umu.sePublications
Change search
Refine search result
2345678 201 - 250 of 2769
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the Create feeds function.
  • 201.
    Berglund, Lars
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Deadlift training for patients with mechanical low back pain: a comparison of the effects of a high-load lifting exercise and individualized low-load motor control exercises2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

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

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

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

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

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

  • 202.
    Berglund, Lars
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Which patients with persistent mechanical low back pain will respond to highload motor control training?2010Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Introduction

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

    Aim

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

    Method

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

    Results

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

    Conclusion

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

  • 203.
    Berglund, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Aasa, Björn
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Michaelson, Peter
    Luleå Tekniska Universitet, Institutionen för hälsovetenskap, Avdelningen för hälsa och rehabilitering, Fysioterapi.
    Styrketräning som behandling vid långvariga ländryggsbesvär2017In: Fysioterapi, ISSN 1653-5804, no 4, p. 8p. 28-33Article, review/survey (Other academic)
    Abstract [sv]

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

  • 204.
    Berglund, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Aasa, Björn
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Hellqvist, Jonas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Michaelson, Peter
    Luleå Tekniska Universitet, Institutionen för hälsovetenskap, Avdelningen för hälsa och rehabilitering, Fysioterapi .
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Which patients with low back pain benefit from deadlift training?2015In: Journal of Strength and Conditioning Research, ISSN 1064-8011, E-ISSN 1533-4287, Vol. 29, no 7, p. 1803-1811Article in journal (Refereed)
    Abstract [en]

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

  • 205.
    Berglund, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
    Aasa, Björn
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics. Norrlandskliniken Hlth Care Ctr, Umea, Sweden.
    Michaelson, Peter
    Luleå Tekniska Universitet, Institutionen för hälsovetenskap, Avdelningen för hälsa och rehabilitering, Fysioterapi .
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine.
    Effects of Low-Load Motor Control Exercises and a High-Load Lifting Exercise on Lumbar Multifidus Thickness: A Randomized Controlled Trial2017In: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 42, no 15, p. E876-E882Article in journal (Refereed)
    Abstract [en]

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

  • 206.
    Berglund, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Social Sciences, Umeå Sport Sciences Center.
    Aasa, Björn
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics. Norrlandskliniken Health Care Centre, Umeå, Sweden.
    Michaelson, Peter
    Luleå Tekniska Universitet, Institutionen för hälsovetenskap, Avdelningen för hälsa och rehabilitering, Fysioterapi .
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Social Sciences, Umeå Sport Sciences Center.
    Sagittal lumbopelvic alignment in patients with low back pain and the effects of a high-load lifting exercise and individualized low-load motor control exercises: a randomized controlled trial2018In: The spine journal, ISSN 1529-9430, E-ISSN 1878-1632, Vol. 18, no 3, p. 399-406Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

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

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

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

  • 207.
    Berglund, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Aasa, Björn
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Michaelson, Peter
    Luleå Tekniska Universitet, Institutionen för hälsovetenskap, Avdelningen för hälsa och rehabilitering, Fysioterapi .
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    The effects of low-load motor control exercises and a high-load lifting exercise on lumbar multifidus thickness – a randomized controlled trialManuscript (preprint) (Other academic)
    Abstract [en]

    Study Design

    Randomized controlled trial

    Objective

    The aim of this study was to compare the effects of low-load motor control exercises and a high-load lifting exercise on lumbar multifidus thickness among patients with nociceptive mechanical low back pain.

    Summary of Background Data

    There is evidence that patients with low back pain may have a decreased size of the lumbar multifidus muscles with an asymmetry between left/right sides in the lower back. It has also been shown that low-load motor control training can affect this asymmetry; essentially, it is effective in equalizing side differences in lumbar multifidus muscle size. It is, however, not known whether a high-load exercise has the same effect.

    Methods

    Sixty-five participants diagnosed with nociceptive mechanical low back pain were included and randomized into low-load motor control exercises or a high-load lifting exercise, the deadlift. The lumbar multifidus thickness at the fifth lumbar vertebra was measured, using rehabilitative ultrasound imaging, at baseline and after a 2-month training period.

    Results

    There were no differences between interventions regarding effect on lumbar multifidus muscle thickness. However, the linear mixed model analysis showed a significant effect for asymmetry. The thickness of the lumbar multifidus muscle on the small side increased significantly compared to the large side in both intervention groups.

    Conclusions

    There was a difference in thickness of the lumbar multifidus muscles between sides. It seems that exercises focusing on spinal alignment may increase the thickness of the lumbar multifidus muscles on the small side, irrespective of exercise load.

  • 208.
    Berglund, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Falk, Jimmy
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Eliasson, Kim
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    What is the best squat and deadlift technique?2015Conference paper (Refereed)
  • 209.
    Berglund, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hellqvist, Jonas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Aasa, Björn
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Holmberg, David
    Luleå Tekniska Universitet, Institutionen för hälsovetenskap, Avdelningen för hälsa och rehabilitering, Fysioterapi.
    Michaelson, Peter
    Luleå Tekniska Universitet, Institutionen för hälsovetenskap, Avdelningen för hälsa och rehabilitering, Fysioterapi.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Which patients with persistent mechanical low back pain will respond to high load motor control training?2011Conference paper (Refereed)
  • 210.
    Bergman, Birgitta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Being a physiotherapist: professional role, utilization of time an d vocational strategies1989Doctoral thesis, monograph (Other academic)
    Abstract [en]

    In a research series carried out between 1984 and 1988 in the county of Västerbotten in northern Sweden, various aspects of the professional role and work of physiotherapists were studied. A variety of research methods were used: questionnaires (n = 163), a time budget study (n = 149), and a qualitative interview (n = 24). Physiotherapy was considered varied and creative, but not well defined or very specific in its objectives. Physiotherapy is still a predominantly female profession, though the proportion of male physiotherapists was increasing. The proportion entering full-time employment in physiotherapy increased due both to the greater number of male graduates and the increasing number of women working full-time. A partial internal division of work between the sexes has arisen. More women than men are employed in in-patient care, while proportionately more men worked outside institutions. Most respondents were firmly in control of their treatment methods, but were somewhat restricted in their freedom to decide whom to treat, and when to terminate treatment. Few had carried out any research concerning treatment and results. The time budget study showed that the treatment of patients took up on average 33% of the physiotherapists’ gross working hours and was the largest single task. Continuing education accounted for 5%, development work for 1% and the remaining occupational tasks for 38%. Occupational area was the most important factor in explaining the distribution of working hours, when other factors were kept constant. Neither sex nor gender markedly affects the carrying out of tasks other than treatment. Nor does professional post particularly affect time utilization other than for administrative tasks. This profession has a double objective: care and service more generally and to provide physiotherapy in particular—both equally important. In order to improve the quality of physiotherapy, and at the same time to extend their own specific, theoretical body of knowledge, a number of physiotherapists have reappraised and extended their concept of the profession to include management and research in their everyday work.

    Conclusion: The fact that occupational area exercises such a profound influence on the work of physiotherapists, taken together with the slight influence that professional post has, reveals that the individual physiotherapist must be prepared to play a broadly defined professional role. There seems to be a wealth of skill and expertise available within the profession, which could, however, be more efficiently used if the management and organization of physiotherapy service were better adapted to serve its objectives, and if these were better delineated and communicated.

  • 211.
    Bergman, Frida
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Active workstations: a NEAT way to prevent and treat overweight and obesity?2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Modern society is triggering sedentary behaviours in different domains. Different strategies can be used to reduce the time spent sitting and increase physical activity in the office environment, which is one domain where sedentary time is often high. One such strategy could be to install treadmill workstations. With these, the office workers can walk on a treadmill while performing their usual work tasks at the computer. However, the long-term effects of these workstations are not known. 

    Aim: The overall aim of this thesis was to investigate the long-term effects on sedentary behaviour, physical activity and associated health factors of installing treadmill workstations in offices compared to regular office work.

    Method: In this randomized controlled trial, 80 sedentary, middle-aged, healthy office workers with overweight or obesity were individually randomized into either an intervention or a control group. Those in the intervention group had a treadmill workstation installed at their sit-stand desk, to use for at least one hour per day for 13 months. They further received boosting e-mails at four time-points during the study. Participants in the control group continued to work as normal at their sit-stand office desk. All participants also received a health consultation at the beginning of the study, where they got to discuss physical activity and diet recommendations. Measurements reported include physical activity and sedentary behaviour, anthropometric measurements, body composition, metabolic outcomes, stress, depression and anxiety, cognitive function, structural brain images and interview data. Linear mixed models were used for the main statistical analyses of the quantitative data. An exploratory approach was also undertaken, using orthogonal partial least squares regression on the baseline data. Finally, interview data from participants in the intervention group were analysed using a modified Grounded Theory approach.

    Results: The intervention group increased their daily walking time and their number of steps at all follow-ups compared to the control group. Concomitantly, a decrease in moderate-to-vigorous intensity physical activity (MVPA) was observed within both groups, mainly during weekends. No intervention effects were observed on any of the body, cognitive or brain volume measurements. Our exploratory analyses revealed a significant association between smaller hippocampal volume and percentage sitting time among participants over 51 years of age. From the interview data, we discovered a core category, “The Capacity to Benefit”. The categories were described as the ideal types the Convinced, the Competitive, the Responsible and the Vacillating, based on the principal characteristics of the participants representing their different motivational status and strategies to reach the goal of benefitting from the intervention.  

    Conclusion: It is possible to increase daily physical activity in office environments by introducing treadmill workstations. Future interventions should adapt strategies for the individuals based on their motivational level, but should also workwith the social and physical environment and with factors within the organization to gain the best effects of these interventions.

  • 212.
    Bergman, Frida
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Enbenssidohopp 23 år efter främre korsbandsskada: en funktionell och kinematiskjämförelse mellan effekten av kirurgi och skräddarsydd sjukgymnastik mot friska kontroller2013Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Långtidseffekten av olika behandlingar efter skada på det främre korsbandet (ACL) på knäfunktion och rörelsemönster är fortfarande oklart.

     Syfte: Att undersöka hoppkapacitet och kinematik hos de skadade och icke-skadade benen under enbenssidohopp hos ACL-skadade personer som antingen behandlats med rekonstruktion (ACLR) eller med ett skräddarsytt sjukgymnastikprogram (ACLTPP) i jämförelse med friska kontroller.

     Metod: Trettiotre personer i ACLR-gruppen, trettiosju i ACLTPp-gruppen och trettiotre i kontrollgruppen utförde enbenssidohopp under 30 sekunder, vilket registrerades i ett 30-rörelseanalyssystem. Antal sidohopp, kvot mellan godkänt och totalt antal hopp, bensymmetri, tid mellan hopp samt vinklar i höft, knä och fotled analyserades.

     Resultat: ACLTPP utförde minst antal sidohopp av alla grupper, samt hade längre tid mellan hoppen, mer knäabduktion  och mindre knäflexion, höftflexion, höftabduktion och fotledsflexion än ACLR. De skiljde sig också från kontrollerna  i de flesta av knävinklarna. Inga kinematiska skillnader fanns mellan ACLR och kontroller.  Få kinematiska  skillnader fanns mellan  benen  inom grupperna.

     Konklusion: ACI.mP uppvisar  en reducerad  knäfunktion  och ett avvikande  rörelsemönster jämfört  med kontrollerna  och ACLR, vilka mer liknar de knäfriska kontrollerna. Få skillnader mellan benen  indikerar bilaterala anpassningar inom ACLTPP·

  • 213.
    Bergman, Frida
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Tyngdtäckets inverkan  på aktiviteter i vardagslivet Vuxnas upplevelser kring användandet: Vuxnas upplevelser kring användandet2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Människor har ett medfött behov av att utföra aktiviteter där behovet av aktivitetsbalans är en förutsättning för att främja hälsa och välmående. Aktivitetsbalans är när meningsfulla, godtyckliga och förväntade aktiviteter harmonierar vilket ger en känsla av kontroll i vardagen, rubbas balansen ökar risken för ohälsa. Syftet med studien var att undersöka tyngdtäckets inverkan på aktiviteter i vardagslivet hos personer i arbetsför ålder. Kvalitativ metod tillämpades och fem täckesanvändare intervjuades genom semistrukturerade intervjuer som analy­ serades genom innehållsanalys. I resultatet framkom att tyngdtäcket hade en positiv inverkan på aktivitetsbalansen och framför allt på sömnen vilket medförde fler aktiva tim­ mar på dagen jämfört med innan informanterna började an­ vända täcket. Det framkom även att medicinanvändning minskat som följd av användandet av täcket vilket har lett till att informanterna känner sig piggare under dagtid. Det finns vinster med att använda detta hjälpmedel ur ekonomisk syn­ punkt för såväl den enskilda personen som för samhället i stort, men även ur miljösynpunkt.

     

     

  • 214.
    Bergman, Frida
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Boraxbekk, Carl-Johan
    Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI). Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).
    Wennberg, Patrik
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Sörlin, Ann
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Olsson, Tommy
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Increasing physical activity in officeworkers – the Inphact Treadmill study: a study protocol for a 13-month randomized controlled trial of treadmill workstations2015In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 15, article id 632Article in journal (Refereed)
    Abstract [en]

    Background: Sedentary behaviour is an independent risk factor for mortality and morbidity, especially for type 2 diabetes. Since office work is related to long periods that are largely sedentary, it is of major importance to find ways for office workers to engage in light intensity physical activity (LPA). The Inphact Treadmill study aims to investigate the effects of installing treadmill workstations in offices compared to conventional workstations.

    Methods/Design: A two-arm, 13-month, randomized controlled trial (RCT) will be conducted. Healthy overweight and obese office workers (n = 80) with mainly sedentary tasks will be recruited from office workplaces in Umeå, Sweden. The intervention group will receive a health consultation and a treadmill desk, which they will use for at least one hour per day for 13 months. The control group will receive the same health consultation, but continue to work at their regular workstations. Physical activity and sedentary time during workdays and non-workdays as well as during working and non-working hours on workdays will be measured objectively using accelerometers (Actigraph and activPAL) at baseline and after 2, 6, 10, and 13 months of follow-up. Food intake will be recorded and metabolic and anthropometric variables, body composition, stress, pain, depression, anxiety, cognitive function, and functional magnetic resonance imaging will be measured at 3–5 time points during the study period. Interviews with participants from the intervention group will be performed at the end of the study.

    Discussion: This will be the first long-term RCT on the effects of treadmill workstations on objectively measured physical activity and sedentary time as well as other body functions and structures/morphology during working and non-working hours among office workers. This will provide further insight on the effects of active workstations on our health and could fill in some of the knowledge gaps regarding how we can reduce sedentary time in office environments.

  • 215.
    Bergman, Frida
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Mattson-Frost, Tove
    Jonasson, Lars
    Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI). Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Chorell, Elin
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Sörlin, Ann
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wennberg, Patrik
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Öhberg, Fredrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Ryberg, Mats
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Levine, James
    Olsson, Tommy
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Boraxbekk, Carl-Johan
    Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).
    Installing treadmill workstations in offices does little for cognitive performance and brain structure, despite a baseline association between sitting time and hippocampus volumeManuscript (preprint) (Other academic)
  • 216.
    Bergman, Frida
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Wahlström, Viktoria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Stomby, Andreas
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Otten, Julia
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Lanthén, Ellen
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Renklint, Rebecka
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Waling, Maria
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Sörlin, Ann
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Boraxbekk, Carl-Johan
    Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR). Danish Research Center for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, Hvidovre, Denmark.
    Wennberg, Patrik
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Öhberg, Fredrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Levine, James A.
    Department of Endocrinology, The Mayo Clinic, Rochester, MN, USA; Fondation IPSEN, Paris, France.
    Olsson, Tommy
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Treadmill workstations in office workers who are overweight or obese: a randomised controlled trial2018In: The Lancet Public Health, ISSN 2468-2667, Vol. 3, no 11, article id e523-e535Article in journal (Refereed)
    Abstract [en]

    Background: Treadmill workstations that enable office workers to walk on a treadmill while working at their computers might increase physical activity in offices, but long-term effects are unknown. We therefore investigated whether treadmill workstations in offices increased daily walking time.

    Methods: We did a randomised controlled trial of healthy office workers who were either overweight or obese. We recruited participants from 13 different companies, which comprised 17 offices, in Umeå, Sweden. We included people who were aged 40-67 years, had sedentary work tasks, and had a body-mass index (BMI) between 25 kg/m2 and 40 kg/m2. After the baseline measurement, we stratified participants by their BMI (25-30 kg/m2 and >30 to 40 kg/m2); subsequently, an external statistician randomly assigned these participants (1:1) to either the intervention group (who received treadmill workstations for optional use) or the control group (who continued to work at their sit-stand desks as usual). Participants in the intervention group received reminders in boosting emails sent out to them at four occasions during the study period. Researchers were masked to group assignment until after analysis of the primary outcome. After the baseline measurement, participants were not masked to group belongings. The primary outcome was total daily walking time at weekdays and weekends, measured at baseline, 2 months, 6 months, 10 months, and 13 months with the accelerometer activPAL (PAL Technologies, Glasgow, UK), which was worn on the thigh of participants for 24 h a day for 7 consecutive days. We used an intention-to-treat approach for our analyses. This trial is registered with ClinicalTrials.gov, number NCT01997970, and is closed to new participants.

    Findings: Between Nov 1, 2013, and June 30, 2014, a total of 80 participants were recruited and enrolled (n=40 in both the intervention and control groups). Daily walking time during total time awake at weekdays increased between baseline and 13 months by 18 min (95% CI 9 to 26) in the intervention group and 1 min (-7 to 9) in the control group (difference 22 min [95% CI 7 to 37], pinteraction=0·00045); for weekend walking, the change from baseline to 13 months was 5 min (-8 to 18) in the intervention group and 8 min (-5 to 21) in the control group (difference -1 min [-19 to 17]; pinteraction=0·00045). Neither measure met our predetermined primary outcome of 30 min difference in total walking time between the intervention and control group, so the primary outcome of the trial was not met. One adverse event was reported in a participant who accidently stepped on their Achilles tendon.

    Interpretation: In a sedentary work environment, treadmill workstations result in a statistically significant but smaller-than-expected increase in daily walking time. Future studies need to investigate how increasing physical activity at work might have potentially compensatory effects on non-work activity.

  • 217.
    Bergman, J
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Nordström, Anna
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. School of Sport Sciences, Arctic University of Norway, Tromsø, Norway..
    Nordström, Peter
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Bisphosphonate use after clinical fracture and risk of new fracture: response to comments by Wu et al.2018In: Osteoporosis International, ISSN 0937-941X, E-ISSN 1433-2965, Vol. 29, no 9, p. 2159-2160Article in journal (Refereed)
  • 218.
    Bergman, Johanna
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Vesterberg, Hanna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Webbaserad träning för patienter med långvarig smärtproblematik: En studie med Single Subject Experimental Design2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Patienter med långvarig smärta har ofta en nedsatt funktionsförmåga och fysisk aktivitetsnivå. Det finns stark vetenskaplig evidens för att olika träningsformer har effekt på smärta och funktion. Vilken typ av träning som ger bäst effekt är dock inte klarlagt. Webbaserad träning har fått stor genomslagskraft senaste åren men Socialstyrelsen kan i dagsläget inte rekommendera interventionen på grund av det otillräckliga vetenskapliga underlaget. De efterfrågar därför fler studier som utvärderar effekten av dessa.

     

    Syfte: Att undersöka om webbaserad träning kan påverka funktionsförmåga och minska smärta hos patienter som sökt fysioterapi för sin långvariga smärtproblematik och nedsatta funktionsförmåga. Vi vill även undersöka om tillgång till webbaserade träningsprogram kan leda till en ökad fysisk aktivitetsnivå och ökad fysisk kapacitet som i sin tur kan påverka patienternas smärtintensitet och funktionsförmåga.

     

    Metod: Studien har följt upplägget för en Single Subject Experimental Design med en A-B design. Under hela studiens fortlöpande skedde upprepade mätningar av beroende mätvariabler, smärtintensitet (NRS) och funktionsförmåga (PSFS). Baslinjefasen (A) varade i 1-3 veckor och interventionsfasen (B) varade i 4 veckor med webbaserad träning. Studiedesignen kompletterades med tester av den fysiska kapaciteten. Testerna utfördes innan och efter interventionen. Antalet deltagare i studien var 9 stycken i åldrarna 21-63 år.

     

    Resultat:  Fem deltagare fick en ökad funktionsförmåga under studiens gång och fyra deltagare hade ingen påtaglig förändring. Fem deltagare hade en oförändrad smärtintensitet under studiens gång och fyra deltagare fick en minskning.

     

    Konklusion: Fyra veckor med webbaserad träning kan ge positiva effekter på smärtintensitet och funktionsförmåga för patienter med långvarig smärta. Dock krävs en längre interventionsperiod för att påvisa ytterligare effekter.

  • 219.
    Bergman, Jonathan
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Nordström, Anna
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health. School of Sport Sciences, UiT Arctic University of Norway, Postboks 1621, 9509, Alta, Norway..
    Hommel, A.
    Department of Care Sciences, Malmö University, 20506, Malmö, Sweden..
    Kivipelto, M.
    Division of Clinical geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Plan 7, 14183, Huddinge, Sweden. Research and Development Unit, Stockholm Sjukhem, Mariebergsgatan 22, 11219, Stockholm, Sweden..
    Nordström, Peter
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Bisphosphonates and mortality: confounding in observational studies?2019In: Osteoporosis International, ISSN 0937-941X, E-ISSN 1433-2965, Vol. 30, no 10, p. 1973-1982Article in journal (Refereed)
    Abstract [en]

    Summary: Numerous observational studies suggest that bisphosphonates reduce mortality. This study showed that bisphosphonate use is associated with lower mortality within days of treatment, although the association was not significant until the second week. Such an early association is consistent with confounding, although an early treatment effect cannot be ruled out.

    Introduction: The purpose of this study was to examine whether confounding explains why numerous observational studies show that bisphosphonate use is associated with lower mortality. To this end, we examined how soon after treatment initiation a lower mortality rate can be observed. We hypothesized that, due to confounding, the association would be observed immediately.

    Methods: This was a retrospective cohort study of hip fracture patients discharged from Swedish hospitals between 1 July 2006 and 31 December 2015. The data covered 260,574 hip fracture patients and were obtained from the Swedish Hip Fracture Register and national registers. Of the 260,574 patients, 49,765 met all eligibility criteria and 10,178 were pair matched (bisphosphonate users to controls) using time-dependent propensity scores. The matching variables were age, sex, diagnoses, prescription medications, type of hip fracture, type of surgical procedure, known or suspected dementia, and physical functioning status.

    Results: Over a median follow-up of 2.8 years, 2922 of the 10,178 matched patients died. The mortality rate was 7.9 deaths per 100 person-years in bisphosphonate users and 9.4 deaths in controls, which corresponded to a 15% lower mortality rate in bisphosphonate users (hazard ratio 0.85, 95% confidence interval 0.79–0.91). The risk of death was lower in bisphosphonate users from day 6 of treatment, although the association was not significant until the second week.

    Conclusion: Bisphosphonate use was associated with lower mortality within days of treatment initiation. This finding is consistent with confounding, although an early treatment effect cannot be ruled out.

  • 220.
    Bergman, Jonathan
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Nordström, Anna
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Nordström, Peter
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Alendronate use and the risk of nonvertebral fracture during glucocorticoid therapy: a retrospective cohort study2018In: Journal of Clinical Endocrinology and Metabolism, ISSN 0021-972X, E-ISSN 1945-7197, Vol. 103, no 1, p. 306-313Article in journal (Refereed)
    Abstract [en]

    Context: Glucocorticoids increase the risk of nonvertebral fracture, but no clinical trial has shown that nonvertebral fractures can be prevented by co-administration of an anti-osteoporotic drug.

    Objective: To estimate the effect of alendronate on the risk of nonvertebral fracture in older adults taking oral glucocorticoids.

    Design: Retrospective cohort study using national Swedish registers.

    Setting: Hospitalized care and ambulatory specialist care.

    Patients: Among adults aged 50 years or older (N=3,347,959), we identified those who initiated oral glucocorticoid therapy from 2006 through 2011 (≥2.5 mg/day of prednisone or equivalent for ≥91 days). The final analysis included 16,890 alendronate users and 16,890 nonusers, who were matched using time-dependent propensity scores.

    Main Outcome Measure: Nonvertebral fracture. This was not pre-specified.

    Results: Over a median follow-up of 14.5 months, the incidence rate of nonvertebral fracture was 2.0 cases per 100 person-years in alendronate users and 2.4 cases in nonusers. This difference corresponded to a 16% lower rate in users (hazard ratio 0.84, 95% confidence interval 0.75 to 0.94). For hip fractures specifically, the rate was 34% lower in alendronate users relative to nonusers (hazard ratio 0.66, 95% confidence interval 0.55 to 0.78). The association of alendronate use with a lower risk of nonvertebral fracture was strongest in patients who received high doses of glucocorticoid.

    Conclusion: Alendronate use was associated with a lower risk of nonvertebral fracture, including hip fracture. Similar, but not statistically significant, associations have been reported in meta-analyses of clinical trials.

  • 221.
    Bergman, Jonathan
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Nordström, Anna
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Nordström, Peter
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Bisphosphonate use after clinical fracture and risk of new fracture2018In: Osteoporosis International, ISSN 0937-941X, E-ISSN 1433-2965, Vol. 29, no 4, p. 937-945Article in journal (Refereed)
    Abstract [en]

    Summary: Among older adults with a previous fracture, treatment for osteoporosis was initially associated with a higher risk of new fracture. However, the relative risk of new fracture decreased over time, a trend that is consistent with a beneficial effect, as treatment for osteoporosis is prescribed to reduce high fracture risks.

    Introduction: The purpose of this study was to examine whether bisphosphonate use is associated with a lower risk of new fracture after a clinical fracture in older adults.

    Methods: Data were available for 3,329,400 adults in Sweden who were aged ae<yen> 50 years between 2006 and 2011. During this period, 260,353 sustained a clinical fracture and were naïve to bisphosphonates at the time. Those who subsequently received a bisphosphonate were matched to up to three others on sex, year of birth, and type and year of initial fracture. The final cohort comprised 83,104 adults (26.3% bisphosphonate users).

    Results: During the period from initial fracture to initiation of bisphosphonate treatment, the incidence rate of any new clinical fracture was higher in those who later became bisphosphonate users than in those who remained nonusers (175.1 vs. 75.9 per 1000 person-years; hazard ratio 2.30, 95% confidence interval 2.19 to 2.41). Similarly, during the first 6 months of treatment, the incidence rate was higher in bisphosphonate users than in nonusers (128.8 vs. 90.2 per 1000 person-years; hazard ratio 1.41, 95% confidence interval 1.32 to 1.51). However, this difference decreased over time: by months 12 to 18, the incidence rate was similar in users and nonusers (59.3 vs. 55.3 per 1000 person-years; hazard ratio 1.03, 95% confidence interval 0.91 to 1.16).

    Conclusions: There was a decrease in the relative risk of new fracture during bisphosphonate treatment, a trend that is consistent with a beneficial treatment effect, as bisphosphonates are prescribed to reduce high fracture risks.

  • 222.
    Bergman, Jonathan
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Nordström, Anna
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health. School of Sport Sciences, UiT Arctic University of Norway, Postboks 1621, 9509, Alta, Norway.
    Nordström, Peter
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Epidemiology of osteonecrosis among older adults in Sweden2019In: Osteoporosis International, ISSN 0937-941X, E-ISSN 1433-2965, Vol. 30, no 5, p. 965-973Article in journal (Refereed)
    Abstract [en]

    Summary: This study estimated the incidence of osteonecrosis in a Swedish, nationwide cohort of older adults. Osteonecrosis was approximately 10 times more common than in previous studies. The strongest risk factors were dialysis, hip fracture, osteomyelitis, and organ transplantation, but only hip fractures could have contributed substantially to the disease burden.

    Introduction: The aim of this study was to estimate the incidence of osteonecrosis in a Swedish, nationwide cohort of older adults and in a large number of risk groups in that cohort.

    Methods: In this retrospective cohort study, we included everyone who was aged 50 years or older and who was living in Sweden on 31 December 2005. We used Swedish national databases to collect data about prescription medication use, diagnosed medical conditions, and performed medical and surgical procedures. The study outcome was diagnosis of primary or secondary osteonecrosis at any skeletal site. The strength of risk factors was assessed using age- and sex-standardized incidence ratios (SIRs).

    Results: The study cohort comprised 3,338,463 adults. The 10-year risk of osteonecrosis was 0.4% (n = 13,425), and the incidence rate was 4.7 cases/10000 person-years (95% confidence interval [CI], 4.6 to 4.7 cases). The strongest risk factors for osteonecrosis were hip fracture (SIR, 7.98; 95% CI, 7.69–8.27), solid organ transplantation (SIR, 7.14; 95% CI, 5.59–8.99), dialysis (SIR, 6.65; 95% CI, 5.62–7.81), and osteomyelitis (SIR, 6.43; 95% CI, 5.70–7.23). A history of hip fracture was present in 21.7% of cases of osteonecrosis, but osteomyelitis, dialysis, and solid organ transplantation were present in only 0.5 to 2% of cases.

    Conclusions: Osteonecrosis was approximately 10 times more common than a small number of previous population-based studies have suggested. The strongest risk factors for osteonecrosis were dialysis, hip fracture, osteomyelitis, and solid organ transplantation, but only hip fractures could have contributed substantially to the disease burden.

  • 223.
    Bergman, Jonathan
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Nordström, Anna
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health. School of Sport Sciences, Arctic University of Norway, Tromsø, Norway.
    Nordström, Peter
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Overestimation of the Limitations of Randomized Controlled Trials2019In: Journal of Bone and Mineral Research, ISSN 0884-0431, E-ISSN 1523-4681Article in journal (Refereed)
  • 224.
    Bergqvist, Caroline
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Dödförklaring: Förändringari teorin och praktiken efter Estoniakatastrofen och tsunamin i Sydostasien2012Student paper other, 5 credits / 7,5 HE creditsStudent thesis
    Abstract [sv]

    En händelse likt Estoniakatastrofen den 28 september 1994 eller tsunamin i Sydostasien den 26 december 2004 är förödande, inte bara för inblandade och dess familj utan för hela världen. Hur kan en sådan händelse inträffa? Varför inträffade det? Hade det kunna förebyggas? Tänk om just jag hade varit med, eller känt någon som var med, hur hade jag reagerat då? Flertalet frågor bland världens befolkning uppstår. Något som kanske inte väcker särskilt mycket uppmärksamhet eller frågor är vad som händer efter att de stora tidningarna slutat skriva om katastrofen, antalet offer är fastställt och allt går tillbaka till det vanliga i övriga världen. Men sökandet, och kanske framför allt lidandet, för de inblandade och närstående har bara börjat. I de båda ovan nämnda katastroferna har många svenskar varit inblandade och i båda katastroferna slutade arbetet med att söka offer långt innan alla var hittade. Personer, som med största sannolikhet avlidit, måste alltså dödförklaras utan att deras kroppar hittats.

    Den 1 april 2005 fick vi en ny lag, lag (2005:130) om dödförklaring (lagen om dödförklaring), med regler om hur och när dödförklaring ska ske. Lagen om dödförklaring ersatte kap. 25 i ärvdabalken (ÄB) som tidigare gällde. Reglerna i den nya lagen överensstämmer till viss del med den äldre regleringen men på en, för händelser likt Estoniakatastrofen och tsunamin i Sydostasien, viktig punkt skiljer de sig. Det är detta denna uppsats kommer behandla, vilken betydelse har ändringen – i teorin och i praktiken.

  • 225.
    Bergqvist, Matilda
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lindahl, Maja
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Jämförelse av statisk och dynamisk lårmuskeluthållighet hos personer med kroniskt obstruktiv lungsjukdom och friska ålders- och könsmatchade kontroller: - en tvärsnittsstudie2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Även om kroniskt obstruktiv lungsjukdom (KOL) karakteriseras av en påverkan på luftvägar och lungvävnad, är manifestationer även utanför lungorna vanliga. Vid KOL är det exempelvis  vanligt med nedsatt lårmuskeluthållighet. Dock är det ej klarlagt om statisk och dynamisk uthållighet är nedsatt till samma grad vid KOL vilket är av betydelse för att kunna erbjuda adekvata behandlingsstrategier.

    Syfte: Att undersöka och jämföra statisk och dynamisk lårmuskeluthållighet hos personer med KOL och jämföra med friska ålders- och könsmatchade kontrollpersoner.

    Metod: Tvärsnittsstudie bestående av 17 personer med KOL och 31 friska ålder- och könsmatchade kontrollpersoner. Det genomfördes fyra tester, ett för maximal viljemässig kontraktion (MVK) samt tre uthållighetstester (isotonisk, isokinetisk, isometrisk) för lårmuskelfunktion. Testerna gjordes i en stationär dynamometer. Jämförelser mellan grupperna utfördes och redovisas i procent i differens mellan grupperna samt effektstorlek (ES) av relativt arbete (antal repetitioner respektive sekunder) och absolut arbete (totalt arbete i Joule).

    Resultat: En statistiskt signifikant skillnad mellan friska kontrollpersoner och personer med KOL uppmättes i MVK (31% skillnad, ES 0.47), isokinetisk uthållighet (32% skillnad, ES 0.52), isotoniskt absolut arbete i Joule (37% skillnad, ES 0.40) samt isometriskt absolut arbete i Joule (37% skillnad, ES 0.39) där de friska försökspersonerna fick högre värden. Däremot sågs ingen signifikant skillnad i relativt arbete i isotonisk (repetitioner) (15% skillnad, ES 0.16) eller isometrisk (sekunder) (0% skillnad, ES 0.00) uthållighet.

    Slutsats: Hos personer med KOL är såväl statisk som dynamisk uthållighet nedsatt i liknande utsträckning. I jämförelse med friska kontroller har personer med KOL en nedsatt absolut lårmuskelfunktion medan relativ lårmuskeluthållighet inte verkar vara nedsatt.

  • 226.
    Bergström, Christoffer
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Eliasson, Martin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Äldre personers inställning till fallpreventiv träning: - en enkätstudie2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    BAKGRUND: Fallolyckor är vanliga bland äldre och medför lidande och kostnader för individ och samhälle. Trots att tidigare studier visat att träning i fallpreventivt syfte har goda effekter är det få äldre som påbörjar eller fullföljer ett sådant träningsprogram.

    SYFTE: Huvudsyftet med studien var att undersöka och jämföra äldre kvinnors och mäns inställning till träningsprogram i fallpreventivt syfte samt vad de uppfattade vara motiverande faktorer i ett sådant träningsprogram.

    METOD: En enkät med frågor om inställning till fallpreventiv träning, baserat på Theory of Planned Behavior, samt frågor om motiverande faktorer vid en sådan träning delades ut till två grupper av äldre. I studien inkluderades 58 personer över 65 år.

    RESULTAT: Resultaten visade att det inte fanns någon större skillnad i hur männen och kvinnorna ville träna i fallpreventivt syfte, däremot ansåg sig kvinnorna mer än männen vara den typ av person som borde göra övningar i fallpreventivt syfte (p=0,047). Kvinnorna var mer positivt inställda till fallpreventiv träning (p=0,030).

    KONKLUSION: Resultaten kan vara till hjälp för att lättare skapa fallpreventiva träningsprogram som kvinnor och män vill delta i och på så vis öka deltagandet. Vid skapandet av fallpreventivt träningsprogram behöver ingen eller liten hänsyn tas till vilket kön personen har.

  • 227.
    Bergström, Emelie
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Lundberg, Sofia
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Elevers erfarenheter om faktorer som upplevs påverka förmågan till lärandet: En kvalitativ studie2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Abstrakt 

    Barn och ungdomar tillbringar en stor del av sin dag på skolan och det är på skolan som elever utvecklar sin självkännedom och sin självtillit. Elevers möjlighet till lärande påverkas av den omgivande miljön och strukturen i skolans utformning. Syftet med studien var att beskriva elevers upplevelser och svårigheter om vad som påverkat att de inte har fullständiga betyg från grundskolan. Kvalitativ innehållsanalys användes som metod för att skapa en förståelse för individens subjektiva upplevelse utifrån sin egen erfarenhet med det manifesta budskapet, det som står i texten. Datainsamling gjordes via semistrukturerade intervjuer med hjälp av en intervjuguide. Enskilda in-tervjuer hölls med åtta personer i ålder 16-18 år om deras erfarenheter som svarar mot syftet. Materialet transkriberades i sin helhet, analyserades ge-nom kvalitativ innehållsanalys vilket gav tre kategorier och nio underkate-gorier. De tre kategorierna benämns: Stöd i skolan och eget ansvar, Be-gränsningar under grundskolan och Möjligheter inom det specifika pro-grammet. De faktorer som setts påverka eleverna till att inte uppnå studie-målen under grundskolan var otillräcklig hjälp från lärare, skolmiljön, det egna intresset och den egna motivationen. För att ge framtida elever goda förutsättningar till att uppnå person- och kunskapsutveckling som förbere-der eleverna inför vidare studier på gymnasiet rekommenderas vidare över-syn och studier om behovet av arbetsterapi i skolan.

  • 228.
    Bergström, Emma
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine.
    Offerman, Jens
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine.
    Unga kvinnors järnstatus i relation till aerob metabolism under cykelarbete.2018Independent thesis Basic level (degree of Bachelor), 180 HE creditsStudent thesis
    Abstract [en]

    Introduction: Iron is an essential trace mineral whose main function in the body is to produce hemoglobin, a transport molecule for oxygen and carbon dioxide. Iron deficiency is the most common nutritional deficiency in athletes and women are at particular risk of becoming iron deficient.  Objective: Examine the iron status of athletic women and the possible relation to 1) aerobic metabolism, 2) efficacy, and 3) VO2max during cycling workload  Method: Descriptive cross-sectional study. The participants mean age is 22±5,8 year, mean VO2max 43,5 ±4,6 ml/kg/min. Iron status was compared to oxygen consumption, efficacy and VO2max during a ergometer cycle test. Blood samples with analysis of the participants serum ferritin (sFer) with a cut off value of <29 ug/l were considered as low and >30 ug/l were considered as normal iron status. A submaximal and maximal ergometer cycle test was conducted on the participants. Analysis was done in form of regression analysis in JMP 13, in order to try to predict a relationship. Result: No relationship was found between the different parameters that have been compared. SFer of participants (n=48) was an average of 23±11 ug/l. SFer and VO2/l/min at 100 watts (r2=.09, P<0.05), sFer and kcal/min (r2=0.05, sFer and sFer and VO2max (r2=0.05). Conclusion: The main findings is that iron status does not have a significant relationship with aerobic metabolism, although previous research has suggested such. More participants with bigger value of ferritin and a clearer standardization around the training, diet and menstrual cycle of the women compared could have given another result.   

  • 229.
    Bergström, Matilda
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Larsson, Helena
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Konditionsträning i intervallform som behandling vid hjärntrötthet efter stroke: en single-subject-studie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Hjärntrötthet efter stroke är ett vanligt men ofta förbisett tillstånd. Det upplevs i många fall som det värsta symtomet efter stroke och kan vara en stor begränsning i vardagen. Orsak såväl som behandling är för närvarande okänt. En tänkbar orsak är att försämrad fysisk kapacitet leder till en negativ spiral där vardagliga aktiviteter kräver mer ansträngning vilket förvärrar hjärntröttheten och bidrar till en mer inaktiv livsstil. Konditionsträning i intervallform kan därför vara en möjlig behandlingsform då intervallträning har visat sig vara effektivt i syfte att uppnå konditionsförbättring i olika patientgrupper, inklusive stroke.

    Syfte: Undersöka om konditionsträning i intervallform på cykel påverkar hjärntrötthet efter stroke.

    Metod: Två män, 77 och 83 år, deltog i denna upprepade single-subject-studie. Interventionsfasen bestod av ett fyra veckor långt intervallträningsprogram. Träningspassen utfördes under övervakning tre gånger i veckan på cykel i testpersonernas hem. Genomförbarhet av interventionen registrerades. Hjärntrötthet mättes två gånger i veckan under baslinjefas och interventionsfas med Swedish fatigue assessment scale (S-FAS). Konditionstester genomfördes före och efter interventionen.

    Resultat: Samtliga träningspass genomfördes utan farliga händelser. En minskning av hjärntrötthet gick att observera, dock kunde en sann skillnad ej fastställas. Kondition förbättrades med 7 % respektive 17 % på sex minuters gångtest (6MWT) samt med 7 % respektive 35 % på Åstrands cykelergometertest.

    Konklusion: Resultaten antyder att hjärntrötthet kan minska samt att kondition kan förbättras efter intervallträning på cykel hos personer som drabbats av stroke. Längre interventionstid krävs för att påvisa en eventuell sann skillnad i hjärntrötthet.

  • 230.
    Bergström, Sara
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Patienters syn på personcentrerad vård: - En kvalitativ studie med personer som genomgått reumatisk rehabilitering2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Personcentrerad vård är en vårdmodell där patienten ses som   expert på sig själv och sin situation. I en personcentrerad vård anpassas   vården efter varje individ och patienten är aktiv i sin egen vård.

    Syfte:   Syftet med uppsatsen var att undersöka erfarenheter av och synen   på personcentrerad vård hos personer som genomgått reumatisk rehabilitering.

    Metod:   Kvalitativ metod användes och uppsatsen baserades på fem   semistrukturerade intervjuer som analyserades med kvalitativ innehållsanalys.   Inklusionskriterierna var att ha genomgått rehabilitering på reumatologens   dagvård någon gång under senaste halvåret.

    Resultat: Analysen utmynnade i tre kategorier som var Patientens   självkännedom, Vårdpersonalens kunskap och Interaktion mellan patient,   vårdpersonal och grupp. Kategorierna bildade temat Personcentrerad vård- när   patient och vård möts genom förmågor och gemensamt engagemang. Intervjupersonerna   beskrev att de hade betydelsefull självkännedom och att vårdpersonalen hade   betydelsefull kunskap för rehabiliteringen. För att självkännedomen/kunskapen   skulle kunna nyttjas i rehabiliteringen krävdes, enligt intervjupersonerna,   ett gott samarbete mellan patient och vårdpersonal där båda parter var   engagerade. Intervjupersonernas acceptans av sin funktionsnedsättning samt   förväntningar på en personcentrerad vård både från patient och vårdpersonal   gynnade, enligt intervjupersonerna, en personcentrerad vård.

    Slutsats: Resultatet visade att både patient och vårdpersonal hade en aktiv roll i att uppnå en personcentrerad vård vilket skulle kunna betyda att vården blir personcentrerad i olika utsträckning beroende på patienten. Mer forskning krävs för att undersöka patientens påverkan på att uppnå en personcentrerad vård och för att undersöka ämnet utifrån vårdpersonalens perspektiv.

  • 231.
    Bergström, Ulrica
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
    Jonsson, H
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Olofsson, B
    Pettersson, U
    Svensson, O
    Serial fractures - age and fracture site important predictors for a second fracture: results from 13-years population based dataManuscript (Other academic)
  • 232.
    Bergström, Ulrica
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Jonsson, Håkan
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Pettersson, Ulrika
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Pharmacology.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Svensson, Olle
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    The hip fracture incidence curve is shifting to the right: a forecast of the age-quake2009In: Acta Orthopaedica, ISSN 1745-3674, E-ISSN 1745-3682, Vol. 80, no 5, p. 520-524Article in journal (Refereed)
    Abstract [en]

    Background The number of hip fractures has doubled in the last 30–40 years in many countries. Age-adjusted incidence has been reported to be decreasing in Europe and North America, but is there a decreasing trend in all age groups? Patients and methods This population-based study included all hip-fracture patients over 50 years of age (a total of 2,919 individuals, 31% of whom were men) admitted to Umeå University Hospital, Sweden, from 1993 through 2005. Results The incidence of hip fracture declined between the periods 1993–1996 and 2001–2005: from 706 to 625 hip fractures per 105 women and from 390 to 317 hip fractures per 105 men. However, there was a 114% increase in the number of fractures in women aged 90 or older (12 and 25 hip fractures/year, respectively, in the two time periods). For the period 2001–05, women ≥ 90 years of age accounted for almost the same numbers of hip fractures as women aged 75–79 (27 fractures/year). The rate increased during this period, from 2,700 per 105 women to 3,900 per 105 women > 90 years. In men there were declining trends for both relative and absolute numbers. Interpretation Although age-adjusted incidence declined in the population > 50 years of age, absolute fracture rate and incidence increased in the very old. Women over 90 now have the same absolute number of hip fractures every year as women aged 75–79 years. There was a right-shift in hip fracture distribution towards the oldest old, probably due to an increased number of octo/nonagenarians, a new population of particularly frail old people that hardly existed earlier. Better health among septuagenarians may also have delayed the age at which fractures occurred. This changing pattern will strain orthopedic and geriatric resources even more.

  • 233.
    Bernspång, Birgitta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Consequences of stroke: aspects of impairments, disabilities and life satisfaction : with special emphasis on perception and on occupational therapy1987Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Perceptual and motor functions and self-care ability after stroke were assessed within two weeks (n:109; mean age 69±10) and 4-6 years (n:75;70±9) after admission to a non-intensive care stroke unit. Sixty-two of the long-term stroke survivors reported on their life satisfaction (7 items) as experienced (in retrospect) before the stroke and at the time of the investigation. Perceptual functions and actual levels of life satisfaction were registered in 60 clinically healthy subjects aged about 60 or about 80 years.

    Both early on and late after stroke the 16 items of perceptual function were clearly grouped into two factors, which neatly fitted an ecological perceptual concept. One factor characterized low-order and the other higher-order perception. Impairments of low-order perception occurred for about 10% of the patients, whether investigated early or late after stroke. No one among the reference populations had such impairments. Higher-order perceptual impairments prevailed in 60% early on and in 57% late after stroke and were often more pronounced than those occurring in the reference populations, among whom 35% of the 60 year olds and significantly more - 77% - of the 80 year olds had such impairments. Hence, perceptual impairments are common after stroke, but slight age-dependent reductions should be considered when higher-order perceptual function is assessed and treated after stroke.

    Together with motor function, which was impaired in 52% of the early and 36% of the late stroke samples, higher-order perceptual function and to a limited extent low-order perception could predict the level of self-care ability in 70% and 62% of the early and late samples, respectively.

    Whereas levels of global and of domain specific variables of life satisfaction were similar in the two reference populations, the stroke had lead to a reduction in life satisfaction for 61% of the long-term survivors. Reductions were particularly pronounced for global life satisfaction and for satisfaction with leisure and sexuality. Although significantly associated with motor impairment and self-care disability, these reductions could not be attributed only to impairments and disability.

    The findings are discussed with particular reference to assessment and treatment in occupational therapy.

  • 234.
    Bernspång, Birgitta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Editorial2007In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 14, no 4, p. 203-204Article in journal (Refereed)
  • 235.
    Bernspång, Birgitta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Editorial. A more global arena for occupational therapy science.2009In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 16, no 2, p. 67-67Article in journal (Refereed)
  • 236.
    Bernspång, Birgitta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    International occupational therapy journal.2010In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 17, no 2, p. 99-100Article in journal (Refereed)
  • 237.
    Bernspång, Birgitta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Rater calibration stability for the assessment of motor and process skills1999In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 6, no 3, p. 101-109Article in journal (Refereed)
  • 238.
    Bernspång, Birgitta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Scandinavian journal of occupational therapy2011In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 18, no 2, p. 83-84Article in journal (Refereed)
  • 239.
    Bernspång, Birgitta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    The publications are covering fields of great interest to our researchers and research students, as well as all clinicians2013In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 20, no 1, p. 1-1Article in journal (Refereed)
  • 240.
    Bernspång, Birgitta
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Asplund, Kjell
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Eriksson, Sture
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Fugl-Meyer, Axel R.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Motor and perceptual impairments in acute stroke patients: effects on self-care ability1987In: Stroke, ISSN 0039-2499, E-ISSN 1524-4628, Vol. 18, no 6, p. 1081-1086Article in journal (Refereed)
    Abstract [en]

    The relative importance of motor, perceptual, and some cognitive functions for self-care ability was analyzed in a representative sample of 109 subjects within 2 weeks of acute stroke. Forty-nine patients (45%) were dependent or partly dependent in self-care. Profound motor dysfunction was present in 39%, low-order perceptual deficits in 10%, high-order perceptual deficits in 60%, and disorientation in time and space in 13% of the patients. There was a significant covariation between motor function and self-care ability and between low-order perception and orientation function. Low-order and high-order perception covaried only weakly. Discriminant analyses showed that the actual level of self-care proficiency could be correctly predicted in 70% of the cases by the 4 indexes of motor function, low-order perception, high-order perception, and orientation. The dominating predictor was motor function, and the next highest was high-order perception. When a program for early training is designed with the aim to alleviate long-term self-care disability after stroke, correct assessment of motor and perceptual functions in the individual stroke patient is essential.

  • 241.
    Bernspång, Birgitta
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Fischl, Caroline
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Sawert, Bertil
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Från kulturell nyfikenhet till samarbete2015In: Universitetspedagogiska konferensen 2015: Gränslös kunskap, Umeå: Umeå universitet , 2015, p. 65-Conference paper (Other academic)
  • 242.
    Bernspång, Birgitta
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Fisher, Anne G.
    Department of Occupational Therapy, College of Applied Human Sciences, Colorado State University.
    Differences between persons with right or left cerebral vascular accident on the Assessment of Motor and Process Skills1995In: Archives of Physical Medicine and Rehabilitation, ISSN 0003-9993, E-ISSN 1532-821X, Vol. 76, no 12, p. 1144-1151Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Persons with right and left cerebral vascular accident (RCVA and LCVA) differ in terms of discrete impairments, but there is limited information with regard to how such impairments translate into differences in disability. The following hypotheses were tested: (1) persons with stroke have lower instrumental or domestic activities of daily living (IADL) ability than do matched nondisabled controls, (2) persons with RCVA do not differ from persons with LCVA in IADL ability, and (3) persons with RCVA and LCVA differ in specific motor and process skills that affect IADL performance.

    DESIGN: Descriptive comparison.

    SETTING: Subjects were tested in settings where rehabilitation services were received (home or clinic).

    SUBJECTS: 71 persons with RCVA, 76 persons with LCVA, and 83 community-living nondisabled individuals drawn from the Assessment of Motor and Process Skills (AMPS) database, matched for age, gender, and number of tasks performed.

    MAIN OUTCOME MEASURE: AMPS, designed to measure type and severity of impairments manifested in the context of IADL performance. The AMPS was administered to all subjects in accordance with standardized testing procedures.

    RESULTS: The two stroke groups did not differ significantly in IADL ability, but both stroke groups had significantly lower IADL performance than did the nondisabled subjects. On the AMPS motor scale, persons with RCVA demonstrated greater impairment in pacing, transporting, and coordinating two body parts. Persons with LCVA demonstrated greater impairments in calibrating movements. No differences were found between the two groups in AMPS process skills.

    CONCLUSIONS: Persons with RCVA and LCVA have hemisphere-specific differences in motor impairments, but do not differ significantly in IADL ability.

  • 243.
    Bernspång, Birgitta
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Fugl-Meyer, Axel R.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Viitanen, Matti
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Perceptual function in the elderly and after stroke1988In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 2, no 2, p. 75-79Article in journal (Refereed)
    Abstract [en]

    Perceptual function was assessed in 60 clinically healthy subjects aged about 60 (n=34) and 80 (n=26), and in stroke survivors who were assessed either early (n=109) or four to six years (n=75) after the stroke. Using two indices, one characterising low-order perception and the other higher-order perception, the clinically healthy subjects invariably had no impairment in the low-order index. Slight impairments occurred in 35% of 60-year-old and 77% of 80-year-old healthy subjects. Considerably more pronounced disturbances occurred in the stroke victims, among whom about 60% had impairment or higher-order perceptual function and about 10% had low-order perceptual deficits. Thus as higher-order perception is age dependent, it appears that in rehabilitation of stroke allowance should be made for predictable signs of advancing age.

  • 244.
    Bernspång, Birgitta
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Aktivitetsengagemang under åldrandet2012In: Det goda åldrandet / [ed] Astrid Norberg, Berit Lundman, Regina Santamäki Fischer, Lund: Studentlitteratur AB, 2012, 1, p. 217-236Chapter in book (Other academic)
  • 245.
    Berzelius, Adam
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Cognitive impairments in stroke patients at acute stage: Comparison of three neuropsychological screening tests2014Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
  • 246.
    Berzelius, Adam
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Cognitive impairments in stroke patients at acute stage. Comparison of three neuropsychological screening tests2014Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • 247.
    Betten, Carola
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Skånevård Kryh, Division Primärvård Skurup, Sweden.
    Sandell, Christofer
    Hill, Jonathan C.
    Gutke, Annelie
    Cross-cultural adaptation and validation of the Swedish STarT Back Screening Tool2015In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 17, no 1, p. 29-36Article in journal (Refereed)
    Abstract [en]

    Objectives : The STarT Back Screening Tool (SBT) is a newly validated questionnaire that identifies modifiable risk factors of poor prognosis in patients with low back pain (LBP). The aim of this study was to cross-culturally adapt the SBT into Swedish and to test its concurrent validity in patients with LBP in primary healthcare.

    Methods: The SBT was translated according to established guidelines. Concurrent validity was tested on 62 patients by comparing the SBT with the Orebro Musculoskeletal Pain Screening Questionnaire, short form (OMPSQ-short). Analysis of correlations between the instruments' total scores and between psychosocial sub-score of SBT and OMPSQ-short was performed using Spearman's rank correlation.

    Results: A translation of the SBT into Swedish required minor semantic adaptation until the final version was acceptable. Correlation between the SBT and the OMPSQ-short was large with r = 0.61 (SBT total with OMPSQ-short total score) and r = 0.60 (SBT psychosocial subscale with OMPSQ-short total score).

    Conclusion: The original SBT was successfully translated into Swedish. Correlation between the Swedish SBT and OMPSQ- short was large. The present study supports the use of the Swedish SBT for further clinical practice and research.

  • 248.
    Bexing, Daniel
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Geisor, Daniel
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Arbetsterapeutiska insatser som kan främja aktivitetsbalans hos unga vuxna med ADHD: En kvalitativ studie2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Personer med Attention Deficit Hyperactivity Disorder (ADHD) har vanligen stora svårigheter med uppmärksamhet, impulsivitet och överaktivitet. Dessa svårigheter orsakar ofta problem i personernas vardagsfungerande och påverkar därmed också hälsa och välbefinnande. Då ADHD är ett relativt vanligt tillstånd, ca 2,5% av alla vuxna i Sverige, är det viktigt att känna till vilka interventioner som främjar aktivitetsbalansen hos dem. Aktivitetsbalans är individspecifik och utgör en egen uppfattning om vilka aktiviteter som en person mår bra av att utföra. Huruvida dessa aktiviteter kan organiseras till ett för personen fungerande och tillfredsställande mönster i vardagen, blir avgörande för den subjektiva upplevelsen av aktivitetsbalans. Syftet med vår studie var att utforska arbetsterapeuters erfarenheter av insatser för unga vuxna med ADHD, med fokus på deras aktivitetsmönster och aktivitetsbalans. Intervjuer genomfördes med tre arbetsterapeuter som har klinisk erfarenhet av att arbeta med unga vuxna med ADHD och deras aktivitetsbalans i vardagen.  Intervjuerna analyserades utifrån en kvalitativ innehållsanalys och resulterade i följande fem kategorier: Att kartlägga personers aktivitetsmönster och prioriterade aktivitetsområden, Medvetenhet om aktivitetsmönster, Hjälpmedel som bidrar till struktur och balans i vardagen, Strategier för att skapa vanor och rutiner och Främja förståelsen och vikten av aktivitetsbalans i tidig ålder. Slutsatsen blir att arbetsterapeuter besitter en värdefull kompetens till att hitta strategier, strukturera upp vardagen, bidra med kompensatoriska insatser och främja aktivitetsbalans för unga vuxna med ADHD. Att tidigt i livet få hjälp att utforma strategier för en fungerande vardag, vore en hälsovinst för personerna med ADHD och en ekonomisk vinst för samhället.

  • 249.
    Biberg, Elisabeth
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Falk, Terese
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Arbetsterapeuters kliniska resonemang i interventioner i psykiatrisk verksamhet: erfarenheter av att främja delaktighet och social interaktion i rehabilitering2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Förmåga till social interaktion är betydande för om en person med psykisk sjukdom kan bygga upp ett socialt liv och delta i samhället. Delaktighet i de dagliga aktiviteterna i livet är också viktigt för människans utveckling och erfarenhet. Arbetsterapeuter kan stödja individer att uppnå optimal hälsa och välbefinnande genom att stärka individens färdigheter i just dessa områden. Kliniskt resonemang, är en naturlig del i arbetsterapeutens arbete som reflekterar hur patientens behov analyseras och hur åtgärder genomförs. Syftet var att beskriva arbetsterapeuters kliniska resonemang i rehabiliteringsprocessen med klienter inom psykiatrisk verksamhet, med fokus på interventioner som främjar delaktighet och social interaktion. En kvalitativ studie genomfördes. Sex yrkesverksamma arbetsterapeuter intervjuades personligen eller via telefon och data analyserades med innehållsanalys. Resultatet utgjordes av tre kategorier: ”procedurspåret”, ”samspelsspåret” och ”förutsättningsspåret. Procedurspåret beskriver hur arbetsterapeuten tydliggör klientens förmåga och oförmåga för att främja klientens delaktighet i sin rehabilitering. Samspelsspåret reflekterar hur arbetsterapeuterna använder sociala aktivitetsgrupper för att främja klienternas sociala interaktioner. Förutsättningsspåret visar på hur arbetsterapeuten kan vara som ett stöd för att främja rehabiliteringsprocessen. Slutsatsen visar på att arbetsterapeuten växlar mellan olika resonemang för att hjälpa klienten uppnå ett självständigt och tillfredsställande liv.

  • 250.
    Bjerke, Joakim
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gait and postural control after total knee arthroplasty2014Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim of the thesis was to investigate deficits and compensatory strategies after total knee arthroplasty (TKA) in different conditions during gait and quiet standing. Although TKA is considered the gold standard treatment for end-stage knee osteoarthritis, it is associated with a number of implications. Reduced physical function after osteoarthritis is partly, but apparently not fully, remedied by surgery. The two most common deficits are reduced knee muscle strength and limited range of knee joint motion (ROM), partly due to prosthesis mechanics. Reduced postural control has also been shown shortly after surgery. In spite of sufficient passive knee joint ROM for normal ambulation, gait patterns are characterized by reduced knee flexion. Several factors such as reduced knee muscle strength, reduced proprioception, habitual strategies or fear of movement may be suggested as explanations for difficulties in gait and posture. As an effect, compensatory strategies may result. In order to focus on the implications of TKA, participants had to be less than 65 years of age and healthy, TKA being the only factor different form controls. The same 23 individuals with unilateral TKA ~ 19 months post-operative and 23 controls participated in all studies.

     

    3D whole body kinematics was used to assess gait and posture and electromyography was used to record muscle activity. Isokinetic measurements were used to determine dynamic knee muscle strength. Gait in the frontal and sagittal planes were assessed. The tasks included in the test protocol were negotiation up and down stairs, gait on hard and soft surface, quiet standing with sensory modulation (with and without vision and on soft surface), and single limb stance.  Primary outcome variables addressed were: knee and hip joint kinematics in frontal and sagittal planes, upper body inclination, postural sway and relative knee muscle activity as an indicator of relative effort. Background factors used to explain group differences in the primary outcomes were derived from demographics, clinical examination, and questionnaires. Demographic factors were age, body mass index (BMI), and time since surgery. Clinical examinations were conducted for passive knee joint ROM, joint position sense, knee muscle strength, anterior knee joint laxity, and leg length. Questionnaires assessed fear of movement, pain, and knee related function and quality of life. The results showed that knee flexion was reduced during stair descent in both the prosthetic and the contralateral knee in the TKA group compared to controls. Although reduced passive knee joint flexion in the TKA group was sufficient for normal stair descent, it was the only factor identified that explained reduced knee flexion in stair descent. As knee muscle strength was significantly reduced in the TKA group, it is reasonable to suggest that as a contributing factor. Furthermore, the TKA group also displayed increased hip adduction during stair descent, which may indicate both a compensatory strategy as well as reduced hip muscle strength. In stair ascent, no significant group differences were found in relative knee muscle activity as expected due to knee muscle weakness. Nor were there any indications of compensatory forward inclination of the trunk to reduce knee joint moments. Instead, probably compensating for muscle weakness, the TKA group ascended stairs at a significantly slower speed. Surface modulation during level gait showed that reduced knee flexion in the prosthetic knee during the stance phase when walking on a hard surface was further decreased during gait on a soft surface. Knee and hip adduction at the stance phase were not affected by surface conditions. Nevertheless, the TKA group displayed increased knee adduction and hip adduction compared to controls, particularly in the prosthetic side. In addition, the TKA group displayed increased step width on the soft compared to hard surface. Single-limb stance for 20 seconds failed in 30 % of the TKA group and in 4 % of the control group. Those in the TKA group who were able to perform single-limb stance performed equally well as controls. During bilateral quiet standing, postural sway was similar in both groups, and inability to stand on one leg did not affect bilateral stance. Older age, higher BMI and reduced quadriceps strength determined the failure to maintain single-limb stance in the TKA group.

     

    In conclusion, this thesis indicates that reduced knee muscle strength is a common denominator as part of the explanatory factors for reduced performance and compensatory strategies in individuals with TKA. Reduced speed during stair ascent as well as reduced knee flexion during stair descent may be compensations for reduced lower extremity strength. Increased hip adduction may compensate for reduced knee flexion in stair descent, but may also represent hip muscle weakness or reduced motor control as increased hip adduction is found also in level gait. The failure to maintain single-limb stance in the TKA group is also partly explained by reduced knee muscle strength. Muscle weakness may be and indicator for reduced physical capacity in general.

2345678 201 - 250 of 2769
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf