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  • 51.
    Axelsson, Helena
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Ridderström, Ida
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Is Pilates more effective than a Motor Control Exercise program when treating chronic low back pain: A randomised Control Trial2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 52.
    Axén, Malin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Stålnacke, Hanna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Upplevelser av en multidisciplinär grupputbildning för patienter med diabetes typ II: En kvalitativ studie2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Det finns god evidens för att patientutbildning i grupp har bra effekt på långtidssocker (HbA1c) hos patienter med diabetes typ II. Det är dock ovisst om sådan grupputbildning är genomförbar i primärvård och hur den i så fall bör utformas. För att undersöka detta har det startats ett pilotprojekt med en grupputbildning på en vårdcentral i Västerbottens län.

    Syfte: Att studera deltagarnas upplevelser av en multidisciplinär grupputbildning för patienter med diabetes typ II, inom primärvården.

    Metod: Semistrukturerade intervjuer utfördes med fyra informanter, som deltagit i grupputbildningen. Öppna frågor ställdes kring de ämnen som utbildningen behandlat samt huruvida informanterna gjort förändringar efter kursen. Intervjuerna analyserades med kvalitativ innehållsanalys.

    Resultat: Studien resulterade i fyra kategorier. Onödig undervisning men användbara tips: den teoretiska undervisningen upplevdes onödig, men konkreta tips var givande för att uppnå livsstilsförändringar. Viljan att lära av och stötta varandra: att få ta del av varandras erfarenheter ansågs vara det viktigaste i utbildningen. Känsla av otillräcklighet: de förändringar informanterna gjort sågs som otillräckliga och ibland för små för att nämna. Förnekar som skydd och söker efter hopp: skam, hopplöshet och en rädsla för framtiden uttrycktes. Förnekelse användes som försvarsmekanism samtidigt som informanterna sökte hopp om att kunna må bra.

    Slutsats: Resultatet antyder att en grupputbildning bör ge utrymme för deltagarna att utbyta erfarenheter. För informanterna var det viktigt att utbildningen ingav hopp om att kunna må bra. Det uppskattades att utbildningen bistod med konkreta tips om hur deltagarna kunde gå tillväga för att nå de övergripande livsstilsmålen.

  • 53.
    Balnožan, Stevan
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Isgren, Andreas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Samband mellan träningsbelastning vid högintensiva cykelintervaller och styrkekapacitet hos yngre, friska och tränade individer: En pilotstudie2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Under senare år har olika former av mycket högintensiv intervallträning givits ett ökat intresse. Denna träningsmetod har potential att vara användbar av många. Problematiken idag är att det inte finns någon kliniskt användbar metod för att styra/reglera träningsintensiteten på ett säkert sätt. 

    Syfte: Att undersöka om tester av styrkeprestation vid 30s Chair Stand Test och Isometriskt marklyft kan användas som mått för att reglera intensitet vid högintensiva intervaller.

    Metod: 12 försökspersoner mellan åldrarna 20-30år (6 kvinnor, 6 män)[BR1]  genomförde Borg Cycle Strenght [BR2] Test för att estimera maximal anaerob effekt (Watt) för 30 sekunders cykelarbete (MAnP, Maximal Anaerobic Power). Därutöver genomfördes två styrketester: Isometriskt marklyft och 30s Chair Stand Test. Sambandet mellan kapaciteten i styrketesterna och MAnP analyserades med Pearson`s[BR3]  korrelationstest.

    Resultat: Signifikant korrelation fanns i båda styrketesten i relation till Cycle Strenght Test, (p<0.01, r=0,77 för 30s Chair Stand Test och p<0.05, r=0,61 för det isometriska marklyftet).

    Konklusion: I den här pilotstudien visar resultatet att det finns ett samband mellan prestationsförmågan vid Marklyft respektive 30s Chair Stand Test och maximal prestationsförmåga vid cykling under 30 sekunder hos unga individer. 30s Chair Stand Test visar sig vara ett mer lämpat styrketest än det isometriska marklyftet för att kunna styra träningsintensiteten vid supramaximala 30 sekunders intervaller. Testmetodiken kan vara möjlig för att kunna styra träningsintensiteten. Vidare studier krävs för användning i klinisk miljö exempelvis bland äldre.

  • 54. Barreto, Philipe de Souto
    et al.
    Morley, John E.
    Chodzko-Zajko, Wojtek
    Pitkala, Kaisu H.
    Weening-Djiksterhuis, Elizabeth
    Rodriguez-Manas, Leocadio
    Barbagallo, Mario
    Rosendahl, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sinclair, Alan
    Landi, Francesco
    Izquierdo, Mikel
    Vellas, Bruno
    Rolland, Yves
    Recommendations on Physical Activity and Exercise for Older Adults Living in Long-Term Care Facilities: A Taskforce Report2016In: Journal of the American Medical Directors Association, ISSN 1525-8610, E-ISSN 1538-9375, Vol. 17, no 5, p. 381-392Article in journal (Refereed)
    Abstract [en]

    A taskforce, under the auspices of The International Association of Gerontology and Geriatrics-Global Aging Research Network (IAGG-GARN) and the IAGG European Region Clinical Section, composed of experts from the fields of exercise science and geriatrics, met in Toulouse, in December 2015, with the aim of establishing recommendations of physical activity and exercise for older adults living in long-term care facilities (LTCFs). Due to the high heterogeneity in terms of functional ability and cognitive function that characterizes older adults living in LTCFs, taskforce members established 2 sets of recommendations: recommendations for reducing sedentary behaviors for all LTCF residents and recommendations for defining specific, evidence-based guidelines for exercise training for subgroups of LTCF residents. To promote a successful implementation of recommendations, taskforce experts highlighted the importance of promoting residents' motivation and pleasure, the key factors that can be increased when taking into account residents' desires, preferences, beliefs, and attitudes toward physical activity and exercise. The importance of organizational factors related to LTCFs and health care systems were recognized by the experts. In conclusion, this taskforce report proposes standards for the elaboration of strategies to increase physical activity as well as to prescribe exercise programs for older adults living in LTCFs. This report should be used as a guide for professionals working in LTCF settings.

  • 55.
    Bay, Annika
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Sandberg, Camilla
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Thilen, U.
    Wadell, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Johansson, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Exercise self-efficacy (ESE) in adults with congential heart disease2017In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 38, no Suppl. 1, article id ehx501.P618Article in journal (Refereed)
    Abstract [en]

    Background: Many adults with congenital heart disease (CHD) have reduced aerobic exercise capacity and impaired muscle function. However, it is largely unknown which factors have influence on the confidence to perform exercise training, i.e. Exercise Self-Efficacy (ESE).

    Aims: To identify factors related to low ESE, and thus identify potential targets for rehabilitation and thereby enhance the potential for being physically active.

    Methods: Seventy-nine adults with CHD; simple lesions n=38 (women n=16), complex lesions n=41 (women n=17) (mean age 36.7±14.6 years) and 42 age and sex matched controls were recruited. All participants completed questionnaires on ESE, quality of life (EQ-5D), and physical activity (international physical activity questionnaire, IPAQ), and performed muscle endurance tests.

    Results: ESE was categorised into low (<26 points, n=24) and high (≥26 points, n=55). Patients with low ESE were older (45.2±15.4 vs. 32.6±12.5 years, p=0.002), more often had prescribed medication (67% vs. 44%, p=0.06), higher New York Heart Association functional class (NYHA) (≥ III) (25% vs. 7%, p=0.03) and performed fewer shoulder flexions (30.9±16.1 vs. 45.9±23.9, p=0.01) compared with those with high ESE. In the high ESE group, ESE did not differ from controls (33.8±3.9 vs. 33.4±6.1, p=0.74). In linear multivariate analysis age (B;-0.18, 95% CI -0.28- -0.08), smoking (B;-3.73, 95% CI -7.17- -0.28), EQ-5Dindex <1 (B;-3.33, 95% CI -6.08- -0.57) and number of shoulder flexions (B; 0.09, 95% CI 0.03–0.16) were independently associated with ESE.

    Conclusion: Many adults with CHD have low ESE. Rehabilitation targeting quality of life, smoking cessation and muscle training may improve ESE, and thus enhance the potential for being physically active in this population.

  • 56. Bengtsson, Karin
    et al.
    Forsblad-d'Elia, Helena
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology. Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden .
    Lie, Elisabeth
    Klingberg, Eva
    Dehlin, Mats
    Exarchou, Sofia
    Lindstrom, Ulf
    Askling, Johan
    Jacobsson, Lennart T. H.
    Risk of cardiac rhythm disturbances and aortic regurgitation in different spondyloarthritis subtypes in comparison with general population: a register-based study from Sweden2018In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 77, no 4, p. 541-548Article in journal (Refereed)
    Abstract [en]

    Objectives: To describe the incidence of atrioventricular (AV) block II-III, atrial fibrillation (AF), pacemaker implantation (PM) and aortic regurgitation in patients with ankylosing spondylitis (AS), undifferentiated spondyloarthritis (uSpA) and psoriatic arthritis (PsA) compared with the general population (GP) and with each other. Methods: A prospective nationwide study with cohorts of patients with AS (n=6448), PsA (n=16063) and uSpA (n=5190) and a GP (n=266435) cohort, identified in 2001-2009 in the Swedish National Patient and Population registers. Follow-up began on 1 January 2006 and ended at event, death, emigration or 31 December 2012. Age-standardised and sex-standardised incidence rates and hazard ratios (HRs) were calculated. Results: The highest incidence rates were noted for AF (5.5-7.4 events per 1000 person-years), followed by PM (1.0-2.0 events per 1000 person-years). HRs for AV block, AF, PM and aortic regurgitation were significantly increased in AS (HRs 2.3, 1.3, 2.1 and 1.9), uSpA (HRs 2.9, 1.3, 1.9 and 2.0) and PsA (HRs 1.5, 1.5, 1.6 and 1.8) compared with the GP cohort. The highest HRs were seen for AV block in male uSpA (HR 4.2) and AS (HR 2.5) compared with GP. Compared with PsA, significantly increased HRs were noted for PM (HR 1.5) in AS and for AV block (HR 1.8) in uSpA. Conclusions: Patients with SpA are at increased risk of aortic regurgitation, cardiac rhythm disturbances and, as a probable consequence, also PM. Particularly for AF, the most common arrhythmia, increased caution is warranted, whereas AV block should be looked for especially in men with AS or uSpA.

  • 57.
    Bengtsson, Patrik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Postoperativ knäsvullnad efter främre korsbandsrekonstruktion: - en jämförelse mellan standard- och accelererad rehabilitering.2013Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Nu för tiden är det vanligt att använda sig av så kallad accelererad rehabilitering efter främre korsbandsrekonstruktion. Den accelererade rehabiliterings påverkan på uttöjning av det nya korsbandsgraftet och lårmuskelstyrka är väl kända. Däremot är kunskapen om hur accelererad rehabilitering påverkar svullnad i knäleden mer begränsad.

    Syfte: Att undersöka om det finns någon skillnad avseende knäledssvullnad efter främre korsbandsrekonstruktion vid ett standard- och ett accelererat rehabiliteringsprogram.

    Studiedesign: Sekundäranalys av randomiserad kontrollerad studie.

    Material och metod: Etthundra sextioen främre korsbandsrekonstruerade patienter med patellar- eller hamstringssena randomiserades till standard- och ett accelererat rehabiliteringsprogram. Nittio patienter, standard rehabilitering (n=29) och accelererad rehabilitering (n=61) inkluderades för beräkning av svullnad, vid baseline, 1 vecka postoperativt. Svullnad definierades som skillnad i omkrets mätt med måttband av icke opererat knä jämfört med opererat knä. Svullnad beräknades vid vecka 1 och månad 1, 2, 3 och 4 postoperativt.

    Resultat: Det var ingen signifikant skillnad avseende knäsvullnad vid jämförelse  mellan standard- och ett accelererat rehabiliteringsprogram vid något av uppföljningstillfällena.

    Slutsats: Denna studie visar att träning enligt ett accelererat rehabiliteringsprogram efter främre korsbandrekonstruktion inte ökar knäsvullnad signifikant jämfört med ett standard rehabiliteringsprogram. Gruppen som tränat enligt ett accelererat rehabiliteringsprogram uppvisade dock en något större knäsvullnad suprapatellärt.

  • 58.
    Bengtsson, Victor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    The three-dimensional movement patterns in the thoracolumbar and lumbopelvic spine during the deadlift exercise2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Marklyft är en vanlig styrketräningsövning. Det saknas emellertid studier av ryggradens rörelsemönster under utförandet av marklyft. Syftet med den här studien var att kvantifiera ryggradens tredimensionella rörelsemönster under utförandet av marklyft och vid vanehållning i de thorakolumbala och lumbosakrala regionerna samt studera inverkan av kön.

    Tjugofyra tävlande lyftare, 14 män och 10 kvinnor med 1 repetition maximum (1RM) i marklyft på 162.5 ± 55.5 kg, utförde tre repetitioner av tunga marklyft. Ryggens tredimensionella rörelsemönster, rörelseomfång (ROM) och kurvatur i thorakolumbala (T11-L2) och lumbosakrala (L2-S2) regionerna mättes med rörelsesensorer.

    Resultatet visade att rörelser sker i sagittal-, frontal- och horizontalplanet i thorakolumbala (ROM = 11.8 ± 7.6, 4.3 ± 2.8, and 3.4 ± 1.6 degrees) och lumbosakrala regionerna (ROM = 21.7 ± 6.5, 2.8 ± 1.7, och 2.8 ± 1.4 grader) under marklyftsutförandet. I jämförelse med vanehållningen ändrades ryggens kurvatur i start- och stoppläget mot ett mer flekterat läge. Signifikanta skillnader hittades mellan könen avseende vanehållning, startläge och ROM.

    Sammanfattningsvis ändras ryggens kurvatur under utförandet av tunga marklyft i sagittalplanet samt att vanehållningen och rörelsemönster skiljer sig mellan män och kvinnor.

  • 59.
    Bengtsson, Victor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    The three-dimensional thoracolumbar and lumbopelvic spinal alignment during the squat exercise: a comparison between powerlifters and weightlifters2018Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Introduction: The squat is a common strength training exercise used by athletes for injury-reduction, rehabilitation, muscle hypertrophy, and performance-enhancement. Aims: To quantify the three-dimensional spinal alignment in the thoracolumbar and lumbopelvic spine during the squat exercise, compare the alignment during the squat to the alignment during habitual posture, determine whether powerlifters and weightlifters differ in these aspects, and to examine the absolute and relative intrarater test-retest reliability of the spinal alignment during the squat exercise. Methods: Twenty-three competitive lifters: 13 powerlifters and 10 weightlifters were included. They performed the squat exercise with three repetitions at 70% of one-repetition maximum. Three-dimensional thoracolumbar (T11-L2) and lumbopelvic (L2-S2) spinal alignment and range of motion (ROM) were measured using inertial measurement units. Absolute reliability was estimated with minimal detectable change (MDC). Relative reliability was calculated using the intraclass correlation coefficient (ICC). Results: No statistically significant group*time interaction was found for thoracolumbar or lumbopelvic spinal alignment in neither dimension. However, statistically significant interactions for time was found in all three dimensions in thoracolumbar and lumbopelvic spinal alignment. During the squat, adjustments were made in all three dimensions in both the thoracolumbar and lumbopelvic spinal alignment. The MDC ranged between 3.4-27.4° and ICC between 0.91-1.00. Conclusion: These findings suggest that that powerlifters and weightlifters assumes a less lordotic thoracolumbar spinal alignment when the loaded barbell is placed on the upper back and that further adjustments are made in the thoracolumbar and lumbopelvic spinal alignment during the squat. Despite high relative reliability, the MDC was considered high.

  • 60.
    Bengtsson, Victor
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Berglund, Lars
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Social Sciences, Umeå Sport Sciences Center.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Social Sciences, Umeå Sport Sciences Center. Medfit, Primary Care Rehabilitation and Fitness Centre, Stockholm, Sweden.
    Narrative review of injuries in powerlifting with special reference to their association to the squat, bench press and deadlift2018In: BMJ Open Sport & Exercise Medicine, E-ISSN 2055-7647, Vol. 4, article id e000382Article in journal (Refereed)
    Abstract [en]

    Pain and injuries are considered a common problem among elite athletes and recreational lifters performing the squat, bench press and deadlift. Since all three lifts engage multiple joints and expose the lifters' bodies to high physical demands often several times a week, it has been suggested that their injuries might be related to the excessively heavy loads, the large range of motion during the exercises, insufficient resting times between training sessions and/or faulty lifting technique. However, no previous article has summarised what is known about specific injuries and the injury aetiology associated with the three lifts. Thus, the aim of this narrative review was to summarise what is known about the relationships between the powerlifting exercises and the specific injuries or movement impairments that are common among lifters and recreationally active individuals.

  • 61.
    Bentzer, Linda
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hedlund, Linnea
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Functional movement screen, skadeförekomst och träningsmängd hos kvinnliga innebandyspelare2012Student thesis
  • 62.
    Berggren, Monica
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Karlsson, Åsa
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Lindelöf, Nina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Englund, Undis
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Olofsson, Birgitta
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics. Umeå University, Faculty of Medicine, Department of Nursing.
    Nordstöm, Peter
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Stenvall, Michael
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Effects of geriatric interdisciplinary home rehabilitation on complications and readmissions after hip fracture: a randomized controlled trial2019In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 33, no 1, p. 64-73Article in journal (Refereed)
    Abstract [en]

    Objective: This pre-planned secondary analysis of geriatric interdisciplinary home rehabilitation, which was initially found to shorten the postoperative length of stay in hospital for older individuals following hip fracture, investigated whether such rehabilitation reduced the numbers of complications, readmissions, and total days spent in hospital after discharge during a 12-month follow-up period compared with conventional geriatric care and rehabilitation.

    Design: Randomized controlled trial.

    Setting: Geriatric department, participants' residential care facilities, and ordinary housing.

    Subjects: Individuals aged ⩾70 years with acute hip fracture (n = 205) were included.

    Intervention: Geriatric interdisciplinary home rehabilitation was individually designed and aimed at early discharge with the intention to prevent, detect, and treat complications after discharge.

    Main measures: Complications, readmissions, and days spent in hospital were registered from patients' digital records and interviews conducted during hospitalization and at 3- and 12-month follow-up visits.

    Results: No significant difference in outcomes was observed. Between discharge and the 12-month follow-up, among participants in the geriatric interdisciplinary home rehabilitation group (n = 106) and control group (n = 93), 57 (53.8%) and 44 (47.3%) had complications (P = 0.443), 46 (43.4%) and 38 (40.9%) fell (P = 0.828), and 38 (35.8%) and 27 (29.0%) were readmitted to hospital (P = 0.383); the median total days spent in hospital were 11.5 and 11.0 (P = 0.353), respectively.

    Conclusion: Geriatric interdisciplinary home rehabilitation for older individuals following hip fracture resulted in similar proportions of complications, readmissions, and total days spent in hospital after discharge compared with conventional geriatric care and rehabilitation.

  • 63. Berglind, Daniel
    et al.
    Nyberg, Gisela
    Willmer, Mikaela
    Persson, Margareta
    Umeå University, Faculty of Medicine, Department of Nursing.
    Wells, Michael
    Forsell, Yvonne
    An eHealth program versus a standard care supervised health program and associated health outcomes in individuals with mobility disability: study protocol for a randomized controlled trial2018In: Trials, ISSN 1745-6215, E-ISSN 1745-6215, Vol. 19, article id 258Article in journal (Refereed)
    Abstract [en]

    Background: Young adults with mobility disability (MD) are less likely to engage in regular physical activity (PA) compared with their able-bodied peers and inactive adults with a MD are more likely to report one or more chronic diseases compared to those who are physically active. Despite the vast amount of research published in the field of PA interventions over the past decades, little attention has been focused on interventions aiming to increase PA among individuals with MD. Thus, we propose to compare the effects of an eHealth program compared to a usual care supervised health program on levels of PA and other health behaviors. 

    Methods: The current intervention will use a randomized controlled trial (RCT) design with two treatment groups (an eHealth program and a usual care supervised health program) in young adults with newly acquired MD. In total, 110 young adults (aged 18-40 years) with a MD, acquired within the past 3 years, will be recruited to participate in a 12-week intervention. The primary study outcome is accelerometer-measured time spent in moderate to vigorous PA. Secondary outcomes includes health-related quality of life, depression, stress, fitness, body composition, diet, musculoskeletal pain, motivation to exercise and work ability.

    Discussion: There is a lack of RCTs investigating effective ways to increase levels of PA in young adults with MD. Increased levels of PA among this physically inactive population have the potential to substantially improve health-related outcomes, possibly more so than in the general population. The trial will put strong emphasis on optimizing exercise adherence and investigating feasibility in the two treatment programs. The Ethical Review Board (EPN) at Karolinska Institutet has approved the study (2017/1206-31/1).

  • 64.
    Berglund, Jon
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Inter-rater reliabilityfor visual assessment of six movement qualities during supervised musicexercise performance2013Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Visuella bedömningar är vanligt förekommande i det dagliga arbetet bland sjukgymnaster, personliga tränare och gym instruktörer. Med målet att optimera rörelser och minimera risken för skada läggs förtroende till den visuella bedömning som grund för korrigering av rörelser. Det saknas dock vetenskapligt underlag för den visuella bedömningen av rörelsekvalitéer genom att titta på videoinspelningar av deltagares utförande under ledd träning till musik.

     Syfte: Syftet med denna studie var att undersöka inter-bedömar reliabiliteten för visuell bedömning av rörelsekvalitéerna timing, kvickhet, likhet, initiering, kraft och generell koordination genom att titta på videoinspelningar av deltagares utförande av dem under ledd träning till musik.

     Metod: För att undersöka inter-bedömar reliabiliteten så fick fyra bedömare visuellt bedöma videoinspelningar av 85 deltagare avseende deras utförande av ledd träning till musik genom skattning av sex olika rörelsekvalitéer. För varje deltagare fanns tre videosekvenser att bedöma.

     Resultat: Analyser med linjärt viktad kappa (k) utfördes för att bedöma likheten mellan bedömarna vilket gav medianvärdet för k = 0,206.

     Slutsats: På grund av brister i metoden kan inga säkra slutsatser dras avseende inter-bedömar reliabilteten för visuell bedömning av sex rörelsekvalitéer genom att titta på videoinspelningar av deltagares utförande av dem under ledd träning till musik.

  • 65.
    Berglund, Lars
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Deadlift training for patients with mechanical low back pain: a comparison of the effects of a high-load lifting exercise and individualized low-load motor control exercises2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

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

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

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

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

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

  • 66.
    Berglund, Lars
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Which patients with persistent mechanical low back pain will respond to highload motor control training?2010Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Introduction

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

    Aim

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

    Method

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

    Results

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

    Conclusion

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

  • 67.
    Berglund, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Aasa, Björn
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Michaelson, Peter
    Luleå Tekniska Universitet, Institutionen för hälsovetenskap, Avdelningen för hälsa och rehabilitering, Fysioterapi.
    Styrketräning som behandling vid långvariga ländryggsbesvär2017In: Fysioterapi, ISSN 1653-5804, no 4, p. 8p. 28-33Article, review/survey (Other academic)
    Abstract [sv]

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

  • 68.
    Berglund, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Aasa, Björn
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Hellqvist, Jonas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Michaelson, Peter
    Luleå Tekniska Universitet, Institutionen för hälsovetenskap, Avdelningen för hälsa och rehabilitering, Fysioterapi .
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Which patients with low back pain benefit from deadlift training?2015In: Journal of Strength and Conditioning Research, ISSN 1064-8011, E-ISSN 1533-4287, Vol. 29, no 7, p. 1803-1811Article in journal (Refereed)
    Abstract [en]

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

  • 69.
    Berglund, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
    Aasa, Björn
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics. Norrlandskliniken Hlth Care Ctr, Umea, Sweden.
    Michaelson, Peter
    Luleå Tekniska Universitet, Institutionen för hälsovetenskap, Avdelningen för hälsa och rehabilitering, Fysioterapi .
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine.
    Effects of Low-Load Motor Control Exercises and a High-Load Lifting Exercise on Lumbar Multifidus Thickness: A Randomized Controlled Trial2017In: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 42, no 15, p. E876-E882Article in journal (Refereed)
    Abstract [en]

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

  • 70.
    Berglund, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Social Sciences, Umeå Sport Sciences Center.
    Aasa, Björn
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics. Norrlandskliniken Health Care Centre, Umeå, Sweden.
    Michaelson, Peter
    Luleå Tekniska Universitet, Institutionen för hälsovetenskap, Avdelningen för hälsa och rehabilitering, Fysioterapi .
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Social Sciences, Umeå Sport Sciences Center.
    Sagittal lumbopelvic alignment in patients with low back pain and the effects of a high-load lifting exercise and individualized low-load motor control exercises: a randomized controlled trial2018In: The spine journal, ISSN 1529-9430, E-ISSN 1878-1632, Vol. 18, no 3, p. 399-406Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

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

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

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

  • 71.
    Berglund, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Aasa, Björn
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Michaelson, Peter
    Luleå Tekniska Universitet, Institutionen för hälsovetenskap, Avdelningen för hälsa och rehabilitering, Fysioterapi .
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    The effects of low-load motor control exercises and a high-load lifting exercise on lumbar multifidus thickness – a randomized controlled trialManuscript (preprint) (Other academic)
    Abstract [en]

    Study Design

    Randomized controlled trial

    Objective

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

    Summary of Background Data

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

    Methods

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

    Results

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

    Conclusions

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

  • 72.
    Berglund, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Falk, Jimmy
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Eliasson, Kim
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    What is the best squat and deadlift technique?2015Conference paper (Refereed)
  • 73.
    Berglund, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hellqvist, Jonas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Aasa, Björn
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Holmberg, David
    Luleå Tekniska Universitet, Institutionen för hälsovetenskap, Avdelningen för hälsa och rehabilitering, Fysioterapi.
    Michaelson, Peter
    Luleå Tekniska Universitet, Institutionen för hälsovetenskap, Avdelningen för hälsa och rehabilitering, Fysioterapi.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Which patients with persistent mechanical low back pain will respond to high load motor control training?2011Conference paper (Refereed)
  • 74.
    Bergman, Birgitta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Being a physiotherapist: professional role, utilization of time an d vocational strategies1989Doctoral thesis, monograph (Other academic)
    Abstract [en]

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

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

  • 75.
    Bergman, Frida
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Active workstations: a NEAT way to prevent and treat overweight and obesity?2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

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

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

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

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

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

    The full text will be freely available from 2019-11-16 00:00
  • 76.
    Bergman, Frida
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Enbenssidohopp 23 år efter främre korsbandsskada: en funktionell och kinematiskjämförelse mellan effekten av kirurgi och skräddarsydd sjukgymnastik mot friska kontroller2013Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

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

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

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

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

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

  • 77.
    Bergman, Johanna
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Vesterberg, Hanna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Webbaserad träning för patienter med långvarig smärtproblematik: En studie med Single Subject Experimental Design2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

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

     

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

     

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

     

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

     

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

  • 78.
    Bergqvist, Matilda
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lindahl, Maja
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Jämförelse av statisk och dynamisk lårmuskeluthållighet hos personer med kroniskt obstruktiv lungsjukdom och friska ålders- och könsmatchade kontroller: - en tvärsnittsstudie2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

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

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

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

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

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

  • 79.
    Bergström, Cecilia
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynecology.
    Persson, Margareta
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynecology. Umeå University, Faculty of Medicine, Department of Nursing.
    Mogren, Ingrid
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynecology.
    Psychosocial and behavioural characteristics in women with pregnancy-related lumbopelvic pain 12 years postpartum2019In: Chiropractic and Manual Therapies, ISSN 2045-709X, E-ISSN 2045-709X, Vol. 27, no 1, article id 34Article in journal (Refereed)
    Abstract [en]

    Background: There is insufficient evidence regarding psychosocial factors and its long-term association with persistent pregnancy-related lumbopelvic pain. The overall aim of this study was to investigate women with persistent pregnancy-related lumbopelvic pain 12 years postpartum based on psychosocial and behavioural characteristics using the Swedish version of the Multidimensional Pain Inventory (MPI-S) classification system.

    Material and methods: This is a cross-sectional study based on a previous cohort. Data collection took place through a questionnaire. A total of 295 women from the initial cohort (n = 639) responded to the questionnaire giving a response rate of 47.3%. To determine the relative risk (RR) of reporting pain 12 years postpartum, a robust modified Poisson regression was used. This is the first study using the MPI-S as a predictive variable on women with persistent pregnancy-related lumbopelvic pain.

    Results: The MPI-S classification procedure was carried out on a total of n = 226 women, where 53 women were classified as interpersonally distressed (ID), 82 as dysfunctional (DYS), and 91 as adaptive copers (AC). Women in the ID and DYS subgroups had a relative risk (RR) of reporting persistent pregnancy-related lumbopelvic pain 12 years postpartum that was more than twice as high compared to the AC subgroup (95% confidence interval (CI) in parenthesis): RR 2.57 (CI 1.76 - 3.75), p<0.0001 and RR 2.23 (CI 1.53 - 3.25), p<0.0001 respectively. Women in the DYS subgroup had more than 5 times increased risk of reporting sick leave the past 12 months compared to the AC subgroup (RR 5.44; CI 1.70 - 17.38, p=0.004).

    Conclusions: The present study demonstrates that it is possible to classify women with persistent pregnancy-related lumbopelvic pain 12 years postpartum into relevant clinical subgroups based on psychosocial and behavioural characteristics using the MPI-S questionnaire.

  • 80.
    Bergström, Christoffer
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Eliasson, Martin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Äldre personers inställning till fallpreventiv träning: - en enkätstudie2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

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

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

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

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

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

  • 81.
    Bergström, Matilda
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Larsson, Helena
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Konditionsträning i intervallform som behandling vid hjärntrötthet efter stroke: en single-subject-studie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

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

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

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

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

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

  • 82.
    Bergström, Sara
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Patienters syn på personcentrerad vård: - En kvalitativ studie med personer som genomgått reumatisk rehabilitering2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

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

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

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

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

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

  • 83.
    Betten, Carola
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Skånevård Kryh, Division Primärvård Skurup, Sweden.
    Sandell, Christofer
    Hill, Jonathan C.
    Gutke, Annelie
    Cross-cultural adaptation and validation of the Swedish STarT Back Screening Tool2015In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 17, no 1, p. 29-36Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 84.
    Bjerke, Joakim
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gait and postural control after total knee arthroplasty2014Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

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

     

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

     

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

  • 85.
    Bjerke, Joakim
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Department of Physiotherapy, School of Health Education & Social Work, Sør-Trøndelag University College, Trondheim, Norway.
    Öhberg, Fredrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Nilsson, Kjell G
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Foss, Olav A
    Orthopaedic Research Centre, Trondheim University Hospital, Trondheim, Norway.
    Stensdotter, Ann-Katrin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Department of Physiotherapy, School of Health Education & Social Work, Sør-Trøndelag University College, Trondheim, Norway.
    Peak knee flexion angles during stair descent in TKA patients2014In: The Journal of Arthroplasty, ISSN 0883-5403, E-ISSN 1532-8406, Vol. 29, no 4, p. 707-711Article in journal (Refereed)
    Abstract [en]

    Reduced peak knee flexion during stair descent (PKSD) is demonstrated in subjects with total knee arthroplasty (TKA), but the underlying factors are not well studied. 3D gait patterns during stair descent, peak passive knee flexion (PPKF), quadriceps strength, pain, proprioception, demographics, and anthropometrics were assessed in 23 unilateral TKA-subjects ~ 19 months post-operatively, and in 23 controls. PKSD, PPKF and quadriceps strength were reduced in the TKA-side, but also in the contralateral side. A multiple regression analysis identified PPKF as the only predictor (57%) to explain the relationship with PKSD. PPKF was, however sufficient for normal PKSD. Deficits in quadriceps strength in TKA-group suggest that strength is also contributing to smaller PKSD. Increased hip adduction at PKSD may indicate both compensatory strategy and reduced hip strength.

  • 86.
    Bjerke, Joakim
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Department of Physiotherapy, School of Health Education & Social Work, Sør-Trøndelag University College, Trondheim, Norway.
    Öhberg, Fredrik
    Department of Biomedical Engineering & Informatics, Umeå University Hospital, Umeå, Sweden.
    Nilsson, Kjell G
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Stensdotter, Ann-Katrin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Department of Physiotherapy, School of Health Education & Social Work, Sør-Trøndelag University College, Trondheim, Norway.
    Compensatory strategies for muscle weakness during stair ascent in subjects with total knee arthroplasty2014In: The Journal of Arthroplasty, ISSN 0883-5403, E-ISSN 1532-8406, Vol. 29, no 7, p. 1499-1502Article in journal (Refereed)
    Abstract [en]

    Subjects with total knee arthroplasty (TKA) exhibit decreased quadriceps and hamstring strength. This may bring about greater relative effort or compensatory strategies to reduce knee joint moments in daily activities. To study gait and map out the resource capacity, knee muscle strength was assessed by maximal voluntary concentric contractions, and whole body kinematics and root mean square (RMS) electromyography (EMG) of vastus lateralis and semitendinosus were recorded during stair ascent in 23 unilateral TKA-subjects ~19months post-operation, and in 23 healthy controls. Muscle strength and gait velocity were lower in the TKA group, but no significant group differences were found in RMS EMG or forward trunk lean. The results suggest that reduced walking velocity sufficiently compensated for reduced knee muscle strength.

  • 87.
    Bjerke, Joakim
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Department of Physiotherapy, School of Health Education & Social Work, Sør-Trøndelag University College, Trondheim, Norway.
    Öhberg, Fredrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Nilsson, Kjell G
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
    Stensdotter, Ann-Katrin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Department of Physiotherapy, School of Health Education & Social Work, Sør-Trøndelag University College, Trondheim, Norway.
    Gait on soft versus hard surface after total knee arthroplastyManuscript (preprint) (Other academic)
    Abstract [en]

    Asymmetric gait patterns are common following total knee arthroplasty (TKA). Gait on even and hard surface is primarily characterized by reduced peak knee flexion in the prosthetic knee, increased contralateral knee adduction angle, and decreased walking speed compared to controls. Natural conditions may however lead to different strategies. Therefore, the objective of the present study was to explore how gait patterns may differ when walking on a soft surface. Methods: 3D kinematics during gait on hard and soft surface were assessed in 23 unilateral TKA-subjects ~19 months post-operative, and in 23 controls. Results: Gait characteristics in TKA-subjects that differed from controls observed on hard surface were amplified on soft surface. Flexion in the prosthetic knee was further decreased and a tendency towards reduced flexion in the contralateral knee was observed. Knee and hip adduction were not affected by surface conditions nevertheless there was a difference between groups, in particular with regard to the prosthetic side. In addition, step width increased on soft surface in TKA-subjects. Conclusion: Gait on an even and soft surface did not amplify asymmetries in TKA-subjects, but decreased knee flexion and increased step-width, albeit with similar gait speed as the control group suggests that the soft surface provided a small but significant challenge making the TKA-subjects precautious.

  • 88.
    Björkbacka, Sofia
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Holmberg, Elin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Polisstudents träningsvanor och uppfattning om polisyrkets fysiska krav2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

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

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

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

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

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

  • 89.
    Björkholm, Annika
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wahlström, Olivia
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Är yt-EMG ett reliabelt instrument i kombination med Biodex vid mätning av bukmuskelaktivitet?: En pilotstudie med friska kontrollpersoner och personer med abdominal rektusdiastas.2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

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

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

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

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

  • 90.
    Björkkvist, Johan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Interplay in deformation between dorsal neck muscles: an observational ultrasound study2018Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

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

  • 91.
    Björklund, Martin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, Gävle, Sweden.
    Djupsjöbacka, Mats
    Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, Gävle, Sweden.
    Svedmark, Åsa
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, Gävle, Sweden.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Effects of tailored neck-shoulder pain treatment based on a decision model guided by clinical assessments and standardized functional tests: a study protocol of a randomized controlled trial2012In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 13, article id 75Article in journal (Refereed)
    Abstract [en]

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

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

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

    Trial registration: Current Controlled Trials registration ISRCTN49348025.

  • 92.
    Björklund, Martin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Djupsjöbacka, Mats
    Svedmark, Åsa
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Effects of tailored versus non-tailored treatment on pain and pressure pain threshold in women with non-specific neck pain: A randomized controlled trial2014Conference paper (Other academic)
  • 93. Blain, H.
    et al.
    Masud, T.
    Dargent-Molina, P.
    Martin, F. C.
    Rosendahl, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    van der Velde, N.
    Bousquet, J.
    Benetos, A.
    Cooper, C.
    Kanis, J. A.
    Reginster, J. Y.
    Rizzoli, R.
    Cortet, B.
    Barbagallo, M.
    Dreinhoefer, K. E.
    Vellas, B.
    Maggi, S.
    Strandberg, T.
    A comprehensive fracture prevention strategy in older adults: the European Union Geriatric Medicine Society (EUGMS) statement2016In: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 28, no 4, p. 797-803Article in journal (Refereed)
    Abstract [en]

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

  • 94.
    Blom, Anna-Klara
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Andersson, Charlotta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Akuta responser vid högintensiv uppvärmning hos idrottare2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

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

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

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

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

  • 95.
    Blomqvist, Sven
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Postural balance, physical activity and capacity among young people with intellectual disability2013Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

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

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

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

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

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

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

  • 96.
    Blomqvist, Sven
    et al.
    Gävle Högskola.
    Lönnberg, Lisa
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wester, Anita
    Skolverket.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Physical Exercise Frequency Seem not to Influence Postural Balance but Trunk Muscle Endurance in Young Persons with Intellectual Disability2017In: Journal of Physical Education and Sports Management, ISSN 2373-2156, E-ISSN 2373-2164, Vol. 4, no 2, p. 38-47Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 97.
    Blomqvist, Sven
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Olsson, Josefine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wallin, Louise
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wester, Anita
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Adolescents with intellectual disability have reduced postural balance and muscle performance in trunk and lower limbs compared to peers without intellectual disability2013In: Research in Developmental Disabilities, ISSN 0891-4222, E-ISSN 1873-3379, Vol. 34, no 1, p. 198-206Article in journal (Refereed)
    Abstract [en]

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

  • 98.
    Blomqvist, Sven
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wester, Anita
    Skolverket.
    Persson, Elin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sundkvist, Hillevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Postural stability, physical activity, aerobic capacity and their associations for young people with and without intellectual disabilities2014In: European Journal of Adapted Physical Activity, ISSN 1803-3857, E-ISSN 1803-3857, Vol. 7, no 1, p. 22-30Article in journal (Other academic)
    Abstract [en]

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

  • 99.
    Blomqvist, Sven
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wester, Anita
    Skolverket.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Postural muscle responses and adaptations to backward platform perturbations in young people with and without intellectual disability2014In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 39, no 3, p. 904-908Article in journal (Refereed)
    Abstract [en]

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

  • 100.
    Blomqvist, Sven
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wester, Anita
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Test-retest reliability, smallest real difference and concurrent validity of six different balance tests on young people with mild to moderate intellectual disability2012In: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 98, no 4, p. 313-319Article in journal (Refereed)
    Abstract [en]

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

    Design Test-retest reliability assessment.

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

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

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

    Main outcomes Balance test performances.

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

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

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

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