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  • 251.
    Björkbacka, Sofia
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Holmberg, Elin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Polisstudents träningsvanor och uppfattning om polisyrkets fysiska krav2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Polisyrket är ett stillasittande arbete som stundtals ställer höga krav på polisers fysiska kapacitet.

    Syfte: Syftet med denna studie var att undersöka nyrekryterade polisstudenters tidigare och nuvarande träningsvanor. Syftet var också att undersöka studenternas uppfattning om träning och motivation för att klara de fysiska kraven på det framtida yrket.

    Metod: Totalt deltog 69 studenter från en polisutbildning i Sverige i denna frågeformulärsbaserade studie.

    Resultat: Polisstudenterna tränade i genomsnitt 7,6 timmar i veckan vid tiden för studien och 97 % angav att de tränat regelbundet under det senaste halvåret. De främsta anledningarna till att de tränade var för psykiskt och fysiskt välmående och för att klara det framtida yrket som polis. 90% av studenterna hade tränat regelbundet under ungdomsåren. De flesta polisstudenterna var positiva till införandet av regelbundna fystester för yrkesverksamma poliser.

    Slutsats: Polisstudenterna i denna studie hade flera års erfarenhet av träning och alla studenterna uppgav att de var motiverade att fortsätta träna. Eftersom tidigare studier visat att personer med lång träningsvana lättare upprätthåller en god fysisk kapacitet högre upp i åldern tydde resultatet i denna studie på att denna grupp studenter har goda förutsättningar att fortsätta vara fysiskt aktiva även efter avslutade studier.

  • 252.
    Björkholm, Annika
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wahlström, Olivia
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Är yt-EMG ett reliabelt instrument i kombination med Biodex vid mätning av bukmuskelaktivitet?: En pilotstudie med friska kontrollpersoner och personer med abdominal rektusdiastas.2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Abdominal rektusdiastas (ARD) är ett tillstånd då de raka magmusklerna delar på sig för att linea alba blir slapp. Detta kan drabba kvinnor under graviditet och kraftigt överviktiga. Personer med ARD kan uppleva nedsatt styrka och obehagskänsla.

    Metod: Totalt fem deltagare medverkade i bukmuskelmätningar, tre friska kontrollpersoner och två personer med ARD. Elektroder för yt-elektromyografi (yt-EMG) placerades på sex olika ställen över deltagarnas m. rectus abdominis och m. obliquus externus abdominis. Muskelaktivitet och muskelstyrka mättes genom isometriska kontraktioner i Biodex dynamometer. Deltagarna fick utföra fem kontraktioner om fem sekunder med fem sekunder vila mellan varje kontraktion. Detta upprepades två gånger för varje deltagare med en veckas mellanrum. Relativ och absolut test-retest relabilitet beräknades med intraclass correlation coefficient (ICC) och minimal detectable change i % (MDC %) på timing, amplitud och fatigue uppmätt med yt-EMG och muskelstyrka uppmätt med Biodex.

    Resultat: Den relativa och absoluta reliabiliteten visade sig vara varierad avseende samtliga variabler. Relativ reliabilitet gick från låg till utmärkt (ICC: 0,36—0,92) och absolut reliabilitet visade MDC % 42—362

    Konklusion: Denna pilotstudie kan ge en grund för vidare studier om hur muskelfunktionen är påverkad hos personer med ARD med hjälp av yt-EMG, dock krävs fortsatta studier med fler deltagare för att resultat ska kunna generaliseras.

  • 253.
    Björkkvist, Johan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Interplay in deformation between dorsal neck muscles: an observational ultrasound study2018Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Introduction: Neck pain is an increasing problem today and impaired neck muscle function may lead to disability. Neck specific training can reduce pain and increase function, but the activation of the muscles is unknown. Ultrasound with post-process speckle tracking can be used to measure deformation and deformation rate of the muscles. No previous studies have investigated neck exercise used in rehabilitation of neck pain. Aim: To investigate differences in deformation between different muscle layers in dorsal neck muscles and their interplay during quadruped rotational training in neck-healthy subjects. Method: Deformation and deformation rate were investigated in three dorsal neck muscles in twenty neck healthy subjects by ultrasonography with speckle tracking analyses. Repeated measures ANOVA was used to measure differences between the muscles and Kendall’s tau correlation was used to calculate the interplay between the muscles. Results: The semispinalis capitis muscle show the highest deformation in left rotation (F(1.23, 24.26)=6.90, p=0.01) compared to the multifidus (p=0.05) and trapezius (p=0.03) muscles. Interplay was seen between semispinalis capitis and the trapezius muscles in both left and right rotation, respectively (r=0.42 and r=0.34) regarding deformation. In deformation rate the semispinalis capitis muscle showed the highest degree of deformation in both left (F(1.43, 27.25)=9.05, p=<0.01) and right rotation (F(2, 38)=14.26, p=< 0.01). Interplay was seen between the semispinalis capitis and the trapezius muscle in right rotation (r=0.47) the multifidus muscles in both left (r=0.58) and right rotation (r=0.62). Conclusion: The ultra sound examination shows that the semispinalis capitis muscle is activated mainly but that it interacts with both the trapezius and the multifidus muscle. This result should be interpreted with care. More studies are needed to confirm if the deformations are active or passive.

  • 254.
    Björklund, Marie
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Johansson, Linnea
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Rehabiliteringskoordinatorers arbetsprocess i primärvård2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    En utsatt grupp i dagens samhälle är de som är långtidssjukskrivna och de personer som riskerar att bli sjukskrivna. Brister inom primärvården har resulterat i långa väntetider för rehabilitering och handläggning av sjukskrivningsärenden. En åtgärd som vidtogs var att införa koordinatorer i primärvården. Syftet med studien var att undersöka hur koordinatorernas arbetsprocess ser ut. För att ta reda på detta, valdes en kvalitativ metod och en semistrukturerad intervju. Sex koordinatorer intervjuades. Studien visar att en central del i koordinatorns uppdrag är att kontakta de patienter som är eller riskerar att bli långtidssjukskrivna, för att vidare kartlägga behovet av rehabilitering och stöd. Koordinatorn fungerar som stödperson för patienten och som samarbetspartner till vårdens interna och externa aktörer, som Försäkringskassan, Arbetsförmedlingen och socialtjänsten. Studien visar att förutsättningar för koordinatorns arbete är ett välfungerande samarbete med det interna teamet och de externa aktörerna.

  • 255.
    Björklund, Martin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, Gävle, Sweden.
    Djupsjöbacka, Mats
    Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, Gävle, Sweden.
    Svedmark, Åsa
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, Gävle, Sweden.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Effects of tailored neck-shoulder pain treatment based on a decision model guided by clinical assessments and standardized functional tests: a study protocol of a randomized controlled trial2012In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 13, article id 75Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: A major problem with rehabilitation interventions for neck pain is that the condition may have multiple causes, thus a single treatment approach is seldom efficient. The present study protocol outlines a single blinded randomised controlled trial evaluating the effect of tailored treatment for neck-shoulder pain. The treatment is based on a decision model guided by standardized clinical assessment and functional tests with cut-off values. Our main hypothesis is that the tailored treatment has better short, intermediate and long-term effects than either non-tailored treatment or treatment-as-usual (TAU) on pain and function. We sub-sequentially hypothesize that tailored and non-tailored treatment both have better effect than TAU.

    METHODS: 120 working women with minimum six weeks of nonspecific neck-shoulder pain aged 20-65, are allocated by minimisation with the factors age, duration of pain, pain intensity and disability in to the groups tailored treatment (T), non-tailored treatment (NT) or treatment-as-usual (TAU). Treatment is given to the groups T and NT for 11 weeks (27 sessions evenly distributed). An extensive presentation of the tests and treatment decision model is provided. The main treatment components are manual therapy, cranio-cervical flexion exercise and strength training, EMG-biofeedback training, treatment for cervicogenic headache, neck motor control training. A decision algorithm based on the baseline assessment determines the treatment components given to the each participant of T- and NT-groups. Primary outcome measures are physical functioning (Neck Disability Index) and average pain intensity last week (Numeric Rating Scale). Secondary outcomes are general improvement (Patient Global Impression of Change scale), symptoms (Profile Fitness Mapping neck questionnaire), capacity to work in the last 6 weeks (quality and quantity) and pressure pain threshold of m. trapezius. Primary and secondary outcomes will be reported for each group with effect size and its precision.

    DISCUSSION: We have chosen not to include women with psychological ill-health and focus on biomedical aspects of neck pain. Future studies should aim at including psychosocial aspects in a widened treatment decision model. No important adverse events or side-effects are expected.

    Trial registration: Current Controlled Trials registration ISRCTN49348025.

  • 256.
    Björklund, Martin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Djupsjöbacka, Mats
    Svedmark, Åsa
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Effects of tailored versus non-tailored treatment on pain and pressure pain threshold in women with non-specific neck pain: A randomized controlled trial2014Conference paper (Other academic)
  • 257.
    Björklund, Martin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hamberg, Jern
    Heiden, Marina
    Barnekow-Bergkvist, Margareta
    The ProFitMap-neck - reliability and validity of a questionnaire for measuring symptoms and functional limitations in neck pain2012In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 34, no 13, p. 1096-1107Article in journal (Refereed)
    Abstract [en]

    Purpose: To assess overall reliability and validity of a neck-specific questionnaire, the Profile Fitness Mapping neck questionnaire (ProFitMap-neck), on three chronic neck pain groups. Method: Participating groups were as follows: whiplash associated disorders, inpatient care (IP-WAD, n = 127); nonspecific neck pain, inpatient care (IP-NS, n = 83) and nonspecific neck pain subjects (non-IP-NS, n = 104). All groups answered the ProFitMap-neck and the SF-36, whereas non-IP-NS also answered the Neck Disability Index (NDI) and the Functional Self-Efficacy Scale (SES). Internal consistency, test-retest reliability and components of convergent construct, face and content validity were determined for the ProFitMap-neck. Results: The ProFitMap-neck showed good internal consistency in all three groups, and ICC test-retest reliability (0.80-0.91). Good correlation (0.66-0.78) and highest agreement was reached with NDI. According to the International Classification of Functioning, Disability and Health, the symptom scale of the ProFitMap-neck was mainly classified to the domain of impairments-body functions, and the functional limitation scale to the activity limitation domain. Conclusion: The results indicate that the ProFitMap-neck is valid for measuring symptoms and functional limitations in people with chronic neck pain. The combination of a composite total score of symptoms and function as well as separate scores of each domain makes ProFitMap-neck suitable for research as well as in clinical practice.

  • 258.
    Björklund, Martin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Ga¨vle.
    Wiitavaara, Birgitta
    Heiden, Marina
    Responsiveness and minimal important change for the ProFitMap-neck questionnaire and the Neck Disability Index in women with neck-shoulder pain2017In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 26, no 1, p. 161-170Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The aim was to determine the responsiveness and minimal important change (MIC) of the questionnaire ProFitMap-neck that measures symptoms and functional limitations in women with neck pain. The same measurement properties were determined for Neck Disability Index (NDI) for comparison purposes.

    METHODS: Longitudinal data were derived from two randomized controlled trials, including 103 and 120 women with non-specific neck pain, with questionnaire measurements performed before and after interventions. Sensitivity and specificity to discriminate between improved and not or little changed participants, based on categorization of a global rating of change scale (GRCS), were determined for the ProFitMap-neck indices and NDI by using area under receiver operating characteristic curves (AUC). Correlations between the GRCS anchor and change scores of the questionnaires were also used to assess responsiveness. The change score that showed the highest combination of sensitivity and specificity was set for MIC.

    RESULTS: The ProFitMap-neck indices showed similar responsiveness as NDI with AUC exceeding 0.70 (Range: ProFitMap-neck, 0.74-0.83; NDI, 0.75-0.86). The MIC in the two samples ranged between 6.6 and 13.6 % for ProFitMap-neck indices and 5.2 and 6.3 % for NDI. Both questionnaires had significant correlations with GRCS (Spearman's rho 0.47-0.72).

    CONCLUSIONS: Validity of change scores was endorsed for the ProFitMap-neck indices and NDI with adequate ability to discriminate between improved and not or little changed participants. Values of minimal important change were presented.

  • 259.
    Björkqvist, Lisa
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Östman, Cecilia
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Aktivitetsschema för barn och ungdomar med kognitiv funktionsnedsättning- ett föräldraperspektiv: En kvalitativ studie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Barn och ungdomar med kognitiv funktionsnedsättning har ofta svårigheter med att påbörja och slutföra en aktivitet samt att hantera och uppfatta tid. För att dessa barn och ungdomar ska vara mer självständiga och delaktiga i sin egen vardag är de i behov av en tydlig struktur över vardagens aktiviteter. Ett kognitivt stöd som används för att bland annat öka självständighet och delaktighet är ett aktivitetsschema. Aktivitetsscheman kan vara en serie av symboler, bilder, foton eller text som används för att framställa en följd av händelser. Syftet med denna studie var att undersöka hur föräldrar till barn och ungdomar med kognitiv funktionsnedsättning upplever aktivitetsscheman som ett kognitivt stöd i vardagen. För att undersöka detta intervjuades fyra föräldrar till barn och ungdomar med kognitiv funktionsnedsättning som använder eller har använt aktivitetsscheman. Intervjuerna analyserades med hjälp av kvalitativ innehållsanalys och resulterade i fem huvudkategorier: ‘’Aktivitetsscheman får vardagen att fungera’’, ‘’Utformningen av aktivitetsscheman tar mycket energi av föräldrarna’’, ‘’Aktivitetsscheman bidrar till utveckling, självständighet och delaktighet hos användarna’’, ‘’Aktivitetsscheman leder till en bättre relation mellan barn och förälder’’ och ‘’Föräldrarna upplever ett behov av stöd från arbetsterapeuten’’.  Resultatet visar att aktivitetsscheman är ett viktigt stöd i vardagen, det bidrar till ökad självständighet och delaktighet. Aktivitetsscheman ger en trygghet hos både barn och föräldrar men framställning och hantering av aktivitetsscheman innebär ett tidskrävande arbete för föräldrarna. Utifrån studien kan vi dra slutsatsen att arbetsterapeuten har en viktig roll genom att ge stöd till föräldrarna och att en arbetsterapeutisk intervention som aktivitetsscheman kan bidra till hälsa och välbefinnande för en hel familj.

  • 260.
    Björkén, Elin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Medicinsk gräns mellan grov misshandel och synnerligen grov misshandel: En studie av svensk rättspraxis2014Student paper other, 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Den 1 juli 2010 infördes, genom SFS 2010:370, nya straffbestämmelser i brottsbalken (1962:700) (BrB). Dessa innebar en uppdelning av den grova formen av misshandel som reglerades i 3 kap. 6 § BrB, den kvalificerade formen av misshandel delades upp till grov misshandel och synnerligen grov misshandel. De grövsta brotten skulle omfattas av den strängare brottsrubriceringen som innebar en strängare straffskala på fyra till tio års fängelse, medan grov misshandel skulle ge fängelse om lägst ett år och högst sex år. Det främsta syftet med reformen var att de grövsta brotten skulle stå i proportion till brottets allvar då man tidigare gjort bedömningen att de grövsta brotten endast dömdes ut i den nedre delen av straffskalan.

     

    Olika rekvisit tas hänsyn till när domstolarna ska bedöma en misshandel som grov eller synnerligen grov men det jag främst vill undersöka i denna promemoria är om det finns någon medicinsk gräns som man kan utläsa för att skilja på grov misshandel samt synnerligen grov misshandel. Jag kommer främst försöka finna detta genom hänvisning till de rättsintyg som eventuellt finns med i domskälen till de rättsfall jag valt att studera. Ett rättsintyg är ett dokument som har arbetats fram av en läkare innehållande bedömning och beskrivning av olika medicinska fynd. Dessa dokument ska framläggas inför domstol eller användas vid utredning av brott. Ett rättsintyg är ingen patientjournal utan har ett juridiskt ändamål. I ett rättsintyg presenteras samtliga undersökningsfynd, både förekomst och frånvaro av skador.

  • 261.
    Björnfot, Elina
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Eriksson, Amanda
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Samband mellan fysisk aktivitetsnivå, kinesiofobi och symtomskattning hos kvinnor med lokal nacksmärta och generaliserad spinal smärta: En korrelationsstudie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Nacksmärta är ett globalt hälsoproblem och samtidig smärta i nacke och rygg påträffas ofta, särskilt hos kvinnor. Den bakomliggande orsaken är till stor del okänd och en funktionsnedsättande rädsla för rörelse, dvs. kinesiofobi är vanligt förekommande hos personer med muskuloskeletal smärta vilket är problematisk då fysisk aktivitet har visat fördelaktiga effekter mot ospecifik nacksmärta.Syfte: Att undersöka samband mellan symtomskattning, fysisk aktivitetsnivå och kinesiofobi hos kvinnor med kronisk ospecifik nacksmärta, samt analysera eventuella skillnader mellan lokal nacksmärta och samtidig rygg- och nacksmärta (generaliserad spinal smärta). Metod: I studien ingick 118 deltagare. Två undergrupper skapades för att skilja generaliserad spinal smärta och lokal nacksmärta. Symtomskattning baserades på ProFitMap-neck, kinesiofobi på the Tampa Scale for Kinesiophobia och fysisk aktivitetsnivå på utvalda frågor från LIV2000. En korrelationsanalys gjordes mellan variablerna i helgrupp och därefter i undergrupper, enligt Spearman’s rho. Test av skillnader i undergrupperna gjordes enligt Mann Whitney och oparat t-test. Resultat: Ett signifikant samband sågs mellan kinesiofobi och fysisk aktivitetsnivå i helgrupp (rho= -0,261 p=0,005), samt hos personer med generaliserad spinal smärta (rho= -0,308 p=0,013). För personer med generaliserad spinal smärta sågs en signifikant högre symtomskattning (p=0,003) jämfört med personer med lokal nacksmärta. Slutsats: Kvinnor med generaliserad spinal smärta upplever mer symtom än kvinnor med lokal nacksmärta, därför är det viktigt att ta hänsyn till utbredningen av symtom vid utredning och rehabilitering av kronisk ospecifik nacksmärta. Fler studier bör utföras för att undersöka hur symtom samverkar med kinesiofobi och fysisk aktivitetsnivå hos personer med generaliserad spinal smärta och lokal nacksmärta. 

  • 262.
    Björngard, Robert
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Benandlas kvinnor och män lika när de kontaktar hälsocentralen: en pilotstudie vid Offerdals hälsocentral2012Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 263.
    Björnstig, Ulf
    et al.
    Umeå University, Faculty of Medicine, Surgical and Perioperative Sciences, Surgery.
    Björnstig, Johanna
    Umeå University, Faculty of Medicine, Surgical and Perioperative Sciences, Surgery.
    Ahlm, Kristin
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation.
    Sjögren, Harmeet
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation.
    Violent deaths in small children in northern Sweden.2006In: International journal of circumpolar health, ISSN 1239-9736, Vol. 65, no 1, p. 28-34Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To identify causes and trends of violent deaths among children younger than 4 years in a northern region. STUDY DESIGN: Retrospective analysis of medico-legal autopsy and police data. METHODS: Data from all 72 deaths from "external causes" 1977-2004, in children < 4 years from the northern half of Sweden were analysed. RESULTS: The death rate was 7.1 per 100,000 children and year during the first half of the study period, and 5.2 during the second half. Vehicle- and drowning-related deaths were halved. Fifteen were struck by motor vehicles (in 8 cases by heavy vehicles), 14 car occupants were killed in car crashes, 12 were killed by intentional violence inflicted by an adult, and 9 each were killed by (i) carbon monoxide/smoke inhalation, (ii) asphyxiation, or (iii) drowning. The boy:girl ratio was 1:1 in all groups, except in the groups "drowning" and "run over by motor vehicle", where boys dominated. CONCLUSIONS: Medical professionals have a difficult but important task in identifying and taking action against child abuse and in promoting child safety especially in the traffic and home environments.

  • 264.
    Björnstig, Ulf
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Björnstig, Johanna
    The Emergency and Disaster Medical Center, University Hospital, SE-901 85 Umeå, Sweden.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine. Rättsmedicin.
    Passenger car collision fatalities - with special emphasis on collisions with heavy vehicles2008In: Accident Analysis and Prevention, ISSN 0001-4575, E-ISSN 1879-2057, Vol. 40, no 1, p. 158-166Article in journal (Refereed)
    Abstract [en]

    Between 1995 and 2004, 293 passenger car occupants died in collisions with other vehicles in northern Sweden (annual incidence: 3.3 per 100,000 inhabitants, 6.9 per 100,000 cars, or 4.8 per 109 km driven); half of these deaths involved heavy vehicles. The annual number of passenger car occupant death per 100,000 cars in var-truck/bus collisions has remained unchanged since the 1980s, , but in car-car collisions it has decreased to one third of its former level. As crash objects, trucks and buses killed five times as many car occupants per truck/bus kilometer driven as did cars.

    The collisions were characterized by crashes in the oncoming vehicle´s lane, under icy, snowy, or wet conditions; crashes into heavy vehicles generally occurred in daylight, on workdays, in winter, and on 90 and 70 km/h two-lane roads. Head and chest injuries accouted for most of the fatal injuries. multiple fatal injuries and critical and deadly head injuries characterized the deaths in collisions with heavy vehicles.

    An indication of suicide was present in 4% of the deaths; for thos who crashed into trucks, this percentage was doubled. Among the driver victims, 4% had blood alcohol levels above the legal limit of 0.2 g/L.

    Frontal collision risks might be reduced by a mid-barrier, by building less injurious fronts on trucks and buses, by efficient skid prevention, and by use of flexible speed limits varying with road and light conditions.

  • 265.
    Bladh, Stina
    et al.
    Department of Health Sciences, Lund University, Lund, Sweden.
    Nilsson, Maria H
    Department of Health Sciences, Lund University, Lund, Sweden.
    Hariz, Gun-Marie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy. Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience.
    Westergren, Albert
    School of Health and Society, Kristianstad University, Kristianstad, Sweden.
    Hobart, Jeremy
    Department of Clinical Neuroscience, Peninsula Medical School, Plymouth, UK.
    Hagell, Peter
    Department of Health Sciences, Lund University, Lund, Sweden.
    Psychometric performance of a generic walking scale (Walk-12G) in Multiple Sclerosis and Parkinson's disease2012In: Journal of Neurology, ISSN 0340-5354, E-ISSN 1432-1459, Vol. 259, no 4, p. 729-738Article in journal (Refereed)
    Abstract [en]

    Walking difficulties are common in neurological and other disorders, as well as among the elderly. There is a need for reliable and valid instruments for measuring walking difficulties in everyday life since existing gait tests are clinician rated and focus on situation specific capacity. The Walk-12G was adapted from the 12-item multiple sclerosis walking scale as a generic patient-reported rating scale for walking difficulties in everyday life. The aim of this study is to examine the psychometric properties of the Walk-12G in people with multiple sclerosis (MS) and Parkinson’s disease (PD). The Walk-12G was translated into Swedish and evaluated qualitatively among 25 people with and without various neurological and other conditions. Postal survey (MS, n = 199; PD, n = 189) and clinical (PD, n = 36) data were used to test its psychometric properties. Respondents considered the Walk-12G relevant and easy to use. Mean completion time was 3.5 min. Data completeness was good (<5% missing item responses) and tests of scaling assumptions supported summing item scores to a total score (corrected item-total correlations >0.6). Coefficient alpha and test–retest reliabilities were >0.9, and standard errors of measurement were 2.3–2.8. Construct validity was supported by correlations in accordance with a priori expectations. Results are similar to those with previous Walk-12G versions, indicating that scale adaptation was successful. Data suggest that the Walk-12G meets rating scale criteria for clinical trials, making it a valuable complement to available gait tests. Further studies involving other samples and application of modern psychometric methods are warranted to examine the scale in more detail.

  • 266. Blain, H.
    et al.
    Masud, T.
    Dargent-Molina, P.
    Martin, F. C.
    Rosendahl, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    van der Velde, N.
    Bousquet, J.
    Benetos, A.
    Cooper, C.
    Kanis, J. A.
    Reginster, J. Y.
    Rizzoli, R.
    Cortet, B.
    Barbagallo, M.
    Dreinhoefer, K. E.
    Vellas, B.
    Maggi, S.
    Strandberg, T.
    A comprehensive fracture prevention strategy in older adults: the European Union Geriatric Medicine Society (EUGMS) statement2016In: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 28, no 4, p. 797-803Article in journal (Refereed)
    Abstract [en]

    Prevention of fragility fractures in older people has become a public health priority, although the most appropriate and cost-effective strategy remains unclear. In the present statement, the Interest Group on Falls and Fracture Prevention of the European Union Geriatric Medicine Society, in collaboration with the International Association of Gerontology and Geriatrics for the European Region, the European Union of Medical Specialists, and the International Osteoporosis Foundation-European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, outlines its views on the main points in the current debate in relation to the primary and secondary prevention of falls, the diagnosis and treatment of bone fragility, and the place of combined falls and fracture liaison services for fracture prevention in older people.

  • 267. Blain, H.
    et al.
    Masud, T.
    Dargent-Molina, P.
    Martin, F. C.
    Rosendahl, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    van der Velde, N.
    Bousquet, J.
    Benetos, A.
    Cooper, C.
    Kanis, J. A.
    Reginster, J. Y.
    Rizzoli, R.
    Cortet, B.
    Barbagallo, M.
    Dreinhofer, K. E.
    Vellas, B.
    Maggi, S.
    Strandberg, T.
    A comprehensive fracture prevention strategy in older adults: the European Union Geriatric Medicine Society (EUGMS) statement2016In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 20, no 6, p. 647-652Article in journal (Refereed)
    Abstract [en]

    Prevention of fragility fractures in older people has become a public health priority, although the most appropriate and cost-effective strategy remains unclear. In the present statement, the Interest Group on Falls and Fracture Prevention of the European Union Geriatric Medicine Society (EUGMS), in collaboration with the International Association of Gerontology and Geriatrics for the European Region (IAGG-ER), the European Union of Medical Specialists (EUMS), the International Osteoporosis Foundation - European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, outlines its views on the main points in the current debate in relation to the primary and secondary prevention of falls, the diagnosis and treatment of bone fragility, and the place of combined falls and fracture liaison services for fracture prevention in older people.

  • 268. Blain, H.
    et al.
    Masud, T.
    Dargent-Molina, P.
    Martin, F. C.
    Rosendahl, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    van der Velde, N.
    Bousquet, J.
    Benetos, A.
    Cooper, C.
    Kanis, J. A.
    Reginster, J. Y.
    Rizzoli, R.
    Cortet, B.
    Barbagallo, M.
    Dreinhöfer, K.
    Vellas, B.
    Maggi, S.
    Strandberg, T.
    Alvarez, M. N.
    Annweiler, C.
    Bernard, P. -L
    Beswetherick, N.
    Bischoff-Ferrari, H. A.
    Bloch, F.
    Boddaert, J.
    Bonnefoy, M.
    Bousson, V.
    Bourdel-Marchasson, I.
    Capisizu, A.
    Che, H.
    Clara, J. G.
    Combe, B.
    Delignieres, D.
    Eklund, Patrik
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Emmelot-Vonk, M.
    Freiberger, E.
    Gauvain, J. -B
    Goswami, N.
    Guldemond, N.
    Herrero, A. C.
    Joel, M. -E
    Jonsdottir, A. B.
    Kemoun, G.
    Kiss, I.
    Kolk, H.
    Kowalski, M. L.
    Krajcik, S.
    Kutsal, Y. G.
    Lauretani, F.
    Macijauskiene, J.
    Mellingsaeter, M.
    Morel, J.
    Mourey, F.
    Nourashemi, F.
    Nyakas, C.
    Puisieux, F.
    Rambourg, P.
    Ramirez, A. G.
    Rapp, K.
    Rolland, Y.
    Ryg, J.
    Sahota, O.
    Snoeijs, S.
    Stephan, Y.
    Thomas, E.
    Todd, C.
    Treml, J.
    Adachi, R.
    Agnusdei, D.
    Body, J. -J
    Breuil, V.
    Bruyere, O.
    Burckardt, P.
    Cannata-Andia, J. B.
    Carey, J.
    Chan, D. -C
    Chapuis, L.
    Chevalley, T.
    Cohen-Solal, M.
    Dawson-Hughes, B.
    Dennison, E. M.
    Devogelaer, J. -P
    Fardellone, P.
    Feron, J. -M
    Perez, A. D.
    Felsenberg, D.
    Glueer, C.
    Harvey, N.
    Hiligsman, M.
    Javaid, M. K.
    Jorgensen, N. R.
    Kendler, D.
    Kraenzlin, M.
    Laroche, M.
    Legrand, E.
    Leslie, W. D.
    Lespessailles, E.
    Lewiecki, E. M.
    Nakamura, T.
    Papaioannou, A.
    Roux, C.
    Silverman, S.
    Henriquez, M. S.
    Thomas, T.
    Vasikaran, S.
    Watts, N. B.
    Weryha, G.
    A comprehensive fracture prevention strategy in older adults: the European union geriatric medicine society (EUGMS) statement2016In: European Geriatric Medicine, ISSN 1878-7649, E-ISSN 1878-7657, Vol. 7, no 6, p. 519-525Article in journal (Refereed)
    Abstract [en]

    Prevention of fragility fractures in older people has become a public health priority, although the most appropriate and cost-effective strategy remains unclear. In the present statement, the Interest group on falls and fracture prevention of the European union geriatric medicine society (EUGMS), in collaboration with the International association of gerontology and geriatrics for the European region (IAGG-ER), the European union of medical specialists (EUMS), the Fragility fracture network (FFN), the International osteoporosis foundation (IOF) - European society for clinical and economic aspects of osteoporosis and osteoarthritis (ECCEO), outlines its views on the main points in the current debate in relation to the primary and secondary prevention of falls, the diagnosis and treatment of bone fragility, and the place of combined falls and fracture liaison services for fracture prevention in older people.

  • 269.
    Blom, Anna-Klara
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Andersson, Charlotta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Akuta responser vid högintensiv uppvärmning hos idrottare2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Att undersöka förändringar i autonom balans och forcerad expiratorisk volym (FEV1) före jämfört med efter specifik intervalluppvärmning hos idrottare utan någon form av astma eller ansträngningsutlöst bronkokonstriktion (EIB). Detta för att se vilken belastning som är bäst lämpad att använda i vidare studie av akuta responser vid högintensiv uppvärmning hos individer med EIB, samt om en förskjutning i autonom balans mot en förhöjd sympatikusaktivitet parallellt med ett ökat FEV1 kan ses hos friska idrottare. 

    Metod: Fyra deltagare utförde ett Maximal Aerobic Power output test (MAP) för att beräkna maximal aerob effekt. Cykelintervaller utfördes sedan på fyra olika nivåer av intensitet (75–150% av MAP) där hjärtfrekvensvariabilitet och FEV1 mättes före och efter.

    Resultat: Endast vid cykelintervaller på 150% av MAP sågs en förändring i autonom balans med ett ökat sympatikuspåslag och ett minskat parasympatikuspåslag hos alla deltagare före jämfört med efter intervallerna. Ingen tydlig ökning sågs i FEV1 före jämfört med efter cykelintervaller på de fyra olika nivåerna av belastning (75–150% av MAP).

    Slutsats: En belastning på minst 150% av MAP kan leda till en förskjutning i autonom balans mot en förhöjd sympatikusaktivitet skall ske hos friska idrottare. FEV1 tycks ej följa kurvan för autonom balans vid samma belastning hos idrottare utan astma.

  • 270.
    Blom, Josefina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Bevisning i våldtäktsmål: Hur starkt bevisvärde har rättsintyg?2012Student paper other, 5 credits / 7,5 HE creditsStudent thesis
    Abstract [sv]

    Överfallsvåldtäkter är sällsynta och av naturliga skäl saknas oftast vittnen till händelsen, den huvudsakliga bevisningen består vanligtvis av målsägandens och den åtalades utsagor. I NJA 2009 s. 447 I och II menade Högsta domstolen att det inte räckte att målsägandens utsaga var mer trovärdig än den tilltalades. Det krävede dessutom att målsägandens utsaga, till den del det var möjligt, kunde kontrolleras. De två åtalade männen, som av lägre instanser dömdes för våldtäkt, friades av Högsta domstolen. Deras nekande och avsaknaden av stödbevis medförde att det inte kunde anses vara ställt utom rimligt tvivel att de gjort sig skyldiga till de påstådda brotten.

    I våldtäktsmål ska alltså målsägandens utsaga kontrolleras för att kunna värderas högre än den åtalades. Det gäller, i enlighet med NJA 2009 s. 447 I och II, även om den målsägandens utsaga anses vara mer trovärdig än den åtalades. Med andra ord är det särskilt viktigt med stödbevisning, till exemple i form av rättsintyg, i våldtäksmål om en fällande dom ska kunna komma på tal. Med anledning av ovanståden finner jag det intressant att undersöka i vilken omfattning rättsintyg har åberopats och vilket bevisvärde rättsintygen tillmäts i våldtäktsmål.

  • 271.
    Blomdahl, Christina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Stationära ramfaktorer inom bildterapi vid depression: – en litteraturstudie –2007Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Depression innebär ofta ett stort lidande och stora konsekvenser i det dag-liga livet. Bildterapeuter har arbetat med gruppen, men det finns ingen sammanställning över behandling och metoder. Syftet med studien var där-för att undersöka vilka stationära ramfaktorer som anges i studier av bildte-rapi vid depression. En systematisk litteraturstudie användes som metod. Sökningar genomfördes i de fyra databaserna Medline, PsycINFO, AMED och CINAHL och resulterade i 10 artiklar som uppfyllde inklusionskriteri-erna. Studien resulterade i två huvudgrupper dels genomförande av bildte-rapi med fem undergrupper, material, genomförande, målsättning, grupp och verbal genomgång och dels bildterapiteman med sex undergrupper bildte-man med fokus på dialog om klientens livssituation, med fokus på att ut-trycka känslor, med fokus på kroppsupplevelse, med fokus på tydliggö-rande, med fokus på problemlösning och bildteman med fokus på omformu-lering. Förslag till bildterapi för klientgruppen som baseras på resultatet ut-arbetades.

  • 272.
    Blomqvist, Johanna
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Ullsten, Sara
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Idrottens betydelse för ungdomars vardag och hälsa: En kvalitativ studie om upplevelsen av att idrotta2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Innehållet i ungdomars vardagsliv har stor inverkan på hur den psykiska och fysiska hälsan senare i livet kommer att utvecklas. Oro, nedstämdhet, sömnbesvär, trötthet och huvudvärk är vanliga symtom som det skett en ökning av bland unga. Idrott kan hjälpa ungdomar att utvecklas fysiskt samt psykiskt och det är en aktivitet som kan resultera i att hälsa och välmående uppnås. Syftet med denna studie var att belysa vilken betydelse idrott har i ungdomars vardag. Fem deltagare i åldrarna 15-19 år intervjuades och materialet analyserades genom kvalitativ innehållsanalys. Följande två huvudkategorier framkom i resultatet: Idrott ger mening och Hur idrotten inverkar på hälsa och välmående. I studien framkom det att idrott har, utifrån många olika aspekter, uttalade effekter för ungdomars vardag och hälsa. Exempelvis ger idrott social samhörighet och glädje, ungdomarna får mer energi och bättre koncentrationsförmåga i skolan. Det kan även ge negativa konsekvenser, såsom nedstämdhet, när ungdomar tvingas avstå från idrott. Denna studie kan bidra till att belysa idrottens betydelse för ungdomar och att inspirera arbetsterapeuter till att uppmärksamma idrott som ett medel inom arbetsterapi.

    Sökord: Ungdomar, tonåringar, idrott, fysisk aktivitet, sport, arbetsterapi

  • 273.
    Blomqvist, Sven
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Postural balance, physical activity and capacity among young people with intellectual disability2013Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of this thesis was to investigate postural balance, physical activity, physical capacity and their associations in young people (16-20 years) with intellectual disability (ID), mild to moderate. The aim was also to study the reliability and concurrent validity of postural balance tests.

    To evaluate postural balance, one assessor used five common postural balance tests and one new test. The tests were performed twice for 89 young people with ID (one to twelve days apart). Intraclass correlation coefficients greater than 0.80 were achieved for four of the common balance tests: Extended Timed Up and Go Test (ETUGT), Modified Forward Reach Test (MFRT), One-Leg Stance Test (OLS), and a Force Platform Test (FPT). The smallest real difference ranged from 12% to 40%; less than 20% is considered to be low. For the six balance tests, the concurrent validity varied between none to low.

    Falls are more common for young people with ID compared to young people without ID. One reason could be impaired postural balance. The postural balance for young people with ID has not been thoroughly investigated. Therefore, five balance tests and three muscle strength tests were used to compare young people with ID with an age-matched control group without ID (n=255). The young people with ID had significantly lower scores on most of the postural balance tests and muscle strength tests of the trunk and lower limbs. Muscle strength, height, and body mass index had no strong association with postural balance. The results also illustrated that young people with ID did not rely more on vision for their balance ability compared to peers without ID.

    It seems that postural balance is impaired for young people with ID when evaluated with common tests. An everyday situation is to react to unexpected balance disturbances to avoid falls by using different postural responses. Since young people with ID seem to fall more often than peers without ID, it is valuable to investigate if those postural responses are different between the groups. Therefore, young people with and without ID (n=99) were exposed to six backward surface translations and several postural muscle responses were evaluated: muscle synergies and strategies, muscle onset latency, time-to-peak amplitude, and adaptation. The responses of the investigated muscles – the gastrocnemius, the biceps femoris, and the erector spinae L4 level – were measured using electromyography. The results showed that there were no differences between the two groups with respect to synergies or strategies, muscle onset latency, and time-to-peak amplitude. An overall pattern was seen, that young people with ID adapted their muscle response slower in all three muscles than peers without ID, but this pattern was not statistically significant.

    Studies have shown that people with ID have impaired postural balance, a lower level of physical activity, and lower aerobic capacity compared to people without ID. The association is however not investigated. Therefore, postural balance (postural sway indirectly measured with the subjects standing on a force platform), physical activity (measured with a pedometer), and aerobic capacity (measured with a sub-maximal ergometer cycle test) were used to assess young people with and without ID (n=106). To investigate the subjects’ view of their own health, the subjects completed an adapted questionnaire that addressed their perceived health. The analysis showed no significant associations between postural balance, level of physical activity, and aerobic capacity. The subjects in the ID group, both men and women, had significantly lower aerobic capacity compared to subjects without ID. The answers from the health questionnaire did not correspond to the measured outcomes from the physical tests for young people with ID.

    In conclusion, ETUGT and MFRT can be used to evaluate change in postural balance over time in young people with mild to moderate ID. The low concurrent validity suggests that the postural balance tests probably challenge various subsystems. Young people with ID have impaired postural balance and perform lower on muscle strength tests than age-matched controls. Postural muscle responses after external perturbations seem to be similar for young people with and without ID, but the ability to adapt muscle responses after repeated perturbations appears to be slower for young people with ID. The studies in the thesis also indicate that young people with ID have reduced level of physical activity and lower aerobic capacity. The lack of association between the different physical functions indicates that they should be evaluated and exercised separately. Young persons with ID might have more difficulty realising the health advantage of being physically active, as they do not seem to make this connection. Because of this, it is important that parents/guardians, school staff, physiotherapists, and others encourage them to participate in physical activity.

  • 274.
    Blomqvist, Sven
    et al.
    Gävle Högskola.
    Lönnberg, Lisa
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wester, Anita
    Skolverket.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Physical Exercise Frequency Seem not to Influence Postural Balance but Trunk Muscle Endurance in Young Persons with Intellectual Disability2017In: Journal of Physical Education and Sports Management, ISSN 2373-2156, E-ISSN 2373-2164, Vol. 4, no 2, p. 38-47Article in journal (Refereed)
    Abstract [en]

    Background: The influence of various physical exercise frequencies on postural balance and muscle performance among young persons with intellectual disability (ID) is not well understood.

    Method: Cross-sectional data from 26 elite athletes were compared with 37 students at a sports school and to 57 students at a special school, all diagnosed with mild to moderate ID and with different exercise frequencies. Data were also compared with a group of 149 age-matched participants without ID.

    Results: There were no significant differences in postural balance between young ID groups regardless of physical exercise frequency, all of them had however impaired postural balance compared to the non-ID group. The group with high exercise performed better than the other ID groups in the trunk muscle endurance test.

    Conclusions: It appears as if physical exercise frequency don’t improve postural balance but endurance in the trunk muscles for young persons with ID.

  • 275.
    Blomqvist, Sven
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Olsson, Josefine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wallin, Louise
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wester, Anita
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Adolescents with intellectual disability have reduced postural balance and muscle performance in trunk and lower limbs compared to peers without intellectual disability2013In: Research in Developmental Disabilities, ISSN 0891-4222, E-ISSN 1873-3379, Vol. 34, no 1, p. 198-206Article in journal (Refereed)
    Abstract [en]

    For adolescent people with ID, falls are more common compared to peers without ID. However, postural balance among this group is not thoroughly investigated. The aim of this study was to compare balance and muscle performance among adolescents aged between 16 and 20 years with a mild to moderate intellectual disability (ID) to age-matched adolescents without ID. A secondary purpose was to investigate the influence of vision, strength, height and Body Mass Index (BMI) on balance. A group of 100 adolescents with ID and a control group of 155 adolescents without ID were investigated with five balance tests and three strength tests: timed up and go test, one leg stance, dynamic one leg stance, modified functional reach test, force platform test, counter movement jump, sit-ups, and Biering-Sorensen trunk extensor endurance test. The results showed that adolescents with an ID in general had significantly lower scores in the balance and muscle performance tests. The group with ID did not have a more visually dominated postural control compared to the group without ID. Height, BMI or muscle performance had no strong correlations with balance performance. It appears as if measures to improve balance and strength are required already at a young age for people with an ID. 

  • 276. Blomqvist, Sven
    et al.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Validity and reliability of the Dynamic One Leg Stance (DOLS) in people with vision loss2007In: Advances in physiotherapy, ISSN 1403-8196, Vol. 9, no 3, p. 129-135Article in journal (Refereed)
  • 277.
    Blomqvist, Sven
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wester, Anita
    Skolverket.
    Persson, Elin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sundkvist, Hillevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Postural stability, physical activity, aerobic capacity and their associations for young people with and without intellectual disabilities2014In: European Journal of Adapted Physical Activity, ISSN 1803-3857, E-ISSN 1803-3857, Vol. 7, no 1, p. 22-30Article in journal (Other academic)
    Abstract [en]

    Previous studies show that people with intellectual disability (ID) appear to have impaired postural stability, a lower level of physical activity, and lower aerobic capacity compared to persons without ID, limitations that could affect their health. This study investigates these physical functions and their associations in a group of young people with ID compared to an age-matched group without ID. In total, this cross-sectional study included 106 high school students (16-20 years): 57 students with mild to moderate ID and 49 agematched students without ID (control group). Tests were performed for postural stability, level of physical activity, and aerobic capacity. Both females and males with ID had significantly lower estimated maximum oxygen uptake (l O2/min) (p< 0.001 for females and p=0.004 for males) and a lower aerobic capacity expressed relative to body weight (ml O2/ kg*min) (p< 0.001 for females and p=0.012 for males) compared to age-matched peers. Analyses of associations were made using the Pearson’s correlation coefficient and multivariate linear regression analysis. No significant associations could be found. Physical status appears impaired for young people with ID and functions, such as postural stability, should be evaluated separately

  • 278.
    Blomqvist, Sven
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wester, Anita
    Skolverket.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Postural muscle responses and adaptations to backward platform perturbations in young people with and without intellectual disability2014In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 39, no 3, p. 904-908Article in journal (Refereed)
    Abstract [en]

    This study examines postural muscle responses to backward perturbations in young people with and without intellectual disability (ID). The study included 56 young people with ID and 43 age-matched without ID volunteers. The subjects stood on a platform that was moved backwards in a surface translation. Lower and upper leg muscles and lower back spine muscles were recorded with surface electromyography (EMG). Muscle onset latency, time to peak amplitude (EMG), adaption of muscle responses to repeated perturbations (using IEMG for epochs), and synergies and strategies were assessed. The result showed no differences between the two groups in muscle onset latency, time to peak amplitude, synergies, and strategies. However, young people with ID tended to adapt their IEMG less compared to the controls. These findings suggest that young people with ID have limited ability to adapt their postural muscle responses to repeated perturbations.

  • 279.
    Blomqvist, Sven
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wester, Anita
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Test-retest reliability, smallest real difference and concurrent validity of six different balance tests on young people with mild to moderate intellectual disability2012In: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 98, no 4, p. 313-319Article in journal (Refereed)
    Abstract [en]

    Objectives Some studies have reported that people with intellectual disability may have reduced balance ability compared with the population in general. However, none of these studies involved adolescents, and the reliability and validity of balance tests in this population are not known. The purpose of this study was to examine the reliability of six different balance tests and to investigate their concurrent validity.

    Design Test-retest reliability assessment.

    Settings All subjects were recruited from a special school for people with intellectual disability in Bollnas, Sweden.

    Participants Eighty-nine adolescents (35 females and 54 males) with mild to moderate intellectual disability with a mean age of 18 years (range 16 to 20 years).

    Interventions All subjects followed the same test protocol on two occasions within an 11-day period.

    Main outcomes Balance test performances.

    Results Intraclass correlation coefficients greater than 0.80 were achieved for four of the balance tests: Extended Timed Up and Go Test, Modified Functional Reach Test, One-leg Stance Test and Force Platform Test. The smallest real differences ranged from 12% to 40%; less than 20% is considered to be low. Concurrent validity among these balance tests varied between no and low correlation.

    Conclusion The results indicate that these tests could be used to evaluate changes in balance ability over time in people with mild to moderate intellectual disability. The low concurrent validity illustrates the importance of knowing more about the influence of various sensory subsystems that are significant for balance among adolescents with intellectual disability.

    (C) 2011 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  • 280.
    Blomstedt, Patric
    et al.
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurosurgery.
    Hariz, Gun-Marie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Hariz, Marwan I
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurosurgery.
    Pallidotomy versus pallidal stimulation2006In: Parkinsonism & Related Disorders, ISSN 1353-8020, E-ISSN 1873-5126, Vol. 12, no 5, p. 296-301Article in journal (Refereed)
    Abstract [en]

    Both posteroventral pallidotomy and pallidal deep brain stimulation (DBS) have a documented effect on Parkinsonian symptoms. DBS is more costly and more laborious than pallidotomy. The aim of this study was to analyse the respective long-term effect of each surgical procedure on contralateral symptoms in the same patients. Five consecutive patients, two women and three men, who at first surgery had a mean age of 64 years and a mean duration of disease of 18 years, received a pallidotomy contralateral to the more symptomatic side of the body. At a mean of 14 months later, the same patients received a pallidal DBS on the side contralateral to the pallidotomy. All patients had on–off phenomena and dyskinesias. There were three left-sided and two right-sided pallidotomies, and, subsequently, two left-sided and three right-sided pallidal DBS. The latest evaluation was performed 37 months (range 22–60) after the pallidotomy and 22 months (range 12–33) after the pallidal DBS. Mean UPDRS motor score pre-operatively was 49 and at last follow-up 33 (32.7% improvement, p<0.05). Appendicular items 20–26 contralateral to pallidotomy remained improved more significantly than contralateral to DBS. Dyskinesia scores were also improved more markedly contralateral to the pallidotomy. Two patients exhibited moderate dysarthria and one patient severe dysphonia following DBS. Symptoms contralateral to the chronologically older pallidotomy, especially dyskinesias, rigidity and tremor, were still more improved than symptoms contralateral to the more recent pallidal DBS, despite numerous post-operative patient visits to optimise stimulation parameters.

  • 281.
    Blomstedt, Patric
    et al.
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurosurgery.
    Hariz, Gun-Marie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Hariz, Marwan I
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurosurgery.
    Koskinen, Lars-Owe D
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurosurgery.
    Thalamic deep brain stimulation in the treatment of essential tremor: a long-term follow-up2007In: British Journal of Neurosurgery, ISSN 0268-8697, E-ISSN 1360-046X, Vol. 21, no 5, p. 504-509Article in journal (Refereed)
    Abstract [en]

    Deep brain stimulation (DBS) of the nucleus ventralis intermedius thalami (Vim) in the treatment of essential tremor (ET) is well documented concerning the acute effects. Reports of the long-term effects are, however, few and the aim of the present study was to analyse the long-term efficacy of this treatment. Nineteen patients operated with unilateral Vim-DBS were evaluated with the Essential Tremor Rating Scale (ETRS) before surgery, and after a mean time of 1 and 7 years after surgery. The ETRS score for tremor of the contralateral hand was reduced from 6.8 at baseline to 1.2 and 2.7, respectively, on stimulation at follow-up. For hand function (item 11 – 14) the score was reduced from 12.7 to 4.1 and 8.2, respectively. Vim-DBS is an efficient treatment for ET, also after many years of treatment. There is, however, a decreasing effect over time, most noticeable concerning tremor of action.

    Read More: http://informahealthcare.com/doi/abs/10.1080/02688690701552278

  • 282.
    Blomstedt, Patric
    et al.
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurosurgery.
    Sandvik, Ulrika
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurosurgery.
    Hariz, Marwan
    UCL Insitute of Neurology, Queen Square, London, Uk.
    Fytagoridis, Anders
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurosurgery.
    Forsgren, Lars
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Hariz, Gun-Marie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Koskinen, Lars-Owe
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Neurosurgery.
    Influence of age, gender and severity of tremor on outcome after thalamic and subthalamic DBS for essential tremor2011In: Parkinsonism & Related Disorders, ISSN 1353-8020, E-ISSN 1873-5126, Vol. 17, no 8, p. 617-620Article in journal (Refereed)
    Abstract [en]

    Deep brain stimulation (DBS) is an established treatment for essential tremor (ET). The nucleus ventralis intermedius thalami (Vim) is the target of choice, but promising results have been presented regarding DBS in the posterior subthalamic area (PSA). The aim of this study was to evaluate the possible influence of gender, age and severity of disease on the outcome of these procedures. Sixty eight patients (34 Vim, 34 PSA) with ET were included in this non-randomised study. Evaluation using the Essential Tremor Rating Scale (ETRS) was performed before, and one year after surgery concerning PSA DBS, and at a mean of 28 ± 24 months concerning Vim DBS. Items 5/6 and 11-14 (hand tremor and hand function) were selected for analysis of tremor outcome. The efficacy of DBS on essential tremor was not related to age or gender. Nor was it associated with the severity of tremor when the percentual reduction of tremor on stimulation was taken into account. However, patients with a more severe tremor at baseline had a higher degree of residual tremor on stimulation. Tremor in the treated hand and hand function were improved with 70% in the Vim group and 89% in the PSA group.

  • 283.
    Blomstedt, Patric
    et al.
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Stenmark Persson, Rasmus
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience.
    Hariz, Gun-Marie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy. Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Linder, Jan
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Fredricks, Anna
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Häggström, Björn
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Philipsson, Johanna
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Forsgren, Lars
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Hariz, Marwan
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience. Unit of Functional Neurosurgery, UCL Institute of Neurology, London, UK.
    Deep brain stimulation in the caudal zona incerta versus best medical treatment in patients with Parkinson's disease: a randomised blinded evaluation2018In: Journal of Neurology, Neurosurgery and Psychiatry, ISSN 0022-3050, E-ISSN 1468-330X, Vol. 89, no 7, p. 710-716Article in journal (Refereed)
    Abstract [en]

    Background: Several open-label studies have shown good effect of deep brain stimulation (DBS) in the caudal zona incerta (cZi) on tremor, including parkinsonian tremor, and in some cases also a benefit on akinesia and axial symptoms. The aim of this study was to evaluate objectively the effect of cZi DBS in patients with Parkinson's disease (PD).

    Method: 25 patients with PD were randomised to either cZi DBS or best medical treatment. The primary outcomes were differences between the groups in the motor scores of the Unified Parkinson's Disease Rating Scale (UPDRS-III) rated single-blindly at 6 months and differences in the Parkinson's Disease Questionnaire 39 items (PDQ-39). 19 patients, 10 in the medical arm and 9 in the DBS arm, fulfilled the study.

    Results: The DBS group had 41% better UPDRS-III scores off-medication on-stimulation compared with baseline, whereas the scores of the non-surgical patients off-medication were unchanged. In the on-medication condition, there were no differences between the groups, neither at baseline nor at 6 months. Subitems of the UPDRS-III showed a robust effect of cZi DBS on tremor. The PDQ-39 domains 'stigma' and 'ADL' improved only in the DBS group. The PDQ-39 summary index improved in both groups.

    Conclusion: This is the first randomised blinded evaluation of cZi DBS showing its efficacy on PD symptoms. The most striking effect was on tremor; however, the doses of dopaminergic medications could not be decreased. cZi DBS in PD may be an addition to existing established targets, enabling tailoring the surgery to the needs of the individual patient.

  • 284.
    Blomstedt, Yulia
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Sahlén, Klas Göran
    Umeå University, Faculty of Medicine, Department of Nursing.
    Nilsson, Ingeborg
    Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR). Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Sundström, Anna
    Umeå University, Faculty of Social Sciences, Department of Psychology. Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).
    Brändström, Anders
    Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).
    Elderly care in Swedish welfare state: implications of the population ageing2013In: Global aging issues and policies: understanding the importance of comprehending and studying the aging process / [ed] Yushi Li, Springfield: Charles C. Thomas Publisher Ltd., 2013, p. 226-244Chapter in book (Refereed)
  • 285.
    Blusi, Madeleine
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation. Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Nieves, Juan Carlos
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Feasibility and Acceptability of Smart Augmented Reality Assisting Patients with Medication Pillbox Self-Management2019In: Studies in Health Technology and Informatics, ISSN 0926-9630, E-ISSN 1879-8365, p. 521-525Article in journal (Refereed)
    Abstract [en]

    Complex prescribed medicine regimens require extensive self-management. Handling multiple pills can be confusing; using a pillbox organiser is a common strategy. A smart Medication Coach Intelligent Agent (MCIA) can support patients in handling medicine. The aim of this research was to evaluate the feasibility and acceptability of the MCIA. A prototype was tested with 15 participants, age 17-76, filled a pillbox according to prescription assisted by the MCIA implemented in a Microsoft HoloLens. A quantitative method using questionnaires was applied. Results showed that using the MCIA implemented in an AR-headset, to assist people with prescribed polypharmacy regimen in filling a pillbox, was feasible and acceptable. There was a difference related to age regarding people's willingness to use an AR-headset for medication self-management. People older than 65 felt less comfortable using the technology and were also more hesitant to use the technology than those under 65.

  • 286.
    Blusi, Madeleine
    et al.
    Umeå University, Faculty of Science and Technology, Department of Computing Science. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Nilsson, Ingeborg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Lindgren, Helena
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Older adults co-creating meaningful individualized social activities online for healthy ageing2018In: Building continents of knowledge in oceans of data: The future of co-created eHealth / [ed] Adrien Ugon, Daniel Karlsson, Gunnar O. Klein, Anne Moen, IOS Press, 2018, Vol. 247, p. 775-779Chapter in book (Refereed)
    Abstract [en]

    Social isolation and loneliness among older people is a growing problem with negative effects on physical and mental health. In co-creation with older adults individualized social activities were designed where older adults through computer mediated communication were able to participate in social activities without leaving their homes. Four types of activities were designed; outdoor activity, music event, visiting a friend and leisure activity. A participatory action research design was applied, where end users together with scientists from two research fields developed, tested and evaluated online participation in the activities. Usability and safety of the systems were major concerns among older adults. The evaluation pointed out that level of simplicity, usability and audio-video quality determined the level of satisfaction with the human interaction during the activity, thereby affecting the meaningfulness of the activity. The research presented in this paper constitutes the first step in a long-term research process aiming at developing a digital coaching system that gives older adults personalized support for increasing participation in meaningful social activities.

  • 287. Bo, Kari
    et al.
    Artal, Raul
    Barakat, Ruben
    Brown, Wendy J.
    Davies, Gregory A. L.
    Dooley, Michael
    Evenson, Kelly R.
    Haakstad, Lene A. H.
    Kayser, Bengt
    Kinnunen, Tarja I.
    Larsén, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine. The Swedish School of Sport and Health Sciences, Stockholm, Sweden.
    Mottola, Michelle F.
    Nygaard, Ingrid
    van Poppel, Mireille
    Stuge, Britt
    Khan, Karim M.
    Exercise and pregnancy in recreational and elite athletes: 2016/2017 evidence summary from the IOC expert group meeting, Lausanne. Part 5. Recommendations for health professionals and active women2018In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 52, no 17, p. 1080-1085Article in journal (Refereed)
  • 288.
    Bocké, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Uppfattningar efter total höftledsplastik hos patienter som inte är nöjda med resultatet efter operationen: En kvalitativ innehällsanalys.2013Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Bakgrund

    För patienter med höftledsartros och som genomgått primär höftprotesoperation i Sverige, är implantatöverlevnaden nästan 100% efter ett år. Trots detta är nöjdheten hos patienterna knappt 90%. Genom patientrapporterat utfall har Svenska höftprotesregistret identifierat personer som angett att de är osäkra och missnöjda vid ett ärsuppföljningen.

    Syfte

    Syftet med studien var att belysa uppfattningar om resultatet ett år efter höftprotesoperation hos patienter som inte är nöjda trots avsaknad av registrerad komplikation.

    Metod

    Deltagare rekryterades frän Svenska höftprotesregistrets databas. Semistrukturerade intervjuer genomfördes med tjugotvå personer (femton kvinnor och sju män) i åldern 49-85 är om sina erfarenheter och uppfattningar av resultet efter total höftprotesoperation. Intervjuerna analyserades med kvalitativ innehållsanalys.

    Resultat

    Deltagarna hade en önskan om en gedigen och förlängd support och vägledning när livet var begränsat av funktionshinder. Analysen resulterade i fyra kategorier: Ett liv begränsat av funktionshinder, Negativ inverkan på det dagliga livet, Upplevelse av otillräckligt stöd och bemötande, Sjukvärdspersonalens begränsade tillgänglighet.

    Konklusion

    Patienters uppfattningar om nöjdhet med resultatet efter total höftprotesoperation är komplext och innefattar många av livets områden. Ingen av deltagarnas förväntningar var helt uppfyllda. Vägledning och stöd från hälso- och sjukvården är viktiga för patienten även om ortopedkliniken anser att interventionen är uppfylld.

  • 289.
    Bodin, Jimmy
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine.
    Eklund, Viktor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine.
    En jämförelse av den fysiska kapaciteten mellan kvinnliga och manliga fotbollsspelare2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Football (or soccer) is a physically complex sport that involves everything from kicking, running, throwing, tackling etc. Even if most of the participants are men, more and more women are playing. As many know there are general differences between genders. A common knowledge is that men are stronger and have higher aerobic capacity. Therefore the purpose of this study was to investigate gender differences in football. 32 experienced football players participated in this study. 17 men (mean age: 22,7 ± 3,5 years, bodyweight: 79,4 ± 7,4kg) and 17 women (mean age: 22,1 ± 3,3 years, bodyweight: 65,2 ± 8,4 kg). The women play in the Swedish first division while men are playing in the Swedish third division. Subjects were tested in endurance (Yo- Yo Intermittent Endurance level 2 test), jumping ability  (Squat jump (SJ), Countermovement jump without (CMJ) and with arm swing (CMJ (a)) and sprinting ability (10 meter sprint). The result shows none significant differences between the two teams. The most differences were found in the Yo- Yo IE2 test where the men ran 2321 ± 605m in contrast to the women 1965± 505m (p=0,07).  In the sprint testes the men ran 10 meters at 1,77± 0,1s and the women 1,79± 0,1s (p=0,57). At the vertical jump testes the result where in SJ for men 33,2 ± 3,3 and women 31,2 ± 5,2 cm (p=0,11), In CMJ the men performed 35,9 ±5,2 cm and women 33,1±3,6 cm (p=0,10) and in CMJ (a) the men performed 40,0 ±7,3 cm and the women 40,0 ± 3,5 cm (p=0,98). In conclusion the men and women have a similar physical capacity since there were no significant differences found. This could be a result from different training structures or the different physical demands varying from the two divisions.

  • 290. Boffetta, Paolo
    et al.
    Bobak, Martin
    Borsch-Supan, Axel
    Brenner, Hermann
    Eriksson, Sture
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Grodstein, Fran
    Jansen, Eugene
    Jenab, Mazda
    Juerges, Hendrik
    Kampman, Ellen
    Kee, Frank
    Kuulasmaa, Kari
    Park, Yikyung
    Tjonneland, Anne
    van Duijn, Cornelia
    Wilsgaard, Tom
    Wolk, Alicja
    Trichopoulos, Dimitrios
    Bamia, Christina
    Trichopoulou, Antonia
    The Consortium on Health and Ageing: Network of Cohorts in Europe and the United States (CHANCES) project-design, population and data harmonization of a large-scale, international study2014In: European Journal of Epidemiology, ISSN 0393-2990, E-ISSN 1573-7284, Vol. 29, no 12, p. 929-936Article in journal (Refereed)
    Abstract [en]

    There is a public health demand to prevent health conditions which lead to increased morbidity and mortality among the rapidly-increasing elderly population. Data for the incidence of such conditions exist in cohort studies worldwide, which, however, differ in various aspects. The Consortium on Health and Ageing: Network of Cohorts in Europe and the United States (CHANCES) project aims at harmonizing data from existing major longitudinal studies for the elderly whilst focussing on cardiovascular diseases, diabetes mellitus, cancer, fractures and cognitive impairment in order to estimate their prevalence, incidence and cause-specific mortality, and identify lifestyle, socioeconomic, and genetic determinants and biomarkers for the incidence of and mortality from these conditions. A survey instrument assessing ageing-related conditions of the elderly will be also developed. Fourteen cohort studies participate in CHANCES with 683,228 elderly (and 150,210 deaths), from 23 European and three non-European countries. So far, 287 variables on health conditions and a variety of exposures, including biomarkers and genetic data have been harmonized. Different research hypotheses are investigated with meta-analyses. The results which will be produced can help international organizations, governments and policy-makers to better understand the broader implications and consequences of ageing and thus make informed decisions.

  • 291.
    Bohlin, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Ahlgren, Christina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hammarström, Anne
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Gustafsson, Per E.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Perceived gender inequality in the couple relationship and musculoskeletal pain in middle-aged women and men2013In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 41, no 8, p. 825-831Article in journal (Refereed)
    Abstract [en]

    Aims: Musculoskeletal pain is a major health problem, especially in women, and is partially determined by psychosocial factors. The aim of the present study was to investigate whether gender inequality in the couple relationship was related to musculoskeletal pain. Methods: Participants (n=721; 364 women and 357 men) were all individuals living in a couple relationship in the Northern Swedish Cohort, a 26-year Swedish cohort study. Self-administered questionnaire data at age 42 years comprised perceived gender inequality in the couple relationship and musculoskeletal pain (in three locations, summarised into one score and median-split), concurrent demographic factors, psychological distress, and previous musculoskeletal pain at age 30 years. Associations were examined using logistic regression. Results: Gender inequality was positively associated with symptoms of musculoskeletal pain in the total sample, remaining significant after addition of possible confounders and of previous musculoskeletal pain. Separate adjustment for concurrent psychological distress attenuated the association but not below significance. The association was present and of comparable strength in both women and men. Conclusions: Gender inequality in the couple relationship might contribute to the experience of musculoskeletal pain in both women and men. The results highlight the potential adverse bodily consequences of living in unequal relationships.

  • 292.
    Bohlin, Emelie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine.
    Difference in the muscle cell proteome between clean and doped athletes A study of protein-protein interactions2015Independent thesis Basic level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • 293. Bohlin, Lisa
    et al.
    Sandström, Susanne
    Ångström, Lars
    Lindström, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Inter-tester reliability of active hip range of motion in patients with rheumatic diagnosis2005In: Advances in Physiotherapy, ISSN 1403-8196, Vol. 7, p. 32-39Article in journal (Refereed)
  • 294.
    Bohman, Peter
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Upplevelser av hur fysisk aktivitet på recept - FaR - påverkar den fysiska och mentala hälsan hos patienter inom primärvården: En intervjustudie2016Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Otillräcklig fysisk aktivitet är idag ett stort problem på både individ- och samhällsnivå. Fysisk aktivitet på recept, FaR, har på senare år blivit ett vanligt verktyg för att behandla och förebygga sjukdomar hos patienter inom primärvården. Det råder idag en brist på information om patienternas upplevelser av FaR. Syftet med studien var därför att undersöka hur patienter, som har blivit ordinerade FaR, upplever att receptet har påverkat den fysiska och mentala hälsan.

    Metod: I processen har en kvalitativ, beskrivande forskningsdesign använts. Studien bygger på intervjuer med 10 personer och individuella intervjuer med ett semistrukturerat frågeformulär användes. Intervjuerna transkriberades och analyserades med hjälp av kvalitativ innehållsanalys. Målet med den induktiva, kvalitativa innehållsanalysen var att ge en ökad kunskap och förståelse inom det undersökta området.

    Resultat: Resultatet av innehållsanalysen visade på upplevelser av bland annat ökat fysiskt och psykosomatiskt välbefinnande samt ökad fysisk uthållighet och styrka .

    Slutsats: Studien visar på ett antal olika upplevelser hos patienter inom primärvården som har ökat sin fysiska aktivitetsnivå via FaR. Upplevelser som kan tas tillvara på av sjukgymnaster/fysioterapeuter i det kliniska arbetet för att stödja patienter i deras strävan till ett mer aktivt liv. Fortsatt forskning inom området premieras förhoppningsvis i framtiden för att ytterligare öka förståelsen kring upplevelser av FaR samt för att öka förståelsen kring vilka motivationsfaktorer som kan vara avgörande för en ökad fysisk aktivitet.

  • 295. Bohman, Tony
    et al.
    Bottai, Matteo
    Björklund, Martin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation. Department of Occupational Health Sciences and Psychology, University of Gävle, Gävle, Sweden.
    Predictive models for short-term and long-term improvement in women under physiotherapy for chronic disabling neck pain: a longitudinal cohort study2019In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 4, article id e024557Article in journal (Refereed)
    Abstract [en]

    Objectives: To develop predictive models for short-term and long-term clinically important improvement in women with non-specific chronic disabling neck pain during the clinical course of physiotherapy.

    Design: Longitudinal cohort study based on data from a randomised controlled trial evaluating short-term and long-term effects on sensorimotor function over 11 weeks of physiotherapy.

    Participants and settings: Eighty-nine women aged 31–65 years with non-specific chronic disabling neck pain from Gävle, Sweden.

    Measures: The outcome, clinically important improvement, was measured with the Patient Global Impression of Change Scale (PGICS) and the Neck Disability Index (NDI), assessed by self-administered questionnaires at 3, 9 and 15 months from the start of the interventions (baseline). Twelve baseline prognostic factors were considered in the analyses. The predictive models were built using random-effects logistic regression. The predictive ability of the models was measured by the area under the receiver operating characteristic curve (AUC). Internal validity was assessed with cross-validation using the bootstrap resampling technique.

    Results: Factors included in the final PGICS model were neck disability and age, and in the NDI model, neck disability, depression and catastrophising. In both models, the odds for short-term and long-term improvement increased with higher baseline neck disability, while the odds decreased with increasing age (PGICS model), and with increasing level of depression (NDI model). In the NDI model, higher baseline levels of catastrophising indicated increased odds for short-term improvement and decreased odds for long-term improvement. Both models showed acceptable predictive validity with an AUC of 0.64 (95% CI 0.55 to 0.73) and 0.67 (95% CI 0.59 to 0.75), respectively.

    Conclusion: Age, neck disability and psychological factors seem to be important predictors of improvement, and may inform clinical decisions about physiotherapy in women with chronic neck pain. Before using the developed predictive models in clinical practice, however, they should be validated in other populations and tested in clinical settings.

  • 296. Bohman, Tony
    et al.
    Tegern, Matthias
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation. Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.
    Halvarsson, Alexandra
    Broman, Lisbet
    Larsson, Helena
    Concurrent validity of an isokinetic lift test used for admission to the Swedish Armed Forces2018In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 11, article id e0207054Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to assess the concurrent validity of the IsoKai isokinetic lift test peak force (IsoKai(Peak))1 in comparison to a submaximal 5-1ORM deadlift test (5-10RM(DL)), and to develop an equation for converting the IsoKai(Peak) in Newton (N) to an estimated 1 RM (1 RMest) deadlift load in kilograms (kg). The participants included 28 males and 16 female employees in the Swedish Armed Forces (20-59 years). Each participant conducted the IsoKai lift test, followed by the 5-1ORM(DL) test at one occasion. The Pearson's correlation coefficient, with a 95% confidence interval was calculated to evaluate the validity between the IsoKai(peak) and the 1 RMest deadlift load derived from the 5-10RM(DL) test. Univariate and multivariable linear regressions were used to derive the equation for calculating the 1 RMest deadlift load based on the IsoKai(Peak)- The IsoKai(p)(eak) showed good- to-excellent correlation with the 1 RMest deadlift weight with a correlation coefficient of 0.84 (0.72-0.91) for the total sample, and 0.65 (0.37-0.83) and 0.81 (0.53-0.93) in males and females, respectively. The final equation, 1 RMest deadlift weight (kg) = -51.63 + (0.08 x IsoKai(Peak))1+ (2.28 x BMI), explained 72% (adjusted R-2 = 0.72) of the total variance in the 1 RMest, and had a standard error of the estimate (SEE) of 16.57 kg. In conclusion, the IsoKai isokinetic lift test could be considered a highly valid measure of maximal dynamic muscular strength in comparison to the 5-10RM(DL). The equation can be used to convert the IsoKai lift test (N) results to an 1 RMest deadlift load (kg), but with consideration of the relative large SEE.

  • 297. Bohman, Tony
    et al.
    Tegern, Matthias
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation. Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.
    Halvarsson, Alexandra
    Broman, Lisbet
    Larsson, Helena
    Reliability and agreement of the IsoKai isokinetic lift test - A test used for admission to the Swedish Armed Forces2018In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 12, article id e0209419Article in journal (Refereed)
    Abstract [en]

    This study was performed to evaluate the reliability and agreement of the IsoKai isokinetic lift test as it is currently administered in admission to the Swedish Armed Forces. The study included an intrarater (n = 534) and interrater reliability sample (n = 137), of Swedish male conscripts who performed the test on two test occasions about two hours apart. Two-to-four lifts were performed at each occasion, and the highest mean (IsoKai(MF)) and peak force (IsoKai(PF)) produced (N) were used for evaluation. All intraclass coefficients showed excellent reliability. The interrater analyses resulted in intraclass coefficients of 0.942 (95% CI; 0.920-0.959) and 0.858 (95% CI; 0.806-0.896) for the IsoKai(MF) and IsoKai(PF), respectively, while the corresponding coefficients for the intrarater analyses were 0.935 (95% CI; 0.923-0.946) and 0.865 (95% CI; 0.842-0.886). Agreement, the capability of a test to detect changes, was assessed by the standard error of measurement (SEM/SEM%) and the smallest real difference (SRD/SRD%). These estimate indicated that it is possible to achieve measurements relevant to use in real practice with the IsoKai isokinetic lift test. Bland and Altman analyses revealed no systematic errors in either sample. Based on these findings, the IsoKai isokinetic lift test is suggested to be a highly reliable test for maximal dynamic muscular strength. The test could be of use in selection procedures in order to accurately evaluate maximal dynamic muscular strength, and for evaluating longitudinal changes in strength.

  • 298.
    Bolin, Jonas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    En motorisk 5 års-uppföljning av underburna barn på Sundsvalls Sjukhus2016Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Sammanfattning:  Syfte: Att beskriva perinatala bakgrundsfaktorers betydelse avseende motorisk utveckling vid fem års ålder hos barn födda före vecka 32+0 GA, vårdade vid länsverksamheten Barn och Ungdom, Sundsvalls sjukhus mellan åren 2006-2009. Ett annat syfte var att se vilken motorisk förmåga denna grupp underburna barn hade vid fem års ålder jämfört med normalpopulationen.

    Metod: En retrospektiv longitudinell journalstudie där journaldata för 43 barn födda före vecka 32+0 GA vid Sundsvall sjukhus, avseende bakgrundsfaktorer som födelsevikt, födelselängd, huvudomfång samt om barnen initialt vårdats i respirator jämfördes med resultat från ett motoriskt test vid fem års ålder (Movement ABC) Resultatet vid den motoriska uppföljningen vid fem års ålder analyserades även mot normativa data från Movement ABC.

    Resultat: Gruppen barn (n=43) födda före vecka 32+0 GA visade signifikant större motoriska funktionsnedsättningar än normalpopulationen p<0,0001. Av dessa hamnade 23,3 % i kategorin avvikande motorisk förmåga (under percentil 5). Ingen skillnad noterades mellan de mycket underburna och de extremt underburna barnen (<vecka 28+0 GA). Födelselängd, födelsevikt samt hur många dygn barnen legat i respirator initialt inverkade inte på det motoriska resultatet vid femårsuppföljningen. Barn med större huvudomfång (≥+1SD) vid födseln uppvisade större motoriska svårigheter vid uppföljningen (p=0,035). En tendens sågs även mot att flickor klarade sig bättre än pojkarna motoriskt men skillnaden var inte signifikant (p=0,06).

    Slutsats: Gruppen mycket och extremt underburna får oftare än fullgångna barn motoriska svårigheter. Därför är det viktigt att denna grupp följs upp så att barn som behöver extra stöd snabbt kan få detta. Stor försiktighet bör iakttas vid tolkning av perinatala bakgrundsfaktorers påverkan då studiepopulationen var mycket liten.

  • 299.
    Boman, Erika
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing. Faculty of Nursing, Åland University of Applied Sciences, Mariehamn, Finland.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Häggblom, Anette
    Faculty of Nursing, Åland University of Applied Sciences, Mariehamn, Finland.
    Santamäki Fischer, Regina
    Umeå University, Faculty of Medicine, Department of Nursing. Faculty of Nursing, Åland University of Applied Sciences, Mariehamn, Finland.
    Nygren, Björn
    Umeå University, Faculty of Medicine, Department of Nursing.
    Inner strength: associated with reduced prevalence of depression among older women2015In: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 19, no 12, p. 1078-1083Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of this study was to explore if inner strength is independently associated with a reduced prevalence of depression after controlling for other known risk factors associated with depression.

    Methods: A population-based cross-sectional study was performed, where all women living in Åland, a Finnish self-govern island community in the Baltic Sea, aged 65 years or older were sent a questionnaire including the Geriatric Depression Scale and the Inner Strength Scale along with several other questions related to depression. Factors associated with depression were analyzed by means of multivariate logistic regression.

    Results: The results showed that 11.2% of the studied women (n = 1452) were depressed and that the prevalence increased with age and was as high as 20% in the oldest age group. Non-depressed women were more likely to never or seldom feel lonely, have a strong inner strength, take fewer prescription drugs, feeling needed, being able to engage in meaningful leisure activities, as well as cohabit.

    Conclusion: Our results showed an association between stronger inner strength and being non-depressed. This can be interpreted to mean that inner strength might have a protective effect against depression. These findings are interesting from a health-promotion perspective, yet to verify these results, further longitudinal studies are required.

  • 300. Boman, Helena
    et al.
    Björnstig, Ulf
    Umeå University, Faculty of Medicine, Surgical and Perioperative Sciences.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Forensic Medicine.
    Små barn lever farligt i traktorers närhet. Håll barn borta från traktorer; gör traktorer säkrare!1999In: Läkartidningen, ISSN 0023-7205, Vol. 96, no 18, p. 2222-4Article in journal (Other academic)
    Abstract [sv]

    Under åren 1992-1997 inträffade i Sverige 14 traktorrelaterade dödsfall bland barn. Elva var pojkar och medelåldern 5 år. I nära hälften av fallen var barnets far förare av traktorn. För att förebygga dessa händelser bör barn inte tillåtas vara i närheten av traktorer i arbete eller färdas som passagerare. Med hänsyn till hur svåråtkomlig "den mänsliga faktorn" är, torde också utvecklande av skadeförebyggande åtgärder i traktorn vara av betydelse.

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