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  • 251.
    Grip, Helena
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Tengman, Eva
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Quantifying motor control of the knee during side hops - healthy subjects and subjects ~20 years after anterior cruciate ligament injury2012Conference paper (Other academic)
  • 252.
    Grip, Helena
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Tengman, Eva
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Häger, Charlotte K
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Dynamic knee stability estimated by finite helical axis methods during functional performance approximately twenty years after anterior cruciate ligament injury2015In: Journal of Biomechanics, ISSN 0021-9290, E-ISSN 1873-2380, Vol. 48, no 10, p. 1906-1914Article in journal (Refereed)
    Abstract [en]

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

  • 253.
    Grip, Helena
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Tengman, Eva
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Liebermann, Dario G
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Kinematic analyses including finite helical axes of drop jump landings demonstrate decreased knee control long after anterior cruciate ligament injury2019In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 10, article id e0224261Article in journal (Refereed)
    Abstract [en]

    The purpose was to evaluate the dynamic knee control during a drop jump test following injury of the anterior cruciate ligament injury (ACL) using finite helical axes. Persons injured 17-28 years ago, treated with either physiotherapy (ACLPT, n = 23) or reconstruction and physiotherapy (ACLR, n = 28) and asymptomatic controls (CTRL, n = 22) performed a drop jump test, while kinematics were registered by motion capture. We analysed the Preparation phase (from maximal knee extension during flight until 50 ms post-touchdown) followed by an Action phase (until maximal knee flexion post-touchdown). Range of knee motion (RoM), and the length of each phase (Duration) were computed. The finite knee helical axis was analysed for momentary intervals of ~15° of knee motion by its intersection (ΔAP position) and inclination (ΔAP Inclination) with the knee's Anterior-Posterior (AP) axis. Static knee laxity (KT100) and self-reported knee function (Lysholm score) were also assessed. The results showed that both phases were shorter for the ACL groups compared to controls (CTRL-ACLR: Duration 35±8 ms, p = 0.000, CTRL-ACLPT: 33±9 ms, p = 0.000) and involved less knee flexion (CTRL-ACLR: RoM 6.6±1.9°, p = 0.002, CTRL-ACLR: 7.5 ±2.0°, p = 0.001). Low RoM and Duration correlated significantly with worse knee function according to Lysholm and higher knee laxity according to KT-1000. Three finite helical axes were analysed. The ΔAP position for the first axis was most anterior in ACLPT compared to ACLR (ΔAP position -1, ACLPT-ACLR: 13±3 mm, p = 0.004), with correlations to KT-1000 (rho 0.316, p = 0.008), while the ΔAP inclination for the third axis was smaller in the ACLPT group compared to controls (ΔAP inclination -3 ACLPT-CTRL: -13±5°, p = 0.004) and showed a significant side difference in ACL injured groups during Action (Injured-Non-injured: 8±2.7°, p = 0.006). Small ΔAP inclination -3 correlated with low Lysholm (rho 0.391, p = 0.002) and high KT-1000 (rho -0.450, p = 0.001). Conclusions Compensatory movement strategies seem to be used to protect the injured knee during landing. A decreased ΔAP inclination in injured knees during Action suggests that the dynamic knee control may remain compromised even long after injury.

  • 254.
    Grrenmyr, Astrid
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Näsström, Anna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Psykisk ohälsa vanligare hos flickor än pojkar: En enkätstudie bland gymnasieelever i Umeå2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 255.
    Guerreiro Semedo, Bruno
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Experiences from multimodal pain rehabilitation in primary healthcare in Sweden: A qualitative study among a group of immigrant women from Somalia.2016Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

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

  • 256.
    Guevara, Balder
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    En utvärdering av samstämmighet och intrabedömarreliabilitet  avseende bedömningar av postural hållning och rörelser med ett 2-dimensionellt rörelseanalysprogram2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

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

     

    Syfte

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

     

    Metod

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

     

    Resultat

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

     

    Konklusion

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

  • 257. Gustafsson, Monika
    et al.
    Ekholm, Jan
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    From shame to respect: musculoskeletal pain patients' experience of a rehabilitation programme, a qualitative study2004In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 36, no 3, p. 97-103Article in journal (Refereed)
    Abstract [en]

    Objective: This study aimed to describe and analyse how participants with fibromyalgia or chronic, widespread, musculoskeletal pain, 1 year after completion, experienced a rehabilitation programme; and what knowledge and strategies they had gained.

    Design, methods and subjects: Semi-structured interviews with 16 female patients were analysed using the grounded theory method of constant comparison.

    Results: One core category, from shame to respect, and 4 categories, developing body awareness/knowledge, setting limits, changing self-image and negative counterbalancing factors, and hopelessness and frustration over one's employment situation emerged from the data. The core category represents a process where the informants changed emotionally. Three categories were identified as important for starting and maintaining the process, one category affected the process negatively.

    Conclusion: The rehabilitation programme started the process of change, from shame to respect. The informants learned new strategies for handling their pain and other symptoms; they improved their self-image and communication in their social environment.

  • 258.
    Gustavsson, Elias
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Håkansson, Simon
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    The why and how of social connectedness: People with multiple LTCs in Christchurch New Zealand2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

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

  • 259.
    Gustavsson, Johan
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Söderqvist, Niklas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Skillnad i rörelseutslag under tvåbensböj för personer med främre korsbandsskada jämfört med kontrollgrupp: En långtidsuppföljning, 20 år efter skada2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Främre korsbandsskada är en relativt vanlig och allvarlig skada i knät som oftast uppkommer vid utövandet av kontaktsporter som t.ex. fotboll eller innebandy. Enligt färska studier beräknas det att det varje år sker ca 5800 främre korsbandsskador i Sverige. Av dessa så opereras ca 3000 med rekonstruktiva metoder medan resterande erhåller sjukgymnastisk rehabilitering.

    Huvudsyftet med denna uppsats är att ta reda på ifall det i knä, höft eller bål finns skillnader i rörelseutslag under tvåbensböj hos personer med främre korsbandsskador som antingen opererats (n=33) eller fått konservativ behandling (n=37) för ca 20 år sedan, jämfört med friska försökspersoner utan knäproblematik (n=33). Även samband mellan rörelseutslag och knäfunktion bedömd med klassindelning enligt Lysholm Knee Scoring Scale studerades.

    Av redan insamlad data bearbetades datormodeller av försökspersonerna under teströrelsen med hjälp av mjukvaruprogrammen Qualysis Track Manager och Visual3D, varpå relativa ledvinklar mellan underben, lår och bäcken beräknades för att kunna få ut rörelseutslag bilateralt för knä- och höftled. Bålens rörelse i förhållandet till rummet beräknades även. Skillnader i rörelseutslag mellan och inom grupperna analyserades samt samband mellan rörelseutslag och poäng på Lysholm Knee Scoring Scale som skattar knäfunktion.

    Resultaten visar att personerna som erhöll konservativ behandling har signifikant mindre rörelseutslag i flexion/extension i knä, höft och bål jämfört med kontrollgruppen. Även samband mellan större rörelseutslag och bättre knäfunktion enligt Lysholm kunde noteras.

    Eftersom de faktiska rörelseomfången, muskelstyrkan eller instabilitet i de olika segmenten inte har undersökts kan inga säkra slutsatser dras om varför den konservativt behandlade gruppen uppvisar lägre flexion-/extension i knä, höft och bål. En möjlig orsak är att en instabilitetskänsla medför minskat utslag i knä såväl som höft och bål

  • 260.
    Gustavsson, Linnéa
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    THE IMPORTANCE OF TIME TO RETURN TO SPORT AND MUSCLE FUNCTION ON SUBSEQUENT ANTERIOR CRUCIATE LIGAMENT INJURIES2018Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Abstract:   

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

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

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

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

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

  • 261.
    Gärdin, Ellinor
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Nordin, Amanda
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Användbarheten av en mobilapplikation för självtest av balans och styrka för äldre2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Sammanfattning:

    Introduktion: Hos äldre leder fall ofta till nedsatt funktion och ökad rädsla för att falla igen. Träning av balans och muskelstyrka har visat sig vara den åtgärd som bäst förebygger fall i åldersgruppen. Appen MinBalans är ett självtest under utveckling för att äldre ska kunna mäta sin balans och benstyrka med en mobiltelefon. Användbarhetstester är viktiga under utvecklandet av appar, särskilt gällande självtester då appen används på egen hand.

     

    Syfte: Syftet med studien var att utvärdera användbarheten av en prototyp av appen MinBalans med avseende på testinstruktioner och genomförande.

     

    Metod: Kvalitativ och kvantitativ metod tillämpades. Användartester av appen, innehållande balanstest och benstyrketest, gjordes på sju deltagare över 70 år. Observationer med Think aloud-metoden, semi-strukturerade intervjuer och System Usability Scale (SUS) användes. Resultaten analyserades genom en deskriptiv sammanställning av observationsprotokoll och SUS-mätning. En tematisk analys gjordes utifrån intervjuerna samt film- och ljudinspelningar av observationerna.

     

    Resultat: Den tematiska analysen resulterade i två teman; Kognitiv utmaning och Otydligheter i appen. Vanligt förekommande problem var att minnas allt från instruktionsfilmerna och att navigera i appen. Observationsprotokollet påvisar en inlärningsfaktor och att alla deltagare klarade 45% av uppgifterna utan problem. SUS-mätningen tyder på en bra användbarhet av appen.

     

    Slutsats: Äldre upplever användandet av MinBalans som positivt och med viss hjälp klarar de av att utföra självtest av balans och styrka. MinBalans kan vara möjlig att använda på egen hand då användaren möjligges en inlärningsperiod. Efter ändringar av främst navigering i appen och information i filmerna är det möjligt att appen kan vara användarvänlig från start.

     

     

     

     

  • 262. Gådin, Katja Gillander
    et al.
    Weiner, Gaby
    Ahlgren, Christina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Young students as participants in school health promotion: an intervention study in a Swedish elementary school2009In: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 68, no 5, p. 498-507Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The aim was to analyse if young students could be substantive participants in a health-promoting school project. The specific aims were to analyse the changes the students proposed in their school environment, how these changes were prioritized by a school health committee and to discuss the students' proposals and the changes from a health and gender perspective.

    STUDY DESIGN: An intervention project was carried out in an elementary school with students (about 150) in Grades 1 through 6. The intervention included small-group discussions about health promoting factors, following a health education model referred to as "It's your decision." At the last of 6 discussions, the students made suggestions for health-promoting changes in their school environment. A health committee was established with students and staff for the purpose of initiating changes based on the proposals.

    METHODS: A content analysis was used to analyse the proposals and the protocols developed by the health committee.

    RESULTS: The analysis showed 6 categories of the students' proposals: social climate, influence on schoolwork, structure and orderliness, security, physical environment and food for well-being. Their priorities corresponded to the students' categories, but had an additional category regarding health education.

    CONCLUSIONS: Principles that guide promoting good health in schools can be put into action among students as young as those in Grades 1 through 6. Future challenges include how to convey experiences and knowledge to other schools and how to evaluate if inequalities in health because of gender, class and ethnicity can be reduced through the focus on empowerment and participation.

  • 263.
    Hagbeg, Bengt
    et al.
    Department of Neuropediatrics, The Queen Silvia Children’s Hospital, Go¨teborg University,.
    Erlandsson, Anna
    Division of Clinical Genetics, Go¨teborg University, Go¨teborg, Sweden.
    Kyllerman, Mårten
    Department of Neuropediatrics, The Queen Silvia Children’s Hospital, Go¨teborg University,.
    Larsson, Gunilla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. The handicap habilitation center, Skellefteå and Rett center, Östersund.
    Odd MECP2-mutated Rett variant: long-term follow-up profile to age 252003In: European journal of paediatric neurology, ISSN 1090-3798, E-ISSN 1532-2130, Vol. 7, no 6, p. 417-421Article in journal (Refereed)
    Abstract [en]

    A 25-year-old MECP2-mutated female with odd developmental and dyspraxic/ataxic features, followed up through two decades, is reported. She does not fit either the classical Rett syndrome or the criteria required for any Rett variant phenotypes so far described. Nevertheless, she belongs clinically to the latter group. This case deserves attention in order, among other things, to provide important clues to better understand the puzzling battery of neuroimpairments and behavioural abnormalities met in classical Rett phenotypes and Rett variants defined thus far.

  • 264.
    Hager, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Changes in sensorimotor behaviour with pain and how to capture these in a movement analysis laboratory2012In: Rheumatology, ISSN 1462-0324, E-ISSN 1462-0332, Vol. 51, p. 14-15Article in journal (Other academic)
  • 265.
    Haglund, Adam
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Brändström Nyström, Filip
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Är förskjutning av balansen i autonoma nervsystemet en möjlig mekanism bakom refraktärperioden vid ansträngningsutlöst bronkkonstriktion?: En experimentell studie2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Ansträngningsutlöst bronkkonstriktion (EIB) innebär en luftvägskonstriktion i samband med ansträngning. Prevalensen av EIB är idag hög, i synnerhet hos elitidrottare. En ordentlig uppvärmning innan fysisk aktivitet tycks hålla luftvägarna öppna under en period, en så kallad refraktärperiod. Patofysiologin bakom EIB samt förklaringen bakom refraktärperioden är inte helt klarlagd och flera hypoteser föreligger. En djupare förståelse för området skulle optimera behandling och underlätta vardagen för de drabbade, detta motiverar därmed denna studie.

     

    Syfte: Att utforska om refraktärperioden efter högintensiva intervaller är relaterad till temporär förskjutning av balansen i autonoma nervsystemet mot en lägre parasympatisk tonus bland friska individer.

     

    Metod: Sex personer utan diagnostiserad EIB utförde högintensiva intervaller vid två testtillfällen. Vid ena testtillfället genomgick deltagarna en kalldusch, en metod för att påverka autonom balans, följt av vila  efter avslutade intervaller och vid andra testtillfället fick deltagarna enbart vila. Mätning av hjärtrytmvariabilitet (HRV) och FEV1 genomfördes kontinuerligt under båda testtillfällena. För analys av data användes ett mått på parasympatisk tonus (RMSSD) och variabeln parasympatisk reaktivering (PR) definierades. För att undersöka eventuella samband plockades FEV1-värden ut för samma tidpunkter som PR.

     

    Resultat: I resultatet påvisades en måttlig (r = -0,452), dock inte statistisk säkerställd (p = 0,14) negativ korrelation mellan variablerna FEV1 och RMSSD. Resultatet indikerar på ett potentiellt samband mellan graden av PR och förändring av FEV1.

                                           

    Konklusion: Även om resultatet från studien bör tolkas med stor försiktighet på grund av det låga antalet deltagare antyder resultatet att en förskjutning i den autonoma balansen kan vara en mekanism bakom refraktärperioden.

  • 266.
    Hakola, Susanne
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wiljeskén, Sanna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Muskuloskelettala- och generella hälsoproblem hos sångare2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

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

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

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

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

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

  • 267. Hale, Leigh
    et al.
    Vollenhoven, Emile
    Caiman, Lisa
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Dryselius, Alice
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Buttery, Yvette
    Feasibility and acceptability of Otago Exercise Programme and Prevention of Falls for Adults with Intellectual Disability: a multiple case study design2019In: International Journal of Therapy and Rehabilitation, ISSN 1741-1645, E-ISSN 1759-779X, Vol. 26, no 6Article in journal (Refereed)
    Abstract [en]

    Background/Aims: Many people with intellectual disability fall frequently. Understanding fall prevention intervention characteristics will assist efficacy trials to target appropriate people. An exploration of two exercise-based fall prevention interventions is reported, focusing on viability and acceptability.

    Methods: A multiple case study of adults with intellectual disability completing either the group Otago Exercise Programme or the Prevention of Falls for Adults with Intellectual Disability intervention was performed. Integrated data sources were used: semi-structured interviews with participants and support workers, observations, attendance/adherence, falls, adverse events and balance measures.

    Results: In total, seven adults with varying intellectual disability levels participated. Overall, three themes enabled understanding of suitability of people to each intervention: suitability of the exercises; role of the environment; and benefits to participants.

    Conclusions: Educating adults with intellectual disability and their support workers of the importance of regular exercise is key to participation. Both programmes required high levels of support and prioritisation to ensure exercises occurred and were carried out safely.

  • 268. Hallstam, Andrea
    et al.
    Lofgren, Monika
    Svensen, Christer
    Stålnacke, Britt-Marie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Patients with chronic pain: One-year follow-up of a multimodal rehabilitation programme at a pain clinic2016In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 10, p. 36-42Article in journal (Refereed)
    Abstract [en]

    Background and aims: Multimodal rehabilitation (MMR) programmes, including, physical training, educational and psychological interventions by an interdisciplinary team are found to be more successful for patients with disabling chronic pain compared with less comprehensive treatments. MMR programmes are based on the biopsychosocial model and the goal is usually to improve function, quality of life and facilitate and enable return to work. As pain clinics traditionally offer conventional medical pain treatment, there is limited knowledge about MMR given in this context. The aim of our study was to describe characteristics of patients with chronic pain, treated with a MMR programme at a conventional pain clinic, to evaluate patient-reported outcome measures (PROM) from start to one year after, and to study possibly associated factors for the improvement of health-related quality of life after one year.

    Methods: A prospective, observational study with a one-year follow-up was performed.

    Subjects: A total of 42 individuals (38 females, age 44.0 ± 12.3 years and 4 men age 40 ± 8.5 years) with different pain diagnoses were included. After a team assessment, the patients began a programme that lasted about three months. The MMR programme contained coordinated, individually adapted treatments administered individually or in groups, and was based on cognitive behavioural principles. Questionnaires regarding health-related quality of life (HRQoL) (EQ-5D), insomnia (ISI), mental health (HADS), pain-related disability (PDI), kinesiophobia (TSK), current pain intensity (VAS) and sense of coherence (SOC) were used at the start of the MMR and at follow-up. Demographic data were collected from the patient records.

    Results: The PROM at baseline showed substantial pain problems with low HRQoL (EQ-5D index of 0.1 ± 0.282, and EQ VAS of 32.67 ± 20.1), moderate insomnia (ISI 18.95 ± 6.7), doubtful cases of depression and anxiety (HADS-depression 9.35 ± 4.1 and HADS-anxiety 9.78 ± 3.95), presence of pain-related disability (PDI 39.48 ±12.64), kinesiophobia (TSK 40.8 ± 9.8), as well as moderate current pain (VAS 61.31 ± 20.4). The sense of coherence was weak (SOC of 51.37 ± 14). At one-year follow-up, significant (p ≤ 0.05) improvement occurred on the EQ-5D index, EQ VAS, ISI, PDI and TSK. In the logistic regression analysis, no significant associations could be identified.

    Conclusions: MMR for patients with complex pain problems can be a successful treatment alternative at conventional pain clinics.

    Implications: Since access to rehabilitation clinics in Sweden may be limited, the availability of MMR can increase by providing this type of intervention in pain clinics. Increased knowledge of MMR in different settings can also contribute to increased understanding and collaboration between pain clinics and rehabilitation units.

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

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

  • 270. Halvarsson, Alexandra
    et al.
    Seth, Monika
    Tegern, Matthias
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation. Departments of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden.
    Broman, Lisbet
    Larsson, Helena
    Remarkable increase of musculoskeletal disorders among soldiers preparing for international missions - comparison between 2002 and 20122019In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 20, no 1, article id 444Article in journal (Refereed)
    Abstract [en]

    Background:

    Musculoskeletal disorders (MSD) are common among soldiers and constitute the most common reason for discontinuing military service within different military populations worldwide. The aims of this study were to investigate the prevalence of musculoskeletal disorders in two cohorts, 10 years apart, in the Swedish Armed Forces, to explore differences between these cohorts and to determine associated factors with MSD.

    Method: Comparative cross-sectional study. Participants were recruited from the Swedish Armed Forces, i.e. soldiers preparing for international missions in 2002 and 2012. A total of 961 soldiers, 7% women, participated in the study.

    Data were collected using the Musculoskeletal Screening Protocol (MSP), which includes questions regarding prevalence of MSD in ten anatomical locations (neck, upper back, low back, shoulders, elbow, hand, hip, knee, lower limb and foot). An additional five questions concern perceived self-rated health, i.e. how the respondent perceives their own physical body, mental health, social environment, physical environment and work ability.

    Results: Over a ten-year period, both point prevalence and one-year prevalence of MSD in any body part increased significantly, with point prevalence increasing from 7.1 to 35.2% (p < 0.001) and one-year prevalence from 27.9 to 67.9% (p < 0.001). The knee was the most common anatomic location for MSD in both cohorts. Across each anatomical location (neck, upper back, low back, shoulders, elbow, hand, hip, knee, lower leg and foot), both point prevalence (p < 0.039) and one-year prevalence (p < 0.005) increased significantly from 2002 to 2012.

    Most soldiers reported good to excellent perceived health, i.e. self-perception of their physical body, mental health, physical and social environments, and work ability.

    The odds of reporting one-year prevalence of MSD in any body part was 5.28 times higher for soldiers in Cohort 2012, 1.91 times higher in age group 31–40 and 2.84 times higher in age group 41 and above.

    Conclusions: The prevalence of MSD increased remarkably over a ten-year period among Swedish soldiers preparing for international missions. With increasing age as one risk factor, systematic monitoring of MSD throughout the soldiers’ careers and implementation of targeted primary-to-tertiary preventive programs are thus important.

  • 271. Halvarsson, Sara
    et al.
    Asplund, Ragnar
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    From authority to coach: parents' experiences of streching as a home programme for childrern with cerebral palsy2010In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 12, no 4, p. 208-216Article in journal (Refereed)
    Abstract [en]

    Stretching is a common treatment for children with cerebral palsy, carried out by parents together with their children in the home. The aim of the present study was to explore parents’ experiences of carrying out stretching as a home programme. In order to capture the informants’ own perceptions and experiences, a qualitative method, the Grounded Theory, was chosen. Fifteen semi-structured interviews with parents, using open-ended questions, were analysed. One core category, “From authority to coach”, and two categories, “Prerequisites for parenting during stretching” and “Child and parent interaction”, emerged. The parents described a gradual development of their own role in the home stretching programme, from that of an authority, when the child was young, to that of a coach when the child grew older. With this gradual development came an increased level of participation from the child, enabling stretching to be carried out regularly. According to the parents, stretching could not be carried out without the child's active participation. Along with the process, the parents perceived increasing stress through added pressure and demands. Mobility, time, coping strategies for stress and support from professionals, in particular physiotherapists, were important prerequisites for parents to help their child best with stretching exercises.

    Read More: http://informahealthcare.com/doi/abs/10.3109/14038196.2010.528023

  • 272.
    Hamberg, Malin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Thelberg, Elin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Jämförelser av Pilatesträning och rörelsekontrollträning för patienter med kronisk ländryggsbesvär: En klinisk studie2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 273.
    Hansson, Victor
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lindell, Frida
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    ”Jag vill inte vara en känslig person”: Förväntningars betydelse för ungdomars smärthantering ur ett genusperspektiv2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Smärta är något som drabbar alla och tar sig i uttryck på många olika sätt. Förekomsten av smärta har under senare år ökat i Sverige hos både män och kvinnor. Eftersom smärta är vanligt förekommande är det viktigt att bredda kunskapen inom området.

    Syfte: Syftet med studien var att ur ett genusperspektiv studera ungdomars upplevelse av hur de hanterar smärta samt hur erfarenheter från uppväxten har påverkat detta.

    Metod: För att få en djupare och mer nyanserad bild av hur ungdomars erfarenheter ser ut och hur de upplever, hanterar och förhåller sig till smärta så valdes en kvalitativ innehållsanalys som metod. Materialet samlades in genom semistrukturerade intervjuer.

    Resultat: Utifrån analysen av intervjuerna bildades ett tema samt sex kategorier. Det framkom att förebilders beteenden och förväntningar av genus påverkade bland annat mognadsprocessen och bildandet av trygghetszoner hos ungdomarna. Det visade sig också att förebilders beteenden, förväntningar av genus, mognadsprocesser och trygghetszoner tillsammans bidrog till att ungdomar bland annat hanterade smärta genom att bita ihop.

    Konklusion: Förväntningar utifrån normer, individen själv och personer i deras omgivning spelade en central roll i hur förhållning och hantering av smärta förändrades under uppväxten. Även erfarenhet och kunskap visade sig vara viktiga komponenter till ungdomars smärthantering.

  • 274.
    Hedlund, Jessie
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Ullberg, William
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Betydelse av undersökningsmetod vid utvärdering av lårmuskeluthållighet hos personer med kroniskt obstruktiv lungsjukdom: En kontrollerad tvärsnittsstudie2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

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

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

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

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

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

  • 275.
    Hedlund, Mattias
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Biomechanical and neural aspects of eccentric and concentric muscle performance in stroke subjects: Implications for resistance training2012Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Muscle weakness is one of the major causes of post-stroke disability. Stroke rehabilitation programs now often incorporate the same type of resistance training that is used for healthy subjects; however, the training effects induced from these training strategies are often limited for stroke patients. An important resistance training principle is that an optimal level of stress is exerted on the neuromuscular system, both during concentric (shortening) and eccentric (lengthening) contractions. One potential problem for post-stroke patients might be difficulties achieving sufficient levels of stress on the neuromuscular system. This problem may be associated with altered muscular function after stroke. In healthy subjects, maximum strength during eccentric contractions is higher than during concentric contractions. In individuals with stroke, this difference in strength is often increased. Moreover, it has also been shown that individuals with stroke exhibit alteration with respect to how the strength varies throughout the range of motion. For example, healthy subjects exhibit a joint specific torque-angle relationship that normally is the same irrespective of contraction mode and contraction velocity. In contrast, individuals with stroke exhibit an overall change of the torque-angle relationship. This change, as described in the literature, consists of a more pronounced strength loss at short muscle length. In individuals with stroke, torque-angle relationships are only partially investigated and so far these relationships have not been analysed using testing protocols that include eccentric, isometric, and concentric modes of contraction.

     

    This thesis investigates the torque-angle relationship of elbow flexors in subjects with stroke during all three modes of contractions – isometric, concentric, and eccentric ­– and the relative loading throughout the range of movement during a resistance exercise. In addition, this thesis studies possible central nervous system mechanisms involved in the control of muscle activation during eccentric and concentric contractions.

     

    The torque-angle relationship during maximum voluntary elbow flexion was examined in stroke subjects (n=11), age-matched healthy subjects (n=11), and young subjects (n=11) during different contraction modes and velocities. In stroke subjects, maximum torque as well as the torque angle relationship was better preserved during eccentric contractions compared to concentric contractions. Furthermore, the relative loading during a resistance exercise at an intensity of 10RM (repetition maximum) was examined. Relative loading throughout the concentric phase of the resistance exercise, expressed as percentage of concentric torque, was found to be similar in all groups. However, relative loading during the eccentric contraction phase, expressed as the percentage of eccentric isokinetic torque, was significantly lower for the stroke group. In addition, when related to isometric maximum voluntary contraction, the loading for the stroke group was significantly lower than for the control groups during both the concentric and eccentric contraction phases.

    Functional magnetic resonance imaging was used to examine differences between recruited brain regions during the concentric and the eccentric phase of imagined maximum resistance exercise of the elbow flexors (motor imagery) in young healthy subjects (n=18) and in a selected sample of individuals with stroke (n=4). The motor and premotor cortex was less activated during imagined maximum eccentric contractions compared to imagined maximum concentric contraction of elbow flexors. Moreover, BA44 in the ventrolateral prefrontal cortex, a brain area that has been shown to be involved in inhibitory control of motor activity, was additionally recruited during eccentric compared to concentric conditions. This pattern was evident only on the contralesional (the intact hemisphere) in some of the stroke subjects. On the ipsilesional hemisphere, the recruitment in ventrolateral prefrontal cortex was similar for both modes of contractions. 

     

    Compared to healthy subjects, the stroke subjects exhibited altered muscular function comprising a specific reduction of torque producing capacity and deviant torque-angle relationship during concentric contractions. Therefore, the relative training load during the resistance exercise at a training intensity of 10RM was lower for subjects with stroke. Furthermore, neuroimaging data indicates that the ventrolateral prefrontal cortex may be involved in a mechanism that modulates cortical motor drive differently depending on mode of the contractions. This might partly be responsible for why it is impossible to fully activate a muscle during eccentric contractions. Moreover, among individuals with stroke, a disturbance of this system could also lie behind the lack of contraction mode-specific modulation of muscle activation that has been found in this population. The altered neuromuscular function evident after a stroke means that stroke victims may find it difficult to supply a sufficient level of stress during traditional resistance exercises to promote adaptation by the neuromuscular system. This insufficiency may partially explain why the increase in strength, in response to conventional resistance training, often has been found to be low among subjects with stroke.

  • 276.
    Hedlund, Mattias
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sojka, Peter
    Lundström, Ronnie
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Lindström, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Insufficient loading in stroke subjects during conventional resistance training2012In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 14, no 1, p. 18-28Article in journal (Refereed)
  • 277.
    Helander, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Test-retest och interbedömarreliabilitetav tre fysiska tester för militärtjänsten2013Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Reliabla testmetoder behövs för att mäta fysisk prestationsförmåga vid rekrytering och uppföljning av personer i militärtjänst. Olika fysiska testbatterier används i länder med väpnade styrkor, men bara ett fåtal av de är uvärderade för reliabilitet. Det svenska försvaret har utvecklat ett nytt testbatteri innehållande sex fysiska tester. Valet av dessa är grundat på de operativa kraven. Syftet med denna studie har varit att bedöma test-retest och interbedömarreliabiliteten av testerna, Dips, Sidoplankan och Ranger test.

    Metod: Totalt 43 friska, aktiva, tjänstgörande militärer vid Göta regemente i Eksjö, ålder 19-46, genomförde alla tester. För att bedöma test-retest testades deltagarna vid två tillfällen, separerade av sju dagar, av en bedömare. Inter-bedömarreliabilitet bedömdes vid det andra testtillfället med fyra bedömare. Test-retest och inter-bedömarreliabilitet analyserades med hjälp av intra-klass korrelationskoefficienten (ICC), standard error of measurement (SEM) och smallest real difference (SRD).

    Resultat: Föreliggande studie visade utmärkta ICC-värden (0,992 till 1,0) för inter-bedömarreliabilitet. Test-retest visade goda till utmärkta ICC-värden (0,713-0,963). SEM% värdet vid test-retest var för Dips (12.6%), för Sidoplankan (17.2%) och Ranger test (22.2%).

    Slutsats: Studien visade att Dips, Sidoplankan och Ranger test är reliabla test för att mäta soldaters fysiska prestationsförmåga. Resultaten från studien kan ge värdefull information för forskare och kliniker som vill bedöma fysisk prestation även i andra sammanhang.   

  • 278.
    Hellberg, Jessica
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Redeborn, Tova
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Samband mellan fysisk aktivitet och självskattad hälsa: En enkätstudie bland svenska ungdomar i årskurs 92018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

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

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

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

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

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

  • 279.
    Hellersteth, Sophia
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wirén, Anna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Virtual Reality with Robotic Technology for Teachhing Adolescents with Autism Spectrum Disorders: A Feasibility Study2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 280.
    Hellgren, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Åhlander, Anna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Fysioterapeutstudenters uppfattningar om psykisk ohälsa hos unga och interventioner via e-hälsa2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

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

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

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

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

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

  • 281.
    Hellgren, Susanne
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sundqvist, Camilla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Muskuloskeletala besvär, upplevd hälsa och krav/kontroll hos Load Haul Dump-förare i malmgruva2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion:

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

     

    Metod:

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

     

    Resultat:

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

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

     

    Konklusion:

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

  • 282.
    Hellgren, Susanne
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sundqvist, Camilla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Muskuloskeletala besvär, upplevdhälsa och krav/kontroll hos Load Haul Dump-förare i malmgruva.2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion:

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

    Metod:Ett kvantitativt frågeformulär rörande förekomst av muskuloskeletala besvär (Nordic Musculosceletal Questionnaire - NMQ), hälsa, krav/kontroll (Demand Control Questionnaire - DCQ) och förarmiljö besvarades av LHD-förarna. 104 (12 kvinnor, 90 män, 2 uppgav ej kön) av totalt 138 raslastare deltog i studien. Bortfallet var 25 %.Resultat:79 % hade upplevt muskuloskeletala besvär senaste året. Nacke, ländrygg och skuldra/axel var vanligaste besvärsområdena. Besvärsfrekvensen var högre hos de som körde dieseldriven maskin. 79,6 % upplevde hälsan som god. Endast 27,7 % upplevde högra krav och låg kontroll i arbetet.

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

  • 283.
    Hellqvist, Jonas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Can Kinesiophobia, Disability and Pain Intensity Discriminate Between Different Patterns of Control Impairment in Patients With Persistent Low Back Pain?2010Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Introduction

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

    Aim

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

    Design

    Cross-sectional design.

    Method

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

    Result

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

    Conclusion

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

  • 284. Hendrick, P
    et al.
    Bell, ML
    Bagge, PJ
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Milosavljevic, S
    Can accelerometry be used to discriminate levels of activity?2009In: Ergonomics, ISSN 0014-0139, E-ISSN 1366-5847, Vol. 52, no 8, p. 1019-1025Article in journal (Refereed)
    Abstract [en]

    The aims of this study were to investigate the associations between an activity logbook and the RT3 accelerometer and to assess whether the RT3 can discriminate activity levels in healthy adults. Ten participants completed two trials wearing an RT3 accelerometer over a 4-6h period and completed a detailed activity log. Results showed a poor correlation between the RT3 in moderate activities (r=0.22) in comparison to low (r=0.52) and hard (r=0.70) from the logbook. A significant difference was found in average RT3 vector magnitude (VM) counts/min in each activity level (p0.0001). Discriminant analysis demonstrated that an RT3VM counts/min value of approximately 500 was found to have high sensitivity (88%), and specificity (88%) for discriminating between low and moderate activity levels from the logbook. This study found that accelerometry has the potential to discriminate activity levels in free living. This study is the first to investigate whether tri-axial accelerometry can discriminate different levels of free-living activity recorded in an activity logbook. The RT3 accelerometer can discriminate between low and moderate physical activities and offers a methodology that may be applicable to future research in occupational settings.

  • 285.
    Hermiz, Nawar
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Thorsson, Nils
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Physical health of support worker in the aged care sector: – A cross-sectional study2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

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

     

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

     

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

     

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

     

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

  • 286.
    Hertzberg, Andreas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Långvarig smärta och utmattningssyndrom – Olika diagnoser, liknande besvär?2015Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

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

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

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

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

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

  • 287.
    Hesselman Borg, Johanna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Den longitudinella svenska studien om fysisk aktivitet och kondition (SPAF 1958):: Vilka faktorer är relaterade till utveckling av besvär från nacke/skuldra vid 52 års ålder?2014Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
  • 288.
    Hesselman Borg, Johanna
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Westerståhl, Maria
    Institutionen för laboratoriemedicin, Karolinska institutet.
    Lundell, Sara
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Madison, Guy
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Longitudinal study exploring factors associated with neck/shoulder pain at 52 years of age2016In: Journal of Pain Research, ISSN 1178-7090, E-ISSN 1178-7090, Vol. 9, p. 303-310Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 289.
    Hjerpe, Magda
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Bäckström, Michaela
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Test-retest reliability of a novel supine knee joint position sense test2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Proprioception, including joint position sense (JPS), is important when coordinating body movements which require an efficient and intact sensorimotor system. However, there is no gold standard test method for evaluating JPS. The supine, active and non-weight-bearing test position in this study may make it possible to detect poor JPS in newly-injured persons. Aim: To evaluate the test-retest reliability of a novel knee JPS test in a supine position.. Method: 15 healthy and active students from Umeå University (Mean±SD: age 25±3.1 years, height 178±9.1 cm and weight 74±11.2 kg) participated on two test occasions with one week in between. The participants were instructed to flex their knee from an extended position untill a stop sign was displayed and then to reproduce the angle. The stop sign was activated when participants reached either 35 or 60 degrees knee flexion, taking into considiration reaction time and system delay within the program, 40 and 65 degrees were analysed. Thus, the participants were told that the knee angles were randomly selected. The test occasions involved five repetitions for each knee angle on each leg. An eight-camera motion capture system registered the knee joint movement of reflective markers on the participant. The intraclass correlation coefficient (ICC3,1) and standard error of the measurement (SEM) were used to report the result of the test-retest reliability. Results:. Our test indicated moderate- to good test-retest reliability where the knee flexion of 40 degrees showed a higher reliability than 65 degrees. Conclusions: This test has the potential to be developed for use in clinics to evaluate JPS. Further research should analyse the velocity component, whether there was a learning effect, and the impact of different angles.

  • 290.
    Hjorth, Maximilian
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Frykholm, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Motivation to participate in high-intensity functional exercise among older people with dementia2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med studien var att jämföra motivation att delta i ett högintensivt funktionellt träningsprogram (HIFE) med motivation att delta i en stillasittande social kontrollaktivitet hos äldre med demens boende i särskilda boenden. 186 personer randomiserades till träning (n=93) eller kontroll (n=93). De hade en medelålder på 85 år och 76 % var kvinnor. De hade fysiska och kognitiva nedsättningar och aktivitetsbegränsningar. Interventionen pågick under 4 månader med totalt 40 tillfällen om 45 minuter vardera. Frågor om deltagarnas motivation och utmaningar för genomförandet av aktiviteterna besvarades av aktivitetsledarna och personal.

    I hela gruppen fanns signifikant korrelation mellan motivation innan och under aktivitet. Motivation innan aktivitet skiljde sig signifikant till fördel för kontrollgruppen  vid ett av fyra mättillfällen. De största hindren för att utföra aktiviteterna var för träningsgruppen “låg motivation” och “smärta” och för kontrollaktiviteten “trötthet” och “minnesnedsättning”. 

    Äldre personer med demens som bor på serviceboende och är beroende i dagliga aktiviteter är i vår studie lika motiverade att delta i funktionellt högintensivt träningsprogram jämfört med social kontrollaktivitet. Därför kan funktionell högintensiv träning rekommenderas när sociala  aktiviteter blir svåra att genomföra pga. kognitiva nedsättningar. 

  • 291. Hodges, Paul W
    et al.
    Eriksson, A E Martin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Shirley, Debra
    Gandevia, Simon C
    Intra-abdominal pressure increases stiffness of the lumbar spine2005In: Journal of Biomechanics, ISSN 0021-9290, E-ISSN 1873-2380, Vol. 38, no 9, p. 1873-1880Article in journal (Refereed)
    Abstract [en]

    Intra-abdominal pressure (IAP) increases during many tasks and has been argued to increase stability and stiffness of the spine. Although several studies have shown a relationship between the IAP increase and spinal stability, it has been impossible to determine whether this augmentation of mechanical support for the spine is due to the increase in IAP or the abdominal muscle activity which contributes to it. The present study determined whether spinal stiffness increased when IAP increased without concurrent activity of the abdominal and back extensor muscles. A sustained increase in IAP was evoked by tetanic stimulation of the phrenic nerves either. unilaterally or bilaterally at 20 Hz (for 5 s) via percutaneous electrodes in three subjects. Spinal stiffness was measured as the force required to displace an indentor over the L4 or L2 spinous process with the subjects lying prone. Stiffness was measured as the slope of the regression line fitted to the linear region of the force-displacement curve. Tetanic stimulation of the diaphragm increased IAP by 27-61% of a maximal voluntary pressure increase and increased the stiffness of the spine by 8-31% of resting levels. The increase in spinal stiffness was positively correlated with the size of the IAP increase. IAP increased stiffness at L2 and L4 level. The results of this:study provide evidence that the stiffness of the lumbar spine is increased when IAP is elevated.

  • 292. Holland, Anne E
    et al.
    Wadell, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Spruit, Martijn A
    How to adapt the pulmonary rehabilitation programme to patients with chronic respiratory disease other than COPD2013In: European Respiratory Review, ISSN 0905-9180, E-ISSN 1600-0617, Vol. 22, no 130, p. 577-586Article in journal (Refereed)
    Abstract [en]

    Dyspnoea, fatigue, reduced exercise tolerance, peripheral muscle dysfunction and mood disorders are common features of many chronic respiratory disorders. Pulmonary rehabilitation successfully treats these manifestations in chronic obstructive pulmonary disease (COPD) and emerging evidence suggests that these benefits could be extended to other chronic respiratory conditions, although adaptations to the standard programme format may be required. Whilst the benefits of exercise training are well established in asthma, pulmonary rehabilitation can also provide evidence-based interventions including breathing techniques and self-management training. In interstitial lung disease, a small number of trials show improved exercise capacity, symptoms and quality of life following pulmonary rehabilitation, which is a positive development for patients who may have few treatment options. In pulmonary arterial hypertension, exercise training is safe and effective if patients are stable on medical therapy and close supervision is provided. Pulmonary rehabilitation for bronchiectasis, including exercise training and airway clearance techniques, improves exercise capacity and quality of life. In nonsmall cell lung cancer, a comprehensive interdisciplinary approach is required to ensure the success of pulmonary rehabilitation following surgery. Pulmonary rehabilitation programmes provide important and underutilised opportunities to improve the integrated care of people with chronic respiratory disorders other than COPD.

  • 293.
    Holm, Christian
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Ackermann, Kajsa
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Fysisk aktivitet i skolan för bättre resultat i teoretiska ämnen och kognitiva test: En systematisk litteraturgranskning2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Majoriteten av sveriges barn uppnår mindre än de rekommenderade 60 minuterna måttlig till kraftfull fysisk aktivitet (FA) per dag. Tidigare forskning indikerar att träning och FA i skolan kan förbättra resultaten i teoretiska ämenen, och att utökad FA inte försämrar resultaten.

    Syfte: Syftet med studien är att utifrån senaste forskningen sammanställa rekommenderad organiserad FA för skolbarn under skoltid för att maximera resultat i teoretiska ämnen och kognitiv prestation. 

    Metod: Systematisk litteraturgranskning enligt rekommendationer från en handbok av Statens beredning för medicinsk utvärdering (SBU).

    Resultat: Efter sållning kvalitetsgranskades 27 artiklar varav 18 bedömdes ha medel- eller hög kvalitet, de inkluderades därmed i den narrativa sammanvägningen. Resultaten från studierna kategoriserades mellan idrottslektioner, fysiskt aktiva teoretiska lektioner och fysiskt aktiva pauser. Studierna involverar barn och ungdomar i åldrarna 6–16 år och interventionernas duration varier från ett testtillfälle under en dag till en intervention över hela grundskolan, 9 år.

    Konklusion: Spridningen av inkluderade studiers interventioner och resultat är stor och det finns ett behov av vidare, mer omfattande, forskning. Med nuvarande evidensläge rekommenderar vi Sveriges grundskolor att överväga daglig FA av högre aerob intensitet med inslag av motorisk träning under idrottslektioner på 30-55 minuter. De äldre skolungdomarna rekommenderas även ha minst 30 minuter FA paus per dag med lägst moderat intensitet.

  • 294.
    Holmertz, Linnea
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Eriksson, Emil
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Träningsmotivation och mentalt välbefinnande hos elitidrottare: En jämförelse mellan individuella idrottare och lagidrottare på elitnivå2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Att undersöka skillnader i motivationsprofil och mentalt välbefinnande mellan individuella idrottare och lagidrottare på elitnivå. Ytterligare syften var att studera skillnader i mentalt välbefinnande mellan elitidrottare och svensk normalpopulation, samt eventuella samband mellan motivationsprofil och mentalt välbefinnande.

     

    Metod: Självskattningsformulären BREQ-3 och HADS besvarades online av 80 elitidrottare, 45 individuella idrottare och 35 lagidrottare. Svarsenkäterna analyserades med avseende på skillnader i träningsmotivation och mentalt välbefinnande mellan de två grupperna. Även skillnader i mentalt välbefinnande mellan elitidrottarna och normativ data för Sverige analyserades.

     

    Resultat: Ingen signifikant skillnad mellan grupperna gällande motivationsprofil eller mentalt välbefinnande påvisades. Analysen visade ett signifikant samband mellan motivationsprofil och mentalt välbefinnande. Elitidrottarna skattade högre ångestnivåer men lägre depressionsnivåer jämfört med normalbefolkningen.

     

    Konklusion: Varken motivationsprofil eller mentalt välbefinnande skiljer sig för individuella idrottare och lagidrottare på elitnivå. En mer självbestämmande motivationsprofil vilket bygger på en hög grad av inre motivation, är associerat med mentalt välbefinnande. Detta innebär att en inre motivation bör eftersträvas inom elitidrotten för att öka välbefinnandet. Detta resultat indikerar även att psykisk ohälsa hos elitidrottare bör studeras ytterligare.

  • 295.
    Holmgren, Eva
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gosman-Hedström, Gunilla
    3Department of Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg.
    Lindström, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wester, Per
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    What is the benefit of a high intensive exercise program?: A randomized controlled trial2010In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 12, no 3, p. 115-124Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to evaluate a high intensive exercise program in stroke subjects with risk of falls regarding balance, activities of daily life, falls efficacy, number of falls and lifestyle activities. The intervention program contained high intensity functional exercises (HIFE) implemented to real-life situations together with education on falls and security aspects. This was a single-center, single-blinded, randomized controlled trial. Consecutive >55-year-old patients with risk of falls were enrolled and randomized 3–6 months after first or recurrent stroke to the intervention group (IG, n=15) or to the control group (CG, n=19) who received group discussions about hidden dysfunctions after stroke. Outcomes were Berg Balance Scale (BBS) primarily, Barthel Index (BI), Falls Efficacy Scale – International (FES-I) and number of falls secondarily and Frenchay Activities Index last 3 months (FAI-3) tertially. Assessments were done at baseline, post-intervention, 3- and 6-month follow-up by two physiotherapists and one nurse blinded to group allocation. Generalized Estimating Equations with Repeated-measure statistics were used to analyze the data. There were no significant differences between the IG and the CG regarding balance (BBS). BI at 6 months and FES-I post-intervention and 3 months follow-up showed significant improvement in the IG compared with the CG (p<0.05). Number of falls and FAI-3 were without significant change. This study suggests that our program consisting of HIFE implemented in real-life situations together with educational discussions may improve performance of everyday life activities and improve falls efficacy in stroke subjects with risk of falls.

  • 296.
    Holmgren, Eva
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gosman-Hedström, Gunilla
    Göteborgs Universitet, 3Department of Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy.
    Lindström, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wester, Per
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    What is the benefit of a high intensive exercise program on health-related quality of life and depression after stroke?: A randomized controlled trial2010In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 12, no 3, p. 125-133Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to evaluate the impact of a high-intensive exercise program containing high-intensive functional exercises implemented to real-life situations together with group discussions on falls and security aspects in stroke subjects with risk of falls. This was a pre-specified secondary outcome for this study. For evaluation, Short Form-36 (SF-36) health-related quality of life (HRQoL) and the Geriatric Depression Scale-15 (GDS-15) were used. This was a single-center, single-blinded, randomized, controlled trial. Consecutive ≥55 years old stroke patients with risk of falls at 3–6 months after first or recurrent stroke were randomized to the intervention group (IG, n=15) or to the control group (CG, n=19) who received group discussion with focus on hidden dysfunctions but no physical fitness training. The 5-week high-intensive exercise program was related to an improvement in the CG in the SF-36 Mental Component Scale and the Mental Health subscale at 3 months follow-up compared with baseline values while no improvement was seen in the IG at this time. For the SF-36 Physical Component Scale, there was an improvement in the whole study group at 3 and 6 months follow-up compared with baseline values without any significant changes between the IG and CG. The GDS-15 was unchanged throughout the follow-up period for both groups. Based on these data, it is concluded that high-intensive functional exercises implemented in real-life situations should also include education on hidden dysfunctions after stroke instead of solely focus on falls and safety aspects to have a favorable impact on HRQoL.

  • 297.
    Holmgren, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Waling, Kerstin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Inter-examiner reliability of four static palpation tests used for assessing pelvic dysfunction2008In: Manual Therapy, ISSN 1356-689X, E-ISSN 1532-2769, Vol. 13, no 1, p. 50-56Article in journal (Refereed)
    Abstract [en]

    In muscle energy technique (MET), palpation is an important tool aimed at detecting asymmetry and selecting interventions. The aim of this study was to test the inter-examiner reliability of static palpation of the transverse processes of L5 (L5), sacral sulci (SS), inferior lateral angles of the sacrum (ILA), and the medial malleoli (MM) in a clinical setting. Twenty-five participants, aged 18–78 years, with low back pain and/or sacroiliac pain with or without radiating pain to the knee, were independently examined by two experienced physiotherapists. For L5, SS, ILA, the proportion of observed agreement was 40–44% and the κ coefficient 0.11 (SE=0.12) to 0.17 (SE=0.10). For MM, the observed agreement was 52% and the κ coefficient 0.28 (SE=0.15). Differences in palpation technique seem to be the most likely source of the low inter-examiner reliability in this study. For clinical practise, continued use of these tests as methods for detecting asymmetry and selecting interventions is of doubtful utility.

  • 298.
    Holmström, Linda
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rydstedt, Elsa
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Tandvårdsstudenters och tandvårdspersonals uppfattning, upplevelse och hantering av muskulär spänning2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Många inom tandvårdsyrken har spänningsrelaterade besvär men det råder brist på tidigare studier om hur tandvårdspersonal upplever och hanterar muskulär spänning. Syfte: Syftet med den här uppsatsen var att beskriva hur tandvårdsstudenter och tandvårdspersonal uppfattar, upplever och hanterar muskulär spänning. Metod: Studien utgick från en kvalitativ design med semistrukturerade individuellla intervjuer. Vid analysen av intervjuerna användes en kvalitativ innehållsanalys. Åtta personer som antingen arbetade som tandvårdspersonal eller studerade till det deltog i intervjuerna. Resultat: Resultatet från intervjuerna presenterade en bred bild av hur tandvårdsstudenter och personal upplevde och hanterade muskulär spänning. Innehåller i intervjuerna utmynnade i 5 kategorier: Spänning uppfattas som en rörelseinskränkning, Fysiska besvär och spänning kopplas till arbetsställningar och långa behandlingar, Höga prestationskrav leder till stress och spänningar, Medveten hållning och träning används som strategier samt Oro för vad spänningar skulle kunna leda till i framtiden. Konklusion: Muskulär spänning uppfattades som en ofrivillig muskelaktivering som kunde leda till en rörelseinskräkning och undvikande av rörelser. Spänning upplevdes bland annat som en stramhet och smärta. Den upplevda spänningen hanterades genom fysisk aktivitet, ergonomiska justeringar och strävan mot att släppa prestationskrav. Undervisning om ergonomi och tips om träning av fysioterapeut upplevdes underlätta för tandvårdsstudenter och tandvårdspersonals uppelvda spänning. Framtida forskning inom ergonomiska hjäpmedel och behandlingsmetoder för muskuloskeletala besvär är nödvändigt hos denna yrkesgrupp.  

  • 299.
    Hugosson, Rebecka
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Vikström, Thilda
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Motivation till fysisk träning, elitidrottare jämfört med motionärer: En enkätstudie2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Sammanfattning:

     Introduktion:

    Fysisk aktivitet och träning är viktiga faktorer för att hålla sig hälsosam och frisk. Trots att fysisk inaktivitet kan påverka både den fysiska och psykiska hälsan negativt så är 1,5 miljarder vuxna i hela världen inaktiva. Att förstå drivkrafterna till varför man väljer att vara fysiskt aktiv eller inte är viktigt. Tidigare studier har visat att olika typer av motivation kan vara av olika betydelser för motionärer jämfört med det som driver elitidrottare till att träna.

     Syfte:

    Syftet med denna studie var att undersöka skillnader i motivationsfaktorer bland elitidrottare inom längdskidåkning och orientering jämfört med motionärer. Hypotesen var att elitidrottarna bör ha mer inre motivation och att motionärer styrs av yttre faktorer.

     Metod:

    Självskattningsformuläret BREQ-3 delades ut till elitidrottande längdskidåkare och orienterare samt motionärer på Umeå Universitet och genom sociala medier. Tjugoen stycken elitidrottare och 25 stycken motionärer svarade på enkäten. Svaren sammanställdes och analyserades med avseende på skillnader i graden av inre och yttre motivation samt icke-motivation mellan de båda grupperna.

     Resultat:

    Resultatet visade på en signifikant skillnad i motivationsfaktorer mellan elitidrottare och motionärer där motionärerna hade en högre grad av icke-motivation och elitidrottarna hade en högre grad av inre motivationsfaktorer och av de yttre motivationsfaktorerna integrerad, identifierad och introjected reglering.

     Konklusion:

    Studien visade att elitidrottare (inom längdskidåkning och orientering) tränar framförallt för att nå ett mål och värderar fördelarna med sin träning medan motionärerna inte är lika motiverade till fysisk träning.

  • 300.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Förbättrad klinisk bedömning och behandling med stöd av instrumentell rörelseanalys2013Conference paper (Other academic)
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