och andra liknande ord nämndes. Resultat: Studenterna på både Umu och KCMC tyckte att fysisk aktivitet är ett viktigt instrument för behandling av sjukdomar och majoriteten kommer att använda sig av metoden i sitt framtida yrkesliv.

    Innehållsanalysen av kursplanerna för utbildningarna visade attfysisk aktivitet nämns totalt sex och tre gånger på Umu respektive på KCMC. Slutsats: Det finns inga signifikanta skillnader mellan studenternas syn på fysisk aktivitet som sjukdomsbehandling. Fysisk aktivitet förekommer mer sällan i teorin än i praktiken.

  • 214.
    Forslund, Maja
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Rödin, Malin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    En kvalitativ studie om diabetessjuksköterskors syn på fysisk aktivitet: Upplevelser och erfarenheter av att rekommendera fysisk aktivitet2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Diabetes är en välkänd sjukdom och idag lever cirka fem procent av Sveriges vuxna befolkning med diabets och antalet ökar. Vid diabets vet forskarna att fysisk aktivitet är en viktig behandling och att det kan förebygga komplikationer. Studier har visat att vårdpersonal med högre grad av fysisk aktivitet under fritiden samt de som besitter kunskap om de positiva effekterna är mer benägna att rekommendera fysisk aktivitet till patienter. Tidigare studier visar även att personalen upplever att de saknar kunskap och kompetens angående fysisk aktivitet, de känner oro och osäkerhet inför att rekommendera det.

    Syfte: Syftet med denna kvalitativa studie är att undersöka diabetessjuksköterskors erfarenheter kring fysisk aktivitet samt deras upplevelser av att rekommendera fysiska aktivitet till patienter som behandlingsmetod.

    Metod: Data samlades in via kvalitativa semistrukturerade intervjuer med fyra diabetssjuksöterskor som är arbetsverksamma i Västerbottens län. Deltagarna fick svara på frågor angående upplevelser och erfarenheter kring fysisk aktivitet som behandlingsmetod.

    Resultat: Deltagarna upplevde att det var svårt att prata med patienten om fysisk aktivitet. De upplever en bristande kunskap inom området för fysisk aktivitet samt att tidsbrist påverkade arbetssituationen. Deltagarna önskade en bredare kunskap angående fysisk aktivitet, utvecklat samarbete mellan professioner samt förbättrade arbetsredskap. Detta för att de ansåg att det kunde höja kvalitén på mottagningen.

    Konklusion: Diabetessjuksköterskorna upplevde det svår att rekommendera fysisk aktivitet och önskade sig ett samarbete med fysioterapeut samt mer arbetsverktyg för att underlätta rådgivning kring fysisk aktivitet. 

  • 215.
    Fredin, Christine
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Horuz, Ali
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Tai Chi som behandling vid muskuloskeletal smärta: En systematisk litteraturgranskning2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Purpose: Musculoskeletal pain is a growing problem in modern society. The objective was to determine the effectiveness of Tai Chi for reducing pain in patients with musculosceletal pain.Methods: Six databases (PubMed, CINAHL, PEDro, PsychINFO, MEDLINE, AMED) were searched for randomized controlled trials (RCT) and clinical controlled trials (CCT) using Tai Chi as the main intervention with the purpose of evaluating its effectiveness on reducing pain. SBU's (Statens beredning för medicinsk utvärdering) template for evaluating RCT's was used to rate the quality of the studies.Results: Fifty titles were identified and 18 met the inclusion criteria. Seven RCT's where included in the review. Four studied osteoarhtritis, one studied fibromyalgia, one studied low back pain and one studied osteopaenia. The majority of the studies found a small but statistically significant effect on pain reduction compared to the control group.Conclusion: The analyzed literature shows a small pain reduction from practising Tai Chi but available research on the subject is scarce and the evidence is of low quality. Reports regarding drop outs, compliance and adverse effects were not satisfactory. New and better designed studies are needed in order to come to reliable conclusions.

  • 216.
    Fredrik, Öhberg
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Grip, Helena
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Nilsson, Kjell G
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Edström, Urban
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Gustavsson, Ola
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lundström, Ronnie
    Umeå University, Faculty of Medicine, Department of Radiation Sciences. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Gait analysis using a portable motion sensor system: measurements in subjects with hip implant as compared with healthy controls2013In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 38, no suppl 1, p. 99-100Article in journal (Refereed)
    Abstract [en]

    Introduction: There is an increase of age related diseases such as hip joint arthritis, something that is often treated with hip replacement surgery. The aim of this study was to quantify movement function and its effect on quality of life in persons treated with hip implant, in comparison to matched asymptomatic controls.

    Patients/Materials and Methods: This is an ongoing study, and so far, 2 asymptomatic subjects (CTRL, age 50 ± 13 years, BMI 23 ± 2), and 4 subjects with hip implant (HIP, age 51 ± 15 years, BMI 25 ± 3), have been analyzed. The HIP group received their implant 2.6 ± 1.1 years ago and finished their rehabilitation 1.6 ± 1.1 years ago. Hip dysfunction and Osteoarthritis Outcome Score (HOOS) was used to assess the subject's hip function and its associated problems. A functional calibration (flexion/abduction movements) was done and each subject then performed 5 repetitions of gait (approx. 25 left/right gait cycles). Movement was registered with a custom-developed portable motion sensor system, where each sensor consisted of a tri-axial accelerometer and gyroscope. Sensors were placed on pelvis and each thigh and shank. Further calculations were done in MATLAB (v7.12 R2011a, Mathworks). Cosine rotation matrices were extracted by functional sensor-to- segment-calibration and sensor fusion [1], and hip and knee angles were obtained as Euler angles.

    Results: Preliminary results indicated larger range in hip rotation and smaller range of knee flexion during gait in HIP group than in the CTRL group (Fig. 1). HOOS profile (Fig. 2) indicated that hip function during sports (SP) and the general quality of life (QOL) were lower in the HIP group.

    Fig. 1. 

    Mean and SD of hip and knee angle over 15 gait cycles in one HIP subject (blue) as compared with the CTRL group (black). (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)

    Figure optionsFig. 2. 

    HOOS profiles in HIP (blue square) and CTRL group (black). (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)

    Figure options

    Discussion and conclusions: Motion patterns during gait seemed to be negatively affected in subjects with hip implant, even after the rehabilitation program was completed and even though the HOOS profiles indicated a relative good hip function.

    Reference

    • [1]
    • J. Favre, B.M. Jolles, O. Siegrist, K. Aminian
    • Quaternion-based fusion of gyroscopes and accelerometers to improve 3D angle measurement

  • 217.
    Frisendahl, Nathalie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Upplevelsen av att använde en funktionell ryggortos hos äldre kvinnor med Osteoporos och ryggvärk2015Independent thesis Advanced level (degree of Master (Two Years)), 80 credits / 120 HE creditsStudent thesis
    Abstract [en]

    Abstract:

    Aims: The aim of this study was to explore the perceptions of elderly women with osteoporosis and back pain by using a spinal orthosis.

    Methods:  A qualitative study with five focus group interviews using a semi-structured interview guide, with a total of 18 women (mean age 78 years, min 65-max 90 years) who had all used the Spinomed spinal orthosis during six months in a RCT. The interviews were analyzed using qualitative content analysis with an inductive approach.

    Results: The spinal orthosis showed perceived positive effects on the participants’everyday life by supporting the woman’s autonomy. It was perceived to facilitate performing daily activities and to relieve back pain, to increase mobility and positively influence the woman’s posture. Because the spinal orthosis was perceived as an integrated part of the woman, it was of utmost importance for the spinal orthosis to fit well.

    One overall theme was found: The spinal orthosis could be perceived as an integrated part of everyday life, if it met the needs of the individual woman.

    The four categories found under this theme was: The meaning of the spinal orthosis, The perceived physical changes, Possibilities in everyday life and The importance of the individual shaping of the spinal orthosis.

    Conclusion: The results based on interviews show that the spinal orthosis can have a positive impact on the daily life and facilitate the audience who have osteoporosis and back pain . The spinal orthosis has been shown to be an integral part of everyday life and it is therefore important that it can be individually adapted to receive such a positive impact.

  • 218.
    Frisk, Emelie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy. -.
    Lower limb muscle function in children and adolescents with Fontan circulation: A cross-sectional study2019Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Introduction: Impaired isometric muscle strength and muscle endurance in adults with Fontan circulation has previously been reported. However, the knowledge if corresponding impairment is present in children and adolescents with Fontan circulation is scarce.

    Aim: The aim was to examine the isometric muscle strength and muscle endurance of the lower limbs in children and adolescents with Fontan circulation in comparison to age and sex matched controls.

    Method: In this cross-sectional study 43 children and adolescents (6-18 years) with Fontan circulation and 43 controls were included. Isometric knee extension and plantar flexion muscle strength was assessed using dynamometry (Newton:N). Unilateral isotonic heel-lift until exhaustion was used for evaluation of lower limb muscle endurance. Analysis on group level (n=43) and for the subgroups 6-12 years (n=18) and 13-18 years (n=25) was performed.

    Results: On group level the children and adolescents with Fontan circulation had impaired isometric plantar flexion strength for the left leg compared to controls (393.9±181.1N vs. 492.5±241.6N, p=0.04). In addition, they had impaired isometric knee extension strength bilaterally (right 222.8±101.1N vs. 293.0±164.9N, p=0.02, left 220.7±102.7N vs. 279.5±159.1N, p=0.05). In contrast, lower limb muscle endurance did not differ. In subgroup analysis, the impaired isometric strength was only present in the group of adolescents.

    Conclusion: Adolescents with Fontan circulation had impaired isometric muscle strength compared to controls. However, no corresponding differences were found in children. Further, lower limb muscle endurance did not differ. This implies that the impaired isometric muscle strength may develop during adolescence whereas the impaired muscle endurance may occur later.

  • 219. Frykberg, G.
    et al.
    Johansson, Gudrun
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Grip, Helena
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Selling, Jonas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    The “Arm Posture Score” for assessment of arm swing during gait: Evaluation of additional rotational components and different gait speeds2012Conference paper (Other academic)
  • 220.
    Frykberg, Gunilla E
    et al.
    Department of Neuroscience, Rehabilitation Medicine, Uppsala University, Sweden.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Movement analysis of sit-to-stand: research informing clinical practice2015In: Physical Therapy Reviews, ISSN 1083-3196, E-ISSN 1743-288X, Vol. 20, no 3, p. 156-167Article in journal (Refereed)
    Abstract [en]

    Background: Sit-to-stand (STS) is a crucial transfer influencing a person's independence in daily activities, as well as safety and quality of life, and is thus vital to evaluate in research and in practice. Clinical STS tests provide single values in seconds or numbers of STS. There is, however, increasing numbers of research papers reporting spatial and temporal kinematic and kinetic process STS data.

    Objectives: To provide an overview of research findings from laboratory-based movement analyses regarding phases and determinants of typical STS, characteristics of successful versus failed STS transfers, and finally STS performance in some neurological conditions.

    Major Findings: The STS transfer, previously regarded as mainly requiring lower limb muscle strength, is increasingly recognized as a complex transfer skill. Muscle strength, balance, foot position, chair height and the movement strategy are major determinants influencing STS performance. Scaling and timing of momentum generation throughout STS seems critical for success or failure. Sit-to-stand in stroke and Parkinson's disease (PD) is characterized by asymmetry in force generation and difficulties in switching movement direction, respectively. In-depth, knowledge regarding mechanisms of momentum control during STS sub-phases, STS failures, as well as exploration of variability in normal and atypical STS is still lacking.

    Conclusions: Recent research based on instrumented movement analyses has generated better understanding of movement control during STS, but the specifics are not yet reflected in clinical assessments. There seems to be a call for clinical tools capturing determinants and process characteristics of the STS transfer for a more comprehensive evaluation in rehabilitation.

  • 221.
    Frykberg, Gunilla E.
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Johansson, Gudrun M.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Schelin, Lina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Häger, Charlotte K.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    The Arm Posture Score for assessing arm swing during gait: An evaluation of adding rotational components and the effect of different gait speeds2014In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 40, no 1, p. 64-69Article in journal (Refereed)
    Abstract [en]

    In 3D gait analysis, quantification of leg movements is well established, whereas ameasure of armswing has been lacking. Recently, the Arm Posture Score (APS) was introduced to characterize arm movements in children with cerebral palsy, including information from four variables (APS(4)) in the sagittal and frontal planes. A potential limitation of the APS is that it does not include rotational movements and has not yet been evaluated with regard to gait speed. The aims of this study were (i) to investigate the effect on APS of adding two components of arm rotation (APS(6)) and (ii) to determine the influence of gait speed on the APS measures, when applied to non-disabled adults. Forty-two subjects walked 10 m at a selfselected speed (1.34 m/s), and in addition a subgroup of 28 subjects walked at a slowspeed (0.66 m/s) set by a metronome. Data were collected from markers in a whole-body set up and by eight optoelectronic cameras. The results demonstrated significantly higher APS(6) than APS(4) values for both arms, irrespective of gait speed. Speed condition, whether self-selected or slow, had a significant effect on both APS measures. The two additional arm components are suggested to provide relevant information about arm swing during walking. However, APS(6) needs to be implemented in gait analysis of individuals with gait arm pathologies in order to further examine its utility. Werecommend that gait speed should to be taken into account when using APS measures to quantify arm swing during gait. (C) 2014 Elsevier B. V. All rights reserved.

  • 222.
    Frykholm, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Undersökning av test för muskeluthålligheten i quadriceps hos personer med kronisk obstruktiv lungsjukdom: Intrabedömmarreliabilitet och genomförbarhet av protokoll med isokinetiska, isometriska och isotoniska test2017Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Introduction: Although chronic obstructive pulmonary disease (COPD) is primarily a disease of the respiratory system, a common secondary consequence is reduced quadriceps endurance. This have been associated with important clinical outcomes. However, reliability and feasibility properties of different testing protocols have not been thoroughly investigated within the same setting. Aims: The aim for this study was to determine intra-rater test-retest reliability, minimal detectable change (MDC) as well as the feasibility of the three measurement protocols. Methods: Nineteen participants with COPD were included and tested on consecutive weeks in a test-retest design. The specific endurance measurements were conducted in a randomised order at visit two and three with protocols that were isokinetic, isometric and isotonic. All tests were performed in a computerised dynamometer. Results: Quadriceps muscle endurance measurements were reliable in this group irrespective of measurement technique used. In specific, isokinetic measurements demonstrated very high reliability with a intra class correlation (ICC) of 0.97. Isometric and isotonic measurements demonstrated a high reliability with a ICC of 0.89 and 0.72, respectively. The isokinetic protocol had the smallest relative MDC of 14% whereas the isometric and the isotonic MDCs were 43% and 40%. All three test were also feasable with an average time consumption of 7 minutes and 12 seconds, limited exertional dyspnoea and no major adverse advents. Conclusion: For measurements of quadriceps muscle endurance our result indicates that an isokinetic protocol of 30 repetitions with a pace of 90°/second is the most reliable assessment strategy.

  • 223.
    Frykholm, Erik
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Géphine, Sarah
    Saey, Didier
    van Hees, Hieronymus
    Lemson, Arthur
    Klijn, Peter
    Maltais, François
    Nyberg, André
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Inter-day test–retest reliability and feasibility of isokinetic, isometric, and isotonic measurements to assess quadriceps endurance in people with chronic obstructive pulmonary disease: A multicenter study2018In: Chronic Respiratory Disease, ISSN 1479-9723, E-ISSN 1479-9731, Vol. 16, article id UNSP 1479973118816497Article in journal (Refereed)
    Abstract [en]

    The aims were to determine reliability and feasibility of measurements to assess quadriceps endurance in people with chronic obstructive pulmonary disease. Sixty participants (forced expiratory volume in one second (mean ± standard deviation) 55 ± 18% of predicted, age 67 ± 8 years) were tested in an inter-day, test–retest design. Isokinetic, isometric, and isotonic protocols were performed using a computerized dynamometer. Test–retest relative and absolute reliability was determined via intraclass correlation coefficient (ICC), coefficient of variation (CV%), and limits of agreement (LoA%). Isokinetic total work demonstrated very high relative reliability (ICC: [95% confidence interval] = 0.98 [0.94–0.99]) and the best absolute reliability (CV% (LoA%) = 6.5% (18.0%)). Isokinetic fatigue index, isometric, and isotonic measures demonstrated low-to-high relative reliability (ICC = 0.64 [0.46–0.77], 0.88 [0.76–0.94], 0.91 [0.85–0.94]), and measures of absolute reliability (CV% (LoA%)) were 20.3% (56.4%), 14.9% (40.8%), and 15.8% (43.1%). For isokinetic total work and isometric measurements, participants performed better on retest (4.8% and 10.0%, respectively). The feasibility was similar across protocols with an average time consumption of less than 7.5 minutes. In conclusion, isokinetic, isometric, and isotonic measurements of quadriceps endurance were feasible to a similar extent and presented low-to-very high relative reliability. Absolute reliability seems to favor isokinetic total work measurements.

  • 224.
    Frykholm, Erik
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Klijn, Peter
    Saey, Didier
    van Hees, Hieronymus W. H.
    Stål, Per
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB).
    Sandström, Thomas
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Sörlin, Ann
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Maltais, François
    Nyberg, Andre
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Effect and feasibility of non-linear periodized resistance training in people with COPD: study protocol for a randomized controlled trial2019In: Trials, ISSN 1745-6215, E-ISSN 1745-6215, Vol. 20, no 1, article id 6Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In people with chronic obstructive pulmonary disease (COPD), limb-muscle dysfunction is one of the most troublesome systemic manifestations of the disease, which at the functional level is evidenced by reduced strength and endurance of limb muscles. Improving limb-muscle function is an important therapeutic goal of COPD management, for which resistance training is recommended. However, current guidelines for resistance training in COPD mainly focus on improving muscle strength which only reflects one aspect of limb-muscle function and does not address the issue of reduced muscle endurance. The latter is of importance considering that the reduction in limb-muscle endurance often is greater than that of muscle weakness, and also, limb-muscle endurance seems to be closer related to walking capacity as well as arm function than to limb-muscle strength within this group of people. Thus, strategies targeting multiple aspects of the decreased muscle function are warranted to increase the possibility for an optimal effect for the individual patient. Periodized resistance training, which represents a planned variation of resistance training variables (i.e., volume, intensity, frequency, etc.), is one strategy that could be used to target limb-muscle strength as well as limb-muscle endurance within the same exercise regimen.

    METHODS: This is an international, multicenter, randomized controlled trial comparing the effect and feasibility of non-linear periodized resistance training to traditional non-periodized resistance training in people with COPD. Primary outcomes are dynamic limb-muscle strength and endurance. Secondary outcomes include static limb-muscle strength and endurance, functional performance, quality of life, dyspnea, intramuscular adaptations as well as the proportion of responders. Feasibility of the training programs will be assessed and compared on attendance rate, duration, satisfaction, drop-outs as well as occurrence and severity of any adverse events.

    DISCUSSION: The proposed trial will provide new knowledge to this research area by investigating and comparing the feasibility and effects of non-linear periodized resistance training compared to traditional non-periodized resistance training. If the former strategy produces larger physiological adaptations than non-periodized resistance training, this project may influence the prescription of resistance training in people with COPD.

    TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT03518723 . Registered on 13 April 2018.

  • 225.
    Frykholm, Erik
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lima, Vanessa Pereira
    Janaudis-Ferreira, Tania
    Nyberg, Andre
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Physiological responses to arm versus leg activity in patients with chronic obstructive pulmonary disease: a systematic review protocol2018In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, BMJ open, Vol. 8, no 2, p. 1-5Article in journal (Refereed)
    Abstract [en]

    Compared with healthy older adults, people with chronic obstructive pulmonary disease (COPD) have reduced capacity and increased symptoms during leg and arm activities. While the mechanisms underlying limitations and symptoms during leg activities have been investigated in detail, limitations and symptoms during arm activities are not well understood, and the potential differences between physiological responses of leg and arm activities have not been systematically synthesised. Determining physiological responses and symptoms of arm activities compared with physiological responses and symptoms of leg activities will help us understand the mechanisms behind the difficulties that people with COPD experience when performing physical activities, and determine how exercise training should be prescribed. Thus, the aim of this systematic review is to compare the physiological responses and symptoms during activities involving the arms relative to activities involving the legs in people diagnosed with COPD.

  • 226.
    Frykholm, Erik
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Pereira Lima, Vanessa
    Selander, Hanna-Vega
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Nyberg, Andre
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Janaudis-Ferreira, Tania
    Physiological and Symptomatic Responses to Arm versus Leg Activities in People with Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis2019In: COPD: Journal of Chronic Obstructive Pulmonary Disease, ISSN 1541-2555, E-ISSN 1541-2563Article in journal (Refereed)
    Abstract [en]

    While the mechanisms underlying exercise limitations and symptoms during leg activities have been investigated in detail, knowledge of potential differences between leg and arm activities are not well understood and results from individual studies are contradictory. Thus, the aim of the present study was to synthesize physiological and symptomatic responses during activities involving the arms relative to activities involving the legs in people with Chronic Obstructive Pulmonary Disease (COPD). Any study with a cross-sectional comparison of acute physiological (cardiorespiratory, metabolic) and symptomatic responses to activities performed with the arms versus the legs were included. Studies were sub-grouped based on the type of activity performed (cycle ergometer, resistance exercises, or functional test/activities). Eighteen studies with 423 individuals with COPD were included. Leg cycle ergometer resulted in greater tidal volume (137?mL), minute ventilation (4.8?L/min), and oxygen consumption (164?mL/min) than arm cycle ergometer, while symptomatic responses were similar. Resistance exercises resulted in similar physiological and symptomatic responses irrespective of whether the legs or the arms were involved while studies on functional activities report different results depending on the type and intensity of the activity performed. With the exception of cycle ergometer activities, physiological and symptomatic responses do not seem to depend on whether the arms or the legs are used, but rather seem to be task and intensity dependent. These novel findings suggest, for example, that strategies used to increase exercise tolerance should not be dependent on whether the arms or the legs are used, but rather the intensity of specific activity performed.

  • 227.
    Fyhr, Charlotte
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gustavsson, Linnea
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    The effect of shoulder injury on proprioception: a sytematic review and meta-::malysis2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Abstrakt

    Bakgrund: Axelskador anses störa proprioception  som i sin tur kan leda till ytterligare eller ny skada.

    Syfte: Undersöka om proprioception, framförallt rörelse och ledkänsla, hos skadade axlar är annorlunda jämfört med kontrollgrupp eller den kontralaterala friska axeln.

    Metod: Databaserna MEDLINE, EMBASE, CINAH L, PubMed och SportDiscus söktes fram till den 13 augusti 2013. Undersökning för partiskhet gjordes och gav utslag som låg, moderat eller hög. Metaanalys utfördes för aktiv och passiv ledåterförings känsla (AJ RS och PJRS) och rörelse känsla, med tröskel för att uppfatta passiv rörelse (TTDPM).

    Resultat: Sjutton studier uppfyllde inklusionskriterierna. Fem studier klassificerades som låg partiskhet, fem som moderat och sju som hög. Det var en statistisk signifikant skillnad mellan

    TTDPM hos skadade jämfört med både kontroll grupp och kontralaterala axeln  vilket visar på

     

    försämrad ledkänsla. För AJ RS och PJRS var det statistisk signifika nt skill nad mellan skadad och kontralaterala axeln, men ingen skillnad jämför med kontroll grupp.

    Slutsats: Ledkä nsla är troligen påverkad i skadad axel jämfört med kontralaterala och kontroll gru pp, meda n AJRS och PJRS bara visar på skillnad till den kontralaterala. De inkluderade studierna var små med få deltagare och finns risk för publikations partiskhet där av bör resultatet tolkas med försiktighet.

  • 228.
    Fyhr, Charlotte
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gustavsson, Linnea
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wassinger, Craig
    Department of Physical Therapy, East Tennessee State University, USA.
    Sole, Gisela
    Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, New Zealand.
    The effects of shoulder injury on kinaesthesia: A systematic review and meta-analysis2015In: Manual Therapy, ISSN 1356-689X, E-ISSN 1532-2769, Vol. 20, no 1, p. 28-37Article, review/survey (Refereed)
    Abstract [en]

    The aim of this systematic review was to synthesize the evidence for changes for proprioceptive variables consisting of movement and position sense in participants with glenohumeral musculoskeletal disorders. Five databases were searched until 13th August 2013. Methodological quality was assessed and meta-analyses were performed for active and passive joint reposition sense (AJPS and PJPS) and movement sense, determined with threshold to detection of passive motion (TTDPM). The search yielded 17 studies, four of which were classified as having high methodological quality, seven as moderate and six as low quality. For participants with post-traumatic glenohumeral instability, pooled findings indicate moderate evidence for higher TTDPM for involved shoulders compared to control groups and the contralateral uninvolved side, indicating decreased movement sense. For AJPS and PJPS there was moderate to limited evidence for significant increased errors for involved compared to uninvovled shoulders, but not when compared to the control groups. Limited evidence was found for decreased AJPS acuity for patients with chronic rotator cuff pain and for patients with unspecified shoulder pain compared to healthy controls. Movement sense is most likely to be impaired after shoulder injury involving post-traumatic instability when compared to the contralateral shoulder and to controls, while deficits for AJPS and PJPS are more likely to be evident compared to the contralateral shoulder in participants with glenohumeral musculoskeletal disorders. (C) 2014 Elsevier Ltd. All rights reserved.

  • 229. Gard, Lisbeth
    et al.
    Rösblad, Birgit
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    The qualitative motor observations in movement ABC: Aspects of reliability and validity2009In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 11, p. 51-57Article in journal (Refereed)
  • 230.
    Gardtman, Cecilia
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lindeberg, Hanna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Utvärdering av en fysisk funktionsanalys inomföretagshälsovården2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Ländryggsbesvär är vanligt förekommande bland byggnadsarbetare. En metod som används inom företagshälsovården för att upptäcka och förebygga ländryggsbesvär är fysiska test vid hälsoundersökning.

    Syfte: Det övergripande syftet var att utvärdera delar av Feelgood Funktionsanalys (FFA) med fokus på de test som mäter rörlighet och styrka i ländryggen

    Metod: Resultaten (n=7149) från FFA var registrerade i en databas. Populationen bestod av yrkesarbetare och tjänstemän inom byggnadsbranschen. Rörlighetstest och styrketest jämfördes för att undersöka om de olika testmomenten överenstämde. Sambandet mellan resultat av styrketest och skattning av ländryggssmärta jämfördes vid två testtillfällen för att eventuellt kunna predicera framtida besvär. Den sammanfattande bedömningen jämfördes mellan olika individer. Fördelningen av åtgärder samt effekten av dem undersöktes.

    Resultat: Korrelationerna för rörlighetstesterna varierade från rs 0,26 till 0,47 och styrkestesterna från rs 0,17 och 0,59. De som inte klarade Sörensens test (ryggstyrka) hade en ökad risk att drabbas av ländryggsbesvär (oddskvot 2,3; 95% KI 1,2-4,7). Den sammanfattande bedömningen skiljde sig åt för individer med samma resultat på testmomenten.

    Konklusion: I FFA bör samtliga styrke- och rörlighetstest för ländryggen kvarstå. Utifrån FFA kan individer som har en ökad risk att drabbas av framtida ländryggsbesvär identifieras med hjälp av Sörensens test. Manualen behöver utvecklas och tydliggöras för att underlätta användningen och sammanställningen av FFA. 

  • 231.
    Gashi, Nathalie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Måluppfyllelse, smärta och livskvalitet efter fysioterapeutiska interventioner hos patienter med långvarig smärta2019Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Fysioterapeutiska interventioner har effekt för att minska smärtintensitet och bidra till förbättrad kroppsmedvetenhet hos patienter med långvarig smärta. Ingen fysioterapeutisk intervention har visat sig vara mer effektiv än någon annan för att minska smärtintensitet. Inkludering av behandlingsmål och fokus på livskvalitet kan bidra till förbättrade behandlingsresultat. Syfte: Syftet med studien var att utvärdera om det finns skillnader i hur patienter med långvarig smärta självskattar måluppfyllelse, upplevd smärta och livskvalitet efter olika fysioterapeutiska interventioner. Metod: En tvärsnittsstudie med enkät som datainsamlingsmetod. Primärt utfallsmått var måluppfyllelse (GAS), sekundära utfallsmått var smärta (NRS) och livskvalitet (SF-36). Interventionsgrupperna delades in i; Basal kroppskännedom (BK), Joanne Elphinstone Movement Systems (JEMS), gymträning, stabilitetsträning och annat. Resultat: Fyrtiosex deltagare (78% kvinnor) rekryterades konsekutivt via distriktsrehabiliteringsenheterna alternativt via brev. Medelålder 53 år (SD ±16). En smärtduration på 1-5 år var vanligast förekommande i hela studiepopulationen. Ingen statistiskt signifikant skillnad mellan interventionsgrupperna påvisades vid analys med Kruskal-Wallis H-test. Skattningarna visade på högst skattad måluppfyllelse hos interventionsgruppen BK. Högst skattat medianvärde av allmänna hälsouppfattningar hos interventionsgruppen gymträning. Högst skattat medianvärde av genomsnittlig smärta hos interventionsgruppen JEMS. Slutsats: Studien påvisade inga statistiska skillnader mellan interventionsgrupperna men en viss variation i utfallen. Framtida större studier vore önskvärt för att verifiera resultaten i denna studie.

  • 232.
    Gashi, Nathalie
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Karlsson, Madelene
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Träning – nödvändigt måste för att leva som man lär: - Fysioterapeutstudenters tankar kring träning och hälsa2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Abstrakt

    Introduktion:

    Under grundutbildningen i fysioterapi förespråkas fysisk aktivitet och träning, men det finns inget krav för studenten att vara intresserad av idrott för att bli antagen till fysioterapeututbildningen.

    Syfte:

    Syftet med vår studie var att undersöka unga kvinnliga fysioterapeutstudenters tankar, känslor och förhållningssätt till fysisk träning och hälsa.

    Metod:

    Studien baserades på fem semistrukturerade intervjuer som sedan analyserades med Grounded Theory metoden. Inkluderingskriterierna för att vara med i studien var att man skulle gå termin två på fysioterapeutprogrammet på Umeå universitet, vara kvinna mellan 20-25 år och träna regelbundet, minst två gånger/vecka.

    Resultat:

    Analysen av innehållet resulterade i kärnkategorin “Träning – nödvändigt måste för att leva som man lär” samt fem kategorier med tillhörande underkategorier. Det framkom att fysioterapeutstudenter tränade mycket och att det var en del av deras vardag. En fysioterapeut beskrevs som en vältränad person, något som ansågs vara viktigt då fysioterapeuter ”bör leva som de lär” och vara ”trovärdiga” för patienterna. Fysioterapeutstudenterna levde efter normen att man ska träna som fysioterapeut och fysioterapeutstudent för att inte hamna utanför normen, studenterna ansåg att det skulle bli motsägelsefullt om man inte tränade och var överviktig som fysioterapeut.

    Konklusion:

    I resultatet framkom att normen för en fysioterapeut var att man skulle vara fysiskt aktiv för att vara lämpad som fysioterapeut. Det är viktigt att fysioterapeuter är medvetna om sin egen träning och hur den kan upplevas av andra.

  • 233. Gendron, Louis McCusky
    et al.
    Nyberg, Andre
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy. Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, Canada.
    Maltais, François
    Lacasse, Yves
    Active mind‐body movement therapies as an adjunct to or in comparison to pulmonary rehabilitation for people with chronic obstructive pulmonary disease2016In: Cochrane Database of Systematic Reviews, ISSN 1469-493X, E-ISSN 1469-493X, no 7, article id CD012290Article in journal (Refereed)
    Abstract [en]

    This is the protocol for a review and there is no abstract. The objectives are as follows:

    To assess the effect of active mind-body movement therapies (AMBMT) compared with pulmonary rehabilitation (PR), or in addition to PR, in the management of chronic obstructive pulmonary disease (COPD).

  • 234. Gendron, Louis McCusky
    et al.
    Nyberg, Andre
    Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada.
    Saey, Didier
    Maltais, François
    Lacasse, Yves
    Active mind‐body movement therapies as an adjunct to or in comparison with pulmonary rehabilitation for people with chronic obstructive pulmonary disease2018In: Cochrane Database of Systematic Reviews, ISSN 1469-493X, E-ISSN 1469-493X, no 10, article id CD012290Article, review/survey (Refereed)
    Abstract [en]

    Background: Active mind‐body movement therapies (AMBMTs), including but not limited to yoga, tai chi, and qigong, have been applied as exercise modalities for people with chronic obstructive pulmonary disease (COPD). AMBMT strategies have been found to be more effective than usual care; however, whether AMBMT is inferior, equivalent, or superior to pulmonary rehabilitation (PR) in people with COPD remains to be determined.

    Objectives: To assess the effects of AMBMTs compared with, or in addition to, PR in the management of COPD.

    Search methods: We searched the Cochrane Airways Group Specialised Register of trials and major Chinese databases, as well as trial registries from inception to July 2017. In addition, we searched references of primary studies and review articles. We updated this search in July 2018 but have not yet incorporated these results.

    Selection criteria: We included (1) randomised controlled trials (RCTs) comparing AMBMT (i.e. controlled breathing and/or focused meditation/attention interventions for which patients must actively move their joints and muscles for at least four weeks with no minimum intervention frequency) versus PR (any inpatient or outpatient, community‐based or home‐based rehabilitation programme lasting at least four weeks, with no minimum intervention frequency, that included conventional exercise training with or without education or psychological support) and (2) RCTs comparing AMBMT + PR versus PR alone in people with COPD. Two independent review authors screened and selected studies for inclusion.

    Data collection and analysis: Two review authors independently selected trials for inclusion, extracted outcome data, and assessed risk of bias. We contacted study authors if necessary to ask them to provide missing data. We calculated mean differences (MDs) using a random‐effects model.

    Main results: We included in the meta‐analysis 10 studies with 762 participants across one or more comparisons. The sample size of included studies ranged from 11 to 206 participants. Nine out of 10 studies involving all levels of COPD severity were conducted in China with adults from 55 to 88 years of age, a higher proportion of whom were male (78%). Nine out of 10 studies provided tai chi and/or qigong programmes as AMBMT, and one study provided yoga. Overall, the term 'PR' has been uncritically applied in the vast majority of studies, which limits comparison of AMBMT and PR. For example, eight out of 10 studies considered walking training as equal to PR and used this as conventional exercise training within PR. Overall study quality for main comparisons was moderate to very low mainly owing to imprecision, indirectness (exercise component inconsistent with recommendations), and risk of bias issues. The primary outcomes for our review were quality of life, dyspnoea, and serious adverse events.

    When researchers compared AMBMT versus PR alone (mainly unstructured walking training), statistically significant improvements in disease‐specific quality of life (QoL) (St. George's Respiratory Questionnaire (SGRQ) total score) favoured AMBMT: mean difference (MD) ‐5.83, 95% confidence interval (CI) ‐8.75 to ‐2.92; three trials; 249 participants; low‐quality evidence. The common effect size, but not the 95% CI around the pooled treatment effect, exceeded the minimal clinically important difference (MCID) of minus four. The COPD Assessment Test (CAT) also revealed statistically significant improvements favouring AMBMT over PR, with scores exceeding the MCID of three, with an MD of 6.58 units (95% CI ‐9.16 to – 4.00 units; one trial; 74 participants; low‐quality evidence). Results show no between‐group differences with regard to dyspnoea measured by the modified Medical Research Council Scale (MD 0.00 units, 95% CI ‐0.37 to 0.37; two trials; 127 participants; low‐quality evidence), the Borg Scale (MD 0.44 units, 95% CI ‐0.88 to 0.00; one trial; 139 participants; low‐quality evidence), or the Chronic Respiratory Questionnaire (CRQ) Dyspnoea Scale (MD ‐0.21, 95% CI ‐2.81 to 2.38; one trial; 11 participants; low‐quality evidence). Comparisons of AMBMT versus PR alone did not include assessments of generic quality of life, adverse events, limb muscle function, exacerbations, or adherence.

    Comparisons of AMBMT added to PR versus PR alone (mainly unstructured walking training) revealed significant improvements in generic QoL as measured by Short Form (SF)‐36 for both the SF‐36 general health summary score (MD 5.42, 95% CI 3.82 to 7.02; one trial; 80 participants; very low‐quality evidence) and the SF‐36 mental health summary score (MD 3.29, 95% CI 1.45 to 4.95; one trial; 80 participants; very low‐quality evidence). With regard to disease‐specific QoL, investigators noted no significant improvement with addition of AMBMT to PR versus PR alone (SGRQ total score: MD ‐2.57, 95% CI ‐7.76 to 2.62 units; one trial; 192 participants; moderate‐quality evidence; CRQ Dyspnoea Scale score: MD 0.04, 95% CI ‐2.18 to 2.26 units; one trial; 80 participants; very low‐quality evidence). Comparisons of AMBMT + PR versus PR alone did not include assessments of dyspnoea, adverse events, limb muscle function, exacerbations, or adherence.

    Authors' conclusions: Given the quality of available evidence, the effects of AMBMT versus PR or of AMBMT added to PR versus PR alone in people with stable COPD remain inconclusive. Evidence of low quality suggests better disease‐specific QoL with AMBMT versus PR in people with stable COPD, and evidence of very low quality suggests no differences in dyspnoea between AMBMT and PR. Evidence of moderate quality shows that AMBMT added to PR does not result in improved disease‐specific QoL, and evidence of very low quality suggests that AMBMT added to PR may lead to better generic QoL versus PR alone. Future studies with adequate descriptions of conventional exercise training (i.e. information on duration, intensity, and progression) delivered by trained professionals with a comprehensive understanding of respiratory physiology, exercise science, and the pathology of COPD are needed before definitive conclusions can be drawn regarding treatment outcomes with AMBMT versus PR or AMBMT added to PR versus PR alone for patients with COPD.

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

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

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

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

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

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

  • 236.
    Gerdle, Björn
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Leisure and muscular performance in health and disease: a study of 40-64-year-old northern Swedes1985Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Categories and frequencies of leisureactivities employed by 156 randomly selected males and females aged 40-44, 50-54, 60-64 were investigated by structured interviews and were related to leisuresatisfaction, to experienced health and socio-economic status. In equal numbers (15) of males and females from each group and in 24 males (60 +_6 years) with intermittent claudication (Cl) isokinetic plantar flexion performance was investigated with registrations of peak torque (PT), contractional work (CW), active range-of-motion (RoM) and integrated electromyograms from all threee triceps surae heads. Subjects performed a few maximum plantarflexions at different velocities of angular motion and also up to 200 consecutive plantar flexions at 60 °/s. The males aged 40-44 were re -investigated after two years additionally using electromyographic power frequency analyses.

    Leisure choice was mainly age and sex independent and extensively included outdoor activities. Leisure satisfaction was positively associated with relative frequency of activities. Symptoms of bodily discomfort, in particular backpain, were quite common and apparently caused relatively low level of mutual leisure activities. Thus, with in this age span, leisure activities appear rather rigid but often successfully, adhered to . Common ailments influence partnership mutuality negatively.

    Plantar flexion PT and CW are adequately p re dicta ble by sex, age and crural circumference. Uniformly a 3:2 male/female ratio characterizes mechanical output and iEMG. The latter is velocity independent. Output decreases with increasing age. Hence the output/excitation balance (CW/iEMG) is age, but not sex, dependent. CI-patients produce less PT and CW than do controls. Independently of this disease, of age and sex, PT and CW describe parallel negative exponential functions of velocity.

    During repeated manoeuvres plantar flexion output and iEMG initially drop, there after to maintain nearly steady-state levels. Throughout up to 200 contractions CW/iEMG was unaltered in the clinically healthy. Test/re-test with two years interval yielded nearly identical results. Leftshifts in mean power frequency in parallel with output-drop imply that the latter probably is due to FT-motor unit fatigue. For CW, but not for PT, the drop became slower and the (relative) steady-state level higher with increasing age, indicating significant increase in endurance with age. In the Cl-patients, output, but not excitation, decreased after a few repititions. Therefore, CW/iEMG fell dramatically, implying intramuscular fatigue. Taken together with findings of close associations between total cumulated work and measured/expected maximum walking tole rance it is suggested that measurements of CW and calculations of CW/iEMG are of clinical value.

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

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

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

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

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

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

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

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

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

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

  • 239.
    Gothilander, Jennifer
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Widmark, Sara
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Testprotokoll för tävlande styrkelyftare med och utan ländryggssmärta: En genomförbarhetsstudie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Inledning

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

    Syfte och metod

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

    Resultat och slutsats

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

  • 240.
    Goude Öhgren, Elin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Unspecific gynecological pelvic pain: is there an added value for this patient group with a multimodal treatment method?: A blinded randomized controlled trial.2014Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

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

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

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

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

  • 241.
    Gougeon, Marie-Madeline
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Caught in a foxtrap: Working single mothers´experiences of barriers, facilitators and wishes for support for physical activity.2018Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

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

     

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

     

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

     

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

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

  • 242.
    Granberg, Anna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Upplevelser av kroppsmedvetenhet hos yogautövande individer: en kvalitativ intervjustudie2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

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

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

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

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

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

  • 243.
    Granholm, David
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Åsing, Caroline
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Inter- och intrabedömarreliabilitet gällande ryggradens kurvatur med analysprogrammet Kinovea och visuell bedömning2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

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

    Syfte:

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

    Metod:

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

    Resultat:

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

    Konklusion:

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

  • 244.
    Granström, Niklas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Skadeprofil hos tennisspelare. En prospektiv tvä-ärs studie.2014Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

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

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

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

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

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

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

  • 245.
    Granås, Marie
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Tronarp, Rebecca
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    OfficeBiking® in sedentary office workers whilst still performing their usual desk work: - A controlled pilot field study2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund och syfte

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

    Metod

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

    Resultat

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

    Slutsats

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

  • 246.
    Grenehed, Joel
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Fhärm, Josefin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Finger movement control in persons who have suffered a stroke: - A Pilot Study2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

  • 247.
    Grenholm, Anton
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Stensdotter, Ann-Katrin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Häger-Ross, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Kinematic analyses during stair descent in young women with patellofemoral pain2009In: Clinical Biomechanics, ISSN 0268-0033, E-ISSN 1879-1271, Vol. 24, no 1, p. 88-94Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Compensatory movement strategies may develop in response to pain to avoid stress on the affected area. Patellofemoral pain is characterised by intermittent periods of pain and the present study addresses whether long-term pain leads to compensatory movement strategies that remain even when the pain is absent. METHOD: Lower extremity kinematics in three dimensions was studied in stair descent in 17 women with patellofemoral and in 17 matched controls. A two-dimensional geometric model was constructed to normalise kinematic data for subjects with varying anthropometrics when negotiating stairs of fixed proportions. RESULTS: There were minor differences in movement patterns between groups. Knee joint angular velocity in the stance leg at foot contact was lower and the movement trajectory tended to be jerkier in the patellofemoral group. The two-dimensional model showed greater plantar flexion in the swing leg in preparation for foot placement in the patellofemoral group. INTERPRETATION: The results indicate that an altered stair descent strategy in the patellofemoral group may remain also in the absence of pain. The biomechanical interpretation presumes that the strategy is aimed to reduce knee joint loading by less knee joint moment and lower impact force.

  • 248.
    Grip, Helena
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    A new approach to measure functional stability of the knee based on changes in knee axis orientation2013In: Journal of Biomechanics, ISSN 0021-9290, E-ISSN 1873-2380, Vol. 46, no 5, p. 855-862Article in journal (Refereed)
    Abstract [en]

    There is a lack of measures that quantify functional knee stability, which is of particular relevance in knee rehabilitation. Therefore, the aim of this study was to investigate the usefulness of knee finite helical axis (FHA) variables in 33 healthy subjects during two different functional tasks; One leg side hop (SH) and Two Leg Squat (TLS), and to investigate correlations of these variables with laxity. Laxity was assessed with a KT-1000 arthrometer and the Beighton Hypermobility Score. Movements were registered with an optical motion capture system. Knee rotation and translation were defined by a six degree of freedom segment model. FHA was calculated for finite steps of 20 degrees knee flexion, based on error simulations. We computed the FHA inclination, the translation along FHA and an FHA Direction Index quantifying directional changes. All variables were repeatable (average ICCs similar to 0.97 during TLS and similar to 0.83 during SH). The lower functional knee stability in SH was reflected by a significantly higher FHA Direction Index and a larger medio-lateral FHA inclination compared to those in TLS. The superior-inferior inclination was smaller during Landing in SH compared to Take-Off and TLS. Translation along FHA was generally small as expected in healthy subjects. Beighton Hypermobility Score and KT-1000 values had weak but significant correlations with FHA Direction Index and FHA translation, which show that laxity influences the functional knee stability. We conclude that FHA measures were sensitive enough to discriminate between SH and TLS. The next step is to investigate the usability of these measures in subjects with knee injury.

  • 249.
    Grip, Helena
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences. Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).
    Johansson, Anna-Maria
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).
    Selling, Jonas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).
    Rönnqvist, Louise
    Umeå University, Faculty of Social Sciences, Department of Psychology. Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).
    Boraxbekk, Carl-Johan
    Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR). Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI). Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).
    Three dimensional kinematic analyses of finger movement control and association to brain activity responses: A pilot study on healthy individuals2017In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 57, p. 355-Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

  • 250.
    Grip, Helena
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Nilsson, Kjell G
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
    Häger, Charlotte G.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Lundström, Ronnie
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Öhberg, Fredrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Does the Femoral Head Size in Hip Arthroplasty Influence Lower Body Movements during Squats, Gait and Stair Walking?: A Clinical Pilot Study Based on Wearable Motion Sensors2019In: Sensors, ISSN 1424-8220, E-ISSN 1424-8220, Vol. 19, no 14, article id 3240Article in journal (Refereed)
    Abstract [en]

    A hip prosthesis design with larger femoral head size may improve functional outcomes compared to the conventional total hip arthroplasty (THA) design. Our aim was to compare the range of motion (RoM) in lower body joints during squats, gait and stair walking using a wearable movement analysis system based on inertial measurement units (IMUs) in three age-matched male groups: 6 males with a conventional THA (THAC), 9 with a large femoral head (LFH) design, and 8 hip- and knee-asymptomatic controls (CTRL). We hypothesized that the LFH design would allow a greater hip RoM, providing movement patterns more like CTRL, and a larger side difference in hip RoM in THAC when compared to LFH and controls. IMUs were attached to the pelvis, thighs and shanks during five trials of squats, gait, and stair ascending/descending performed at self-selected speed. THAC and LFH participants completed the Hip dysfunction and Osteoarthritis Outcome Score (HOOS). The results showed a larger hip RoM during squats in LFH compared to THAC. Side differences in LFH and THAC groups (operated vs. non-operated side) indicated that movement function was not fully recovered in either group, further corroborated by non-maximal mean HOOS scores (LFH: 83 +/- 13, THAC: 84 +/- 19 groups, vs. normal function 100). The IMU system may have the potential to enhance clinical movement evaluations as an adjunct to clinical scales.

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