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  • 301.
    Hörnkvist, Robin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine.
    Nyström, Olle
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine.
    Skademekanismer, Riskfaktorer och Prevention för Främre Korsbandsskador inom Fotboll: en Review artikel2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The Anterior Cruciate Ligament (ACL) injury is one of the most prevalent injuries among soccer players. The injury could be devastating for athletes, which might lead to drop-out from sports and other serious injuries later on. We found a need to investigate some of the most recent articles of the matter. Purpose: To investigate recent articles regarding injury mechanisms, risk factors and prevention programs for ACL injuries in soccer players. Method: The databases of PubMed, MedLine and CINHAL were searched for relevant articles for this study. The studies were only to investigate ACL injuries in soccer players and had to be published 2005 or later. Studies which investigated more sports than soccer were excluded from our study. All studies were investigated in three steps (Headline, Abstract and Full Text). Results: The results are showing that there are ACL risk factors and injurie mechanics that are prevalent in soccer players, such as hamstring/quadriceps ratio, hip and knee extension and knee valgus. The literature has also revealed that fatigue and visual stimuli also might change the biomechanics of the hip and knee. Prevention programs for ACL injuries seems to reduce the prevalence of ACL injuries in teenagers and adults, but does not have the same effect on kids. Furthermore, prevention programs do not seem to change performance variables in soccer players. Conclusions: According to the studies included in this review, kinematics and kinetics of the knee and hip have a relationship with ACL injuries. Prevention programs seem to have an injury reducing effect on teenagers and adults, but not in children. Further research should focus on investigating mechanisms and risk factors and how they interact with each other. This would create guidelines for prevention programs in the future.

  • 302.
    Ivarsson, Niklas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Ett nytt hindertest för utvärdering av proprioceptiv förmåga i knäleden, en pilotstudie2017Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Syfte Studien adresserar hur ett hindertest kan utvecklas och användas för att studera den proprioceptiva förmågan i knäleden under ett funktionellt test.

    Metod 25 försökspersoner rekryterades med varierande aktivitetsgrad. Elitidrottare, kontroller samt individer med främre korsbandsskada (ACL) delades in i tre grupper. Grupperna genomförde ett hindertest utan visuell feedback av hinderhöjden. Försökspersonerna fick ställa sig på en standardiserad startposition, vila det ledande benet på hindret för att skapa en efferenskopia. De försökte kliva över hindret med så liten marginal som möjligt utan att slå i hindret. Hindret flyttades utan individens vetskap. Försöken filmades i ett 3D-laboratorium. Två hinderhöjder användes, totalt gjordes 16 försök (åtta försök/ben och hinderhöjd). Avstånd i hinder till fot, knä- och höftflexionsvinkel samt hits studerades. Absoluta felet samt variationskoefficienten analyserades med oberoende t-test samt Mann Whitney u-test. Hits analyserades med Pearsons Chi2-test, signifikansnivån var p<0.05 i alla test.

    Resultat Testet var genomförbart för både knäfriska samt individer med främre korsbandsskador. Kontrollgruppen uppvisade lägre avstånd i hinder till fot för både det låga och höga hindret, för det sistnämnda var skillnaden signifikant (p=0.00). Atletgruppen uppvisade procentuellt mindre spridning i avstånd hinder till fot för både det låga och höga hindret, skillnaderna var icke signifikanta. En signifikant skillnad fanns mellan grupperna gällande antal hits, ACL-gruppen hade slagit i hindret flest gånger om detta inte flyttats under utförandet (p=0.021).

    Slutsats Att utveckla ett validerat och reliabelt mätinstrument av stor vikt för att under och efter rehabiliteringsfasen kunna utvärdera den proprioceptiva förmågan hos individer med en främre korsbandsskada.

  • 303.
    Jakobsson, Frida
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lindgren, Mirjam
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Användning av höj- och sänkbara bord: - En jämförelse mellan de som upplever och de som inte upplever smärta2017Independent thesis Basic level (degree of Bachelor of Fine Arts), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Kontorsarbetare spenderar lång tid stillasittande. Negativa hälsoeffekter förknippas med en stillasittande livsstil, däribland muskuloskeletal smärta. Lösningen verkar inte vara stillastående då även detta kan leda till muskuloskeletal smärta. Det finns HSB (höj- och sänkbara bord) för att minska stillasittande/stillastående hos kontorsarbetare. Mer forskning krävs gällande hur HSB används i praktiken.

    Syfte: Undersöka om det finns skillnad i användning av HSB mellan de som upplever jämfört med de som inte upplever rygg-och nacksmärta.

    Undersöka om det finns samband mellan självskattad tid stående respektive sittande och tid uppmätt med aktivitetsmätare.

    Metod: Data samlades in via självskattningenkäter som delades ut till 26 kontorsarbetare. Enkätena bestod av frågor gällande användning av HSB samt upplevd muskuloskeletal smärta. Kontorsarbetarna delades in i två grupper, smärtgruppen (SG) och icke- smärtgruppen (ISG), som jämfördes med varandra. Elva kontorsarbetare tilldelades aktivitetsmätare samt en självskattningsenkät gällande hur mycket de suttit och stått dagarna de bar aktivitetsmätaren. Sambandsanalyser mellan självskattad tid och tid uppmätt med aktivitetsmätare utfördes. 

    Resultat: Smärtgruppen varierade mer frekvent, satt mindre och stod mer men skillnaderna mot ISG var inte signifikanta (p=0,276; p=0,054; p=0,108). Svagt positiva samband (rho=0,46; rho=0,58) fanns mellan självskattad tid sittande respektive stående och tid uppmätt med aktivitetsmätare, dock var resultaten inte signifikanta (p=0,08; p=0,178).

    Konklusion: Denna studie visade inga signifikanta skillnader gällande användning av HSB mellan SG och ISG. Att SG varierade sig mer frekvent samt stod mer och satt mindre skulle dock kunna tyda på att smärta påverkar användandet av HSB. Mer forskning, fördelaktligen med aktivitetsmätare, krävs angående hur HBS används på kontorsarbetsplatser.

  • 304.
    Jakobsson, Ida
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sundquist, Joel
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Skadeförekomst bland ungdomar på elitnivå inom snowboard och freestyle2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Undersöka skadeförekomsten bland ungdomar på snowboard- och freestylegymnasier i Sverige samt att jämföra skadeförekomsten mellan dessa två discipliner. Metod: Retrospektiv studie baserad på frågeformulär om träningsvanor och skador under läsåret 2011/2012. Totalt 51 av 93 tillfrågade elever (freestyle n=26, snowboard n= 25, bortfall n=42) i årskurs 2-4 från snowboard- och freestylegymnasier ingick i studien. Resultat: Sammanlagt hade 27 av 51 elever (53%) skadat sig. Snowboardåkarna stod för 12 skador (34%) och freestyleåkarna för 23 skador (66%). Måttliga skador, vilket innebär 8-28 dagars frånvaro, förekom mest frekvent bland freestyleåkarna (n=11; 48%). Lätta skador (1- 3 dagars frånvaro, n=4; 33%) och allvarliga skador (>28 dagars frånvaro, n=4; 33%) var vanligast bland snowboardåkarna. Vanligaste kroppsdel att skada bland freestyleåkarna var huvudet (n=6; 26%) följt av skador i fot/häl/tå (n=5; 22%) medan skulderskador (n=4; 33%) var vanligast hos snowboardåkarna. Slutsats: Skadeförekomsten bland ungdomar på snowboard- och freestylegymnasier i Sverige är hög, mer än hälften av eleverna skadade sig minst en gång under läsåret 2011/2012. Bland freestyleåkarna var huvudskador vanligast medan skulderskador var vanligast för snowboardåkarna. Antalet knäskador var lågt bland både snowboard- och freestyleåkare. Ingen signifikant skillnad sågs i antal skadade elever mellan disciplinerna. Resultaten hade varit mer representativa för hela målgruppen om svarsfrekvensen varit högre. 

  • 305.
    Jakobsson, Niclas
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Persson, My
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    The mechanical and neuromuscular responses of the tibialis anterior muscle during unexpected perturbations2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

     

    Bakgrund: Tidigare forskning föreslår att m. tibialis anterior kan vara en lämplig proprioceptiv indikator under posturalt svaj i stillastående. Huruvida detta förhållande råder under mer utmanande balansuppgifter är ännu oklart. Ett sätt att undersöka posturala responser hos en person är genom att oförutsett förskjuta underlaget denna står på.

     

    Syfte: Denna studie syftade till att beskriva de neuromuskulära och mekaniska responserna hos m. tibialis anterior under de första 0.3 sekunderna av en oförutsedd förskjutning av underlaget.

     

    Metod: Åtta försökspersoner deltog i studien och genomgick 20 oförutsedda framåt och bakåt förskjutningar av underlaget. Deltagarna stod på ett löpband medan elektromyografi, ultraljud och kinematik spelades in.

     

    Resultat: Initialt under framåt-translationerna av underlaget kunde en förlängning av tibialis anteriors muskelfasciklar observeras tillsammans med en ökad fotledsvinkel och en förlängning av muskel-sen-enheten. Efter cirka 30 ms förkortades fasciklarna snabbt och detta associerades med en stor elektromyografisk aktivitet av m. tibialis anterior. Först efter 150 ms så kunde en minskning av fotledsvinkeln och en förkortning av muskel-sen-enheten observeras.

     

    Konklusion: Under första delen av en framåt-translation av underlaget observerades gynsamma förhållanden hos tibialis anterior för att kunna bidra med proprioceptiv information till det centrala nervsystemet .

  • 306.
    Jakobsson, Stephanie
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hagelbrand, Petra
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Polisstudenters fysiska kapacitet och deras syn på träning2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion:   Polisyrket är en profession som anses mycket fysiskt krävande. Yrket har även   stora psykiska påfrestningar. Få studier har undersökt hur den fysiska   kapaciteten hos poliser ser ut och förändras från utbildningsstart och   framåt.   Syfte: Syftet med denna studie var   att beskriva polisstudenters fysiska kapacitet gällande kondition och muskelstyrka,   samt deras syn på träning vid polisutbildningens start.   Metod: 92 polisstudenter besvarade   ett frågeformulär angående träning- och motionsvanor under sin första dag på   utbildningen. 46 studenter utförde dessutom ett konditionstest och 35   studenter styrketestades.  Resultat: Studenterna angav att de   tränade både för att öka sin kondition och sin muskelstyrka. Styrketesterna   visade mycket varierande resultat. Fler studenter angav att de tränade för   att klara utbildningen jämfört med de som angav att de tränade för att klara  arbetet. De manliga polisstudenterna hade bättre kapacitet gällande kondition   samt ben- och handstyrka.  Slutsats: Denna studie visade att   fler studenter tränar för att klara utbildningen jämfört med hur många som   tränar för att klara av sitt framtida yrkesliv. Utifrån detta samt en   tidigare studie, kan det tänkas att den fysiska kapaciteten gällande   kondition och muskelstyrka eventuellt försämras under yrkeslivet. Betydelsen   av att träna bör etableras tidigt hos studenterna för att de ska fortsätta   träna under yrkeslivet. Då män och kvinnor skiljer sig gällande kondition   samt ben- och handstyrka bör kanske antagningskraven ses över och eventuellt   anpassas utefter vilken tjänst inom polisen som den sökande vill ha.

  • 307.
    Janaudis-Ferreira, Tania
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Strategies for exercise assessment and training in patients with chronic obstructive pulmonary disease2010Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Rationale: Chronic obstructive pulmonary disease (COPD) is not only a common lung disease but is a major cause of morbidity and mortality worldwide. Pulmonary rehabilitation (PR) helps optimize function and independence by increasing exercise capacity, reducing symptoms and improving health related quality of life (HRQL). Exercise training is certainly a key component of the PR programs; however, many of its aspects still need to be better defined such as optimal exercise assessment and training modality for these patients. The general purpose of this thesis was to generate new knowledge that could contribute to new strategies for exercise assessment and training in patients with COPD.

    Methods and results: This thesis is comprised of four independent studies. Thigh muscle strength, endurance and fatigue were compared between 42 patients with moderate to severe COPD and 53 healthy controls (Study I). Impaired thigh muscle strength and endurance in patients with COPD was found, except for muscle strength in knee extension in male patients. Female patients had higher fatigue index than female controls while no difference was found between male patients and controls. The six-minute walk test (6MWD) performed on a non-motorized treadmill (6MWD-T) was compared with the 6MWD performed in a corridor (6MWD-C) in 16 healthy elderly subjects (Study II). They performed twelve tests (six 6MWD-C and six 6MWD-T) on two different days in a randomized order. An average discrepancy was found between the two methods with the subjects walking a shorter distance on the non-motorized treadmill. However, the results showed good test-retest reliability between days and test repetitions. A systematic review (Study III) was done of studies that investigated the effects of an arm training program in patients with COPD. The findings of this review indicated that there is evidence that an arm training program improves arm exercise capacity, but its effects on dyspnea, arm fatigue and healthy-related quality of life is unclear. Finally, a two-armed randomized controlled trial examined the effects of an arm training program on arm function, arm exercise capacity, muscle strength, symptoms and HRQL in patients with COPD (Study IV). The groups were randomized to arm training or sham. Compared with the changes observed in the control group, the magnitude of change in the intervention group was greater for arm function, arm exercise capacity and muscle strength. There was no difference between groups in HRQL or symptoms.

    Conclusions: Upper extremity resistance training improves arm exercise capacity, arm function and muscle strength in patients with COPD. Training and assessment of upper and lower limb muscles should be included into PR programs. The 6MWD performed on a non-motorized treadmill may offer an alternative option to the standard 6MWD when a 30-meter corridor is not available.

  • 308.
    Janaudis-Ferreira, Tania
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation. Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada.
    Hill, Kylie
    Goldstein, Roger S
    Robles-Ribeiro, Priscila
    Beauchamp, Marla K
    Dolmage, Thomas E
    Wadell, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Brooks, Dina
    Resistance arm training in patients with chronic obstructive pulmonary disease: a randomized controlled trial2011In: Chest, ISSN 0012-3692, E-ISSN 1931-3543, Vol. 139, no 1, p. 151-158Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The study aimed to evaluate the effect of upper extremity resistance training for patients with COPD on dyspnea during activity of daily living (ADL), arm function, arm exercise capacity, muscle strength and health related quality of life (HRQL)

    METHODS: Patients were randomly assigned to an intervention or control group. The intervention group underwent arm resistance training. The control group performed a sham. Both groups exercised 3 times a week for 6 weeks. Dyspnea during ADL and HRQL were measured using the chronic respiratory disease questionnaire (CRDQ). Arm function and exercise capacity were measured using the 6-minute pegboard and ring test (6PBRT) and the unsupported upper limb exercise test (UULEX), respectively. Muscle strength for the biceps, triceps, anterior and middle deltoids was obtained using an isometric dynamometer.

    RESULTS: Thirty-six patients with COPD (66 +/- 9 yrs) participated in the study. Compared with the control group, the magnitude of change in the intervention group was greater for the 6PBRT (p = 0.03), UULEX (p = 0.01) and elbow flexion force (p = 0.01); elbow extension force (p = 0.02), shoulder flexion force (p = 0.029) and shoulder abduction force (p = 0.01). There was no between-group difference in dyspnea during ADL, HRQL or symptoms during the 6PBRT or UULEX (all p values greater than 0.08).

    CONCLUSIONS: Resistance based arm training improved arm function, arm exercise capacity and muscle strength in patients with COPD. No improvement in dyspnea during ADL, HRQL or symptoms was demonstrated.

  • 309. Janaudis-Ferreira, Tania
    et al.
    Hill, Kylie
    Goldstein, Roger S
    Wadell, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Brooks, Dina
    Relationship and responsiveness of three upper-limb tests in patients with chronic obstructive pulmonary disease2013In: Physiotherapy Canada, ISSN 0300-0508, E-ISSN 1708-8313, Vol. 65, no 1, p. 40-43Article in journal (Refereed)
    Abstract [en]

    Purpose: To determine (1) the relationship among three common upper-limb tests for patients with chronic obstructive pulmonary disease (COPD): unsupported upper limb exercise test (UULEX), 6-minute pegboard and ring test (6PBRT), and a muscle-strength test using a hand-held dynamometer; and (2) the responsiveness of these three tests to changes after pulmonary rehabilitation that included a resistance arm-training programme.

    Methods: The study was a secondary analysis of a randomized controlled trial (RCT). The UULEX and the 6PBRT were used to measure peak arm exercise capacity and arm function, respectively. A handheld dynamometer was used to measure elbow and shoulder flexion force. We analyzed baseline data for all participants in the ACT, as well as baseline and post-PR data for those who completed 6-week follow-up testing.

    Results: 36 patients with COPD (mean forced expiratory volume in 1 second [FEV1] = 35% [SD 15%] predicted; age 66 [9] y) participated, of whom 13 completed an arm-training programme. The correlations among the test results ranged from 0.41 to 0.81 (p < 0.0001). Standardized response means were 1.0 for muscle force of elbow flexion, 1.2 for shoulder flexion, and 1.8 for the 6PBRT and UULEX.

    Conclusions: Although the three tests (UULEX, 6PBRT, and muscle-strength test using a hand-held dynamometer) are intended to measure different constructs, they were moderately to highly correlated with one another. The 6PBRT, UULEX, and muscle-strength test were demonstrated to be responsive to the resistance arm-training programme.

  • 310.
    Janaudis-Ferreira, Tania
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hill, Kylie
    Goldstein, Roger
    Wadell, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Brooks, Dina
    Arm exercise training in patients with cronic obstructíve pulmonary disease: a systematic review2009In: Journal of cardiopulmonary rehabilitation and prevention, ISSN 1932-7501, Vol. 29, p. 277-283Article in journal (Refereed)
  • 311.
    Janaudis-Ferreira, Tania
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wadell, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Comparison of the 6-minute walk distance test performed on a non-motorised treadmill and in a corridor in healthy elderly subjects2010In: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 96, no 3, p. 234-239Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To compare the 6-minute walk distance (6MWD) test performed on a non-motorised treadmill (6MWD-T) with the 6MWD test performed in a corridor (6MWD-C) in healthy elderly subjects.

    PARTICIPANTS: Sixteen healthy elderly individuals.

    DESIGN: Participants performed three 6MWD-T tests and three 6MWD-C tests on two different days.

    OUTCOME MEASURES: Distance walked was recorded in metres. Perceived exertion and leg fatigue were rated on the modified Borg scale before and after each test.

    RESULTS: Using the Bland and Altman limits of agreement analysis method, the mean difference between the two methods was 153.3m (limits of agreement: 28 to 278). The mean difference between days 1 and 2 for the 6MWD-C test was -7.2m (limits of agreement: -45.4 to 30.8), and the mean difference between days 1 and 2 for the 6MWD-T test was -1.6m (limits of agreement: -64.0 to 60.7). The mean difference between the first and second repetitions of the 6MWD-C test was -5m (limits of agreement: -41 to 31), and the mean difference between the first and second repetitions of the 6MWD-T test was -17m (limits of agreement: -85 to 51).

    CONCLUSIONS: The 6MWD-C and 6MWD-T tests are not interchangeable. However, the results showed good test-retest reliability between days and between test repetitions for both tests. Therefore, the 6MWD-T test may offer an alternative option to the 6MWD-C test when a 30-m corridor is not available. These findings may have implications for execution of the 6MWT-T test within cardiac and pulmonary rehabilitation.

  • 312.
    Janaudis-Ferreira, Tania
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wadell, Karin
    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.
    Lindström, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Thigh muscle strength and endurance in patients with COPD compared with healthy controls.2006In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 100, no 8, p. 1451-1457Article in journal (Refereed)
  • 313. Jefferson, Amanda
    et al.
    Leonard, Helen
    Siafarikas, Aris
    Woodhead, Helen
    Fyfe, Sue
    Ward, Leanne M.
    Munns, Craig
    Motil, Kathleen
    Tarquinio, Daniel
    Shapiro, Jay R.
    Brismar, Torkel
    Ben-Zeev, Bruria
    Bisgaard, Anne-Marie
    Coppola, Giangennaro
    Ellaway, Carolyn
    Freilinger, Michael
    Geerts, Suzanne
    Humphreys, Peter
    Jones, Mary
    Lane, Jane
    Larsson, Gunilla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Swedish National Rett Centre, Frösön, Sweden.
    Lotan, Meir
    Percy, Alan
    Pineda, Mercedes
    Skinner, Steven
    Syhler, Birgit
    Thompson, Sue
    Weiss, Batia
    Witt Engerström, Ingegerd
    Downs, Jenny
    Clinical Guidelines for Management of Bone Health in Rett Syndrome Based on Expert Consensus and Available Evidence2016In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 2, article id e0146824Article in journal (Refereed)
    Abstract [en]

    ObjectivesWe developed clinical guidelines for the management of bone health in Rett syndrome through evidence review and the consensus of an expert panel of clinicians.

    MethodsAn initial guidelines draft was created which included statements based upon literature review and 11 open-ended questions where literature was lacking. The international expert panel reviewed the draft online using a 2-stage Delphi process to reach consensus agreement. Items describe the clinical assessment of bone health, bone mineral density assessment and technique, and pharmacological and non-pharmacological interventions.

    ResultsAgreement was reached on 39 statements which were formulated from 41 statements and 11 questions. When assessing bone health in Rett syndrome a comprehensive assessment of fracture history, mutation type, prescribed medication, pubertal development, mobility level, dietary intake and biochemical bone markers is recommended. A baseline densitometry assessment should be performed with accommodations made for size, with the frequency of surveillance determined according to individual risk. Lateral spine x-rays are also suggested. Increasing physical activity and initiating calcium and vitamin D supplementation when low are the first approaches to optimizing bone health in Rett syndrome. If individuals with Rett syndrome meet the ISCD criterion for osteoporosis in children, the use of bisphosphonates is recommended.

    ConclusionA clinically significant history of fracture in combination with low bone densitometry findings is necessary for a diagnosis of osteoporosis. These evidence and consensus-based guidelines have the potential to improve bone health in those with Rett syndrome, reduce the frequency of fractures, and stimulate further research that aims to ameliorate the impacts of this serious comorbidity.

  • 314.
    Jidestål Stenström, Frida
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Örnberg, Elin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Fysioterapeutiska metoder för stressrelaterad ohälsa bland ungdomar som kommit ensamma till Sverige2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Stressrelaterad ohälsa är vanligt bland ensamkommande flyktingbarn. Fysioterapeutiska metoder mot stress har visat sig vara effektiva men kunskapen är otillräcklig om vilka metoder som passar denna grupp.

    Syfte: Att undersöka om fysioterapeutiska metoder, så som basal kroppskännedom, kan minska stressrelaterad ohälsa bland ensamkommande flyktingbarn samt hur dessa metoder upplevs och huruvida en interventionsstudie är genomförbar i denna typ av grupp.

    Metod: En interventionsstudie (n=2) genomfördes där Single-case research design kombinerades med mixed-method. Det kvantitativa datat utgjordes av enkäter och VAS vilket analyseras i tabeller och figurer medan den kvalitativa dataanalysen bestod av loggböcker samt intervjuer som analyserades med innehållsanalys.

    Resultat: Enkäter och VAS visade en tydlig minskning av kroppsliga besvär för den ene deltagaren medan det för den andre varierade. I loggböckerna framkom att de liggande avspänningsövningarna uppskattades mest samt att gruppträffarna var lärorika. Sju kategorier bildades i analysen av intervjuerna som slutligen formade temat: Görande och lärande tillsammans genom kropp och tanke.

    Konklusion: Vår interventionsmodell samt studiedesign är väl värda att vidareutveckla och utvärdera i exempelvis randomiserade och kontrollerade studier. 

  • 315.
    Johansson, Anna-Maria
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Domellöf, Erik
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Rönnqvist, Louise
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    KINEMATIC EFFECTS OF SENSORIMOTOR TIMING TRAINING IN CHILDREN WITH DIPLEGIC CEREBRAL PALSY2013In: 22nd Annual meeting of ESMAC, 2013, Glasgow, Scotland, 2013, p. 167-Conference paper (Refereed)
    Abstract [en]

    INTRODUCTION and AIM

    The objective of the present study was to explore the individual effects of sensorimotor timing training with the Interactive Metronome©  (IM) in young individuals with spastic diplegic cerebral palsy (DCP). IM is a multi- modal integration training method where the goal is to synchronize rhythmic movement activation with a beat. To this end, error feedback is provided via auditory and visual cues. One previous case study has shown positive effects on upper-limb kinematics of IM training in children with hemiplegic CP [1]. However, there is a need for

    extended scientific evaluation of the effects of existing training methods for children with CP of various types and severity. In the present study 3D movement registration technique was used to objectively evaluate training effects on goal-directed upper-limb movements.

    PATIENTS/MATERIALS and METHODS

    Participants comprised three children with spastic DCP (2 boys;1 girl, age range: 12-16 years).  The score on the

    Manual Ability Classification System was II, IV, and III and the Gross Motor Function Classification System score was III, IV, and IV for Case I-III, respectively. The spasticity severely affected arm function in case II and III. All cases were diagnosed with intellectual disability and other comorbidities were diagnoses of autism, epilepsy, cortical visual impairment, strabismus, dysarthria, asthma and scoliosis. IM training consisted of a 4 week (12 sessions) individually customised program including bilateral and unilateral movements of the arms

    and hands. To establish short- and long-term effects, goal-directed upper-limb movements were examined by the

    use of a 6-camera optoelectronic recording system (240Hz, ProReflex, Qualisys Inc.) at three time points, before and at two following occasions after the IM training (post-test I, 1 week after completed training; post-test II, 6 months after post-test I). The goal-directed evaluation task consisted of pushing three buttons in a sequential order in four different directions (extension-flexion; flexion-extension; adduction-abduction; abduction- adduction). The following parameters were derived from the wrist marker; movement duration (time needed to complete the task), segmentation of the movement trajectory (number of movement units), and 3D distance.

    RESULTS

    The intra- as well as the inter-individual variability of IM effects were large. Case I showed some improvement

    in timing ability with auditory error feedback at post-test I as measured by the IM equipment. Self-phased timing was not improved. Case II and III showed no apparent improvement in timing ability. For Case I, the 3D analyses of the movement trajectories during the evaluation task, showed great inconsistency with no systematic improvements at both post-test occasions. However, Case II and III improved significantly as characterized by decreased duration at post-test I. This improvement remained at post-test II. Further, the segmentations of the wrist movement trajectory in terms of the number of movement units significantly decreased at post-test I. This finding  was  also  stable  at  post-test  II.  Few  changes  were  detected  on  the  3D  distance  for  either  case.

    DISCUSSION and CONCLUSIONS

    No substantial improvement was shown on timing ability for any of the cases, possibly due to task constraints

    inflicted by the severity of the CP in these children. However, the training did result in faster and smoother movements for Case II and III. The effect appeared to mainly affect temporal aspects and remained at 6 month follow up. For these cases, the results suggest improved motor planning and control of goal-directed upper-limb actions. Case I showed no improvements, possibly due to the complexity of comorbidity including diagnoses of autism and intellectual disability. Thus, IM appears to be a feasible and promising method to improve movement control in some children diagnosed with severe types of CP. However, future studies should include outcome measures pertaining to attention as the IM encompasses high attentional demand.

    REFERENCES

    [1] Johansson, A.-M., Domellöf, E., & Rönnqvist, L. (2012). Short- and long-term effects of synchronized metronome   training   in   children   with   hemiplegic   cerebral   palsy:   a   two   case   study.   Developmental

    Neurorehabilitation, 15(2), 160–9. doi:10.3109/17518423.2011.635608

  • 316.
    Johansson, Anna-Maria
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Grip, Helena
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics. Umeå University, Faculty of Science and Technology, Centre for Biomedical Engineering and Physics (CMTF).
    Strong, Andrew
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Selling, Jonas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rönnqvist, Louise
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Boraxbekk, Carl-Johan
    Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI). Umeå University, Faculty of Social Sciences, Demographic Data Base.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Finger movement control and associated brain activity responses post-stroke2016In: XXI ISEK Congress, 2016Conference paper (Refereed)
    Abstract [en]

    BACKGROUND AND AIM: Impaired finger dexterity is common after stroke, often affecting activities of daily living. Knowledge of kinematic characteristics and of underlying neurological mechanisms of such impairments is important to understand functional recovery. This study aims to investigate finger movement control and related brain activity patterns post-stroke (PS). METHODS: Data from a subsample including 9 participants PS with residual hemiparesis affecting manual dexterity (M age- 66; 3 female) and 12 able-bodied control (C) participants (M age- 65; 3 female) were analyzed. Two series of self-paced cyclic finger extension-flexion movements in random order were performed for each hand (4 series with vision, V, and 4 without vision, NV). Optoelectronic cameras monitored the 3D movement of markers affixed to the fingertips. Motion data was used to calculate each finger's individuation index (II), reflecting movement independence, each finger's Stationarity index (SI), reflecting the ability to keep the finger still while another moves [1] and Movement frequency (MF). Functional magnetic resonance imaging, with simultaneous movement recording, was used to investigate brain activity patterns in relation to the kinematic parameters. II, SI, MF and the effect of vision were analyzed for the 4th digit. RESULTS: A factorial ANOVA 2 [group] x 2 [condition] x 2 [side] x [index type] showed an effect for group (p < .0001; PS < C); condition (p < .01; NV < V); side (p < .0001; affected/non-preferred < non-affected/preferred); and index type (p < .0001; SI < II). An interaction between group and side (p < .01) showed that indices of the affected side were lower compared to the non-affected side within the PS group and compared to both sides in the C group. No significant effects were apparent for MF but significant correlations were found between the indices and MF that were restricted to the PS group alone (over all conditions- r = -0.22; p < .01; within the NV condition- r = -0.19; p < .01; within the affected side r = -0.15; p < .05; and within the SI categorization r = -0.14; p < .05). Furthermore, within NV for the non-affected hand on the SI alone (r = -0.54; p < .05). All indicate that slower movements had higher indices. DISCUSSION: The associations between slower MF and higher index values within the PS group were located to conditions with increased difficulty (NV, affected side, and SI). Thus, reducing speed may be a selected strategy to increase control of finger movements PS when the demand on motor control is high. Further, with the applied calculation of finger movement independence we were able detect group differences, side differences within the PS group, and a positive effect of vision of the hands during performance. This indicates that this calculation is a sensitive measure that could be used to study the effects of stroke and to monitor progression in motor recovery. [1] Häger-Ross & Schieber, 2000, J Neurosci 20:8542-50

  • 317.
    Johansson, Anna-Maria
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Grip, Helena
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Strong, Andrew
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Selling, Jonas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rönnqvist, Louise
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Boraxbekk, Carl-Johan
    Umeå University, Faculty of Social Sciences, Demographic Data Base.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Three dimensional kinematic analyses of movement control of individual fingers post-stroke2015In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 42, no Supplement 1, p. S33-S33Article in journal (Refereed)
    Abstract [en]

    Research question: Objectives of the present study are: (1) to quantify finger movements in a 3D context and (2) by this method investigate the ability to perform individualized finger movements, with and without vision of the hands, in persons with a chronic stroke diagnosis compared to able-bodied controls.

    Introduction: Increased knowledge of how fine movement control is affected by stroke is important for the understanding of recovery of function. This is crucial for the development of reliable and valid assessment methods for evaluation of rehabilitation of the upper limbs. This study is part of the MOST project (MOST-MOvement control in STroke) where both clinical tests and 3D movement assessments are performed.

    Materials and methods: At present, 18 persons post-stroke (M age = 67 years; 6 women) and 26 able-bodied controls (M age = 62 years, 11 women) have participated. The ability to perform uni-manual individualized finger movements and the effect of vison of the hands were evaluated. Participants were instructed to move a specific finger in cyclic extension–flexion movements at the metacarpophalangeal joint, keeping the rest of the finger straight and the other fingers still, at a self-paced speed during 10 s (2 test series for each hand; 8 test series in total). The task was performed seated. The wrists were extended about 10° and fixated to a wooden frame with forearm support. Reflective markers were affixed to each fingertip and movements were recorded by optoelectronic cameras. Based on the positional change of the fingers during task performance, two indices ranging from 0-1 were calculated: (1) Individuation index (II) where the independence of each finger movement is shown and where 1 indicate complete independence, (2) stationary index (SI) where 1 indicate that the finger remains still when the other fingers move [1].

    Results: Our results show that it is possible to quantify individual finger movements by use of 3D movement analysis addressing the quality of movement performance in stroke survivors: all but 3 persons post-stroke were able to perform the task. Preliminary analyses (based on a subsample constituted of 8 post-stroke and 8 controls) verify that the test discriminated between groups where participants post-stroke had lower values on II and SI as compared to the control persons, the lowest values were observed for the middle and ring fingers. Ongoing analyses will show if vision influences the outcomes.

    Discussion: A set-up has been tested where individual finger movements can be quantified in 3D, and that discriminates between persons post stroke compared to controls. This advancement carries a promise for development of better assessment methods for recovery of function post-stroke.

    Reference

    [1] C. Häger-Ross, M.H. Schieber Quantifying the independence of human finger movements: comparisons of digits, hands and movement frequencies.J Neurosci, 20 (2000), pp. 8542–8550

     

     

  • 318.
    Johansson, Carl
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Nilsson, Olof
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Effekterna av hög respektive lågintensiv cykling på trycksmärttröskel samt kognitiv arbetsförmåga2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Sammanfattning

     Syfte: Syftet med denna studie var att undersöka dos respons förhållandet mellan cykling på högintensiv (HI) respektive lågintensiv (LI) nivå och dess påverkan på trycksmärttröskelen primärt samt kognitiv arbetsförmåga sekundärt.

    Metod: 10 studiedeltagare, samtliga studenter deltog i denna randomiserande 2x2 cross-over studie och rekryterades via annonsering på Umeå Universitet. Samtliga studiedeltagare deltog i två testtillfällen under en tvåveckorsperiod; HI och LI. Utfallsvariablerna bestod av trycksmärttrösklar i form av Pain Pressure Threshold test (PPT-test) och en kognitiv uppgift bestående av Stroop Colour Word test (SCW-test).

    Resultat: Trycksmärttröskelnivån ökade efter genomförd cykling kontra innan cyklingen, oberoende testbetingelse. Efter HI ökade medelvärdet för PPT-värdena signifikant för trapezius med 26,7% (p=0,047) och efter LI med 32,3% (p=0,037). PPT-värdet för quadriceps ökade med 22,8% (p=0,051) vid HI och 17,0% (p=0,203) vid LI. Ingen skillnad sågs mellan testbetingelserna (p=0,445). Deltagarna presterade bättre på SCW-test under cykling kontra innan oberoende testbetingelse, både i antalet avklarade omgångar (HI, p=0,041, LI, p=0,016) och felprocent (HI, p=0,008, LI, p=0,021). Ingen skillnad sågs mellan de båda testbetingelserna under aktivitet.

    Konklusion: Resultaten indikerar att studiedeltagarna fick en minskad smärta och förbättrade kognitiva förmågor i samband med utförd cykling Resultaten indikerar mot att trycksmärttröskeln och kognitionsförmågan ökar i samband med utförd cykling, inga signifikanta skillnader visades i resultatet mellan utfört HI kontra LI cykling. Studiens resultat bör tolkas med försiktighet då tillförlitligheten generaliserbarheten på resultaten studiedeltagarna är försämrad då studiedeltagarna utgjordes av en homogen grupp samt studiens låga, dålig styrka i studien, p.g.a. få studiedeltagare. Fortsatta studier inom området behövs för att kunna ge välgrundade rekommendationer på vilken intensitet och duration som cykling är mest lämplig för att uppnå bäst effekter på trycksmärttröskeln samt kognitiv arbetsförmåga.

  • 319.
    Johansson, Christer
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Balance in patients with newly diagnosed Parkinson´s Disease: -a three year follow-up in Northern Sweden2013Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Background:

    Impaired balance is one of the main features in Parkinson´s Disease (PD), which can result in falls with consequences that can be crucial for people with PD. It is important to detect an impaired balance early in the disease in order to prevent falls.

    Aim:

    The aim of this study was to examine balance, subjective experienced unsteadiness and self-reported falls among patients with idiopathic Parkinson´s Disease, at the very first visit at the neurological clinic and over time during the first three years.

    Materials and methods:

    The subjects were collected from a prospective longitudinal study, the so called NYPUM-study. 150 patients with PD and 31 healthy controls were included. The measurements that have been used are the Berg Balance Scale (BBS), the Timed Up and Go (TUG) and a postural stability-test together with a questionnaire about falls and experienced unsteadiness.

    Results:

    There was statistically significant balance impairment already at the first visit at neurological clinic. The patients had to greater extent experienced unsteadiness and had a higher incidence of falls during the last year, compared to controls. After one year there was an improvement in the TUG. Between one and three year there was a worsening in postural responses seen in the postural stability-test. The balance in general did however not show a significant difference after three years compared to the baseline result.

    Discussion:

    Even though the measured balance impairment might be considered as relatively small, the experienced unsteadiness was apparent. It is therefore of great importance to pay attention to balance early in the disease and to ask the patients about their own experience, to prevent future falls.

  • 320.
    Johansson, Christer
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Elite sprinters, ice hockey players, orienteers and marathon runners: isokinetic leg muscle performance in relation to muscle structure and training1987Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    In male athletes from different sports, isokinetic knee extensor, and in orienteers also plantar flexor peak torque (PT), contractional work (CW) and integrated surface electromyograms (iEMG) were analysed.

    Single contraction PT, CW and iEMG in sprinters and marathon runners were signi­ficantly correlated to the cross-sectional area (CSA) of m. quadriceps, and to the Type II fibre area of m. vastus lateralis. When correcting PT, CW and iEMG for CSA of m. quadriceps, such correlations were found only for Type IIA fibre area at 180° s~1. Elec- tromyographically, m. vastus lateralis (biopsied muscle) was representative for m. quadriceps. Calculated optimal mean power (CW s~1) and electrical efficacy (CW/iEMG) approximated for sprinters 450° s-1 and for marathon runners 270° s~1, i.e. velocities at or above the upper limit of the dynamometers. In orienteers, plantar flexor PT increased during winter training, but decreased during competitive season. Knee extensor PT increased over the whole year. At 30 and 60° s~1 only knee extensor PT was negatively associated with the running velocity at onset of blood lactate accu­mulation (VOBLA)- Changes in VOBLA during winter period were negatively associated with changes in knee extensor PT at 180° s~1. During competitive season, changes in Vobla were negatively associated with the ratio quality : quantity running. In ice hockey players PT varied non-systematically with training and games.

    The biopsy specimens of marathon runners showed irregular fibre shapes, an in­creased amount of connective tissue and central fibre nuclei, indicating an early strain disease or functional adaptation to extreme demands.

    During repetitive contractions in sprinters and marathon runners, fatigue, i.e. slope of decline in CW, was significantly associated with the Type II fibre area of m. vastus lateralis. For knee extensors of sprinters, ice hockey players and orienteers, a steep de­crease in CW/iEMG was observed. In contrast, knee extensors of marathon runners and plantar flexors of orienteers showed an almost unaltered CW/iEMG throughout the test. The knee extensor endurance level (CW/iEMG) was significantly correlated to the maximal oxygen uptake. In orienteers, an increase in endurance level of both tested muscle groups during winter training parallelled an increase in VOBLA and V02obla- In hockey players, fatigue and endurance pattern (CW and CW/iEMG) changed non-systematically with training and games.

    In conclusion, isokinetic measurements and iEMG reflect the structural properties of the knee extensor muscles in sprinters and marathon runners. The demonstrated characteristics and changes in leg muscle function in different groups of athletes apparently reflect varying demands from different sports activities.

  • 321.
    Johansson, Emma
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Forsberg, Josefin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Stresshantering  med hjälp av mindfulness, basal kroppskännedom och progressiv avspänning: En klinisk utvärdering i företagshälsovården2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 322.
    Johansson, Fanny
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Den icke-verbala kommunikationens effekter i patientmötet: - en systematisk litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Som hälso- och sjukvårdspersonal måste man kunna förmedla sin kunskap och nå ut till patienten för att uppnå en lyckad behandling. Den icke-verbala kommunikationen är en viktig del i detta utbyte och forskning har visat att denna kan påverka viktiga utfallsmått i behandlingen. Hälso- och sjukvårdspersonal behöver få kunskap om hur deras beteenden påverkar patientmötet för att sedan kunna ge en bättre vård.

       Syftet i denna studie var att söka svar på hur den icke-verbala kommunikationen i patientmötet påverkar patientens nöjdhet, följsamhet och upplevelse av yrkeskompetens. Detta syfte besvarades genom en systematisk litteraturöversikt. Ett inklusionskriterie för artiklarna i litteraturöversikten var att de skulle var publicerade år 2007-2017. Metodiken följde en handbok från Statens beredning för medicinsk utvärdering (SBU). Efter litteratursökning, relevansbedömning och kvalitetsgranskning kom 10 artiklar att användas till att bygga upp resultatet.

       Litteraturöversikten kunde presentera resultat på de tre undersökta utfallsmåtten. Att sitta framåtlutad mot patienten, ha mycket ögonkontakt samt ha ett uppmuntrande och varmt tonläge påverkar nöjdheten positivt. En professionell klädstil samt ett omtänksamt och empatiskt beteende gör att man uppfattas som mer kompetent. Den förmedlade yrkeskompetensen ihop med ett omtänksamt beteende kan sedan öka följsamheten.

       Det finns således indikeringar på att hälso-och sjukvårdpersonal bör vara medvetna om hur den icke-verbala kommunikationen påverkar patientmötet. Som hälso- och sjukvårdspersonal är det viktigt att veta vilka signaler man sänder ut och hur den icke-verbala kommunikationen kan användas för att optimera patientmötet.

  • 323. Johansson, G. M.
    et al.
    Grip, H.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Introducing a standardized Nine Hole Peg Test in persons with stroke: kinematic analysis2014Conference paper (Refereed)
  • 324.
    Johansson, Gudrun
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Frykberg, G.
    Grip, Helena
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    The Arm Posture Score with additional rotational components (APS6) applied to persons with stroke to assess arm movements during gait.2012Conference paper (Other academic)
  • 325.
    Johansson, Gudrun M.
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Frykberg, Gunilla E.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Grip, Helena
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Broström, Eva W
    Department of Women's and Children's Health, Karolinska Institutet.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Assessment of arm movements during gait in stroke: the Arm Posture Score2014In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 40, no 4, p. 549-555Article in journal (Refereed)
    Abstract [en]

    The purpose of the study was to apply the Arm Posture Score (APS) to a stroke population, since comprehensive measures to quantify arm swing in the affected and non-affected arms during gait are lacking. A further aim was to investigate how gait speed and upper limb function estimated by clinical measures are related to the APS in the stroke group. The APS is the summarized root mean square deviation (RMSD) from normal, based on kinematics. Four arm movements (sagittal and frontal planes) as well as six arm movements (incorporating transversal plane) were included in the calculation of APS, referred to as APS4 and APS6, respectively. The study population consisted of 25 persons with stroke and 25 age- and gender-matched controls. The APS measures were significantly different between the affected and non-affected arms, as well as between the affected arm and the non-dominant arm of the controls (p≤0.001). Spasticity significantly influenced both APS measures, while speed only had a significant effect on the APS4. The APS measures correlated significantly to clinical measures of upper limb function. Both APS measures seem to be useful indices to quantify and discriminate between impaired and normal arm swing during gait after stroke. The variability of rotational arm movements needs to be studied further before considering the additional value of the APS6 over the APS4. When interpreting the APS, complementary kinematics should be taken into account, as the single value of the APS gives no information about the direction of the deviation.

  • 326.
    Johansson, Gudrun M.
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Grip, Helena
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Levin, Mindy F
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    The added value of kinematic evaluation of the timed finger-to-nose test in persons post-stroke.2017In: Journal of NeuroEngineering and Rehabilitation, ISSN 1743-0003, E-ISSN 1743-0003, Vol. 14, article id 11Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Upper limb coordination in persons post-stroke may be estimated by the commonly used Finger-to-Nose Test (FNT), which is also part of the Fugl-Meyer Assessment. The total movement time (TMT) is used as a clinical outcome measure, while kinematic evaluation also enables an objective quantification of movement quality and motor performance. Our aims were to kinematically characterize FNT performance in persons post-stroke and controls and to investigate the construct validity of the test in persons with varying levels of impairment post-stroke.

    METHODS: A three-dimensional motion capture system recorded body movements during performance of the FNT in 33 persons post-stroke who had mild or moderate upper limb motor impairments (Fugl-Meyer scores of 50-62 or 32-49, respectively), and 41 non-disabled controls. TMT and kinematic variables of the hand (pointing time, peak speed, time to peak speed, number of movement units, path ratio, and pointing accuracy), elbow/shoulder joints (range of motion, interjoint coordination), and scapular/trunk movement were calculated. Our analysis focused on the pointing phase (knee to nose movement of the FNT). Independent t or Mann-Whitney U tests and effect sizes were used to analyze group differences. Sub-group analyses based on movement time and stroke severity were performed. Within the stroke group, simple and multiple linear regression were used to identify relationships between TMT to kinematic variables.

    RESULTS: The stroke group had significant slower TMT (mean difference 2.6 s, d = 1.33) than the control group, and six other kinematic variables showed significant group differences. At matched speeds, the stroke group had lower accuracy and excessive scapular and trunk movements compared to controls. Pointing time and elbow flexion during the pointing phase were most related to stroke severity. For the stroke group, the number of movement units during the pointing phase showed the strongest association with the TMT, and explained 60% of the TMT variance.

    CONCLUSIONS: The timed FNT discriminates between persons with mild and moderate upper limb impairments. However, kinematic analysis to address construct validity highlights differences in pointing movement post-stroke that are not captured in the timed FNT.

  • 327.
    Johansson, Gudrun M.
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Häger, Charlotte K.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    A modified standardized nine hole peg test for valid and reliable kinematic assessment of dexterity post-stroke2019In: Journal of NeuroEngineering and Rehabilitation, ISSN 1743-0003, E-ISSN 1743-0003, Vol. 16, no 1, article id 8Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Impairments in dexterity after stroke are commonly assessed by the Nine Hole Peg Test (NHPT), where the only outcome variable is the time taken to complete the test. We aimed to kinematically quantify and to compare the motor performance of the NHPT in persons post-stroke and controls (discriminant validity), to compare kinematics to clinical assessments of upper extremity function (convergent validity), and to establish the within-session reliability.

    METHODS: The NHPT was modified and standardized (S-NHPT) by 1) replacing the original peg container with an additional identical nine hole pegboard, 2) adding a specific order of which peg to pick, and 3) specifying to insert the peg taken from the original pegboard into the corresponding hole of the target pegboard. Eight optical cameras registered upper body kinematics of 30 persons post-stroke and 41 controls during the S-NHPT. Four sequential phases of the task were identified and analyzed for kinematic group differences. Clinical assessments were performed.

    RESULTS: The stroke group performed the S-NHPT slower (total movement time; mean diff 9.8 s, SE diff 1.4), less smoothly (number of movement units; mean diff 0.4, SE diff 0.1) and less efficiently (path ratio; mean diff 0.05, SE diff 0.02), and used increased scapular/trunk movements (acromion displacement; mean diff 15.7 mm, SE diff 3.5) than controls (P < 0.000, r ≥ 0.32), indicating discriminant validity. The stroke group also spent a significantly longer time grasping and releasing pegs relative to the transfer phases of the task compared to controls. Within the stroke group, kinematics correlated with time to complete the S-NHPT and the Fugl-Meyer Assessment (rs 0.38-0.70), suggesting convergent validity. Within-session reliability for the S-NHPT was generally high to very high for both groups (ICCs 0.71-0.94).

    CONCLUSIONS: The S-NHPT shows adequate discriminant validity, convergent validity and within-session reliability. Standardization of the test facilitates kinematic analysis of movement performance, which in turn enables identification of differences in movement control between persons post-stroke and controls that may otherwise not be captured through the traditional time-based NHPT. Future research should ascertain further psychometric properties, e.g. sensitivity, of the S-NHPT.

  • 328.
    Johansson, Gudrun M.
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Häger, Charlotte K.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Measurement properties of the motor evaluation scale for upper extremity in stroke patients (MESUPES)2012In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 34, no 4, p. 288-294Article in journal (Refereed)
    Abstract [en]

    Purpose: To investigate inter-rater reliability of the Motor Evaluation Scale for Upper Extremity in Stroke patients (MESUPES), to provide estimates of the minimal detectable change (MDC) of the MESUPES and to investigate concurrent validity in relation to the arm scores of the Modified Motor Assessment Scale (M MAS). Methods: Forty-two stroke patients (mean age 56 +/- 12 years) were independently assessed within a 48-hours window by two raters in different pairs (total available raters = 4). Results: Weighted. analysis indicated good to very good agreement at item level (range 0.63-0.96). The relative and absolute reliability of the total score of MESUPES (maximum 58) was high according to the intraclass correlation coefficients (ICC = 0.98) and the standard error of measurement (SEM = 2.68). The MDC for three levels of confidence was calculated: A score change of 8, 7 and 5 is necessary for a MDC to have confidence of 95%, 90% and 80%, respectively, of a genuine change. Correlation between the MESUPES and M MAS was high (r(s) = 0.87). Conclusions: The MESUPES shows high inter-rater reliability, and our study provides useful estimates of MDC for different levels of certainty. Additional research to confirm concurrent validity and to examine other psychometric properties of the MESUPES such as sensitivity is needed.

  • 329.
    Johansson, Hanna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Korrelation mellan gånghastighet framåt respektive bakåt, balans och kognition hos personer med demens.2015Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Sammanfattning:

    Syfte. Syftet med studien var att undersöka samband mellan gånghastighet (framlänges och baklänges), balans och kognition vid demenssjukdom.

     

    Metod. Designen var en tvärsnittsstudie där 161 personer med demenssjukdom inkluderades. Deltagarna undersöktes för gånghastighet framåt och bakåt på en sträcka på 2.4 meter samt med Bergs balansskala, Mini-Mental State Examination, Verbalt Flöde och Alzheimers Disease Assessment Scale. Bivariata korrelationsanalyser utfördes mellan variablerna. Multivariata analyser utfördes sedan mellan samtliga variabler utom Alzheimers Disease Assessment Scale.

     

    Resultat. Balans visade en signifikant och måttlig korrelation till gånghastighet både framåt (r=.698) och bakåt (r=.527). Verbalt Flöde visade en signifikant, men låg korrelation (r=.249) till gånghastighet framåt. Verbalt Flöde och Mini-Mental State Examination visade signifikant, men låg korrelation (r=.294 och r=.248) till gånghastighet bakåt. Alzheimers Disease Assessment Scale var inte korrelerad till gånghastighet varken framåt eller bakåt i denna studie.

     

    Slutsats. Det finns samband mellan gånghastighet, kognitiv funktion och balans hos personer med demenssjukdom. Balans tenderar att vara mer korrelerat till framlängesgång än baklängesgång, medan kognitiv funktion förefaller ha ett starkare samband med baklängesgång än framlängesgång.

  • 330.
    Johansson, Jennie
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Öhrling, Amanda
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Omedelbara effekter på välmående av ett högintensivt funktionellt träningsprogram för personer med demenssjukdom2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Utvärdera om ett högintensivt funktionellt träningsprogram ger omedelbara effekter på välmående för personer med demenssjukdom. Bakgrund: Omedelbara effekter av fysisk aktivitet vad gäller exempelvis blodtryck, kolesterol, immunförsvar samt hormonsystem har påvisats. Dock saknas forskning inom området omedelbara effekter på välmående hos personer med demens. Metod: Uppsatsen är en del av The UMDEX Study, en randomiserad kontrollerad studie. 186 personer med demenssjukdom som bodde på särskilt boende deltog. Deltagarna lottades till en högintensiv funktionell träningsgrupp (n=84) och en social aktivitetsgrupp (n=86). 40 möljliga träffar à 45 minuter hölls i små grupper (3-9 personer). Direkt innan och efter varje interventionstillfälle fick en deltagare från varje klustergrupp frågan ”hur känner du dig just nu?”, som besvarades enligt en femgradig skala. Resultat: En signifikant skillnad framkom i skattning av välmående vid en jämförelse före och efter, där ett ökat välmående sågs hos både träningsgruppen (p<0,01) och sociala aktivitetsgruppen (p<0,01). Bland deltagarna i träningsgruppen var det en signifikant större andel av tillfällen med ökat (p=0,03), men även minskat (p=0,01) välmående, jämfört med deltagarna i sociala aktivitetsgruppen. Slutsats: Ett högintensivt funktionellt träningsprogram gav omedelbara effekter på ökat välmående, men även minskat välmående var vanligare förekommande, jämfört med en social aktivitet bland personer med demenssjukdom.

  • 331.
    Johansson, Jonas
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Nordström, Anna
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Westling, Göran
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB).
    Nordström, Peter
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Increased postural sway during quiet stance as a risk factor for prospective falls in community-dwelling elderly individuals2017In: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 46, no 6, p. 964-970Article in journal (Refereed)
    Abstract [en]

    Objective: fall-related injuries constitute major health risks in older individuals, and these risks are projected to increase in parallel with increasing human longevity. Impaired postural stability is a potential risk factor related to falls, although the evidence is inconclusive, partly due to the lack of prospective studies. This study aimed to investigate how objective measures of postural sway predict incident falls.

    Design, setting and participants: this prospectively observational study included 1,877 community-dwelling individuals aged 70 years who participated in the Healthy Ageing Initiative between June 2012 and December 2015.

    Measurements: postural sway was measured during eyes-open (EO) and eyes-closed (EC) trials using the Wii Balance Board. Functional mobility, muscle strength, objective physical activity and cognitive performance were also measured. Participants reported incident falls 6 and 12 months after the examination.

    Results: during follow-up, 255 (14%) prospective fallers were identified. Division of centre of pressure (COP) sway lengths into quintiles revealed a nonlinear distribution of falls for EO trial data, but not EC trial data. After adjustment for multiple confounders, fall risk was increased by 75% for participants with COP sway lengths ≥400 mm during the EO trial (odds ratio [OR] 1.75, 95% confidence interval [CI] 1.09-2.79), and approximately doubled for sway lengths ≥920 mm during the EC trial (OR 1.90, 95% CI 1.12-3.22).

    Conclusion: objective measures of postural sway independently predict incident falls in older community-dwelling men and women. Further studies are needed to evaluate whether postural sway length is of interest for the prediction of incident falls in clinical settings.

  • 332.
    Johansson, Lena
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Fjellman Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Ventilated patients' experiences of body awareness at an intensive care unit2005In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 7, p. 154-161Article in journal (Refereed)
    Abstract [en]

    Treatment with mechanical ventilation (MV) in an intensive care unit (ICU) can cause extensive problems for patients.There is, however, a dearth of research investigation into how ICU treatment affects a person’s body image. The aim of thisstudy was to enhance the knowledge and understanding of body awareness and body image in persons treated with MV in anICU. In order to capture the informants’ own perceptions and experiences, a qualitative method of Grounded Theory waschosen. Seven thematic in-depth interviews were carried out with former ICU patients. To increase credibility, triangulationof researchers and reference group checking was used. The analysis resulted in the core category Limited possibilitiesto act, which relates to the informants’ experiences of not being able to act as they normally would. The core category wasderived from the experiences of feeling like another person, the perceptions of not being in contact with their body andreality and the feeling of being restrained. This study adds a perspective of body awareness to the interpretations of ICUpatients’ experiences. It emphasizes the experience and movement aspects of the body and that physiotherapists have animportant role in the rehabilitation of ICU patients.

  • 333.
    Johansson, Linnea
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Jonsson, Susanna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Low-Calorie Diet och dess påverkan på testdata vid konditionstest på cykel.: - En studie gjord på individer med fetma.2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Sammanfattning:

    Övervikt och fetma är idag ett stort samhällsproblem. Utöver ekonomisk börda för samhället kan detta problem även innebära stora påfrestningar för den enskilde individen. På Arbets- och Beteendemedicinskt centrum på Norrlands Universitetssjukhus behandlas patienter för att minska risken för sjukdomar och ohälsa till följd av ett för högt Body Mass Index (BMI). Patienterna får möjlighet att genomföra en Low-Calorie Diet (LCD), maximalt 900 kcal per dag. För att utvärdera behandlingen används ett konditionstest på cykel, Åstrands, före och efter påbörjad behandling.

    Syfte. Syftet med denna studie är att undersöka om det finns skillnader i testdata insamlad i samband med konditionstest på cykel som utförts före och 2-4 veckor in på en LCD, hos individer med fetma. Metod. I den här studien har två konditionstest på ergometercykel gjorts, ett före dietstart och det andra två till fyra veckor in på dieten. Testgruppen bestod av 11 individer, fyra män, sju kvinnor. 39-61 år. BMI >32. Alla deltagare har genomgått en LCD med måltidsersättning. Testdata bearbetades i SPSS och bestod av BMI, puls minut 1, puls minut 6, testvärde och VO2 max korrigerat efter Åstrands tabell.

    Resultat. En signifikant skillnad i BMI och vikt på gruppnivå sågs (p=0.003). Ingen signifikant skillnad i testresultat mellan de två testerna kunde påvisas vad gäller Puls minut 1, Puls minut 6, VO2 max, Testvärde för Åstrands cykeltest (p<0.05). Konklusion. Det går i dagsläget inte att säga att det är någon skilland på testdata insamlad i samband med konditionstest på cykel som utförts före och 2-4 veckor in på en LCD, hos individer med fetma.

  • 334.
    Johansson, Martin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Magnus, Gerdin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Utvärdering av vattenträning inom habiliteringsverksamheten i Västerbotten: En enkätundersökning2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Västerbottens läns landsting (VLL) habilitering bedriver idag vattenträning på 3 orter i Västerbotten. Vårdpersonal ser idag positiva effekter av träningen men har ingen fast metod att utvärdera träningsdeltagarnas individuella upplevelser av träningen.

    Syfte: Att utvärdera hur barn och föräldrar upplever vattenträningen som erbjuds inom Västerbottens läns landstings (VLL) habiliteringsverksamhet.

    Metod: En enkätundersökning skickades per post till föräldrar med barn inskrivna inom VLLs habilitering. Enkäten skickades ut till 43 familjer och 34 av dessa besvarade enkäten

    Resultat: En majoritet upplever att de är nöjda med träningen som bedrivs av VLL.

    Slutsats: Simförmågan förbättrades hos en majoritet av barnen enligt deltagarna. Att denna förbättras ökar barnets möjlighet till delaktighet i många vardagliga sociala sammanhang. Vattenträningen är en uppskattad träningsform hos både det deltagande barnet och de vuxna som finns omkring barnen. 

  • 335.
    Johansson, Maud
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Kerstin, Adolfsson
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Fysisk aktivitet, stillasittande och stressrelaterade symptom hos medarbetarna på en socialförvaltning – en tvärsnittsstudie2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med studien var att undersöka om samband fanns mellan graden av fysisk aktivitet, stillasittande och upplevda stressrelaterade symtom, kopplade till arbetsmiljön hos anställda på en socialförvaltning.

    Data samlades i en tvärsnittsstudie genom en webbenkät. Två frågor om fysisk aktivitet och en fråga om stillasittande lades till i slutet av enkäten.

    Studiepopulationen bestod av tillsvidareanställda inom socialförvaltningen Östhammars kommun. Resultaten analyserades genom Spermans rh0 och chi två test. Av 741 respondenter svarade 457 stycken (61,7 %). Av dessa var 43 män och 414 kvinnor.

     

    Mellan fysisk aktivitet och stressrelaterade symptom fanns ett mycket svagt signifikant samband (rh0= -0,111), p=0,023) som visade att ju mer fysisk aktivitet desto mindre symptom upplevdes. Något samband sågs ej mellan stillasittande och upplevda symptom. Det var inte heller någon skillnad i upplevda stressrelaterade besvär mellan de som uppnår rekommenderade nivåer för hälsofrämjande fysisk aktivitet jämfört med de som inte uppnår rekommenderade nivåer.

     

    Tidigare forskning visar att fysisk aktivitet fortsatt kan vara en viktig del för vidare arbete med hälsopromotion och prevention avseende stressrelaterade symptom vilket vi dock inte kunde se något tydligt belägg för i denna undersökning. Här behövs vidare forskning avseende vilka nivåer och vilka typer av aktiviteter som kan ge bäst effekt. Det behövs också belysas tydligare vilka andra faktorer och eventuella samband, som förutom fysisk aktivitet behöver beaktas vid planering av förebyggande hälsoinsatser för stressrelaterade symptom.

  • 336.
    Johansson, Mikael
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lilja, Viktor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Skogsröjares fysiska arbetsbelastning: En kartläggning av muskuloskeletala besvär och fysisk arbetsbelastning hos en grupp skogsröjare i Sverige2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Det finns anledning att misstänka en hög fysisk arbetsbelastning hos skogsröjare i Sverige, men bristen på yrkesspecifik statistik och studier medför svårigheter att identifiera problemområden. Eftersom en för hög fysisk arbetsbelastning kan leda till arbetsrelaterade besvär behövs studier som identifierar problemområden för skogsröjare. Syfte: Att kartlägga förekomsten av muskuloskeletala besvär samt att undersöka den generella fysiska arbetsbelastningen hos en grupp skogsröjare i Sverige. Metod: I denna studie deltog 28 män och 2 kvinnor. För att kartlägga förekomsten av muskuloskeletala besvär svarade samtliga forskningspersoner på en webbaserad version av Nordic Musculoskeletal Questionnaire (NMQ). Av dessa forskningspersoner deltog fyra män och en kvinna i hjärtfrekvensmätningar över en arbetsdag. Forskningspersonernas genomsnittliga hjärtfrekvens och hjärtfrekvens i vila användes tillsammans med uppskattad maximal hjärtfrekvens för att räkna ut hur stor del av hjärtfrekvensreserven som nyttjades. Resultat: Resultatet från NMQ undersökningen visar att 28 av 30 hade någon form av muskuloskeletala besvär de senaste 12 månaderna. Besvärsförekomsten var vanligast i ländryggen (66.7%), knän (53,3%) och skuldror/axlar (40%). Hjärtfrekvensmätningarna visade att forskningspersonerna i genomsnitt arbetade på 39,6% av hjärtfrekvensreserven. Konklusion: Resultaten i denna studie tyder på att förekomsten av muskuloskeletala besvär är vanligt förekommande hos skogsröjare i Sverige och att de arbetar på en generell fysisk arbetsbelastning över de föreslagna rekommendationerna.

  • 337.
    Johansson, Roland S
    et al.
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Physiology.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Physiology.
    Riso, Ronald
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Physiology.
    Somatosensory control of precision grip during unpredictable pulling loads. II. Changes in load force rate.1992In: Experimental Brain Research, ISSN 0014-4819, E-ISSN 1432-1106, Vol. 89, no 1, p. 192-203Article in journal (Refereed)
    Abstract [en]

    In the previous paper regarding the somatosensory control of the human precision grip, we concluded that the elicited automatic grip force adjustments are graded by the amplitude of the imposed loads when restraining an 'active' object subjected to unpredictable pulling forces (Johansson et al. 1992a). Using the same subjects and apparatus, the present study examines the capacity to respond to imposed load forces applied at various rates. Grip and load forces (forces normal and tangential to the grip surfaces) and the position of the object in the pulling direction (distal) were recorded. Trapezoidal load force profiles with plateau amplitudes of 2 N were delivered at the following rates of loading and unloading in an unpredictable sequence: 2 N/s, 4 N/s or 8 N/s. In addition, trials with higher load rate (32 N/s) at a low amplitude (0.7 N) were intermingled. The latencies between the start of the loading and the onset of the grip force response increased with decreasing load force rate. They were 80 +/- 9 ms, 108 +/- 13 ms, 138 +/- 27 ms and 174 +/- 39 ms for the 32, 8, 4 and 2 N/s rates, respectively. These data suggested that the grip response was elicited after a given minimum latency once a load amplitude threshold was exceeded. The amplitude of the initial rapid increase of grip force (i.e., the 'catch-up' response) was scaled by the rate of the load force, whereas its time course was similar for all load rates. This response was thus elicited as a unit, but its amplitude was graded by afferent information about the load rate arising very early during the loading. The scaling of the catch-up response was purposeful since it facilitated a rapid reconciliation of the ratio between the grip and load force to prevent slips. In that sense it apparently also compensated for the varying delays between the loading phase and the resultant grip force responses. However, modification of the catch-up response may occur during its course when the loading rate is altered prior to the grip force response or very early during the catch-up response itself. Hence, afferent information may be utilized continuously in updating the response although its motor expression may be confined to certain time contingencies. Moreover, this updating may take place after an extremely short latency (45-50 ms).

  • 338.
    Johansson, Roland S
    et al.
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Physiology.
    Riso, Ronald
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Physiology.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Physiology.
    Bäckström, Lars
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Physiology.
    Somatosensory control of precision grip during unpredictable pulling loads. I. Changes in load force amplitude.1992In: Experimental Brain Research, ISSN 0014-4819, E-ISSN 1432-1106, Vol. 89, no 1, p. 181-191Article in journal (Refereed)
    Abstract [en]

    In manipulating 'passive' objects, for which the physical properties are stable and therefore predictable, information essential for the adaptation of the motor output to the properties of the current object is principally based on 'anticipatory parameter control' using sensorimotor memories, i.e., an internal representation of the object's properties based on previous manipulative experiences. Somatosensory afferent signals only intervene intermittently according to an 'event driven' control policy. The present study is the first in a series concerning the control of precision grip when manipulating 'active' objects that exert unpredictable forces which cannot be adequately represented in a sensorimotor memory. Consequently, the manipulation may be more reliant on a moment-to-moment sensory control. Subjects who were prevented from seeing the hand used the precision grip to restrain a manipulandum with two parallel grip surfaces attached to a force motor which produced distally directed (pulling) loads tangential to the finger tips. The trapezoidal load profiles consisted of a loading phase (4 N/s), plateau phase and an unloading phase (4 N/s) returning the load force to zero. Three force amplitudes were delivered in an unpredictable sequence; 1 N, 2 N and 4 N. In addition, trials with higher load rate (32 N/s) at a low amplitude (0.7 N), were superimposed on various background loads. The movement of the manipulandum, the load forces and grip forces (normal to the grip surfaces) were recorded at each finger. The grip force automatically changed with the load force during the loading and unloading phases. However, the grip responses were initiated after a brief delay. The response to the loading phase was characterized by an initial fast force increase termed the 'catch-up' response, which apparently compensated for the response delay--the grip force adequately matched the current load demands by the end of the catch-up response. In ramps with longer lasting loading phases (amplitude greater than or equal to 2 N) the catch-up response was followed by a 'tracking' response, during which the grip force increased in parallel with load force and maintained an approximately constant force ratio that prevented frictional slips. The grip force during the hold phase was linearly related to the load force, with an intercept close to the grip force used prior to the loading. Likewise, the grip force responses evoked by the fast loadings superimposed on existing loads followed the same linear relationship.(ABSTRACT TRUNCATED AT 400 WORDS)

  • 339.
    Johansson, Susanna
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Schau, Mikael
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Ser vi samma sak? Interbedömarreliabiliteten för erfarna och oerfarna bedömare av rörelsekontroll för ländryggen hos styrkelyftare2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    BAKGRUND: Ländryggssmärta är idag ett av de största folkhälsoproblemen och drabbar majoriteten av människor någon gång under deras livstid. Det är viktigt med validerade och reliabla tester för att undersöka problematiken. Nedsatt rörelsekontroll är en trolig källa till symptom i ländryggen. Styrkelyftare utsätts för stora externa krafter på ländryggen, framförallt i knäböj och marklyft, vilket gör att de tillhör riskgruppen för ländryggssmärta. SYFTE: Syftet med denna studie var att undersöka interbedömarreliabiliteten för erfarna och oerfarna bedömare av rörelsekontroll för ländryggen hos styrkelyftare. Det sekundära syftet var att undersöka om det fanns en skillnad i total testbatteripoäng mellan styrkelyftare med och utan ländryggssmärta. METOD: Åtta deltagare filmades när de utförde tester enligt ett testbatteri utvecklat av Luomajoki et al. Dessa filmer bedömdes av två erfarna samt två oerfarna bedömare för att undersöka interbedömarreliabiliteten. RESULTAT: Resultaten presenterades med Cohens kappa samt med procentuell överensstämmelse. Resultaten visade tendenser till att erfarna bedömare hade bättre överensstämmelse än oerfarna bedömare i detta testbatteri. Av de åtta tester som analyserades med Cohens kappa hade de erfarna bedömarna högre kappakoefficienter i fem av testerna. Sett till procentuell överensstämmelse var inte tendensen lika tydlig. Ingen signifikant skillnad fanns i total testbatteripoäng mellan styrkelyftare med och utan ländryggssmärta. SLUTSATS: Tendensen tyder på att erfarna bedömare är mer samstämmiga i sin bedömning än oerfarna bedömare. I den här studien kunde man inte se någon skillnad i resultatet mellan styrkelyftare med respektive utan ländryggsmärta på ett testbatteri för rörelsekontroll i ländryggen. Några säkra slutsatser kunde inte dras av resultaten, framförallt på grund av det låga deltagarantalet.

  • 340.
    Johansson, Tobias
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Ottehall, Daniel
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Reliabilitet och validitet för ett hopptest: Objektiv mätning av knästabilitet med rörelsesensorer2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Stabilitet i knäleden bedöms ofta genom funktionella hopptester tillsammans med teknisk utrustning. Ett problem med de funktionella tester som används är brist på standardisering.

    Syfte: Syftet med denna studie var att med hjälp av rörelsesensorer utvärdera reliabilitet och validitet av Norells ACL jumptest för att mäta dynamisk stabilitet i knäleden hos unga friska personer.

    Metod: Sju unga friska män fick uföra Norells ACL jumptest, Drop jump och One-leg hop for distance vid två testtillfällen. Rörelsedata från första kontakt med marken analyserades. Reliabiliteten utvärderades genom test-återtest och samtidig validitet genom att procentuell differens mellan resultaten från Norells ACL jumptest och Drop jump respektive One-leg hop for distance räknades ut. Deltagarna fick även fylla i självuppskattningsformulären KOOS och IPAQ.

    Resultat: Det fanns en stor spridning i deltagarnas medianvärde gällande både bakåt-framåt- och sidledsacceleration vid test-återtest. Även stor spridning uppmättes i jämförelsen av de tre testerna. Det fanns inget samband mellan ökad stabilitet och dominant ben. Inget samband mellan resultatet på hopptesterna och självskattning av KOOS och IPAQ kunde påvisas.

    Slutsats:Reliabilitet och samtidig validitet av Norells ACL jumptest värderas som låg i denna studie. Inget samband mellan självupplevd knästabilitet och den stabilitet som uppmätts med RS kunde påvisas. Det kunde heller inte påvisas ett samband mellan dominant ben och en ökad knästabilitet. Norells ACL jumptest verkar dock vara ett likvärdigt funktionellt test jämfört med Drop jump och One-leg hop for distance gällande mätning av dynamisk stabilitet i knä enligt denna studie.

  • 341.
    Jonsson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Mobility,pain provocative and palpatory tests in patients with neck pain -A systematic review of intra- and inter raterreliability: -A systematic review of intra- and inter rater reliability2013Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
  • 342.
    Jonsson, Anders
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Rasmussen-Barr, Eva
    Intra- and inter-rater reliability of movement and palpation tests in patients with neck pain: A systematic review2018In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 34, no 3, p. 165-180Article in journal (Refereed)
    Abstract [en]

    Neck pain is common and often becomes chronic. Various clinical tests of the cervical spine are used to direct and evaluate treatment. This systematic review aimed to identify studies examining the intra- and/or interrater reliability of tests used in clinical examination of patients with neck pain. A database search up to April 2016 was conducted in PubMed, CINAHL, and AMED. The Quality Appraisal of Reliability Studies Checklist (QAREL) was used to assess risk of bias. Eleven studies were included, comprising tests of active and passive movement and pain evaluating participants with ongoing neck pain. One study was assessed with a low risk of bias, three with medium risk, while the rest were assessed with high risk of bias. The results showed differing reliabilities for the included tests ranging from poor to almost perfect. In conclusion, active movement and pain for pain or mobility overall presented acceptable to very good reliability (Kappa >0.40); while passive intervertebral tests had lower Kappa values, suggesting poor reliability. It may be a coincidence that the studies indicating very good reliability tended to be of higher quality (low to moderate risk of bias), while studies finding poor reliability tended to be of lower quality (high risk of bias). Regardless, the current recommendation from this review would suggest the clinical use of tests with acceptable reliability and avoiding the use of tests that have been shown to not be reliable. Finally, it is critical that all future reliability studies are of higher quality with low risk of bias.

  • 343.
    Jonsson, Anton
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Bergström, Bernhard
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Kognitiv funktion under fysiskt arbete: - En metodstudie2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Under fysiskt arbete påverkas kognitiv funktion på olika sätt men det finns idag inget kliniskt användbart testprotokoll. 

    Syfte: Syftet var att utforma ett kliniskt användbart testprotokoll samt att med detta undersöka hur friska försökspersoners kognitiva funktion direkt påverkades av ett fysiskt arbete.

    Metod: Fyrtiofem friska försökspersoner (medelålder 25 år, medelvikt 70 kg) män och kvinnor utförde fyra kognitiva tester i vila. Därefter utfördes samma tester under fysiskt arbete på cykel vid ca 70 % av ålderspredicerad maxpuls. Testerna gick ut på att så snabbt och korrekt som möjligt, nämna numren 1 till 20 samt årets månader baklänges respektive framlänges. Dessutom beräknades differensen av tiden det tog att nämna numren respektive månaderna baklänges jämfört med framlänges (Reverse effect).

    Resultat: För flertalet deltester påvisades ingen skillnad i kognitiv funktion mellan vila och fysiskt arbete. En liten, men signifikant, skillnad noterades för deltestet räkna 1-20 framlänges som gick 0,63 sekunder långsammare under arbete jämfört med vila (p=0,001). En liten signifikant skillnad noterades även för Reverse effect för nummertestet som var 0.46 sekunder lägre under arbete jämfört med vila (p= 0,042).

    Konklusion: Då resultatet inte visade på någon större effekt av arbete ansågs testprotokollet vara för lätt för unga och friska personer. Ändå var testprotokollet lätt att genomföra, tog relativt kort tid samt genererade data som till stor del var normalfördelad. Därför tycks resultatet och testmetodiken vara möjlig att använda som referensdata samt mätmetod för att undersöka den kognitiva funktionens effekt av arbete på en matchad population med kognitiva nedsättningar. 

  • 344.
    Jonsson, David
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Association between back pain in adolescence and low back pain in adulthood - studying a group of mine workers.2015Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
  • 345.
    Jonsson, Emma
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wiklund, Emelie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    "Strong is the new skinny".: Gymnasieungdomars uppfattnin gar om hälsa, kost och träning - irelation till fenomenet ortorexi.2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Hälsomedvetenheten  är stor hosbefolkningen, även hos unga. Idag finns hälsoråd och kroppsideal som förespråkar mycket träning och nyttig kost, vilket kan skapa en hysteri i jakten på den perfekta kroppen. Denna hälso- och träningshets kan beskrivas med begreppet  ortrexi

    Syfte:Syftetmedstudienvarattutforskagymnasieungdomars uppfattningar om hälsa,

    kostochträning-irelationtillfenomenetortorexi.

    Metod:!dennastudietillämpadesscmistruktureradeintervjuersomanalyseradesmed

    kvalitativinnehällsanalysenligtGraneheimochLundman.Totaltintervjuadestio gymnasieungdomar från

    enavdestörrekommunalagymnasieskolornaiUmeå. Dera

    så]der,könochutbildningsprogramvarierade.

    Resultat:Analysen  avintenjuernaresulteradeitematDen osunda sundheten samt fem kategorier:Träning och hälsa

    som tävling och hets, Jakten på bekräftelse,

    Ungapressade  av styrande och orimliga ideal, Unga behöver skyddsnät och

    Träning och hälsa som välmående. Resultatetvisadepåattdeintervjuvadeungdomarnauppfattadeattdetråderenhälsohetsisamhälletsomungapåverkasmycketav.

    Deupplevdeattdetfinnsosunda

    kroppsidealsomkanledatill ortorexi.Vidareupplevdessocialamediahastormaktoch bidratillhälsohetsen.Omgivningen

    uppmärksammadessomettbetydelsefullt skyddmothälsohetsen.

    Slutsats: Resultatet visade att de intervjuvade ungdomarna uppfattade att det finns en hälsohetsisamhället som bidrar till

    orimliga och osunda kroppsideal. Det är viktigt att fysioterapeuter har god kunskap och medvetenhet om de hälso- och kroppsideal

    som påverkar ungas inställning till hälsa, mat och träning.Eftersom fysioterapeuter möter

    många unga kan de fånga eventuella problem iett tidigt skede.

     

  • 346.
    Jonsson, Emma
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wiklund, Emelie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Strong is the new skinny: Gymnasieungdomars uppfattningar om hälsa, kost och träning -irelation till fenomenet ortorexi.2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

     

    Abstrakt:

     

    Introduktion:Hälsomedvetenheten är stor hos befolkningen, även hos unga.Idag finns hälsoråd och kroppsideal som förespråkar mycket träning och nyttig kost, vilket kan skapa en hysteri i jakte n på den perfekta kroppen. Denna hälso- och träningshets kan beskrivas med begreppet ortorexi.

     

    Syfte:Syftet med studien var att utforska gymnasieungdomars uppfattnin gar om hälsa, kost och träning -irelation till fenomenet ortorexi.

     

    Metod:!denna  studie tillämpades scmistrukturerade  intenjuer som analyserades med kvalitat iv innehällsanalys enligt Grancheim och Lundman. Totalt intenjuades tio gymnasieungdomar från en av de större kommunala gymnasieskolorna i Umeå.Deras ålder, kön och utbildningsprogram varierade.

     

    Resultat:Analysen av intenjuerna resulterade itemat Den osunda sundheten samt fem kategorier: Träning och hälsa som tävling och hets,Jakten p å bekräftelse, Ungapressade av styrande och orimliga ideal, Unga behöver skyddsnät och Träning och hälsa som

    välmående. Resultatet visade på att de intervjuvade ungdomarna uppfattade att det råder en hälsobets isamhället som unga påverkas mycket av. De upplevde att det finns osunda kroppsideal som kan leda till ortorexi. Vidare upplevdes sociala media ha stor makt och bidra till hälsohetsen. Omgivningen uppmärksammades som ett betyd elsefullt skydd mot hälsobetsen.

     

    Slutsats:Resultatet visade att de intervjuvade ungdomarna uppfatt ade att det finns en hälsohets isamhället som bidrar till orimliga och osunda kroppsideal. Det är viktigt att fysioterapeuter har god kunskap och medvetenhet om de hälso- och kroppsideal som påverkar u ngas inställning till hälsa, mat och träning.Eftersom fysioterapeuter möter många unga kan de fånga eventuella problem iett tidigt skede.

  • 347.
    Jonsson, Jonas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    En utforskning av gången efter stroke genom tredimensionell rörelseanalys: En tvärsnittsstudie2016Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Huvudsyftet med denna studie var att utforska hur gången är påverkad hos personer som drabbats av en stroke gällande avvikelse, rörelsemönster och asymmetri i armar och ben genom att använda tredimensionell analys. Sekundära syften med studien var att undersöka hur kinematisk testning korrelerar med kliniska test och utforska hur spasticitet påverkar gången baserat på dessa test. Metod: Tjugofem personer som drabbats av en stroke och 25 friska köns- och åldersmatchade kontroller undersöktes med tredmiensionell analys. Strokegruppen undersöktes också med klinska test. Resultat: Strokegruppen uppvisade avvikelser från kontrollerna i GVS för det påverkade knät och fötterna (p<0,001), men inte på GPS. I det påverkade benet hade strokegruppen lägre total ROM (p<0,001). Det fanns korrelationer mellan GPS på det påverkade benet och gånghastighet (rs=-0,79), Fugl-Mayer Assessment (rs=-0,70) och 30-second chair-stand test (rs=-0,47). Subgruppen som var spastiska efter sin stroke hade högre GPS i båda benen, gick långsammare, hade en mer asymmetrisk gång och lägre total ROM på den påverkade sidan jämfört med kontrollgruppen. Slutsats: GPS kunde inte upptäcka kinematiska avvikelser mellan grupperna i denna studie och kan kanske inte är lämpligt för att upptäcka gångavvikelser på grupper med personer med lättare gångnedsättningar efter stroke. Vi föreslår att GVS och ROM också bör undersökas för att få en mer komplett förståelse för kinematiken av gången. Klinska tester och gångförmåga kan indikera att gången är förändrad. Spasticitet har en negativ påverkan på gångparametrar.

  • 348.
    Jonsson, Jonas
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hagberg, Jennifer
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Valued competencies and attributes in newly graduated physiotherapists: an employer's of view2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 349.
    Jonsson, Veronica
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Näslund, Marika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Stroops test under gång för äldre personer: Utvärdering av genomförbarheten2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Få studier har tidigare utfört Stroops test under gång på äldre personer. Resultaten har visat att det går att särskilja personer som fallit tidigare och att det tidigt går att upptäcka en kognitiv försämring. Dessa studier saknar dock tydliga instruktioner om hur testet ska genomföras och hur tiderna ska tolkas i förhållande till antal felsteg.

    Syfte: Syftet var att undersöka genomförbarheten av Stroops test under gång för äldre personer. Dessutom undersöka om det gick att se några samband mellan vanlig gånghastighet, vanligt Strooptest och gång på Stroopmatta.

    Metod: Till studien rekryterades 5 personer (2 män och 3 kvinnor) över 70 år genom ett bekvämlighetsurval. Varje deltagare fick utföra ett vanligt Strooptest sittande, test av gånghastighet på svart matta och Stroops test under gång. Slutligen fick de besvara några frågor om hur de upplevde testerna.

    Resultat/Konklusion: Resultaten visade att inga signifikanta samband fanns mellan de olika testvärdena. Stroops test under gång var genomförbart för äldre personer över 70 år. Testet var enkelt att genomföra och deltagarna förstod lätt instruktionerna. Fler studier behöver dock göras för att utveckla testet vidare, bland annat för att granska vilken patientgrupp som testet är lämpligt att utföras på samt för att finna normalvärden.

  • 350.
    Jonsvens, Evelina
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Andersson, Malin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Inter- och intra-bedömarreliabilitet för goniometermätnng av passiv höftledsextension hos hund2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
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