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  • 1. Ahman, Hanna Bozkurt
    et al.
    Giedraitis, Vilmantas
    Cedervall, Ylva
    Lennhed, Bjorn
    Berglund, Lars
    McKee, Kevin
    Kilander, Lena
    Rosendahl, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Ingelsson, Martin
    Aberg, Anna Cristina
    Dual-Task Performance and Neurodegeneration: Correlations Between Timed Up-and-Go Dual-Task Test Outcomes and Alzheimer's Disease Cerebrospinal Fluid Biomarkers2019In: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 71, p. S75-S83Article in journal (Refereed)
    Abstract [en]

    Background: Tools to identify individuals at preclinical stages of dementia disorders are needed to enable early interventions. Alterations in dual-task performance have been detected early in progressive neurodegenerative disorders. Hence, dual-task testing may have the potential to screen for cognitive impairment caused by neurodegeneration. Exploring correlations between dual-task performance and biomarkers of neurodegeneration is therefore of interest.

    Objective: To investigate correlations between Timed Up-and-Go dual-task (TUGdt) outcomes and Alzheimer's disease (AD) cerebrospinal fluid (CSF) biomarkers amyloid-beta 42 (A beta(42)), total tau (t-tau), and phosphorylated tau (p-tau).

    Methods: This cross-sectional cohort study included 90 participants (age range 49-84 years) undergoing memory assessment, who were subsequently diagnosed with AD, other dementia disorders, mild cognitive impairment, or subjective cognitive impairment. TUG combined with "Naming Animals" (TUGdt NA) and "Months Backwards" (TUGdt MB), respectively, were used to assess dual-task performance. The number of correct words and time taken to complete the tests were measured. The CSF biomarkers were analysed by ELISA. Spearman's rank correlation was used for analyses between TUGdt outcomes (TUGdt NA and TUGdt MB), and CSF biomarkers, adjusted for age, gender, and educational level.

    Results: The number of correct words, as well as the number of correct words/10 s during TUGdt NA correlated negatively to CSF t-tau and p-tau. No correlations were found between any time scores and CSF biomarkers.

    Conclusion: The correlations between TUGdt NA and t-tau and p-tau may indicate that neurodegeneration affects dual-task performance. Longitudinal studies are needed to further explore dual-task testing in screening for cognitive impairment due to neurodegeneration.

  • 2. Alexandersson, Maria
    et al.
    Wang, Eugen Yuhui
    Eriksson, Staffan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy. Centre for Clinical Research Sörmland, Uppsala University, Kungsgatan 41, 631 88 Eskilstuna, Sweden; Department of Neuroscience, Physiotherapy, Uppsala University, Box 593, 751 24 Uppsala, Sweden.
    A small difference in recovery between total knee arthroplasty with and without tourniquet use the first 3 months after surgery: a randomized controlled study2019In: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 27, no 4, p. 1035-1042Article in journal (Refereed)
    Abstract [en]

    Purpose: When a tourniquet is used during surgery on the extremities, the pressure applied to the muscles, nerves and blood vessels can cause neuromuscular damage that contributes to postoperative weakness. The hypothesis was that the rehabilitation-related results would be improved if total knee arthroplasty (TKA) is performed without the use of a tourniquet.

    Methods: 81 patients with osteoarthritis of the knee who underwent TKA surgery were randomized to surgery with or without tourniquet. Active flexion and extension of the knee, pain by visual analog scale (VAS), swelling by knee circumference, quadriceps function by straight leg raise, and timed up and go (TUG) test results were measured before and up to 3 months after surgery.

    Results: ANCOVA revealed no between-groups effect for flexion of the knee at day 3 postsurgery. Compared with the tourniquet group, the nontourniquet group experienced elevated pain at 24 h, with a mean difference of 16.6 mm, p = 0.005. The effect on mobility (TUG test) at 3 months was better in the nontourniquet group, with a mean difference of -1.1 s, p = 0.029.

    Conclusions: The hypothesis that the rehabilitation-related results would be improved without a tourniquet is not supported by the results. When the results in this study for surgery performed with and without tourniquet are compared, no clear benefit for either procedure was observed, as the more pain exhibited by the nontourniquet group was only evident for a short period and the improved mobility in this group was not at a clinically relevant level.

    Level of evidence: Inconsistent results, Level II.

  • 3.
    Andersdotter Sandström, Anna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Patienter med utmattningssyndrom, deras upplevelse av fysisk aktivitet på recept i grupp.2019Independent thesis Advanced level (degree of Master (One Year)), 40 credits / 60 HE creditsStudent thesis
    Abstract [sv]

    Sammanfattning:

    Introduktion: Fysisk aktivitet (FA) är effektivt för att förbättra symtom och kognition hos personer med utmattningssyndrom. Trots detta har denna grupp svårigheter att uppnå rekommendationerna gällande fysisk aktivitet. Därför är det intressant att finna metoder som kan stödja en hållbar beteendeförändring och vidmakthållande av rutiner för FA för dessa personer.

     

    Syfte: Syftet med denna studie var att utforska hur personer med utmattningssyndrom upplever FA och fysisk aktivitet på recept som en del av ett gruppbaserat multimodalt rehabiliteringsprogram.

     

    Metod: Totalt deltog 27 informanter i 6 fokusgrupper i studien. Informanterna hade alla genomgått ett multimodalt rehabiliteringsprogram som inkluderade en intervention i form av fysisk aktivitet på recept intervention i grupp. Interventionen baserades på kognitiv beteendeterapi och inkluderade information om FA, hemuppgift och individuell målsättning för FA. Modifierad Grundad Teori användes vid analys av data.

     

    Resultat: Anlysen resulterade i en teoretisk modell med kärnkategorin Internalisera fysisk aktivitet på ett hållbart sätt och tre kategorier Erhålla nya insikter om fysisk aktivitet, Lära genom att göra och Skräddarsy fysisk aktivitet. Att ta del av fysisk aktivitet på recept i grupp gav deltagarna nya insikter om sin FA, detta genom att praktiskt prova FA. Att praktiskt utföra FA på olika sätt och med stöd av andra, internaliserades FA på ett hållbart sätt.

     

    Slutsats: Fysisk aktivitet på recept i grupp kan vara en användbar metod för att internalisera och främja FA på ett hållbart sätt för individer med utmattningssyndrom. Det är dock viktigt att identifiera de personer som är i behov av ett mer skräddarsytt stöd.

  • 4.
    Andersson, Mari
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Perceptions on the use of home telemonitoring in patients with COPD2019Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Introduction: There is a growing interest in how technology can be used in order to provide efficient healthcare.

    Aim: The aim is to explore perceptions on the use of home telemonitoring in patients with COPD.                                                                                                                            

    Method: Semi-structured individual interviews were carried out with eight women and five men who were part of a larger project aiming to develop and evaluate a telemonitoring system. Participants were interviewed after having used the system for two to four months. Interview transcripts were analysed with qualitative content analysis.

    Results: The analysis resulted in the theme a transition towards increased control and security and the categories: facing enablers or barriers, increasing control over the disease, providing easy access to care and affecting technical confidence or concern. Participants expressed initial feelings of insecurity, both in practical aspects using the telemonitoring system as well as regarding their disease. The telemonitoring system could reinforce and confirm the participants´ feelings of their current state of health, and the practical management of the telemonitoring system became easier with time.    

    Conclusion: Telemonitoring can be a valuable complement to healthcare with the potential to contribute to equity in care. However, in order to improve further development and implementation of telemonitoring, several actions are needed such as improved patient education and the use of co-creation. Additional research is needed particularly in the design of user-friendly systems as well as tools to predict which patients are most likely to find the equipment useful as it may result in reduced costs and increased empowerment. 

  • 5.
    Arumugam, Ashokan
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Strong, Andrew
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Tengman, Eva
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Röijezon, Ulrik
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Psychometric properties of knee proprioception tests targeting healthy individuals and those with anterior cruciate ligament injury managed with or without reconstruction: a systematic review protocol2019In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 4, article id e027241Article, review/survey (Refereed)
    Abstract [en]

    Introduction: An anterior cruciate ligament (ACL) injury affects knee proprioception and sensorimotor control and might contribute to an increased risk of a second ACL injury and secondary knee osteoarthritis. Therefore, there is a growing need for valid, reliable and responsive knee proprioception tests. No previous study has comprehensively reviewed all the relevant psychometric properties (PMPs) of these tests together. The aim of this review protocol is to narrate the steps involved in synthesising the evidence for the PMPs of specific knee proprioception tests among individuals with an ACL injury and knee-healthy controls.

    Methods and analysis: The Preferred Reporting Items for Systematic reviews and Meta-Analyses will be followed to report the review. A combination of four conceptual groups of terms-(1) construct (knee proprioception), (2) target population (healthy individuals and those with an ACL injury managed conservatively or with a surgical reconstruction), (3) measurement instrument (specific knee proprioception tests) and (4) PMPs (reliability, validity and responsiveness)-will be used for electronic databases search. PubMed, AMED, CINAHL, SPORTDiscus, Web of Science, Scopus, the Cochrane Central Register of Controlled Trials and ProQuest will be searched from their inception to November 2018. Two reviewers will independently screen titles, abstracts and full text articles, extract data and perform risk of bias assessment using the updated COnsensus-based Standards for the selection of health Measurement INstruments risk of bias checklist for the eligible studies. A narrative synthesis of the findings and a meta-analysis will be attempted as appropriate. Each PMP of knee proprioception tests will be classified as 'sufficient', 'indeterminate' or 'insufficient'. The overall level of evidence will be ascertained using an established set of criteria.

    Ethics and dissemination: Ethical approval or patient consent is not required for a systematic review. The review findings will be submitted as a series of manuscripts for peer-review and publication in scientific journals.

  • 6.
    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.

  • 7.
    Bay, Annika
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Lämås, Kristina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Berghammer, Malin
    Sandberg, Camilla
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Johansson, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Enablers and barriers for physical activity in adults with congenital heart disease2019Conference paper (Refereed)
  • 8. Bui, Kim-Ly
    et al.
    Nyberg, Andre
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Rabinovich, Roberto
    Saey, Didier
    Maltais, François
    The Relevance of Limb Muscle Dysfunction in Chronic Obstructive Pulmonary Disease: A Review For Clinicians2019In: Clinics in Chest Medicine, ISSN 0272-5231, E-ISSN 1557-8216, Vol. 40, no 2, p. 367-383Article in journal (Refereed)
    Abstract [en]

    "Chronic obstructive pulmonary disease (COPD) is often accompanied by extrapulmonary manifestations such as limb muscle dysfunction. This term encompasses several features, including atrophy, weakness, and reduced oxidative capacity. Clinicians should become accustomed with this manifestation of COPD because of its relevance for important outcomes such as exercise tolerance and survival. Measuring muscle strength and mass can be performed with simple and valid tools that could be implemented in clinical practice. One identified, limb muscle dysfunction is amenable to therapy such as exercise training that has been repeatedly shown to improve muscle mass, strength, and oxidative capacity in COPD."

  • 9. Bui, Kim-Ly
    et al.
    Nyberg, André
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Maltais, François
    Saey, Didier
    Functional tests in chronic obstructive pulmonary disease part 2: measurement properties2017In: Annals of the American Thoracic Society, ISSN 2329-6933, E-ISSN 2325-6621, Vol. 14, no 5, p. 785-794Article in journal (Refereed)
    Abstract [en]

    Chronic obstructive pulmonary disease is a major cause of morbidity and mortality worldwide and an important cause of disability and handicap. For a thorough patient-centered outcome assessment and comprehensive management of the disease, measures of lung function, exercise capacity and health-related quality of life, but also of functional capacity in activities of daily life are necessary. In Part 2 of this Seminar Series, we will discuss the main functional tests to assess upper and lower body functional capacity in patients with COPD, to help clinicians substantiate their choice of functional outcome measures in COPD. In agreement with the International Classification of Functioning, Disability and Health to assess functional capacity representative of daily life activities, this review focuses on functional tests that include components such as changing and maintaining body positions, walking, moving and climbing, as well as carrying, moving and handling objects. We will review the validity, reliability and responsiveness of these tests. With 11 links to the International Classification of Functioning, Disability and Health framework addressing several upper and lower body components of functional activities, the Glittre Activities of Daily Life test seems to be the most promising and comprehensive test to evaluate functional capacity in activities of daily life. The links between functional capacity tests and real participation in daily life, as well as with important clinical outcomes such as morbidity and mortality, need further investigation. More studies are also recommended to document minimal detectable changes, minimal clinically important differences and normative values for these functional tests.

  • 10.
    Frisk, Emelie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy. -.
    Lower limb muscle function in children and adolescents with Fontan circulation: A cross-sectional study2019Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Introduction: Impaired isometric muscle strength and muscle endurance in adults with Fontan circulation has previously been reported. However, the knowledge if corresponding impairment is present in children and adolescents with Fontan circulation is scarce.

    Aim: The aim was to examine the isometric muscle strength and muscle endurance of the lower limbs in children and adolescents with Fontan circulation in comparison to age and sex matched controls.

    Method: In this cross-sectional study 43 children and adolescents (6-18 years) with Fontan circulation and 43 controls were included. Isometric knee extension and plantar flexion muscle strength was assessed using dynamometry (Newton:N). Unilateral isotonic heel-lift until exhaustion was used for evaluation of lower limb muscle endurance. Analysis on group level (n=43) and for the subgroups 6-12 years (n=18) and 13-18 years (n=25) was performed.

    Results: On group level the children and adolescents with Fontan circulation had impaired isometric plantar flexion strength for the left leg compared to controls (393.9±181.1N vs. 492.5±241.6N, p=0.04). In addition, they had impaired isometric knee extension strength bilaterally (right 222.8±101.1N vs. 293.0±164.9N, p=0.02, left 220.7±102.7N vs. 279.5±159.1N, p=0.05). In contrast, lower limb muscle endurance did not differ. In subgroup analysis, the impaired isometric strength was only present in the group of adolescents.

    Conclusion: Adolescents with Fontan circulation had impaired isometric muscle strength compared to controls. However, no corresponding differences were found in children. Further, lower limb muscle endurance did not differ. This implies that the impaired isometric muscle strength may develop during adolescence whereas the impaired muscle endurance may occur later.

  • 11.
    Gashi, Nathalie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Måluppfyllelse, smärta och livskvalitet efter fysioterapeutiska interventioner hos patienter med långvarig smärta2019Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Fysioterapeutiska interventioner har effekt för att minska smärtintensitet och bidra till förbättrad kroppsmedvetenhet hos patienter med långvarig smärta. Ingen fysioterapeutisk intervention har visat sig vara mer effektiv än någon annan för att minska smärtintensitet. Inkludering av behandlingsmål och fokus på livskvalitet kan bidra till förbättrade behandlingsresultat. Syfte: Syftet med studien var att utvärdera om det finns skillnader i hur patienter med långvarig smärta självskattar måluppfyllelse, upplevd smärta och livskvalitet efter olika fysioterapeutiska interventioner. Metod: En tvärsnittsstudie med enkät som datainsamlingsmetod. Primärt utfallsmått var måluppfyllelse (GAS), sekundära utfallsmått var smärta (NRS) och livskvalitet (SF-36). Interventionsgrupperna delades in i; Basal kroppskännedom (BK), Joanne Elphinstone Movement Systems (JEMS), gymträning, stabilitetsträning och annat. Resultat: Fyrtiosex deltagare (78% kvinnor) rekryterades konsekutivt via distriktsrehabiliteringsenheterna alternativt via brev. Medelålder 53 år (SD ±16). En smärtduration på 1-5 år var vanligast förekommande i hela studiepopulationen. Ingen statistiskt signifikant skillnad mellan interventionsgrupperna påvisades vid analys med Kruskal-Wallis H-test. Skattningarna visade på högst skattad måluppfyllelse hos interventionsgruppen BK. Högst skattat medianvärde av allmänna hälsouppfattningar hos interventionsgruppen gymträning. Högst skattat medianvärde av genomsnittlig smärta hos interventionsgruppen JEMS. Slutsats: Studien påvisade inga statistiska skillnader mellan interventionsgrupperna men en viss variation i utfallen. Framtida större studier vore önskvärt för att verifiera resultaten i denna studie.

  • 12. Gendron, Louis McCusky
    et al.
    Nyberg, Andre
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy. Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, Canada.
    Maltais, François
    Lacasse, Yves
    Active mind‐body movement therapies as an adjunct to or in comparison to pulmonary rehabilitation for people with chronic obstructive pulmonary disease2016In: Cochrane Database of Systematic Reviews, ISSN 1469-493X, E-ISSN 1469-493X, no 7, article id CD012290Article in journal (Refereed)
    Abstract [en]

    This is the protocol for a review and there is no abstract. The objectives are as follows:

    To assess the effect of active mind-body movement therapies (AMBMT) compared with pulmonary rehabilitation (PR), or in addition to PR, in the management of chronic obstructive pulmonary disease (COPD).

  • 13.
    Grip, Helena
    et al.
    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.
    Häger, Charlotte G.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Lundström, Ronnie
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Öhberg, Fredrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Does the Femoral Head Size in Hip Arthroplasty Influence Lower Body Movements during Squats, Gait and Stair Walking?: A Clinical Pilot Study Based on Wearable Motion Sensors2019In: Sensors, ISSN 1424-8220, E-ISSN 1424-8220, Vol. 19, no 14, article id 3240Article in journal (Refereed)
    Abstract [en]

    A hip prosthesis design with larger femoral head size may improve functional outcomes compared to the conventional total hip arthroplasty (THA) design. Our aim was to compare the range of motion (RoM) in lower body joints during squats, gait and stair walking using a wearable movement analysis system based on inertial measurement units (IMUs) in three age-matched male groups: 6 males with a conventional THA (THAC), 9 with a large femoral head (LFH) design, and 8 hip- and knee-asymptomatic controls (CTRL). We hypothesized that the LFH design would allow a greater hip RoM, providing movement patterns more like CTRL, and a larger side difference in hip RoM in THAC when compared to LFH and controls. IMUs were attached to the pelvis, thighs and shanks during five trials of squats, gait, and stair ascending/descending performed at self-selected speed. THAC and LFH participants completed the Hip dysfunction and Osteoarthritis Outcome Score (HOOS). The results showed a larger hip RoM during squats in LFH compared to THAC. Side differences in LFH and THAC groups (operated vs. non-operated side) indicated that movement function was not fully recovered in either group, further corroborated by non-maximal mean HOOS scores (LFH: 83 +/- 13, THAC: 84 +/- 19 groups, vs. normal function 100). The IMU system may have the potential to enhance clinical movement evaluations as an adjunct to clinical scales.

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

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

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

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

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

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

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

  • 16.
    Johansson, Tobias
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Ottehall, Daniel
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Reliabilitet och validitet för ett hopptest: Objektiv mätning av knästabilitet med rörelsesensorer2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

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

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

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

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

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

  • 17. Kahn, Nicolas
    et al.
    Tomos, Ioannis
    Andrianopoulos, Vasileios
    Arikan, Husevin
    van der Does, Anne
    Almendros, Isaac
    Bonvivi, Sara
    Morgan, Ann
    Nenna, Raffaella
    Magouliotis, Dimitrios
    Rutter, Matthew
    De Soomer, Kevin
    Nyberg, Andre
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Lundell, Sara
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Leceuvre, Katleen
    Singanayagam, Aran
    Bostantzoglou, Clementine
    Karmouty-Quintana, Harry
    De Brandt, Jana
    Early Career Members at the ERS International Congress 2017: highlights from the Assemblies.2017In: Breathe, ISSN 1810-6838, E-ISSN 2073-4735, Vol. 13, no 4, p. e121-e129Article in journal (Refereed)
    Abstract [en]

    The 2017 ERS International Congress was, as always, well organised, providing participants with a good mixture of translational and clinical science. Early career members were very well represented in thematic poster, poster discussion and oral presentation sessions and were also actively involved in chairing sessions. The efforts of the Early Career Members Committee (ECMC) to increase the number of early career members included in the competence list (the list of early career members with an interest in being more actively involved in the society) paid off immensely, because the number of early career members registered improved hugely across all assemblies after the Congress. Several newly registered early career members have collated some highlights of the Congress for their assemblies, which should be of interest to all members. As assemblies 12 and 13 are new, there is no report from assembly 12 as there is not yet, at the time of writing, an early career member representative for this newly created assembly.

  • 18.
    Karlsson, Fredrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Samband mellan muskelstyrka nedre extremitet, muskelmassa och fysisk funktion hos älfdre män - finns skillnader i funktion hos de som faller?2018Independent thesis Advanced level (degree of Master (One Year)), 40 credits / 60 HE creditsStudent thesis
    Abstract [sv]

    Sammanfattning:  Introduktion: Muskelstyrka, muskelmassa och fysisk funktion försämras med åldern. Fall är vanligt förekommande och leder till en stor kostnad för samhället och ett stort lidande för individen. Primära riskfaktorer för fall är nedsatt muskelstyrka, balans och gång. Syfte: Syftet med denna studie var att undersöka sambandet mellan muskelstyrka, muskelmassa och fysisk funktion i nedre extremitet hos äldre män samt undersöka om det finns skillnader hos de som faller jämfört med de som inte faller gällande dessa parametrar. Metod: Detta var en tvärsnittsstudie där 203 försökspersoner deltog. Mätvariabler var lårmuskelstyrka mätt i Newtonmeter med vinkelhastigheter (koncentriskt 60° och 180°/ sekund och excentriskt 60°/sekund) mätt med Kin com isokinestisk muskeldynamometer, muskelmassa mätt med Lunar prodigy DXA, timed stand test, 6-m gångtest och 20 cm smalspårig gång. Frågeformulär gällande om de fallit eller ej. Resultat: Resultatet visade samband mellan muskelstyrka (60◦ och 180°/sekund koncentriskt, 60°/sekund excentriskt) och muskelmassa p<0.001. Både muskelstyrka och muskelmassa korrelerade med de båda gångtesterna p<0,05-0,001, med ett något starkare samband för muskelstyrka. Timed stands test korrelerade endast med 180◦ koncentrisk muskelstyrka p<0,05. Tjugofem procent av männen angav att de fallit det senaste året. Ingen skillnad förelåg i muskelstyrka, muskelmassa eller fysisk funktion hos de som fallit eller de som inte fallit.  Slutsats: Det fanns ett samband mellan muskelstyrka och muskelmassa, mindre samband mellan muskelstyrka och fysisk funktion. Det påvisades ingen skillnad hos fallare eller icke fallare vad gäller muskelstyrka, muskelmassa eller fysisk funktion.

  • 19.
    Larsson, Lena
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Johansson, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Sandberg, Camilla
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Apers, Silke
    Kovacs, Adrienne H.
    Luyckx, Koen
    Thomet, Corina
    Budts, Werner
    Enomoto, Junko
    Sluman, Maayke A.
    Wang, Jou-Kou
    Jackson, Jamie L.
    Khairy, Paul
    Cook, Stephen C.
    Alday, Luis
    Eriksen, Katrine
    Dellborg, Mikael
    Berghammer, Malin
    Rempel, Gwen
    Menahem, Samuel
    Caruana, Maryanne
    Tomlin, Martha
    Soufi, Alexandra
    Fernandes, Susan M.
    White, Kamila
    Callus, Edward
    Kutty, Shelby
    Moons, Philip
    Geographical variation and predictors of physical activity level in adults with congenital heart disease2019In: IJC Heart & Vasculature, ISSN 2352-9067, Vol. 22, p. 20-25Article in journal (Refereed)
    Abstract [en]

    Background: Physical activity is important to maintain and promote health. This is of particular interest in patients with congenital heart disease (CHD) where acquired heart disease should be prevented. The World Health Organization (WHO) recommends a minimum of 2.5 h/week of physical activity exceeding 3 metabolic equivalents(METS) to achieve positive health effects. It is unknown whether physical activity levels (PAL) in adult CHD patients differ by country of origin.

    Methods: 3896 adults with CHD recruited from 15 countries over 5 continents completed self-reported instruments, including the Health Behaviour Scale (HBS-CHD), within the APPROACH-IS project. For each patient, we calculated whether WHO recommendations were achieved or not. Associated factors were investigated using Generalized Linear Mixed Models.

    Results: On average, 31% reached the WHO recommendations but with a great variation between geographical areas (India: 10%–Norway: 53%). Predictors for physical activity level in line with the WHO recommendations, with country of residence as random effect, were male sex (OR 1.78, 95%CI 1.52–2.08), NYHA-class I (OR 3.10, 95%CI 1.71–5.62) and less complex disease (OR 1.46, 95%CI 1.16–1.83). In contrast, older age (OR 0.97, 95%CI 0.96–0.98), lower educational level (OR 0.41, 95%CI 0.26–0.64) and being unemployed (OR 0.57, 95%CI 0.42–0.77) were negatively associated with reaching WHO recommendations.

    Conclusions: A significant proportion of patients with CHD did not reach the WHO physical activity recommendations. There was a large variation in physical activity level by country of origin. Based on identified predictors, vulnerable patients may be identified and offered specific behavioral interventions.

  • 20.
    Larsson, Lena
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Johansson, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Wadell, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Thilen, Ulf
    Sandberg, Camilla
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Adults with congenital heart disease overestimate their physical activity level2019In: IJC Heart & Vasculature, ISSN 2352-9067, Vol. 22, p. 13-17Article in journal (Refereed)
    Abstract [en]

    Background: Physical activity reduces the risk of acquired cardiovascular disease, which is of great importance in patients with congenital heart disease (CHD). There are diverging data whether physical activity level (PAL) differs between patients with CHD and controls. Furthermore, it is unknown if PAL can be reliably assessed in patients with CHD using self-reported instruments.

    Methods: Seventy-five patients with CHD (mean age 37.5 ± 15.5 years, women n = 29 [38.7%]) and 42 age and sex matched controls completed the International Physical Activity Questionnaire (IPAQ) and carried the activity monitor Actiheart over 4 days. Time spent at ≥3 METS ≥21.4 min/day, i.e. reaching the WHO recommendation for PAL to promote health, was used as the outcome measure. Data on PAL obtained from IPAQ were compared with Actiheart.

    Results: The proportion of individuals reaching target PAL according to IPAQ was similar in patients with CHD and controls (70.7%vs.76.2%, p = 0.52) as well as between patients with simple and complex lesions. There was an overall difference between IPAQ and Actiheart in detecting recommended PAL (72.6%vs.51.3%, p b 0.001). In a subgroup analysis, this difference was also detected in patients but was borderline for controls. The negative predictive value for IPAQ in detecting insufficient PAL was higher in patients than in controls (73%vs.40%).

    Conclusions: The proportion of persons reaching sufficient PAL to promote health was similar in patients and controls. The self-reported instrument overestimated PAL in relation to objective measurements. However, with a high negative predictive value, IPAQ is a potentially useful tool for detecting patients with insufficient PAL.

  • 21.
    Lundell, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    UPPLEVELSE AV FYSISK AKTIVITET FÖR PERSONER MED KRONISKT OBSTRUKTIV LUNGSJUKDOM (KOL) EFTER FYSI0TERAPEUTISKA INSATSER I PRIMÄRVÅRDEN2019Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Sammanfattning:Introduktion: Lungrehabilitering är en evidensbaserad rekommenderad del av omhändertagandet av personer med kronisk obstruktiv lungsjukdom (KOL). Fysioterapeutiska interventioner vid lungrehabilitering kan vara patientutbildning och träning, vilka har visat på positiva effekter. Dock saknas det studier om hur personer med KOL upplever dessa interventioner inom primärvård.Syfte: Studien syftar till att utforska upplevelse av fysisk aktivitet för personer med kroniskt obstruktiv sjukdom (KOL) efter att ha deltagit i lungrehabilitering med fysioterapeutiska interventioner i form av träning alternativt patientutbildning eller en kombination av dessa inom primärvården.Metod: Studien tillämpade bekvämlighetsurval ur pågående primärvårdsverksamhet på en vårdcentral. Deltagarna hade erhållit träning i grupp och/eller patientutbildningen ”Aktiv med KOL”. Intervjuer genomfördes med fyra kvinnor och fem män i åldrarna 67–81 år. Materialet analyserades med kvalitativ innehållsanalys enligt Graneheim och Lundman.Resultat: I resultatet framkom fem kategorier: ny kunskap ger motivation, träningsintervention påverkar aktivitetsnivå och stimulerar följsamhet, att få till fysisk aktivitet som en del av vardagen, drivkrafter till fysisk aktivitet samt andfåddhet och smärta begränsar utförandet av fysisk aktivitet. Det övergripande temat för alla intervjuer var ”att vilja vara fysiskt aktiv trots upplevda symtom”.Slutsats: I enlighet med temat visade studien på att deltagarna hade acceptans för symtom inklusive andnöd vid fysisk aktivitet. I studien framkom också acceptans inför det som krävs av individen själv i att ta ansvar för sin fysiska aktivitetsnivå. Mer forskning behövs för att studera interventionernas effekt över tid.

  • 22.
    Lönninge, Markus
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Berglund, Joel
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    COGNITIVE EFFECTS OF EXERCISE AMONG OLDER PEOPLE WITH DEMENTIA AND DEPRESSION2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    ObjectivesTo examine the effect of a high-intensity functional exercise intervention on cognitive function in older people with dementia and depression living in nursing homes. 

    Secondary aim was to assess the association between depressive symptoms and cognitive function.

    MethodsParticipants (n= 186) were included from the Umeå Dementia and Exercise (UMDEX) study who were randomized to a high-intensity functional exercise (HIFE) intervention group or a control activity group over four months. Differences between groups was examined for changes in Mini-Mental State Examination at follow-up and baseline (MMSE-diff) using Independent sample t-test. Association was examined between changes in the 15-item Geriatric Depression Scale between follow-up and baseline (GDS-diff) and MMSE-diff using Pearson’s correlation coefficient. Analysis for differences and associations were performed according to intervention group or presence of depression. 

    ResultsNo significant difference was found in MMSE-diff between depression or interventions. Significant correlation between changes in MMSE-diff and GDS-diff was found in the control group (correlation coefficient -0.224, p-value 0.046), but not in any other group.

    ConclusionsThere was no significant difference of effect on cognition (MMSE) when comparing type of activity or state of depression. Changes in depressive symptoms were associated with changes in cognition in the control activity group, but not in the exercise intervention. Older people with dementia and depression can benefit from exercise, however in this group of older people with dementia living in nursing homes exercise didn’t significantly affect cognition. Further research is needed to examine the effects of longer interventions and aerobic exercise in this group.

  • 23.
    Marklund, Sarah
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Bui, Kim-Ly
    Nyberg, Andre
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Measuring and monitoring skeletal muscle function in COPD: current perspectives2019In: The International Journal of Chronic Obstructive Pulmonary Disease, ISSN 1176-9106, E-ISSN 1178-2005, Vol. 14, p. 1825-1838Article in journal (Refereed)
    Abstract [en]

    Skeletal muscle dysfunction is an important systemic consequence of chronic obstructive pulmonary disease (COPD) that worsens the natural cause of the disease. Up to a third of all people with COPD express some form of impairment which encompasses reductions in strength and endurance, as well as an increased fatigability. Considering this complexity, no single test could be used to measure and monitor all aspects of the impaired skeletal muscle function within the COPD population, resulting in a wide range of available tests and measurement techniques. The aim of the current review is to highlight current and new perspectives relevant to skeletal muscle function measurements within the COPD population in order to provide guidance for researchers as well as for clinicians. First of all, standardized and clinically feasible measurement protocols, as well as normative values and predictive equations across the spectrum of impaired function in COPD, are needed before assessment of skeletal muscle function can become a reality in clinical praxis. This should minimally target the quadriceps muscle; however, depending on the objective of measurements, eg, to determine upper limb muscle function or walking capacity, other muscles could also be tested. Furthermore, even though muscle strength measurements are important, current evidence suggests that other aspects, such as the endurance and power capacity of the muscle, should also be considered. Moreover, although static (isometric) measurements have been favored, dynamic measurements of skeletal muscle function should not be neglected as they, in a larger extent than static measurements, are related to tasks of daily living. Lastly, the often modest relationships between functional tests and skeletal muscle function measurements indicate that they evaluate different constructs and thus cannot replace one another. Therefore, for accurate measurements of skeletal muscle function in people with COPD, specific and formal measurements should still be prioritized.

  • 24.
    Markström, Jonas L.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Movement strategies and dynamic knee control after anterior cruciate ligament injury: a three-dimensional biomechanical analysis2019Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Rupture of the anterior cruciate ligament (ACL) is common and mainly occurs in non-contact situations in sports, often due to momentarily poor movement control. Assessment of movement quality during sport-like tasks iscrucial to understand how to decrease the high risk of reinjury for ACL-injured persons, but also how to prevent primary injury. This thesis addresses movement quality after ACL injury and includes development and evaluation of a novel standardized rebound side hop test (SRSH) for reliability and agreement of landing mechanics, and compares these outcomes between asymptomatic persons with different athletic levels, and between different hop tests.

    Methods: This thesis involves five papers based on two separate data collections performed in a motion analysis laboratory. Paper I is a long-term follow up of ACL-injured persons treated with or without ACL reconstruction (ACLR) compared to asymptomatic persons (total N = 99, age 35-63), while papers II-V included ACLR persons, and asymptomatic elite athletes and non-athletes (total N = 79, age 17-34). A motion capture system synchronized with force plates and surface electromyography (EMG) registered trunk, hip and knee angles and moments and knee muscle activity during the hop for distance, vertical hop, and SRSH. Novel measures of dynamic knee robustness were also evaluated using finite helical axis inclination angles extracted from knee rotation intervals of 10˚.

    Results: On average 23 years after injury, ACL injured persons performed the vertical hop with diverse angles compared to controls and their non-injured leg.The younger groups of ACLR persons and controls generally displayed excellent reliability and agreement for SRSH landing mechanics. These outcomes differed between the groups, and between legs for ACLR persons, despite similar dynamic knee robustness and acceptable knee function outcomes. Curve analyses further displayed differences between athletes and non-athletes, mainly with greater hip moments for athletes, although with similar values for dynamic knee robustness. Finally, greater knee angles and moments considered strenuous for the ACL were evident during the first rebound landing in SRSH compared to the other landings.

    Conclusions: Persons who have suffered an ACL injury, regardless of whether treated with ACLR or not, appear to use task-coping strategies in preparation for and during landings to decrease knee joint loading, probably to preserve dynamic knee robustness. More attention should be given to the trunk and hip in clinics when evaluating movement quality after ACL injury to reduce the risk of future injuries due to movement compensation. High-level athletic training may also improve the ability to maintain dynamic knee robustness whilst performing a sport-like side-to-side task more efficiently through increased engagement of the hip. Finally, side hop landings should be assessed when evaluating and correcting for erroneous landing mechanics to improve knee landing control.

  • 25.
    Nordin, Fredrik
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Nyberg, Andre
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Sandberg, Camilla
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Concurrent validity of a fixated hand-held dynamometer for measuring isometric knee extension strength in adults with congenital heart disease2019In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, p. 1-6Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this study was to examine the concurrent validity of a fixated hand-held dynamometer (HHD) in comparison to a load cell in measurement of maximal isometric knee extension force in adults with congenital heart disease (CHD) and healthy adults.

    Methods: Fourteen adults with CHD and fourteen healthy adults were included. Each participant was tested three times with each method and the mean of the top two results for each participant and method was used in analysis.

    Results: The agreement between the two methods was excellent in both groups (intraclass correlation coefficient [ICC], 95% confidence interval [CI]) 0.98 (0.92–1.00) in the CHD group and ICC 0.99 (0.96–1.00) in the healthy group). There was a small difference of 19.5 Newton or 4.8% (p<.05) between the two methods in the CHD group. No significant difference was seen between the two methods in the healthy group (p>.05).

    Conclusions: The fixated HHD demonstrated excellent concurrent validity when compared to a load cell among adults with CHD as well as in healthy adults. Thus, in a healthy population the methods can be used interchangeably, however, a small difference between the methods is seen in the CHD group.

  • 26.
    Nyberg, Andre
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Saey, Didier
    Martin, Mickael
    Maltais, Francois
    Cardiorespiratory and muscle oxygenation responses to single-limb and two-limb low load/high-repetitive resistance exercises in COPD and healthy controls2017In: Journal of applied physiology, ISSN 8750-7587, E-ISSN 1522-1601Article in journal (Refereed)
  • 27.
    Nyberg, Andre
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Tistad, Malin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy. School of Education Health and Social studies, Dalarna University, Falun, Sweden.
    Wadell, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Can the COPD web be used to promote self-management in patients with COPD in swedish primary care: a controlled pragmatic pilot trial with 3 month- and 12 month follow-up2019In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 37, no 1, p. 69-82Article in journal (Refereed)
    Abstract [en]

    Objective: Evaluate the feasibility of the COPD Web and its study design and study procedures and to increase the understanding of the potential effect of the tool in order to provide guidance for a future large scale trial.

    Design: Parallel-group controlled pragmatic pilot trial.

    Subjects: There was a total of 83 patients with COPD (mean age 70 +/- 8 years with a forced expiratory volume in first second percent predicted of 60 +/- 17%). The intervention group (n = 43) was introduced to and had access to the COPD Web in addition to usual care, while the control group (n = 40) received usual care alone.

    Main outcome measures: The feasibility of the COPD Web (i.e., if and how the COPD Web was used) was automatically collected through the website, while outcomes on health, conceptual knowledge, and physical activity (PA) were collected through questionnaires at baseline, 3 months and 12 months.

    Results: At 3 months, 77% of the intervention group was considered users, and the majority of time spent on the site was related to PA and exercises and was spent during the first month (>80%). In addition, the intervention group reported increased PA (odds ratio [OR] = 4.4, P < .001), increased conceptual knowledge in five domains (OR = 2.6-4.2, all P < .05), and altered disease management strategies (e.g., increased PA) (OR >= 2.7 P < .05) in comparison to the control group. The latter was also different between groups at 12 months (OR = 3.7, P = .044). Knowledge of PA was correlated with level of PA (rho = .425-.512, P < .05) as well as to the use of PA as a strategy to manage their disease (chi(2) = 11.2-32.9, P < .05).

    Conclusion: Giving patients with COPD access to the COPD Web in addition to their ordinary primary care might be an effective shorter term (3 month) strategy to promote self-management. However, these results needs to be confirmed in a definitive large-scale trial.

  • 28.
    Nyström, Miriam
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Karlsson, Helge
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Att optimera patientmöten genom kommunikation: Fyra fysioterapeuters reflektioner2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Kommunikationen mellan patient och fysioterapeut i patientmötet utgör den största delen av den faktiska tiden för mötet, utöver undersökning och behandling som också bör ses som kommunikativa. Kommunikation i patientmötet varierar och är ett komplext område där viktiga faktorer såsom att se till patienters behov beror på situation. Att identifiera kommunikativa metoder och hitta medel för att optimera kommunikationen generellt underlättar fysioterapeutens förståelse för patientens behov och för patienten att bättre ta emot vården som erbjuds. I denna uppsats belyses kommunikationens betydelse för en varierad fysioterapeutisk arbetserfarenhet inom primärvården.

     

    Syfte: Att undersöka hur fysioterapeuter inom primärvården optimerar patientmöten genom kommunikation.

     

    Metod: Studien har genomförts med kvalitativ metod utifrån fyra semistrukturerade intervjuer och kvalitativ innehållsanalys som analysmetod.

     

    Resultat: Utifrån 3 kategorier och 11 subkategorier är temat definierat som: god kommunikation är vägen till patient. Kategorin “kommunikativa verktyg” framställer metoder för att främja kommunikation, kategorin “kommunikativa hinder” identifierar hämmande faktorer för kommunikation. Samtliga informanter strävar efter att ständigt förbättra sin kommunikativa förmåga genom att anpassa kommunikationen till patienter vilket illustreras i den tredje kategorin “strävan att ständigt förbättras”.

     

    Diskussion: För att möjliggöra patientens välmående och ge denna en god vård krävs utvecklade kommunikativa förmågor och en strävan efter att ständigt förbättra dessa genom reflektion och självutvärdering hos fysioterapeuter.

  • 29.
    Pärsson, Carl Axel
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Lindeberg, Patrik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Ocklusionsträning vid knäledsartros, en systematisk litteraturöversikt2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Artros är en folkhälsosjukdom som drabbar cirka en fjärdedel av Sveriges befolkning över 45 år. Det är en progredierande ledsjukdom vars sjukdomsförlopp innebär degeneration av ledbrosk och ledens yta. Det har visats att en ökad quadricepsstyrka korrelerar med minskad smärta och förbättrad funktion vid knäledsartros. Den traditionella rehabiliteringen kan vara belastande och smärtsam medan det finns andra rehabiliteringsmetoder med en lägre grad av belastning och enligt teorin är mindre smärtsamma. En ny metod kallas ocklusionsträning. Genom att sätta stas på det venösa återflödet skapas en anaerob miljö och därav snabbare rekrytering av typ-2 muskelfibrer. Forskningen har visat att träningen kan bedrivas på en lägre relativ nivå, och då med en minskad belastning på ledytorna.

    Metod: Olika databaser genomsöktes för att hitta artiklar, sökord och booleska operatörer användes. Med hjälp av SBU:s metodbok för systematiska litteraturöversikter granskades artiklarna och sammanställdes på ett systematiskt sätt.

    Resultat: Efter en sammanställning av 6 studier inkluderandes män och kvinnor mellan åldern 45-90 år visades att ocklusionsträning verkar vara mindre effektivt än traditionell lätt styrketräning i smärtlindrande syfte, men effektivare än traditionell tung styrketräning. Tung styrketräning verkar vara effektivare än ocklusionsträning vid träning i hypertrofiskt syfte medan ocklusionsträning däremot fungerar bättre än lätt styrketräning. Fler och längre studier krävs för att noggrannare kunna utvärdera effekterna.

    Konklusion: Baserat på sex studier är ocklusionsträning är en interventionsmetod med potential att minska smärta, öka styrka och förbättra funktion vid artros, men det krävs ytterligare studier. Gärna randomiserade för att klargöra effekten av ocklusionsträning jämfört med traditionella behandlingar.

     

  • 30. Sole, Gisela
    et al.
    Pataky, Todd
    Tengman, Eva
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy. Institute of Fiber Engineering, Department of Bioengineering, Shinshu University, Tokida 3-15-1, Ueda, Nagano 386-8567, Japan.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Analysis of three-dimensional knee kinematics during stair descent two decades post-ACL rupture: Data revisited using statistical parametric mapping2017In: Journal of Electromyography & Kinesiology, ISSN 1050-6411, E-ISSN 1873-5711, Vol. 32, p. 44-50Article in journal (Refereed)
    Abstract [en]

    Changes in movement patterns following knee injuries have generally used analyses of pre-defined discrete event-related variables, whereas Statistical Parametric Mapping (SPM) assesses continuous data over time. We applied SPM to test differences for knee trajectories during stair descent between participants with past anterior cruciate ligament (ACL) rupture who underwent reconstruction or only physical therapy compared to healthy controls. Three-dimensional knee joint kinematics during stair descent were registered for 31 subjects with ACL reconstruction (ACLR), 36 subjects with ACL rupture managed with physical therapy only (ACLPT) (∼23years post-injury), and 32 uninjured controls. SPM was used to assess differences between groups for the entire three-component knee trajectory. A significant difference between the three groups was found for the first ∼10% of stance phase. Post-hoc analyses showed between-group differences when comparing the ACLPT to the control groups. Analyses of ACLPT versus control groups for individual vector components suggested a combination of less flexion at initial foot contact, and less adduction during weight acceptance (∼40% of stance). Altered knee kinematics were confirmed during weight acceptance of stair descent for the ACLPT group compared to controls, but not for ACLR group. Further exploration of the use of SPM and agreement with clinical gait assessment is warranted.

  • 31.
    Staaf, Petra
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Motorisk aktivitet och ledrörlighet hos barn med Cerebral Pares i Uganda2019Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Cerebral Pares (CP) är den vanligaste motoriska funktionsnedsättningen i högin­komstländer. Barn med CP har alltid en avvikande motorik och utvecklar ofta nedsatt passiv led­rörlighet (PROM). Kunskap om motorik och ledrörlighet hos barn med CP i låginkomstländer är begränsad.

    Syfte: Att beskriva grovmotorisk kapacitet, motoriskt utförande i var­dagsmiljö och ledrörlighet hos barn med CP i Uganda i förhållande till motorisk nivå, samt undersöka sam­band mellan passiv ledrörlighet, motorisk kapacitet och motoriskt ut­förande i vardagsmiljö.

    Metod: Studien är en deskriptiv tvärsnittsstudie med en populationsbaserad inklusion. Barnen klassificerades med Gross motor function classification system-Extended and Revised (GMFCS-E&R). Grovmotorisk kapacitet bedömdes med Gross Motor Function Measure-66 (GMFM-66) och motoriskt utförande bedömdes med Pediatric Evaluation of Disability Inventory-mobility (PEDI-rörelseförmåga). PROM mättes med goniometer.

    Resultat: Nittiotre barn från området Iganga-Mayuge HDSS i Uganda inkluderades, 40 flickor och 53 pojkar i åldern 2-17 år. Medianvärdet av referenspercentilen på GMFM-66 var 23 (25th–75th:3–30). Medianvärdet för skalpoäng på PEDI-rörelseförmåga var 65 poäng. Nedsatt PROM förekom i höftabduktion hos 15% av barnen, i knäextension hos 13% och i dorsalflexion hos 40%. Korrelation förekom mellan GMFCS-E&R och GMFM-66 (rs=0.894,p<.001), mellan GMFCS-E&R och PEDI-rörelseförmåga (rs=0.859,p< .001). Både GMFM-66 och PEDI-rörelseförmåga korrelerade med höftabduktion (rs=.443,p<.001)(rs=.441,p<.001) samt med knäextension (rs=.329,p=.002)(rs=.356,p<.001), men inte med dorsalflexion (rs=.108)(rs=.181).

    Slutsats: Barnens grovmotoriska kapacitet var lägre än förväntat hos barn med CP i Uganda i förhållande till ålder och motorisk nivå. Grovmotorisk kapacitet och utförande uppvisade ett högt samband, endast ett lågt samband med ledrörlighet i höftabduktion och knäextension. 

  • 32.
    Stenlund, Tobias
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Lindroos, Ola
    Lundström, Ronnie
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Öhberg, Fredrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Assessing postural load among drivers exposed to shock-type whole-body vibration using inertial measurements units: Results from measurements on standardized courses2019Conference paper (Refereed)
  • 33.
    Stenmark, Sara
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Selander, Hanna-Vega
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Finns det könsskillnader i lårmuskelfunktion hos personer med KOL?: En tvärsnittsstudie2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Muskeldysfunktion, så som nedsatt styrka och uthållighet i lårmuskulaturen, är en vanlig extrapulmonell manifestation vid kroniskt obstruktiv lungsjukdom (KOL). Sjukdomen kan dock påverka kvinnor och män på olika sätt och huruvida könsskillnader finns gällande påverkan av sjukdomen på lårmuskulaturen är oklart. Då fysisk träning utgör en viktig del i behandlingen av KOL är det av vikt att klarlägga eventuella skillnader i lårmuskelfunktion bland kvinnor och män för att optimera träningen för den enskilda individen med KOL.

    Syfte: Syftet med denna studie är att undersöka om påverkan av KOL skiljer sig mellan män och kvinnor beträffande lårmuskelfunktion.

    Metod: Lårmuskelstyrka och lårmuskeluthållighet undersöktes hos 38 män och 27 kvinnor med KOL. Värdena jämfördes med friska kontrollpersoner (32 män, 35 kvinnor). Fyra lårmuskeltester genomfördes i en stationär dynamometer: ett för lårmuskelstyrka (isometrisk MVK) och tre lårmuskeluthållighetstester (isometrisk, isokinetisk och isotonisk). Medelvärdena mellan grupperna jämfördes med envägs variansanalys. För att bedöma storleksskillnad mellan grupperna användes effektstorlek (ES).

    Resultat: Den procentuella nedsättningen beträffande isometrisk lårmuskelstyrka var för kvinnor med KOL 18,4 % och för män med KOL 16,7 %. Gällande lårmuskeluthålligheten var den isometriska nedsättningen 25,3 % respektive 27,4 %, och den isotoniska nedsättningen 44,7 % respektive 18,5 %. Effekten av kön på skillnad i lårmuskelfunktion var medelstor (ES=0,24–0,36), dock ej statistiskt signifikant (p=0.053-0.616).

    Slutsats: Resultaten visar inga statistiskt signifikanta könsskillnader gällande påverkan av sjukdomen på lårmuskulaturen hos personer med KOL. Gällande isotonisk lårmuskeluthållighet finns dock en trend för att kvinnor med KOL har en större påverkan på lårmuskeluthållighet än män med KOL.

  • 34. Suijkerbuijk, Mathijs A. M.
    et al.
    Ponzetti, Marco
    Rahim, Masouda
    Posthumus, Michael
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Stattin, Evalena
    Nilsson, Kjell G
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
    Teti, Anna
    Meuffels, Duncan E.
    van der Eerden, Bram J. C.
    Collins, Malcolm
    September, Alison V.
    Functional polymorphisms within the inflammatory pathway regulate expression of extracellular matrix components in a genetic risk dependent model for anterior cruciate ligament injuries.2019In: Journal of Science and Medicine in Sport, ISSN 1440-2440, E-ISSN 1878-1861, Vol. 22, no 11, p. 1219-1225Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To investigate the functional effect of genetic polymorphisms of the inflammatory pathway on structural extracellular matrix components (ECM) and the susceptibility to an anterior cruciate ligament (ACL) injury.

    DESIGN: Laboratory study, case-control study.

    METHODS: Eight healthy participants were genotyped for interleukin (IL)1B rs16944 C>T and IL6 rs1800795 G>C and classified into genetic risk profile groups. Differences in type I collagen (COL1A1), type V collagen (COL5A1), biglycan (BGN) and decorin (DCN) gene expression were measured in fibroblasts either unstimulated or following IL-1β, IL-6 or tumor necrosis factor (TNF)-α treatment. Moreover, a genetic association study was conducted in: (i) a Swedish cohort comprised of 116 asymptomatic controls (CON) and 79 ACL ruptures and (ii) a South African cohort of 100 CONs and 98 ACLs. Participants were genotyped for COL5A1 rs12722 C>T, IL1B rs16944 C>T, IL6 rs1800795 G>C and IL6R rs2228145 G>C.

    RESULTS: IL1B high-risk fibroblasts had decreased BGN (p=0.020) and COL5A1 (p=0.012) levels after IL-1β stimulation and expressed less COL5A1 (p=0.042) following TNF-α treatment. Similarly, unstimulated IL6 high-risk fibroblasts had lower COL5A1 (p=0.012) levels than IL6 low-risk fibroblasts. In the genetic association study, the COL5A1-IL1B-IL6 T-C-G (p=0.034, Haplo-score 2.1) and the COL5A1-IL1B-IL6R T-C-A (p=0.044, Haplo-score: 2.0) combinations were associated with an increased susceptibility to ACL injury in the Swedish cohort when only male participants were evaluated.

    CONCLUSIONS: This study shows that polymorphisms within genes of the inflammatory pathway modulate the expression of structural and fibril-associated ECM components in a genetic risk depended manner, contributing to an increased susceptibility to ACL injuries.

  • 35.
    Toots, Annika
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Taylor, M.
    Lord, S.
    Close, J.
    The relationship between cognitive domain function and gait speed in community-dwelling older people with cognitive impairment2019In: Australasian Journal on Ageing, ISSN 1440-6381, E-ISSN 1741-6612, Vol. 38, p. 29-29Article in journal (Other academic)
  • 36.
    Toots, Annika
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Taylor, Morag E.
    Lord, Stephen R.
    Close, Jacqueline C. T.
    Associations Between Gait Speed and Cognitive Domains in Older People with Cognitive Impairment2019In: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 71, p. S15-S21Article in journal (Refereed)
    Abstract [en]

    Background: While gait has been linked with cognition, few studies have contrasted the strength of the relationships between gait speed and cognitive domains in people with cognitive impairment (CI).

    Objectives: Investigate the association between gait speed and global cognitive function and cognitive domains in older people with CI.

    Method: Three-hundred-and-nine community-dwelling people with CI (mean age 82 years, 47% female, and mean gait speed 0.62 +/- 0.23 m/s) were included using baseline data from the Intervention-Falls in Older Cognitively Impaired Study (iFOCIS). Usual gait speed (m/s) was measured over 2.4 m. Global cognitive function and individual cognitive domains (attention; memory; verbal fluency; language; visuospatial ability) were assessed using the Addenbrooke's Cognitive Examination-III (ACE-III). Additionally, executive function was assessed using the Frontal Assessment Battery (FAB).

    Results: Participants mean f standard deviation ACE-III and FAB scores were 62.8 +/- 19.3 and 11.4 +/- 4.6, respectively. In separate multiple linear regression analyses adjusting for confounders, global cognitive function, and each cognitive domain, was significantly associated with gait speed. Executive function demonstrated the strongest association (FAB: standardized (beta = 0.278, p< 0.001, adjusted R-2 = 0.431), and remained significantly associated with gait speed when adjusted for attention, memory, language, and visuospatial ability.

    Conclusion: In this large study of older people with CI, global cognition and each cognitive domain were associated with gait speed. Executive function had the strongest association, possibly reflecting the higher-level cognitive processes and complex motor task responses required for gait control. Future longitudinal studies are needed to explore the temporal relationships between declines in executive function and gait, and whether the facilitation of executive function lessens gait decline.

  • 37.
    Toots, Annika
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Wiklund, Robert
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Littbrand, Håkan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Nordin, Ellinor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Nordström, Peter
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Rosendahl, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    The Effects of Exercise on Falls in Older People With Dementia Living in Nursing Homes: A Randomized Controlled Trial2019In: Journal of the American Medical Directors Association, ISSN 1525-8610, E-ISSN 1538-9375, Vol. 20, no 7, p. 835-842Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To investigate exercise effects on falls in people with dementia living in nursing homes, and whether effects were dependent on sex, dementia type, or improvement in balance. A further aim was to describe the occurrence of fall-related injuries.

    DESIGN: A cluster-randomized controlled trial.

    SETTING AND PARTICIPANTS: The Umeå Dementia and Exercise study was set in 16 nursing homes in Umeå, Sweden and included 141 women and 45 men, a mean age of 85 years, and with a mean Mini-Mental State Examination score of 15.

    INTERVENTION: Participants were randomized to the high-intensity functional exercise program or a seated attention control activity; each conducted 2-3 times per week for 4 months.

    MEASURES: Falls and fall-related injuries were followed for 12 months (after intervention completion) by blinded review of medical records. Injuries were classified according to severity.

    RESULTS: During follow-up, 118(67%) of the participants fell 473 times in total. At the interim 6-month follow-up, the incidence rate was 2.7 and 2.8 falls per person-year in exercise and control group, respectively, and at 12-month follow-up 3.0 and 3.2 falls per person-year, respectively. Negative binomial regression analyses indicated no difference in fall rate between groups at 6 or 12 months (incidence rate ratio 0.9, 95% confidence interval (CI) 0.5-1.7, P = .838 and incidence rate ratio 0.9, 95% CI 0.5-1.6, P = .782, respectively). No differences in exercise effects were found according to sex, dementia type, or improvement in balance. Participants in the exercise group were less likely to sustain moderate/serious fall-related injuries at 12-month follow-up (odds ratio 0.31, 95% CI 0.10-0.94, P = .039).

    CONCLUSIONS/IMPLICATIONS: In older people with dementia living in nursing homes, a high-intensity functional exercise program alone did not prevent falls when compared with an attention control group. In high-risk populations, in which multimorbidity and polypharmacy are common, a multifactorial fall-prevention approach may be required. Encouraging effects on fall-related injuries were observed, which merits future investigations.

  • 38.
    Wahlberg, Martina
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Zingmark, Magnus
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Municipality of Östersund, Health and Social Care Administration, Östersund, Sweden.
    Stenberg, Gunilla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Munkholm, Michaela
    Rasch analysis of the EQ-5D-3L and the EQ-5D-5L in persons with back and neck pain receiving physiotherapy in a primary care context2019In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177Article in journal (Refereed)
    Abstract [en]

    Aim: The purpose of this study was to investigate the psychometric properties of the EQ-5D-3L and the EQ-5D-5L in patients with back and neck pain.

    Materials and methods: Participants from two independent clinical survey studies was included in this study. In total 164 participants were answering either the EQ-5D-3L or the EQ-5D-5L after their visit to a physiotherapist in primary care for back and neck pain. Rasch analysis was performed to measure the psychometric properties of the two instruments.

    Main findings: Overall, the EQ-5D-5L showed preliminary evidence of good psychometric properties. The items in both the EQ-5D-5L and the EQ-5D-3L showed acceptable goodness-of-fit indicating unidimensionality for both instruments measuring the concept health-related quality of life. All test persons fit the model, but the person separation reliability and person separation index were only barely acceptable for the EQ-5D-5L.

    Conclusions: The results indicate that the EQ-5D-5L should be the preferred option when evaluating health-related quality of life with the EQ-5D, especially for patients with back and neck pain.

  • 39.
    Wall, Emma
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Skarin, Lisa
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Psykisk hälsa hos pojkar och flickor med Juvenil Idiopatisk Artrit: Samband med hälsorelaterad livskvalitet och föräldrars utbildningsnivå2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Juvenil Idiopatisk Artrit (JIA) är den vanligaste långvariga reumatiska sjukdomen hos barn. Få studier har undersökt barn med JIA i relation till psykisk hälsa och hälsorelaterad livskvalitet, därav inriktnigen på detta studentprojekt.

    Syfte: Syftet med denna studie var att beskriva den psykiska hälsan hos barn och unga med JIA och att undersöka skillnader i psykisk hälsa mellan pojkar och flickor. Ett ytterligare syfte var att undersöka sambandet mellan psykisk ohälsa och hälsorelaterad livskvalitet hos barnen samt mellan psykisk ohälsa hos barnen och föräldrarnas utbildningsnivå.

    Metod: I denna tvärsnittsstudie inkluderades 52 barn (37 flickor, 15 pojkar) 8-18 år, diagnostiserade med JIA. Deltagarna besvarade The Strengths and Difficulties Questionnaire (SDQ) och DISABKIDS Chronic generic module (DCGM-37). Bakgrundsdata, sjukdomshistorik samt föräldrars socioekonomiska status samlades in från alla deltagare.

    Resultat: Ingen signifikant skillnad sågs i självskattad generell psykisk hälsa mellan pojkar och flickor. Dock sågs en signifikant skillnad i delskalan kamratrelationsproblem (p=0,04). Det fanns ett samband mellan psykisk hälsa och hälsorelaterad livskvalitet (HRQOL) (r=-0,74) för hela gruppen, även för pojkar och flickor (rho=-0,76). Inget signifikant samband sågs mellan barnens psykiska hälsa och mor- och fars utbildningsnivå, dock sågs ett samband mellan fars utbildningsnivå och delskalorna beteendeproblem (p=0,04) samt prosocialt beteende (p=0,05). Signifikanta samband sågs även mellan delskalorna och mor- och fars utbildningsnivå samt mellan total svårighetspoäng på SDQ och fars utbildningsnivå inom flickgruppen. Inget liknande resultat sågs i pojkgruppen.

    Konklusion: Ingen skillnad i psykisk ohälsa har påvisats mellan pojkar och flickor. Med ökad psykisk ohälsa minskar den upplevda hälsorelaterade livskvaliteten hos båda grupperna. Socioekonomiska faktorer, som föräldrars utbildningsnivå, kan påverka barns psykiska hälsa. Framtida studier på barn med JIA och psykisk ohälsa bör inkludera en större studiepopulation.

  • 40.
    Wallin, Stina
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy. Faculty of Education and Welfare Studies, Health Sciences, Åbo Akademi University, Vaasa, Finland.
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Act with respect: Views of supportive actions for older workers after completion of comprehensive vocational rehabilitation services2019In: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 62, no 4, p. 585-598Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The number of older workers will expand during the next decades. Older workers have more long-term health problems and related limitations.

    OBJECTIVE: This study examined supportive actions provided in occupational healthcare services to older workers after vocational rehabilitation. An additional purpose was to explore occupational healthcare professionals' views on how to realize and improve adequate support activities.

    METHODS: Qualitative and quantitative methods were used, including a postal questionnaire and focus group discussions. Sixty-seven occupational healthcare service units participated in the postal questionnaire. Eight occupational healthcare professionals participated in two focus group discussions. The qualitative data was analyzed using qualitative content analysis.

    RESULTS: The qualitative analysis resulted in one theme (Act with respect), and four categories (Need for cooperation, Collaborative resources of involved stakeholders, Individual needs for support, and Gender as homogenous and separate groups). Quantitative results revealed that the workers' initiative strongly influenced the support carried out. Recommendations from the rehabilitation clinic were almost always considered when deciding on supportive actions. Focus group discussions brought up gender differences especially highlighted in the category Gender as homogenous and separate groups.

    CONCLUSIONS: Appropriate support of older workers requires cooperation between involved stakeholders, including occupational healthcare services. Provided support should be based on individual needs, but a mutual practice of determining needed support is requested.

  • 41.
    Westerlund, Liza
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Persson, Linnea
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Graviditetsbesvär, fysisk aktivtet och stillasittande: En studie av aktivitetsnivå och hälsa hos gravida kvinnor i Västerbotten. (ingående i Northpop-kohorten)2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Trots att det är allmänt känt att fysisk aktivitet främjar vårt välmående både fysiskt och psykiskt är det långt ifrån alla som når upp till den aktivitetsnivå som förespråkas. För gravida kvinnor verkar denna utmaning vara än mer påtaglig. Förutom grad av fysisk aktivitet har på senare tid stillasittandets betydelse för hälsa uppmärksammats allt mer. En stillasittande livsstil på mer än 10h per dag har visat en kraftigt accelererande risk att dö i förtid. Övergripande syfte var därför att undersöka samband mellan låg grad av fysisk aktivitet, hög grad av stillasittande och graviditetsbesvär.

    Denna delstudie innefattar data från ett större pågående projekt vid namn Northpop. Frågor gällande förekomst av graviditetsbesvär, fysisk aktivitetsnivå och stillasittande besvarades av 1569 gravida kvinnor i Västerbotten via enkäter under tidsperioden maj 2016 till februari 2018. All data har analyserats i SPSS. Majoriteten (n= 74%) av kvinnorna i vår studie nådde inte upp till rekommendationerna för fysisk aktivitet trots att det idag finns tydliga riktlinjer, samtidigt som hela 25% satt mer än 10h per dag. Statistiskt signifikanta samband sågs mellan låg fysisk aktivitet och foglossning (p = 0,00) samt blod och järnbrist (p = 0,00). Även ett högt antal stillasittande timmar resulterade i statistiskt signifikanta samband, graviditetsdiabetes (p = 0,03) och preeklampsi (p = 0,02).

    Resultaten i vår studie visar att det finns samband mellan både låg fysisk aktivitetsnivå och hög grad av stillasittande tid samt negativa hälsoutfall hos gravida kvinnor i Västerbotten.

  • 42.
    Österlund, Catharina
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Nilsson, Evelina
    Umeå University, Faculty of Medicine, Department of Odontology.
    Hellström, Fredrik
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Häggman-Henrikson, Birgitta
    Jaw-neck movement integration in 6-year-old children differs from that of adults2019In: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: A functional integration between the jaw and neck regions during purposive jaw movements is well described in adults, but there is a lack of knowledge of such integration during jaw function in children.

    OBJECTIVES: To determine the movement integration between the jaw and neck during jaw motor tasks in 6-year-olds, whether there is a difference between children and adults.

    METHODS: Jaw and neck movements were recorded with an optoelectronic 3D system in 25 healthy 6-year-olds (12 girls, 13 boys) and 24 healthy adults (12 women, 12 men) during paced jaw opening-closing and self-paced gum chewing. Jaw and neck movement amplitudes, intra-individual variation in movement amplitude, ratio between neck-jaw movement amplitudes and movement cycle time were analysed. Differences between children and adults were evaluated with Mann-Whitney U test for independent samples.

    RESULTS: Compared to adults, 6-year-old children showed larger neck movement amplitudes (P = .008) during chewing, higher intra-individual variability in amplitudes of jaw (P = .008) and neck (P = .001) movements, higher ratio between neck-jaw movement amplitudes for jaw opening-closing (P = .026) and chewing (P = .003), and longer jaw movement cycle time (P ≤ .0001) during the jaw opening-closing task.

    CONCLUSION: Despite integrated jaw-neck movements in 6-year-old children, the movement pattern differs from that of adults and may be interpreted as an immature programming of jaw-neck motor behaviour. The well-integrated movements observed in adults most likely develop over years, perhaps into adolescence, and needs further research including well-controlled longitudinal studies to map this development in order to provide appropriate age-related clinical treatment for functional disorders.

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