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  • 1.
    Aasa, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Bengtsson, Victor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Berglund, Lars
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Sports Medicine.
    Öhberg, Fredrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Variability of lumbar spinal alignment among power- and weightlifters during the deadlift and barbell back squat2022In: Sports Biomechanics, ISSN 1476-3141, E-ISSN 1752-6116, Vol. 21, no 6, p. 707-717Article in journal (Refereed)
    Abstract [en]

    The aims of the study were to evaluate the relative and absolute variability of upper (T11-L2) and lower (L2-S2) lumbar spinal alignment in power- and weightlifters during the deadlift and back squat exercises, and to compare this alignment between the two lifting groups. Twenty-four competitive powerlifters (n = 14) and weightlifters (n = 10) performed three repetitions of the deadlift and the back squat exercises using a load equivalent to 70% of their respective one-repetition maximum. The main outcome measures were the three-dimensional lumbar spinal alignment for start position, minimum and maximum angle of their spinal alignment, and range of motion measured using inertial measurement units. Relative intra-trial reliability was calculated using the two-way random model intraclass correlation coefficient (ICC) and absolute reliability with minimal detectable change (MDC). The ICC ranged between 0.69 and 0.99 and the MDC between 1 degrees-8 degrees for the deadlift. Corresponding figures for the squat were 0.78-0.99 and 1 degrees-6 degrees. In all participants during both exercises, spinal adjustments were made in both thoracolumbar and lumbopelvic areas in all three dimensions. In conclusion, when performing three repetitions of the deadlift and the squat, lumbar spinal alignment of the lifters did not change much between repetitions and did not differ significantly between power- and weightlifters.

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  • 2.
    Ahlgren, Emanuel
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Boogh, Jonathan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Mätning av cerebral blodflödeshastighet med transkraniell doppler under stegrat arbetsprov: Genomförbarhet och klinisk relevans2023Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Hjärnskakning är en vanlig diagnos och vissa patienter upplever att fysisk ansträngning utlöser symtom lång tid efter hjärnskakningen. En förändring i reglering av cerebralt blodflöde (CBF) har visats vara en potentiell orsak bakom detta. Konditionsträning under tröskeln för symtomexacerbation kan förkorta återhämtningstiden för patienterna. På Neurorehab vid Norrlands universitetsjukhus i Umeå identifieras tröskeln med ett stegrat arbetsprov på ergometercykel. Det finns inte någon studie där transkraniell doppler (TCD) använts för att mäta förändringar i cerebralt blodflöde (CBF) under detta arbetsprov.

    Syfte: Att undersöka genomförbarhet och klinisk relevans av att använda TCD för mätning av blodflödeshastighet i arteria cerebri media (ACMh), hos friska män, under stegrat arbetsprov.

    Metod: Sex friska och regelbundet aktiva män genomförde ett stegrat arbetsprov på ergometercykel under samtidig mätning av hjärtfrekvens, blodtryck, partialtryck end-tidal CO2 (PetCO2) och blodflödeshastighet i arteria cerebri media (ACMh, mätt med TCD). Smärta från TCD-utrustning och upplevd ansträngning skattades. Tidsåtgången för TCD-tillägget samt eventuell signalförlust noterades.

    Resultat: Fem studiedeltagare rapporterade ökad smärta (huvudvärk), skattad med Borg CR10 skala, från TCD-utrustningen. Total tidsåtgång för TCD-tillägget var 7 minuter och 40 sekunder i median (IQR, 5 minuter och 32 sekunder). Signalförlust uppstod för en studiedeltagare på vänster sida. PetCO2 och ACMh följdes åt under arbetsprovet bortsett från avvikelser vid två tillfällen.

    Slutsatser: Studien visar att mätning av ACMh med TCD är genomförbart och ger relevant information om hur CBF ter sig under genomförandet av stegrat arbetsprov. TCD-utrustningen orsakade smärta vilket kan vara problematiskt vid genomförande för personer med postkontusionellt syndrom.

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  • 3.
    Ahlström, Lina
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Korsvall, Linda
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Stärkt självledarskap genom empatisk dialog främjar hållbara förändringsprocesser: Motiverande samtal vid stressrelaterad psykisk ohälsa – en kvalitativ studie ur fysioterapeuters perspektiv2021Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Motiverande samtal (MI) är en klinisk samtalsmetod som används vid behandling för att understödja förändring hos patienter med sjukdomstillstånd kopplade till beteende. Stressrelaterad psykisk ohälsa innefattar ofta problem med kognition och beteende, vilket påverkar förmågan att göra hälsosamma val. Fysisk aktivitet som behandling har visat god effekt för att lindra kardinalsymtom, men följsamheten är låg. MI kan fylla en viktig funktion då motivation är av betydelse för att fullfölja behandling som syftar till beteendeförändring. Dock behövs ytterligare forskning gällande fysioterapeuters strategier och erfarenheter av att tillämpa MI som samtalsmetod.Syftet med studien var att belysa fysioterapeuters erfarenheter och användande av MI hos patienter med stressrelaterad psykisk ohälsa.

    Metod: I denna studie tillämpades kvalitativ metod. Datainsamlingen gjordes genom fyra semistrukturerade intervjuer med legitimerade fysioterapeuter. Intervjuerna analyserades med kvalitativ innehållsanalys.

    Resultat: Studiens resultat utmynnade i temat Stärkt självledarskap genom empatisk dialog främjar hållbara förändringsprocesser. Temat baserades på fyra kategorier (med tillhörande underkategorier): Ett stärkande och flexibelt förhållningssätt, Inkännande utifrån patientens behov, Stöd till autonomi samt Hinder och motstånd på vägen. Resultatet belyser fysioterapeuters erfarenheter och användande av MI som hjälpsamt för att främja hållbara beteendeförändringar vid stressrelaterad psykisk ohälsa.

    Slutsats: Studien har bidragit till ökad förståelse för fysioterapeuters erfarenheter och användning av MI. Huvudresultatet speglar fysioterapeuternas syn på MI som ett stödjande verktyg vid behandling rörande beteendeförändringar där en empatisk dialog utgör grund för att patientens autonomi stärks. MI upplevs hjälpsamt vid planering anpassad efter patientens individuella behov. Fortsatt forskning behövs som rör fysioterapeuters strategier att motivera patienter till hälsosamma beteendeförändringar.

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  • 4. Ahman, Hanna B.
    et al.
    Cedervall, Ylva
    Kilander, Lena
    Giedraitis, Vilmantas
    Berglund, Lars
    McKee, Kevin J.
    Rosendahl, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Ingelsson, Martin
    Aberg, Anna Cristina
    Dual-task tests discriminate between dementia, mild cognitive impairment, subjective cognitive impairment, and healthy controls: a cross-sectional cohort study2020In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 20, no 1, article id 258Article in journal (Refereed)
    Abstract [en]

    BackgroundDiscrimination between early-stage dementia and other cognitive impairment diagnoses is central to enable appropriate interventions. Previous studies indicate that dual-task testing may be useful in such differentiation. The objective of this study was to investigate whether dual-task test outcomes discriminate between groups of individuals with dementia disorder, mild cognitive impairment, subjective cognitive impairment, and healthy controls.MethodsA total of 464 individuals (mean age 71years, 47% women) were included in the study, of which 298 were patients undergoing memory assessment and 166 were cognitively healthy controls. Patients were grouped according to the diagnosis received: dementia disorder, mild cognitive impairment, or subjective cognitive impairment. Data collection included participants' demographic characteristics. The patients' cognitive test results and diagnoses were collected from their medical records. Healthy controls underwent the same cognitive tests as the patients. The mobility test Timed Up-and-Go (TUG single-task) and two dual-task tests including TUG (TUGdt) were carried out: TUGdt naming animals and TUGdt months backwards. The outcomes registered were: time scores for TUG single-task and both TUGdt tests, TUGdt costs (relative time difference between TUG single-task and TUGdt), number of different animals named, number of months recited in correct order, number of animals per 10s, and number of months per 10s. Logistic regression models examined associations between TUG outcomes pairwise between groups.ResultsThe TUGdt outcomes "animals/10s" and "months/10s" discriminated significantly (p <0.001) between individuals with an early-stage dementia diagnosis, mild cognitive impairment, subjective cognitive impairment, and healthy controls. The TUGdt outcome "animals/10s" showed an odds ratio of 3.3 (95% confidence interval 2.0-5.4) for the groups dementia disorders vs. mild cognitive impairment. TUGdt cost outcomes, however, did not discriminate between any of the groups.ConclusionsThe novel TUGdt outcomes "words per time unit", i.e. "animals/10s" and "months/10s", demonstrate high levels of discrimination between all investigated groups. Thus, the TUGdt tests in the current study could be useful as complementary tools in diagnostic assessments. Future studies will be focused on the predictive value of TUGdt outcomes concerning dementia risk for individuals with mild cognitive impairment or subjective cognitive impairment.

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  • 5. 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.

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  • 6.
    Alaniemi, Niclas
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Nilsson Landén, Oskar
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Hur skiljer sig kroppens akuta fysiologiska responser vid två olika modaliteter av stegrade intervaller?: Cykel och uppresningar från stol, en pilotstudie.2022Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion / bakgrund

    Högintensiva intervaller är en tidseffektiv träningsform, som har potential att ge flera positiva hälsoeffekter. Det finns dock en del svårigheter vid genomförandet av högintensiva intervaller avseende hur intensitetsnivån regleras. Dessutom genomförs dessa intervaller oftast på träningscyklar, och det finns därför kunskapsluckor vad gäller genomförandet i form av andra träningsmodaliteter, som bland annat uppresningar från stol. Syftet med den här studien var att undersöka skillnader i akuta fysiologiska responser vid stegrade arbetsprov av de två olika träningsmodaliteterna cykel respektive uppresningar från stol. 

    Metod 

    I studien deltog 10 träningsvana individer i åldersintervallet 20-30 år. Fem kvinnor och fem män. Vardera deltagare genomförde två olika stegrande arbetsprov i form av uppresningar från stol respektive cykel. Vid genomförandet fick deltagarna skatta sin upplevda ansträngning respektive bentrötthet. Även hjärtfrekvens registrerades. Effektutvecklingen för respektive arbetsprov uppmättes. Deltagarna fick dessutom genomföra test av isometrisk benstyrka både före och efter respektive arbetsprov. Skillnader mellan dessa modaliteter avseende dessa akuta responser analyserades sedan med hjälp av Wilcoxon signed-rank test. 

    Resultat 

    Resultatet påvisade signifikanta skillnader mellan modaliteterna avseende hjärtfrekvens, skattad ansträngning samt skattad bentrötthet vid effektutveckling = 300 watt, där högre värden uppnåddes vid cykel. Vid brytpunkten för arbetsproverna, d.v.s. där deltagarna skattade Borg RPE 17, uppmättes signifikanta skillnader i uppnådd hjärtfrekvens samt uppnådd effektutveckling, med en högre hjärtfrekvens vid cykel och en högre effektutveckling vid uppresningar från stol. 

    Slutsats / konklusion 

    Resultatet indikerade att uppresningar från stol var mindre ansträngande att genomföra i jämförelse med cykel. De mätvärden som registrerades i samband med intervallerna, utvecklades dock i liknande takt under de stegrade arbetsproverna, vilket antyder att modaliteterna har potential att styras. 

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  • 7. 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.

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  • 8.
    Allfors, Malin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Engström, Kristina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    En samtida validering av självtesten i appen MinBalans: En jämförelse mot kraftplatta2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Vid Umeå universitet är applikationen MinBalans under utveckling. Det är ett självtest för äldre personer för att på egen hand kunna utvärdera balansförmåga och funktionella benstyrka. Självtestet har tidigare jämförts mot kliniska tester men ej mot Gold standard (kraftplatta).

    Syfte: Syftet med denna samtida valideringsstudie är att undersöka sambandet mellan variabler uppmätta med appen MinBalans och kraftplatta i ett balans- och ett uppresningstest. Ett ytterligare syfte är att undersöka vilka variabler som tydligast åtskiljer resultaten mellan yngre och äldre testdeltagare.

    Metod: Variabler beräknade från appen jämfördes med motsvarande variabler uppmätta med kraftplattan. Tio äldre och tio yngre deltagare utförde ett balanstest bestående av två delar, fötter ihop och semitandem, samt ett uppresningstest.

    Resultat: I balanstestet fötter ihop korrelerade 4 av 12 variabler och i semitandem 10 av 12. I jämförelsen mellan yngre och äldre deltagares resultat visades signifikant skillnad för 3 av 12 variabler i testet fötter ihop för mobilappen och 1 av 12 för kraftplattan. I jämförelsen i semitandem visades signifikant skillnad för 6 av 12 variabler för mobilappen och 8 av 12 för kraftplattan. Variabeln Power visar på väldigt hög korrelation i uppresningstestet samt en signifikant skillnad i jämförelsen.

    Slutsats: Tre variabler i balanstestet och variabeln Power i uppresningstestet visade på god validitet och skulle kunna utvärderas vidare i fortsatt utveckling av appen MinBalans. Mobiltelefonens placering och kroppsmassans påverkan på resultatet kan studeras vidare för att öka appens validitet. För att ytterligare öka validiteten behövs vidare forskning på ett större urval.

  • 9.
    Alm, Emelie
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Fellbrink, Tove
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Gymnasieungdomars stillasittande och fysiska aktivitet under skolstängning orsakat av Covid-19: En enkätundersökning2021Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Den 11 mars 2020 klassades viruset Covid-19 som en pandemi. För att bromsa smittspridningen beslutade regeringen att stänga gymnasieskolorna runt om i Sverige och övergå till fjärr- och distansundervisning. Flertal idrottsföreningar har inte heller kunnat bedriva sin verksamhet på grund av pandemin. Trots att restriktionerna har varit nödvändiga för att minska smittspridningen kan det ge konsekvenser på ungdomars och unga vuxnas rörelsevanor. 

    Syfte: Studera förekomst av stillasittande och fysisk aktivitet hos gymnasieungdomar i Västerbottens inland till följd av skolstängningen orsakat av Covid-19.

    Metod: Undersökningen utfördes bland 86 gymnasieelever (16–20 år) i Västerbottens inland. En webbenkät med 23 frågor skickades ut till tre gymnasieskolor i olika kommuner. Enkäten var tillgänglig mellan 2 februari och 16 februari 2021. Deskriptiv analys, Chi2-test och Man Whitney U användes för att analysera och jämföra data. 

    Resultat: I denna studie ansåg 81,4 % av eleverna att deras stillasittande hade ökat och 55,8 % ansåg att deras fysiska aktivitet minskat under pandemin. Totalt var det 55,8 % som inte uppnådde FYSS rekommendationer under Covid-19. Unga vuxna (18–20 år) och unga kvinnor visade en viss tendens att vara mindre fysiskt aktiva i jämförelse med ungdomar (16–17 år). Resultatet generade ingen statistisk signifikant skillnad avseende fysisk aktivitet och stillasittande mellan unga kvinnor och unga män. Valet av fysisk aktivitet förändrades under pandemin i jämförelse med innan. 

    Konklusion: Resultatet visar en negativ påverkan på stillasittande och fysisk aktivitet hos ungdomar och unga vuxna i Västerbottens inland på grund av pandemin. Detta skulle kunna leda till ökade hälsorisker hos ungdomar och unga vuxna i Västerbottens inland. Detta resultat kan vägleda insatser för att främja gymnasieelevers hälsa till följd av pandemin. Fortsatt forskning krävs då pandemin är pågående. 

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  • 10.
    Almevall, Ariel
    et al.
    Department of Health, Education and Technology, Division of Nursing and Medical Technology, Luleå University of Technology, Luleå, Sweden.
    Dahlin Almevall, Albin
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Öhlin, Jerry
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Zingmark, Karin
    Department of Health, Education and Technology, Division of Nursing and Medical Technology, Luleå University of Technology, Luleå, Sweden.
    Niklasson, Johan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Nordström, Peter
    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, Section of Physiotherapy.
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Olofsson, Birgitta
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics. Umeå University, Faculty of Medicine, Department of Diagnostics and Intervention.
    Self-rated health in old age, related factors and survival: A 20-Year longitudinal study within the Silver-MONICA cohort2024In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 122, article id 105392Article in journal (Refereed)
    Abstract [en]

    Introduction: Self-rated health (SRH) offers insights into the evolving health demographics of an ageing population.

    Aim: To assess change in SRH from old age to very old age and their associations with health and well-being factors, and to investigate the association between SRH and survival.

    Methods: All participants in the MONICA 1999 re-examination born before 1940 (n = 1595) were included in the Silver-MONICA baseline cohort. The Silver-MONICA follow-up started in 2016 included participants in the Silver-MONICA baseline cohort aged 80 years or older. Data on SRH was available for 1561 participants at baseline with 446 of them also participating in the follow-up. The follow-up examination included a wide variety of measurements and tests.

    Findings: Most participants rated their health as "Quite good" (54.5 %) at baseline. Over the study period, 42.6 % had stable SRH, 40.6 % had declined, and 16.8 % had improved. Changes in SRH were at follow-up significantly associated with age, pain, nutrition, cognition, walking aid use, self-paced gait speed, lower extremity strength, independence in activities of daily living, weekly physical exercise, outdoor activity, participation in organized activities, visiting others, morale, and depressive symptoms. SRH at baseline was significantly associated with survival (p < 0.05).

    Conclusion: This study demonstrates associations between changes in SRH and a multitude of health- and wellbeing-related factors, as well as a relation between survival and SRH, accentuating their relevance within the ageing population.

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  • 11.
    An, Qingfan
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Gebart-Hedman, Karin
    Västerbotten county council, Sweden.
    Wadell, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Democratising eHealth design: empowering healthcare providers with healthcare design abilities through a co-creation training2023In: DS 123: proceedings of the international conference on engineering and product design education (E&PDE 2023) / [ed] Lyndon Buck; Hilary Grierson; Erik Bohemia, The Design Society, 2023, p. 235-240Conference paper (Refereed)
    Abstract [en]

    The market penetration of eHealth interventions is substantially lower than investors anticipated due to their low acceptance. Main causes include the use of top-down approaches and the tendency for research to concentrate on technology rather than service delivery from users’ perspective. Healthcare professionals have exclusive expert knowledge of evidence-based practice in a specific area, which may explain why many eHealth intervention development projects continue to use top-down approaches. It is therefore crucial to empower healthcare professionals with design skills and mindset. On the otherhand, the roles and responsibilities of designers in the twenty-first century have been controversial. Many farsighted designers assert that we are at a turning point of transforming design from an expert driven process focused on objects and services within a taken-for-granted social and economic order towards design practices that advocates design-led societal transition toward more sustainable futures. To foster the transformation, design education should cater to all abilities. Health CASCADE is a MarieSklodowska-Curie Innovative Training Network to consolidate co-creation as an effective tool to fight public health problems. Imparting the knowledge of co-creation in public health to healthcare professionals has the potential to alleviate the gap between design and healthcare, meanwhile provides opportunities for stakeholder participation in the development process to increase trust. This paper illustrates a curriculum development process partnered with a healthcare professional aiming for delivering knowledge of co-creation in public health to healthcare professionals working on designing eHealth programmes on the national healthcare support platform, 1177.se – Support and Treatment in Sweden. 

  • 12.
    An, Qingfan
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Sandlund, Marlene
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Agnello, Danielle
    Glasgow Caledonian University, Glasgow, United Kingdom.
    Mccaffrey, Lauren
    Glasgow Caledonian University, Glasgow, United Kingdom.
    Chastin, Sebastien
    Glasgow Caledonian University, Glasgow, United Kingdom.
    Helleday, Ragnberth
    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.
    A scoping review of co-creation practice in the development of non-pharmacological interventions for people with chronic obstructive pulmonary disease2023In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 62, no Suppl. 67, article id PA2416Article in journal (Refereed)
    Abstract [en]

    Background: Incorporating co-creation process in the development of interventions may improve the outcome. However, there is a lack of synthesis of co-creation practices in the development of Non-Pharmacological Interventions (NPIs) for Chronic Obstructive Pulmonary Disease (COPD).

    Objective: This scoping review aimed to examine the co-creation practice used when developing NPIs for people with COPD.

    Methods: The methodology proposed by Arksey and O’Malley for scoping reviews was followed, and it was reported according to the PRISMA-ScR framework. The search included PubMed, Scopus, CINAHL, and Web of Science. Studies reporting on the process and/or analysis of applying co-creation practice in developing NPIs for people with COPD were included.

    Results: 13 articles complied with the inclusion criteria. The composition of co-creators was diverse and reported in most of the included studies. Facilitating factors described in the co-creation practices included administrative preparations, diversity of stakeholders, cultural considerations, employment of creative methods, creation of an appreciative environment, and digital assistance. Few creative methods were mentioned or explained in the studies. Challenges around the physical limitations of patients, the absence of key stakeholder opinions, a prolonged process, recruitment, and digital illiteracy of co-creators were listed. Most of the studies did not report implementation considerations as a discussion point in their co-creation workshops.

    Conclusion: This review provides suggestions for evidence-based co-creation in COPD care which may improve the quality of care delivered by NPIs.

  • 13.
    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.

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  • 14.
    Andersdotter Sandström, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Sandlund, Marlene
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Eskilsson, Therese
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Patients with stress-induced exhaustion disorder and their experiences of physical activity prescription in a group context2023In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 16, no 1, article id 2212950Article in journal (Refereed)
    Abstract [en]

    Background: Physical activity is a useful means to improve symptoms and memory performance to some extent in individuals with stress-induced exhaustion disorder. Individuals in this group commonly do not need to reach the recommended levels of physical activity. Developing methods to support physical activity as a lasting behaviour is important.

    Objective: The aim of the study was to explore the processes involved when using physical activity prescription as part of rehabilitation in a group context for individuals with stress-induced exhaustion disorder.

    Method: A total of 27 individuals with stress-induced exhaustion disorder participated in six focus groups. The informants underwent a multimodal intervention including prescription of physical activity. The physical activity prescription had a cognitive behaviour approach and included information about physical activity, home assignments and goal setting. The data was analysed with grounded theory method using constant comparison.

    Results: The analysis of the data was developed into the core category ‘trying to integrate physical activity into daily life in a sustainable way’, and three categories: ‘acceptance of being good enough’, ‘learning physical activity by doing’ and ‘advocation for physical activity in rehabilitation’. The informants identified that during the physical activity prescription sessions they learned what physical activity was, what was ‘good enough’ in terms of dose and intensity of physical activity, and how to listen to the body’s signals. These insights, in combination with performing physical activity during home assignments and reflecting with peers, helped them incorporate physical activity in a new and sustainable way. A need for more customised physical activity with the ability to adjust to individual circumstances was requested.

    Conclusion: Prescription of physical activity in a group context may be a useful method of managing and adjusting physical activity in a sustainable way for individuals with stress-induced exhaustion disorder. However, identifying people who need more tailored support is important.

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  • 15.
    Andersson, Fredrik
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Berglund, Lars
    Umeå University, Faculty of Social Sciences, Umeå School of Sport Sciences. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Development of A Training And Injury Log For Powerlifting: A Feasibility Study2023In: International Journal of Strength and Conditioning, ISSN 2634-2235, Vol. 3, no 1Article in journal (Refereed)
    Abstract [en]

    Research on risk factors and injuries in powerlifting has so far only been studied through cross-sectional/observational studies. In other sports, training load has been prospectively investigated and shown to influence injury risk. However, no method to quantify training load in powerlifting exist. The purpose of this study was to assess the feasibility of a novel standardized method for prospective recording of training load and injuries. The study was conducted in two phases with eight powerlifters initially included in each phase respectively. In Phase 1, the powerlifters registered training load and injuries throughout four weeks and answered a feasibility questionnaire. Based on the results from the questionnaire, updates to the training and injury log were made and the powerlifters in Phase 2 used the updated version to log four weeks of training. Training load and injuries were reported consistently which made calculations on training load and injury incidence possible. The participants reported rate of perceived exertion as difficult to assess and report. However, 9/12 powerlifters stated that they could the training and injury log for a period of at least six months. In conclusion, this standardized training and injury log seems to be a feasible method to quantify training load and injuries in powerlifting. The method could be used in further prospective studies on training load and injuries in powerlifting and in clinical practice.

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  • 16.
    Andersson, Hanna
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Börjesson, Josefin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Det vore fantastiskt om varje elevhälsa hade en fysioterapeut: Fysioterapeuters syn på yrkets roll inom elevhälsan2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Skolbarns mående blir allt sämre, såväl fysiskt som psykiskt och statistiken visar att psykosomatiska besvär blir allt vanligare bland barn. Fysioterapeuter har en vision att bli en självklar del inom elevhälsan, emellertid krävs vidare forskning kring fysioterapeutens roll i skolan.

    Syfte: Syftet med denna studie var utforska fysioterapeuters erfarenheter av och tankar om fysioterapeutens roll inom elevhälsan och skolan, med specifikt fokus på barns psykiska och psykosomatiska ohälsa.

    Metod: I denna studie tillämpades kvalitativ metod och datan samlades in genom fyra semistrukturerade intervjuer med legitimerade sjukgymnaster/fysioterapeuter. Intervjuerna analyserades med kvalitativ innehållsanalys enligt Granheim och Lundman.

    Resultat: Studiens resultat utmynnade i temat Fysioterapeutens unika men okända kompetens för att möta barnens komplexitet genom rörelse, samt fem kategorier med tillhörande underkategorier. Kategorierna var Fysioterapeutens helhetsgrepp för barnens hälsa, Gråzonsbarnen som ingen annan ser, Bred kompetensbästa vän och värsta fiende, Trampa ej på tårna kontra våga kaxa och Visionen om att vara en given pusselbit. Resultatet beskriver fysioterapeuters tankar om och erfarenheter av rollen inom elevhälsan. Resultatet speglar att fysioterapeuter kan bidra med mycket i skolan men de upplever att fysioterapeutens roll är relativt okänd.

    Konklusion: Av resultatet framgick det att fysioterapeuter har unik kompetens som kan bidra i skolan och att behovet upplevs vara stort. Fysioterapeuters verktyg är genom rörelse och anpassad fysisk aktivitet, som främjar barnens fysiska och psykiska välmående. För att fysioterapeuter ska få en plats inom elevhälsan krävs det att yrket står omnämnt i skollagen, därmed behövs ett större vetenskapligt underlag vad fysioterapeutiska interventioner i skolan kan bidra med.

  • 17.
    Andersson, Isabelle
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Blinge, Anna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Äldre personers upplevelser och erfarenheter av ett års fallpreventiv träning med applikationen Säkra steg2021Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Ett fungerande fallpreventivt arbete är av stor vikt både ur ett individ- och samhällsperspektiv och de mest effektiva fallförebyggande åtgärderna består av träning. Med ett mer digitaliserat samhälle har möjligheten att utöva träning med stöd av digital teknik utvecklats. Vidare forskning behövs för att undersöka hur äldre personer upplever träning med hjälp av digitala medel. Syftet med denna studie är att belysa äldre personers upplevelser och erfarenheter av en intervention där de under ett år erbjudits fallpreventiv träning med hjälp av ett digitalt program kompletterat med stödjande strategier.Metod: Denna kvalitativa studie baseras på en pragmatisk studie som innefattade intervjuer med äldre personer som erbjudits fallpreventiv träning med en applikation (Säkra steg) under ett år. Semistrukturerade telefonintervjuer gjordes med nio personer över 70 år, varav åtta kvinnor och en man. Materialet analyserades utifrån kvalitativ innehållsanalys.Resultat: De äldre personernas upplevelser och erfarenheter skildras i temat “Individuella komponenter ger insikt och stöd för eget ansvar” som sammanfattar de sex kategorier som analysen resulterade i. Det fanns en medvetenhet kring behovet av “att skapa bästa förutsättningar för ett hållbart åldrande” och för att möjliggöra det krävdes en “innehållsrik och värdefull träning”. Deltagarna utvecklade förmågor för “att finna egna strategier för upprätthållande” och “de stödjande strategiernas roll” hade liten inverkan. Deltagarna upplevde att “styrka i kropp och själ skapar en trygg tillvaro”. Det framkom även “luckor att fylla för en bättre upplevelse” vilka kan användas till utveckling av liknande interventioner.Slutsats: Studien har bidragit till ökad förståelse för äldre personers erfarenheter kring kombinationen träning och digitala medel, den stärker även insikten om att äldre är en heterogen grupp där träningen behöver anpassas utifrån varje enskild individ.

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  • 18.
    Andersson, Johan
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Österberg, Simon
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Förekomst, nöjdhet och trender av olika konservativa behandlingsmetoder för personer med idiopatisk skolios2022Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Intro: Skolios definieras som en 3-dimensionell deviation av ryggraden, det krävs en Cobbvinkel på minst 10 grader för att diagnostiseras. Idiopatisk skolios är när orsaken är okänd. Korsett och PSSE (physiotherapeutic scoliosis-specific exercise) har visat sig vara de konservativa behandlingsmetoder som visat sig vara mest effektiv. Andra konservativa behandlingsmetoder som används är styrketräning, yoga/ pilates, stretching, massage, akupunktur, EMS, Alexandertekniken samt mobilisering/manipulation.

    Syfte: Undersöka vilka konservativa behandlingsmetoder som är vanligt förekommande bland personer med idiopatisk skolios i Sverige, undersöka hur nöjda deltagarna är med respektive behandling samt undersöka om det finns samband mellan behandlingsmetod och kön, topografi samt magnitud av skolios. Trender som refereras till i titeln syftar på ovan nämnda eventuella samband.

    Metod: Enkätundersökning via Google formulär för personer som är medlem i Svenska Skoliosföreningens Facebook sida. Krav på deltagande var; diagnostiserade med idiopatisk skolios, >18 år, utförd konservativ behandling/ar för sin skolios. Analys av data gjord i Jamovi version 2.2.3.

    Resultat: Korsett var den vanligaste konservativa behandlingsmetoden, 35 av 46 hade använt det. Massage var deltagarna mest nöjda med, av 22 var 68,2% nöjda. Mest missnöjd med var deltagarna som använt korsett, av 35 var 42,9% missnöjda. En association sågs mellan korsett och magnitud på skoliosen (p=.002). Ingen analys kunde göras på sambandet mellan behandlingsmetod och kön då en överrepresentation av kvinnor fanns hos deltagarna.

    Slutsats: För att dra större slutsatser kring förekomst, nöjdhet samt trender för konservativa behandlingsmetoder för personer med idiopatisk skolios krävs en studie med ett större urval och jämnare fördelning av kön samt magnitud och topografi av skoliosen. 

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  • 19.
    Andersson, Josefine
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Mäki, Agnes
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Effekt av kombinerad styrke- och uthållighetsträning jämfört med enbart styrketräning avseende styrkeutveckling hos friska män: En systematisk litteraturöversikt2021Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Syftet med denna systematiska litteraturöversikt var att sammanställa effekten av kombinerad styrke- och uthållighetsträning jämfört med enbart styrketräning avseende styrkeutvecklingen hos friska män genom granskning av randomiserade kontrollerade studier (RCT).

    Metod: En systematisk sökning i databaserna PubMed och Cinahl genomsöktes fram till februari 2021 för att identifiera relevanta studier. RCT med engelsk text inkluderades. Risk för bias bedömdes separat av två författare med användning av SBU:s granskningsmall.

    Resultat: Totalt nio RCT’s inkluderades där studierna jämförde kombinerad styrke- och uthållighetsträning mot enbart styrketräning som mättes med 1-10 repetition maximum (RM). Inkluderade studier hade låg till mellanhög risk of bias. Åtta av nio RCT fann att kombinerad styrke- och uthållighetsträning i jämförelse med enbart styrketräning hade en liknande styrkeutveckling mätt i 1-10RM. En studie fann dock att enbart styrketräning leder till ökad styrka från mitt- till postintervention, men att kombinerad träning påvisade liknande styrkeutveckling som enbart styrketräning under hela interventionsperioden. Studien visade även att en mindre mängd uthållighetsträning per vecka inte påverkade styrkeutvecklingen negativt, men om uthållighetsträning utfördes varje pass samtidigt som styrketräning så dämpades styrkeutvecklingen. 

    Slutsats: Resultatet från denna litteraturöversikt tyder på att kombinerad styrke- och uthållighetsträning ger liknande styrkeutveckling som enbart styrketräning hos friska män. Av nio studier visade en studie att uthållighetsträning för underkroppen påverkade styrkeutvecklingen i överkroppen negativt. Kombinerad träning ger liknande ökning i 1RM som enbart styrketräning, men träningssättet kan ge negativa effekter på styrkeutvecklingen om uthållighetsträningen utförs mer än tre dagar i veckan med en hög intensitet. 

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  • 20.
    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. 

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  • 21.
    Andersson, Philip
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Lindholm, Axel
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Multi-tasking och knäkontroll bland idrottande kvinnor med och utan främre korsbandsskada: En pilotstudie2022Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Studiedesign: Kvantitativ experimentell studie

    Syfte: Det primära syftet var att undersöka hur knäledens kinematik påverkas av simultana kognitiva uppgifter under hopplandningar bland fotbollsaktiva kvinnor med och utan främre korsbandsskada. Det sekundära syftet var att, genom poweranalyser, beräkna gruppstorlekar och vilka variabler som bör analyseras i framtida studier.

    Metod: Sju kvinnor med och sex kvinnor utan korsbandsskada utförde tre olika hopptester med och utan maximalt upphopp. Test 1 utfördes utan tillägg av kognitiva uppgifter, test 2 involverade elementen reaktionstid och inhibitorisk kontroll, test 3 involverade elementen reaktionstid, inhibitorisk kontroll och arbetsminne. Knäledens kinematik i alla tre plan (maxvärden och rörelseomfång) och maximal hopphöjd i upphoppet jämfördes mellan grupperna och testerna. Upprepad mixad ANOVA med effekterna Test, Grupp, och interaktionen Test*Grupp genomfördes och dess effektstorlekar användes i poweranalyserna. 

    Resultat: Det skedde mindre rörelse i sagittalplan och mer rörelse i frontalplan hos korsbandsgruppen samt att knäledens kinematik skiljer sig åt mellan grupperna under mer kognitivt krävande situationer simultant med idrottsspecifik rörelse. Power-analyserna för interaktionseffekten Test*Grupp med upphopp visade att 9/10 variabler kräver <100 testpersoner för att få en signifikant statistisk skillnad med en power på 80%.  Motsvarande resultat för landning utan upphopp visade att 5/9 variabler kräver <100 testpersoner.

    Konklusion: Hopplandningar med olika antal simultana kognitiva uppgifter visade på skillnader i knäkinematik mellan individer med och utan tidigare korsbandsskada, mellan testerna oberoende grupptillhörighet samt mellan testerna beroende på grupptillhörighet. De variabler som visade signifikanta skillnader vid landning följt av maximalt upphopp var hopphöjd, Max knäadduktion, Min knäflexion, Max knäutåtrotation och ROM knäadduktion-abduktion. Vid endast landning var det maximal knäflexion och Max knäabduktion som hade signifikanta värden. 

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  • 22.
    Andersson, Sebastian
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Schönqvist, Fredrik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Hälsofrämjande insatser i skolan samt fysioterapins möjligheter att stödja fysisk aktivitet: En kvalitativ intervjustudie från skolpersonalens perspektiv2023Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
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  • 23.
    Antfolk, Amanda
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Funktionell fysisk kapacitet och hälsorelaterad livskvalitet hos icke träningsaktiva äldre: Effekter av cykelträning på moderat och hög intensitet2021Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Sammanfattning: Introduktion: Åldrande processer påverkar funktionell fysisk kapacitet negativt. Även nedsatt hälsorelaterad livskvalitet är ett problem bland äldre personer, men fysisk aktivitet har visat positiva effekter på upplevd hälsa och fysisk funktion. Otillräcklig fysisk aktivitet och ökande andel äldre i befolkningen innebär stora samhällsutmaningar, varför det är viktigt att hitta effektiva träningsformer.

    Syfte: Att utvärdera och jämföra högintensiv intervallträning (HIT) på supramaximal intensitet och kontinuerlig träning på moderat intensitet (MICT) avseende funktionell fysisk kapacitet och hälsorelaterad livskvalitet, samt undersöka sambandet mellan dessa variabler hos icke träningsaktiva äldre personer.

    Metod: Sextioåtta deltagare (≥65 år) randomiserades till respektive träningsgrupp (HIT n=34, MICT n=34). Interventionerna utfördes två gånger i veckan i 12 veckor, och individanpassades för adekvat intensitet. Funktionell fysisk kapacitet mättes med Chair-stand test och hälsorelaterad livskvalitet med Short-Form Health Survey (SF-36) innan och efter intervention.

    Resultat: För hela studiepopultationen sågs signifikant ökning avseende funktionell fysisk kapacitet, upplevd fysisk funktion och fysisk hälsa samt signifikant sänkning av psykisk hälsa. Mellangruppsskillnad för smärta påvisades efter interventionen till fördel för MICT. Samband mellan hälsorelaterad livskvalitet och funktionell fysisk kapacitet sågs varken vid baslinjen eller över tid.

    Slutsats: Supramaximal HIT och MICT kan öka funktionell fysisk kapacitet och fysiska aspekter av hälsorelaterad livskvalitet bland icke träningsaktiva äldre. Deltagarna uppvisade bibehållen fysisk förmåga och god hälsorelaterad livskvalitet, varför framtida studier bör utvärdera och jämföra effekterna av dessa träningsregimer, samt undersöka dessa samband hos äldre personer med nedsatt funktionell fysisk kapacitet eller hälsorelaterad livskvalitet.

  • 24.
    Anton, Söderlund
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Kevin, Berg
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Skillnad i dynamisk stabilitet mellan ett skadat och ett friskt knä: Analys av samband mellan mätmetoder som undersöker knästabilitet.2021Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Tidigare studier har visat på att knäledens stabilitet under statiska förhållanden inte stämmer överens med stabilitet vid funktionella tester. Rörelsesensorer har förmågan att via funktionella tester mäta den dynamiska stabiliteten i knäleden, något som på sikt kan ge fysioterapeuter ett smidigt och lättanvänt verktyg i att upptäcka nedsatt dynamisk stabilitet. 

    Syfte: Vilka skillnader ett objektivt mätinstrument kan uppmäta på ett skadat och icke-skadat knä avseende dynamisk knästabilitet vid enbenshopp, samt att analysera samband mellan olika mätmetoder som undersöker knästabilitet. 

    Metod: För att jämföra knäskadade unga mäns (n=6) knästabilitet i det skadade benet med det icke skadade benet genomfördes ett enbenshopp som ställer krav på den dynamiska stabiliteten. Rörelsesensorer användes för att detekterade olika variabler som vinklar och acceleration. Data samlades in från självskattningsformulär, manuella stabilitetstester och testledarnas visuella bedömning. 

    Resultat: Skadat knä uppvisade delvis tecken på bristande knästabilitet i form av lägre knävinkel vid landning. Högre sidoacceleration var vanligare i friskt knä. Självskattningsformulären KOOS och IPAQ stämde mestadels inte överens med den data uppmät med ett objektivt mätinstrument. Den visuella bedömningen har en del likheter med den insamlade datan. Slutsats: Det objektiva mätinstrumentet kunde delvis detektera skillnader mellan skadat och friskt knä, vilket detekterades i knävinkel vid landning. I sidosacceleration hade det friska knät en högre acceleration, något som var svårt att förklara. Ett relativt starkt samband mellan det objektiva mätinstrumentet och visuell bedömning kunde ses. Framtida forskning behöver fastställa det använda mätinstrumentets användbarhet. 

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  • 25.
    Arkkukangas, Marina
    et al.
    School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
    Johnson, Susanna Tuvemo
    Department of Neuroscience, Physiotherapy, Uppsala University, BMC, Uppsala, Sweden.
    Hellström, Karin
    Department of Neuroscience, Physiotherapy, Uppsala University, BMC, Uppsala, Sweden.
    Söderlund, Anne
    School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
    Eriksson, Staffan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy. Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden.
    Johansson, Ann-Christin
    School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
    A feasibility study of a randomised controlled trial comparing fall prevention using exercise with or without the support of motivational interviewing2015In: Preventive Medicine Reports, E-ISSN 2211-3355, Vol. 2, p. 134-140Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this investigation was to study the feasibility of a randomised controlled trial (RCT) based on a multicentre fall prevention intervention including exercise with or without motivational interviewing compared to standard care in community-living people 75. years and older.

    Method: The feasibility of a three-armed, randomised controlled trial was evaluated according to the following: process, resources, management by questionnaire, and treatment outcomes. The outcome measures were fall frequency, physical performance and falls self-efficacy evaluated after three months. Twelve physiotherapists conducted the measurements and treatments and responded to the questionnaire. The first 45 participants recruited to the ongoing RCT were included: 16 individuals in the Otago Exercise Program group (OEP), 16 individuals in the OEP combined with motivational interviewing group (MI), and 13 individuals in the control group. The study was conducted from November 2012 to December 2013.

    Results: The feasibility of the study process, resources and management reached the set goals in most aspects; however, the set goal regarding the MI guide and planned exercise for the participating older people was not completely reached. No significant differences were found between the groups regarding the outcome measures.

    Conclusion: This study confirmed the acceptable feasibility for the study protocol in the ongoing RCT.

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  • 26.
    Armgren, Evelina
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Olsson, Emma
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Interbedömar- och test-retest reliabilitet av the Foot Posture Index-6 och Navicular Drop Test2022Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Bland en generell vuxen population är fotsmärta vanligt förekommande, där fotställning kan vara en bidragande faktor till fotsmärta. För att bedöma fotställning finns olika tester, där The Foot Posture Index (FPI-6) och Navicular Drop Test (NDT) är bland de vanligaste. Studier som undersöktinterbedömarreliabiliteten har visat på inkonsekventa resultat och få test-retest studier finns beskrivna i litteraturen.

    Syfte: Syftet med studien var att undersöka interbedömarreliabiliteten och test-retest reliabiliteten av de två fot testerna FPI-6 och NDT på en frisk vuxen population.

    Metod: Tjugo individer, i åldrarna 25–63 år, utan smärta, tidigare omfattande eller pågående skada/trauma i foten/fötterna rekryterades genom ett bekvämlighetsurval. Deltagarna testades vid två testtillfällen med 6–7 dagars mellanrum, där fotställningar bedömdes via FPI-6 och NDT av tre olika bedömare. Bedömningen genomfördes av två legitimerade fysioterapeuter och en fysioterapeutstudent, alla utan tidigare erfarenhet av testerna.

    Resultat: Interbedömarreliabiliteten för FPI-6 visade på stor variation från dålig till god reliabilitet och NDT visade på mindre variation men ett generellt sämre resultat med negativa ICC-värden till moderat reliabilitet. Vad gäller test-retest reliabiliteten visade resultaten för FPI-6 på bättre utfall från moderat till excellent reliabilitet och NDT visade även här på sämre resultat från dålig till moderat reliabilitet.

    Slutsats: Resultaten visar på att FPI-6 är ett reliabelt test även bland oerfarna bedömare. Resultaten för NDT påvisar att testet inte är reliabelt, vilket kan bero på olika faktorer i utförandet av testet samt vilken erfarenhet bedömarna har. Vidare reliabilitetsstudier av FPI-6 och NDT behövs med bedömare som besitter olika kliniska erfarenheter och med olika typer av populationer.

  • 27.
    Arumugam, Ashokan
    et al.
    Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
    Björklund, Martin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy. Centre for Musculoskeletal Research, Department of Occupational Health Sciences and Psychology, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden.
    Mikko, Sanna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Häger, Charlotte K.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Effects of neuromuscular training on knee proprioception in individuals with anterior cruciate ligament injury: A systematic review and GRADE evidence synthesis2021In: BMJ Open, E-ISSN 2044-6055, Vol. 11, no 5, article id e049226Article, review/survey (Refereed)
    Abstract [en]

    Objective: To systematically review and summarise the evidence for the effects of neuromuscular training compared with any other therapy (conventional training/sham) on knee proprioception following anterior cruciate ligament (ACL) injury.

    Design: Systematic Review.

    Data sources: PubMed, CINAHL, SPORTDiscus, AMED, Scopus and Physical Education Index were searched from inception to February 2020.

    Eligibility criteria: Randomised controlled trials (RCTs) and controlled clinical trials investigating the effects of neuromuscular training on knee-specific proprioception tests following a unilateral ACL injury were included.

    Data extraction and synthesis: Two reviewers independently screened and extracted data and assessed risk of bias of the eligible studies using the Cochrane risk of bias 2 tool. Overall certainty in evidence was determined using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) tool.

    Results: Of 2706 articles retrieved, only 9 RCTs, comprising 327 individuals with an ACL reconstruction (ACLR), met the inclusion criteria. Neuromuscular training interventions varied across studies: whole body vibration therapy, Nintendo-Wii-Fit training, balance training, sport-specific exercises, backward walking, etc. Outcome measures included joint position sense (JPS; n=7), thresholds to detect passive motion (TTDPM; n=3) or quadriceps force control (QFC; n=1). Overall, between-group mean differences indicated inconsistent findings with an increase or decrease of errors associated with JPS by ≤2°, TTDPM by ≤1.5° and QFC by ≤6 Nm in the ACLR knee following neuromuscular training. Owing to serious concerns with three or more GRADE domains (risk of bias, inconsistency, indirectness or imprecision associated with the findings) for each outcome of interest across studies, the certainty of evidence was very low.

    Conclusions: The heterogeneity of interventions, methodological limitations, inconsistency of effects (on JPS/TTDPM/QFC) preclude recommendation of one optimal neuromuscular training intervention for improving proprioception following ACL injury in clinical practice. There is a need for methodologically robust RCTs with homogenous populations with ACL injury (managed conservatively or with reconstruction), novel/well-designed neuromuscular training and valid proprioception assessments, which also seem to be lacking.

    PROSPERO registration number CRD42018107349.

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  • 28.
    Arumugam, Ashokan
    et al.
    Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Thigh muscle co-contraction patterns in individuals with anterior cruciate ligament reconstruction, athletes and controls during a novel double-hop test2022In: Scientific Reports, E-ISSN 2045-2322, Vol. 12, article id 8431Article in journal (Refereed)
    Abstract [en]

    Efficient neuromuscular coordination of the thigh muscles is crucial in maintaining dynamic knee stability and thus reducing anterior cruciate ligament (ACL) injury/re-injury risk. This cross-sectional study measured electromyographic (EMG) thigh muscle co-contraction patterns during a novel one-leg double-hop test among individuals with ACL reconstruction (ACLR; n = 34), elite athletes (n = 22) and controls (n = 24). Participants performed a forward hop followed by a 45° unanticipated diagonal hop either in a medial (UMDH) or lateral direction (ULDH). Medial and lateral quadriceps and hamstrings EMG were recorded for one leg (injured/non-dominant). Quadriceps-to-Hamstring (Q:H) ratio, lateral and medial Q:H co-contraction indices (CCIs), and medial-to-lateral Q:H co-contraction ratio (CCR; a ratio of CCIs) were calculated for three phases (100 ms prior to landing, initial contact [IC] and deceleration phases) of landing. We found greater activity of the quadriceps than the hamstrings during the IC and deceleration phases of UMDH/ULDH across groups. However, higher co-contraction of medial rather than lateral thigh muscles during the deceleration phase of landing was found; if such co-contraction patterns cause knee adduction, a putative mechanism to decrease ACL injury risk, during the deceleration phase of landing across groups warrants further investigation.

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  • 29. Arumugam, Ashokan
    et al.
    Markström, Jonas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    A novel test reliably captures hip and knee kinematics and kinetics during unanticipated/anticipated diagonal hops in individuals with anterior cruciate ligament reconstruction2020In: Journal of Biomechanics, ISSN 0021-9290, E-ISSN 1873-2380, Vol. 99, article id 109480Article in journal (Refereed)
    Abstract [en]

    Unanticipated land-and-cut maneuvers might emulate lower limb mechanics associated with anterior cruciate ligament (ACL) injury. Reliability studies on landing mechanics of such maneuvers are however lacking. This study investigated feasibility and within-session reliability of landing mechanics of a novel one-leg double-hop test, mimicking a land-and-cut maneuver, in individuals with ACL reconstruction (ACLR). Our test comprised a forward hop followed by a diagonal hop in either of two directions (medial/lateral) under anticipated and unanticipated conditions. Twenty individuals with a unilateral ACLR (aged 24.2 ± 4.2 years, 0.7-10.8 years post-surgery) performed three successful hops/direction per leg. We determined reliability (intraclass correlation coefficient [ICC]) and agreement (standard error of measurement [SEM]) of 3-dimensional hip and knee angles and moments during the deceleration phase of the land-and-cut maneuver (vulnerable for non-contact ACL injuries). Mean success rate for unanticipated hops was 71-77% and for anticipated hops 91-95%. Both limbs demonstrated moderate-excellent reliability (ICC 95% confidence intervals: 0.50-0.99) for almost all hip and knee peak angles and moments in all planes and conditions, with a few exceptions: poor-good reliability for hip and knee frontal and/or transverse plane variables, especially for lateral diagonal hops. The SEMs were ≤5° and ≤0.23 N·m/kg·m for most peak angles and moments, respectively. Our test seems feasible and showed satisfactory reliability for most hip and knee angles and moments; however, low knee abduction and internal rotation angles and moments, and moderate reliability of these moments deserve consideration. The test appears to challenge dynamic knee control and may prove valuable in evaluation during knee rehabilitation.

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  • 30.
    Arumugam, Ashokan
    et al.
    Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; Neuromusculoskeletal Rehabilitation Research Group, RIMHS - Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; Sustainable Engineering Asset Management Research Group, RISE - Research Institute of Sciences and Engineering, University of Sharjah, Sharjah, United Arab Emirates; Adjunct Faculty, Department of Physiotherapy, Manipal College of Health professions, Manipal Academy of Higher Education, Manipal, Karnataka, India.
    Mohammad Zadeh, Shima A.
    Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
    Zabin, Zina Anwar
    Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
    Hawarneh, Tamara Mohammad Emad
    Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
    Ahmed, Hejab Iftikhar
    Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
    Jauhari, Fatema Shabbir
    Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
    Alkalih, Hanan Youssef
    Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
    Shousha, Tamer Mohamed
    Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; Neuromusculoskeletal Rehabilitation Research Group, RIMHS - Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; Adjunct Faculty, Department of Physiotherapy, Manipal College of Health professions, Manipal Academy of Higher Education, Manipal, Karnataka, India.
    Moustafa, Ibrahim M.
    Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; Neuromusculoskeletal Rehabilitation Research Group, RIMHS - Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; Faculty of Physical Therapy, Cairo University, Cairo, Egypt.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Sedentary and physical activity time differs between self-reported ATLS-2 physical activity questionnaire and accelerometer measurements in adolescents and young adults in the United Arab Emirates2023In: BMC Public Health, E-ISSN 1471-2458, Vol. 23, no 1, article id 1045Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Most young adults and adolescents in the United Arab Emirates (UAE) do not meet the established internationally recommended physical activity levels per day. The Arab Teen Lifestyle Study (ATLS) physical activity questionnaire has been recommended for measuring self-reported physical activity of Arab adolescents and young adults (aged 14 years to mid-twenties). The first version of the ATLS has been validated with accelerometers and pedometers (r ≤ 0.30). The revised version of the questionnaire (ATLS-2, 2021) needs further validation. The aim of this study was to validate the self-reported subjective sedentary and physical activity time of the ATLS-2 (revised version) physical activity questionnaire with that of Fibion accelerometer-measured data.

    METHODS: In this cross-sectional study, 131 healthy adolescents and young adults (aged 20.47 ± 2.16 [mean ± SD] years (range 14-25 years), body mass index 23.09 ± 4.45 (kg/m2) completed the ATLS-2 and wore the Fibion accelerometer for a maximum of 7 days. Participants (n = 131; 81% non-UAE Arabs (n = 106), 13% Asians (n = 17) and 6% Emiratis (n = 8)) with valid ATLS-2 data without missing scores and Fibion data of minimum 10 h/day for at least 3 weekdays and 1 weekend day were analyzed. Concurrent validity between the two methods was assessed by the Spearman rho correlation and Bland-Altman plots.

    RESULTS: The questionnaire underestimated sedentary and physical activity time compared to the accelerometer data. Only negligible to weak correlations (r ≤ 0.12; p > 0.05) were found for sitting, walking, cycling, moderate intensity activity, high intensity activity and total activity time. In addition, a proportional/systematic bias was evident in the plots for all but two (walking and moderate intensity activity time) of the outcome measures of interest.

    CONCLUSIONS: Overall, self-reported ATLS-2 sedentary and physical activity time had low correlation and agreement with objective Fibion accelerometer measurements in adolescents and young adults in the UAE. Therefore, sedentary and physical activity assessment for these groups should not be limited to self-reported measures.

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  • 31.
    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, 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.

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  • 32. Arumugam, Ashokan
    et al.
    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.
    Röjezon, Ulrik
    Luleå University of Technology, Luleå, Sweden.
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Knee proprioception deficits following an ACL injury: a myth or a reality2021Conference paper (Refereed)
  • 33.
    Ashnai, Farshad
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Self-reported injuries in the past six months in the foot, ankle, and lower leg do not seem to affect heel raise and hop performance in TeamGym athletes.2022Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Introduction: Injuries in the foot, ankle, and the lower leg (FALL) are common in TeamGym (TG), accounting for ~48% of all reported injuries. Muscular fatigue has been proposed as a risk factor for injuries in TG but has yet to be examined.

    Aims: to 1) examine if there are any differences in the heel raise (HRT), one leg hop for distance (OLHD), and side hop (SH) tests between non-injured TeamGym athletes and those who report previous injury/-ies in the FALL during the last six months, and 2) describe normative test values for the HRT, OLHD, and SH in TeamGym athletes.

    Methods: Injuries were reported retrospectively with a questionnaire. Muscular endurance was assessed with HRT using a linear encoder to calculate total work (Joule). Hop performance was assessed with the OLHD and SH. Between-group differences were analysed with Mann-Whitney U and Independent Samples T-Test.

    Results: Sixty participants (x= 18.3 years, 22% males) were included. No differences were found between non-injured and injured athletes. Normative values for all included TG athletes: Twenty-nine HRs, 1626 Joule, 48 SH and 129 centimetres in the OLHD.

    Conclusion: Performance in the HRT, OLHD, and SH tests did not differ between non-injured TG athletes and those who reported a previous injury in the foot, ankle, and lower leg. Normative values are presented, that may help setting goals to decrease the risk of a secondary injury and increase performance, but should be interpreted with respect to the sample size. 

  • 34.
    Aspholm, Rasmus
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Utveckling och genomförbarhet av ett progredierat arbetsprov med uppresningar från stol som modalitet2022Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Konditionstest utförs för att undersöka en persons aeroba eller anaeroba kapacitet. Många test använder sig av en wattbaserad styrning av effektutvecklingen. Det finns välutvecklade metoder för detta på cykel, men inte i form av uppresningar från stol. Studiens syfte var att utveckla och undersöka genomförbarheten av ett watt-styrt progredierat arbetsprov, med modaliteten uppresningar från stol, för att estimera anaerob kapacitet.

     

    Metod: Det konstruerade arbetsprovet utgick från Borgs Cycle Strength test där deltagarna utförde stegrande intervaller till en intensitet där subjektiv ansträngningsnivå når ”mycket ansträngande”. Effektutvecklingen styrdes genom att kontrollera frekvensen av uppresningar med hjälp av metronom. 10 träningsvana deltagare rekryterades. Deltagarnas utförande spelades in på film, vilket möjliggjorde kontrollering av antal uppresningar för att estimera deltagarnas faktiska effekt mot fastställd effekt. Genom att jämföra knäledsvinkeln vid olika intensitetsnivåer undersöktes deltagarnas rörelseomfång av uppresningarna. Undersökning av deltagarnas subjektiva upplevelse av arbetsprovet gjordes genom att deltagarna besvarade 3 enkätfrågor efter utfört arbetsprov. 

     

    Resultat: Resultaten visar på att 7 av 9 deltagare utförde uppresningar med sådan frekvens att estimerad faktisk effekt kom nära fastställd effekt under intervallerna hela vägen upp till 17 på RPE-skalan. Vid skattning 17 på RPE-skalan avvek den estimerade faktiska effekten från den fastställda effekten med -31 watt. Alla deltagare förutom en befann sig inom det 95 procentiga konfidensintervallet. Resultatet visade att det gick bra att genomföra korrekta uppresningar vid låg och medelhög intensitet, däremot var det vid den sista intensitetsnivån en signifikant ökning av vinkeln i knäleden jämfört med den första intensitetsnivån (p= 0,035). Deltagarna upplevde att takten till uppresningarna gick att följa med hjälp av metronom. 

     

    Konklusion: Metronom kan användas för att styra frekvensen av uppresningar. Effekten går att stegra genom att endast öka antalet uppresningar, men vid hög intensitet klarade inte alla deltagare av att upprätthålla uppresningsfrekvensen eller att utföra korrekta uppresningar.

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  • 35.
    Awad, Sandra
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Westlund, Josefine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Barn och unga vill bestämma mer i sin egen vård: En kvalitativ studie om fysioterapi och delaktighet i vården bland barn och unga med Juvenil Idiopatisk Artrit2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Juvenil Idiopatisk Artrit (JIA) är den vanligaste kroniska reumatiska sjukdomen som drabbar barn och ungdomar upp till 16 års ålder. Att vara fysiskt aktiv som ung person med JIA är extra viktigt för att lindra symptom. Fysioterapeutisk behandling är en av insatserna som lindrar besvären tillsammans med en anpassad och kontinuerlig vård i stort.

    Syfte: Att undersöka barn och ungas samt deras föräldrars erfarenheter av fysioterapeutisk behandling av Juvenil Idiopatisk Artrit och hur delaktiga barn och unga varit i den egna vården.

    Metod: Intervjuer och workshops med totalt 10 stycken deltagare analyserades med Kvalitativ innehållsanalys. Deltagarna var barn och unga vuxna med JIA samt deras föräldrar.

    Resultat: Resultatet bestod av fem kategorier som handlade om blandade erfarenheter av fysioterapeutisk behandling, att hemövningar borde anpassas mer efter patienten, vikten av ett professionellt bemötande, sjukhusbesök som behöver förbättras samt bristfällig delaktighet för barn i vården. Kategorierna utgjorde tillsammans ett tema - “Barn och unga vill ha större utrymme att få bestämma i den egna vården” som beskrev barn och ungas upplevelser om fysioterapi, vården i stort och deras delaktighet i den egna vården.

    Konklusion: Barn och unga vuxna har önskemål om att vara mer delaktiga i den egna behandlingen. Erfarenheterna av fysioterapeutisk behandling är blandade. För att få en mer tydlig bild av erfarenheterna av fysioterapi bör framtida studier med workshops och intervjuer som syftar till att undersöka fysioterapeutisk behandling genomföras.

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  • 36.
    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.

  • 37.
    Bagge, John
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Wahlén, Dennis
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Rehabilitering vid sentransferering av tibialis posterior: en scoping review2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund

    Droppfot är vanligt vid många sjukdomar och tillstånd, och resulterar i en oförmåga att dorsalextendera fotleden. I vissa fall måste en sentransferering av tibialis posterior utföras för att återställa förmågan att dorsalextendera. Operationen utförs på olika sätt, är väldokumenterad och väl beforskad. För att operationen ska ge önskat resultat krävs god rehabilitering postoperativt. Rehabiliteringen är mindre dokumenterad och saknar tydliga direktiv att förhålla sig till. 

    Syfte

    Syftet med denna scoping review var att sammanställa och granska den tillgängliga kunskapen angående rehabiliteringen efter en sentransferering av tibialis posterior. 

     Metod

    En scoping review valdes som studiedesign då artikelutbudet är begränsat. Studien utfördes enligt riktlinjer av Arksey & O’Malley (2005), samt Preferred Reporting Item for Systematic Reviews and Meta-Analyses (PRISMA).

     Resultat

    Resultatet av sökningen och artikelurvalet på 28 artiklar visade på en stor inkonsekvens i hur rehabiliteringen utförs. De data som extraherades var; antal deltagare, typ av operation, belastning postoperativt, immobiliseringstid, samt beskrivning av fysioterapeutiska insatser. Vissa studier vittnar om 11-12 veckors immobilisering i gips, medan andra mobiliserar inom en vecka postoperativt och undviker att gipsa. Den stora inkonsekvensen kan delvis förklaras med att deltagarnas grunddiagnoser varierar mellan de inkluderade studierna, samt att de kirurgiska tillvägagångssätten skilde sig åt, samt inkluderade andra operationer. Endast två studier behandlade rehabiliteringen som sitt huvudsyfte.

    Slutsats

    Bristfällig forskning finns för att kunna dra några vetenskapliga slutsatser. Mer forskning behövs, både som adresserar fysioterapeutiska interventioner och rehabiliteringsfasen i helhet. Mer specifik forskning gällande rehabiliteringen vid sentransferering av tibialis posterior med beaktande av de enskilda diagnoserna behövs också.

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  • 38.
    Bajraktari, Saranda
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Health promotion and fall prevention for older people: impact, relevance and economic justification for decision making in a municipality context2023Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: The proportion of older people is increasing and calls for a shift towards proactive approaches to support healthy ageing. The evidence base on health-promoting and preventive interventions (HPP) is promising in terms of maintaining health in older people, but for such interventions to have an impact on population health, translation of evidence to practice is crucial. To facilitate this process, factors relevant for decision makers are important to consider. One specific public health challenge is fall-related injuries in older people which cause the highest number of injury-related deaths, have many consequences for the individual (physical and psychological) as well as wide-ranging societal costs. Translation of evidence to practice faces challenges with regards to reach, limiting the public health impact of such interventions. Digital interventions have the potential to increase reach and thereby contribute as an innovative proactive approach. The aim with this thesis was twofold. First, to review the scientific literature in the field of health promotion and prevention conducted in Nordic Countries and targeting community-dwelling older people. Secondly, to evaluate reach, self-reported health outcomes and cost-effectiveness of the Safe Step digital fall preventive exercise intervention in an observational study in the municipality of Östersund-Sweden.

    Methods: In paper I, a scoping review design was applied to review and summarise a broad field of research focusing on seven factors important for decision-makers such as: context, population, content, feasibility aspects, experiences of participants, intervention effects, and cost-effectiveness. In Paper II, data related to reach including recruitment rate, and participant characteristics (based on self-reported health outcomes and socioeconomic status) were collected. The sample was compared with a representative sample of older people for the purpose of exploring representativeness. In paper III, self-reported health outcomes in relation to balance, leg strength, fear of falling and health-related quality of life were evaluated over the course of the one-year intervention and in relation to exercise time, reported in quarterly questionnaires. In paper IV, the cost effectiveness of the Safe Step intervention was modelled in a Markov model with five states over 12 years to evaluate the potential cost-effectiveness of the intervention in community-dwelling older people at risk of falling.

    Results: Paper I showed that all included studies, except one, reported a positive effect in at least one health outcome measured. Most studies did not report on cost-effectiveness, feasibility, or experiences of participants. Based on the summarised evidence, senior meetings, preventive home visits and various forms of fall preventive exercise interventions emerged as most recommendable for implementation. Results from paper II showed that the majority of participants had a better health status, were women, and were more commonly using technology in comparison to a sample population. Paper III showed that participants in the intervention self-reported positive changes in balance and leg strength at different follow-ups. Balance and leg strength indicated a small but positive association with self-reported exercise activity. Paper IV showed the potential of Safe Step being a cost-saving intervention with better health outcomes and lower costs compared to no intervention alternative. Assuming a lower estimated intervention effect and higher recruitment costs still indicated that Safe Step was cost effective.

    Conclusion: This thesis provides evidence to support proactive approaches in healthy ageing and recommends increased efforts in research regarding translation of such interventions to practice as to maximize impact on a population level. The Safe Step intervention shows promise in being used independently in community-dwelling older people with good overall health and familiarity with internet and digital technologies. The majority reached were women with higher education, which infers a need for other non-digital interventions or additional support to increase reach in the general population of older people at risk for falling. Preliminary effectiveness results imply that Safe Step can lead to self-rated changes in known fall-risk factors although participants reported exercise time was lower than the recommended levels. Safe Step indicates also to be a cost-effective intervention even with conservative estimates of intervention effects and higher costs.

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  • 39.
    Bajraktari, Saranda
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Sandlund, Marlene
    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. Municipality of Östersund, Health and Social Care Administration, Östersund, Sweden.
    Health-promoting and preventive interventions for community-dwelling older people published from inception to 2019: a scoping review to guide decision making in a Swedish municipality context2020In: Archives of Public Health, ISSN 0778-7367, E-ISSN 2049-3258, Vol. 78, no 1, article id 97Article, review/survey (Refereed)
    Abstract [en]

    Background: Despite the promising evidence of health-promoting and preventive interventions for maintaining health among older people, not all interventions can be implemented due to limited resources. Due to the variation of content in the interventions and the breadth of outcomes used to evaluate effects in such interventions, comparisons are difficult and the choice of which interventions to implement is challenging. Therefore, more information, beyond effects, is needed to guide decision-makers. The aim of this review was to investigate, to what degree factors important for decision-making have been reported in the existing health-promoting and preventive interventions literature for community-dwelling older people in the Nordic countries.

    Methods: This review was guided by the PRISMA-ScR checklist (Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews), the methodological steps for scoping reviews described in the Arksey and O ' Malley's framework, and the Medical Research Council's (MRC) guidance on complex interventions. Eligible studies for inclusion were randomised controlled trials (RCTs) concerning health promotion or primary prevention for community-dwelling older people implemented in the Nordic countries. Additionally, all included RCTs were searched for related papers that were reporting on additional factors. Eligible studies were searched in seven databases: PubMed, SCOPUS, CINAHL, Academic Search Elite, PsycINFO, SocINDEX, and SPORTDiscus.

    Results: Eighty-two studies met the inclusion criteria (twenty-seven unique studies and fifty-five related studies). Twelve studies focused on fall prevention, eleven had a health-promoting approach, and four studies focused on preventing disability. All interventions, besides one, reported positive effects on at least one health outcome. Three studies reported data on cost-effectiveness, three on experiences of participants and two conducted feasibility studies. Only one intervention, reported information on all seven factors.

    Conclusions: All identified studies on health-promoting and preventive interventions for older people evaluated in the Nordic countries report positive effects although the magnitude of effects and number of follow-ups differed substantially. Overall, there was a general lack of studies on feasibility, cost-effectiveness, and experiences of participants, thus, limiting the basis for decision making. Considering all reported factors, promising candidates to be recommended for implementation in a Nordic municipality context are 'Senior meetings', 'preventive home visits' and 'exercise interventions' on its own or combined with other components.

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  • 40.
    Bajraktari, Saranda
    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. Municipality of Östersund, Health and Social Care Administration, Östersund, Sweden.
    Pettersson, Beatrice
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Rosendahl, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Sandlund, Marlene
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Reaching older people with a digital fall prevention intervention in a Swedish municipality context: an observational study2022In: Frontiers In Public Health, ISSN 2296-2565, Vol. 10, article id 857652Article in journal (Refereed)
    Abstract [en]

    Background: There is robust evidence that falls in old age can be prevented by exercise programs that include balance training, functional exercises, and strength training. For the interventions to have a population health impact, outreach to the population of focus with suitable interventions is needed. While digital interventions are promising there is limited knowledge on the characteristics of who is reached. The aim of this study was to describe the recruitment process, estimate reach rate at the population level and to describe participants characteristics and representativeness in a digital fall prevention intervention study.

    Methods: In a municipality-based observational study, reach of a digital fall prevention intervention was evaluated. The intervention included a digital exercise programme (Safe Step) and optional supportive strategies, complemented with a range of recruitment strategies to optimize reach. Recruitment during a period of 6 months was open to people 70 years or older who had experienced a fall or a decline in balance the past year. Reach was based on data from the baseline questionnaire including health and demographic characteristics of participants. Representativeness was estimated by comparing participants to a sample of older people from the Swedish National Public Health Survey.

    Results: The recruitment rate was 4.7% (n = 173) in relation to the estimated population of focus (n = 3,706). Most participants signed up within the first month of the intervention (n = 131). The intervention attracted primarily women, older people with high education, individuals who used the internet or digital applications almost every day and those perceiving their balance as fair or poor. Safe step participants lived more commonly alone and had higher education and better walking ability in comparison to the Swedish National Public Health Survey.

    Conclusions: With a range of recruitment strategies most participants were recruited to a digital fall intervention during the first month. The intervention attracted primarily highly educated women who frequently used the internet or smart technologies. In addition to digital fall prevention interventions, a higher diversity of intervention types (digital and non-digital) is more likely to reach a larger group of older people with different needs.

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  • 41.
    Bay, Annika
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Lämås, Kristina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Berghammer, Malin
    Umeå University, Faculty of Medicine, Department of Nursing. Department of Paediatrics, The Queen Silvia Children’s Hospital, Sweden.
    Sandberg, Camilla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Johansson, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Enablers and barriers for being physically active: experiences from adults with congenital heart disease2021In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 20, no 2, p. 276-284Article in journal (Refereed)
    Abstract [en]

    Background: In general, adults with congenital heart disease have reduced exercise capacity and many do not reach the recommended level of physical activity. A physically active lifestyle is essential to maintain health and to counteract acquired cardiovascular disease, therefore enablers and barriers for being physically active are important to identify.

    Aim: To describe what adults with complex congenital heart diseases consider as physical activity, and what they experience as enablers and barriers for being physically active.

    Methods: A qualitative study using semi-structured interviews in which 14 adults with complex congenital heart disease (seven women) participated. The interviews were analysed using qualitative content analysis.

    Results: The analysis revealed four categories considered enablers and barriers – encouragement, energy level, approach and environment. The following is exemplified by the category encouragement as an enabler: if one had experienced support and encouragement to be physically active as a child, they were more positive to be physically active as an adult. In contrast, as a barrier, if the child lacked support and encouragement from others, they had never had the opportunity to learn to be physically active.

    Conclusion: It is important for adults with congenital heart disease to have the opportunity to identify barriers and enablers for being physically active. They need knowledge about their own exercise capacity and need to feel safe that physical activity is not harmful. This knowledge can be used by healthcare professionals to promote, support and eliminate misconceptions about physical activity. Barriers can potentially be transformed into enablers through increased knowledge about attitudes and prerequisites.

  • 42.
    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)
  • 43.
    Bay, Annika
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    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, Cardiology. 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, Cardiology.
    It's like balancing on a slackline: a description of how adults with congenital heart disease describe themselves in relation to physical activity2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 15-16, p. 3131-3138Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To illuminate how adults with CHD describe themselves in relation to physical activity.

    BACKGROUND: Several studies have shown that adults with congenital heart disease (CHD) have reduced exercise capacity and do not reach the recommended daily level of physical activity. With this in view, it is of immense importance to investigate how this population experiences physical activity.

    DESIGN: Qualitative study with semi-structured interviews analysed with qualitative content analysis.

    METHODS: Semi-structured interviews were individually performed with fourteen adults (women=7, age 19-68 years) with complex CHD. Patients were purposively recruited from the clinic waiting list, based on a scheduled follow-up and diagnosis.

    RESULTS: The overall theme, It's like balancing on a slackline, illustrates how adults with CHD described themselves in relation to physical activity. This overall theme consisted of four subthemes: (1) Being an adventurer- enjoying the challenges of physical activity; (2) Being a realist- adapting to physical ability; (3) Being a non-doer- lacking prerequisites for physical activity; and (4) Being an outsider- feeling excluded depending on physical ability.

    CONCLUSIONS: Adults with CHD seem to have a diverse relationship to physical activity and it involves various aspects throughout the lifespan. The findings point out factors that might constitute as obstacles for being physically active, specific for people with chronic conditions like CHD. This highlights the importance of further exploring the hindering and facilitating factors for being physically active in order to get a deeper understanding of how to support adults with CHD to be physically active.

    RELEVANCE TO CLINICAL PRACTICE: Given the diverse relationship to physical activity, nurses have to further investigate the patients' relationship to physical activity, in order to support a healthy lifestyle. Nurses and allied health professionals should offer individualized exercise prescriptions and education about suitable physical activities in relation to physical ability. This article is protected by copyright. All rights reserved.

  • 44.
    Bengtsson, Victor
    et al.
    Department of Women's and Children's Health, Uppsala university.
    Berglund, Lars
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Öhberg, Fredrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Thoracolumbar and Lumbopelvic Spinal Alignment During the Barbell Back Squat: A Comparison Between Men and Women2023In: International Journal of Sports Physical Therapy, E-ISSN 2159-2896, Vol. 18, no 4, p. 820-830Article in journal (Refereed)
    Abstract [en]

    Background:  Maintaining neutral spinal alignment is considered important when performing the barbell back squat exercise. Since male and female lifters may differ in injury location it is important to examine whether they differ in spinal alignment during the back squat.

    Objectives:  The study aimed to quantify the spinal alignment in the upper and lower lumbar spine during the barbell back squat exercise in male and female lifters. Secondary aims were to compare alignment during the back squat to standing habitual lumbar spine alignment and determine whether male and female lifters differ in these aspects.

    Study design:  Observational, Cross-sectional.

    Methods:  Competitive power- and weightlifters were recruited and performed three repetitions of the barbell back squat exercise using a load equivalent to 70% of their one-repetition maximum. Spinal alignment and range of motion were measured using inertial measurement units placed on the thoracic, lumbar and sacral spine. Data was presented descriptively and comparisons between men and women as well as spinal alignment in four different positions were done with a factorial repeated measures analysis of variance.

    Results:  Twenty-three (14 males, 9 females) were included. During execution of the squat, spinal alignment adjustments in the lumbar spine were made in all three planes of movement, compared to the start position, in both male and female lifters. Compared to their standing habitual posture, all lifters adjusted their upper lumbar spine to a less lordotic position when in the start position of the back squat (standing upright with the barbell on their back). Only male lifters assumed a less lordotic alignment in their lower lumbar spine in the start position compared their habitual posture.

    Conclusions:  Adjustments of spinal alignment, predominantly in the sagittal plane, are made during execution of the back squat in both male and female lifters. Further, lifters adopt a less lordotic alignment with a heavy barbell on their upper back, more so in male than female lifters. In conclusion, it seems that spinal alignment changes noticeably during the barbell back squat.

    Level of evidence:  3

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  • 45.
    Bergdahl, Lisa
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Isaksson, Emma
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Äldre personers erfarenheter av fysisk aktivitet under covid-19 pandemin: -En kvalitativ intervjustudie2022Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: För att bibehålla hälsa och kroppslig funktion är det viktigt att äldre inte blir stillasittande utan kan fortsätta med sin fysiska aktivitet. Covid-19 pandemin har genom råd och restriktioner påverkat och begränsat vardagen, speciellt för äldre personer då de tillhör riskgrupp, och i vissa fall försvårat för fysisk aktivitet. Syftet med denna uppsats var att undersöka äldres erfarenheter av fysisk aktivitet under Covid-19 pandemin.

    Metod: Detta är en kvalitativ studie med en induktiv ansats. Kvalitativ innehållsanalys användes för att systematiskt bearbeta 11 individuella intervjuer gjorda på äldre personer med hjälp av en semistrukturerad intervjuguide.

    Resultat: Deltagarnas erfarenhet av fysisk aktivitet under pandemin belyses i fyra kategorier; Begränsas i urval för fysisk aktivitet genom restriktioner för covid-19, Upplever negativa effekter av pandemin, Skapar strategier för fysisk aktivitet samt Nyttjar personliga förmågor för fortsatt fysisk aktivitet. Resultatet visar att samtliga deltagare har fortsatt vara fysiskt aktiva men har som en följd av pandemin tvingats anpassa livet och aktiviteterna utifrån de förutsättningar som varit.

    Slutsats: Deltagarna i denna studie påverkades av pandemin i form av att deras vardag begränsades av restriktioner och utbudet av aktiviteter förändrades. De visade dock på god förmåga att anpassa sig och forma nya strategier för att möjliggöra fortsatt fysisk aktivitet. Individens egen motivationsförmåga samt kunskap om betydelsen av fysisk aktivitet möjliggjorde denna anpassning. Erfarenheterna från denna studie kan vara till hjälp för att i framtiden bättre förstå hur äldre ska kunna bibehålla sin fysiska kapacitet och hälsa under en pandemi.

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  • 46.
    Berggren, Tilda
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Åkerström, Pauline
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Effekter av fysisk aktivitet hos gravida kvinnor med ländryggs- och/eller bäckensmärta: En systematisk litteraturstudie2021Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Graviditetsrelaterad ländryggs- och bäckensmärta är ett folkhälsoproblem för större andelen gravida i samhället. Mer än två tredjedelar av gravida kvinnor upplever ländryggssmärta och nästan en femtedel upplever bäckensmärta. 

    Syfte: Att utvärdera evidensen för effekter av fysisk aktivitet som intervention för ländryggs- och/eller bäckensmärta hos gravida kvinnor.

    Metod: Litteratursökningen i denna systematiska litteraturstudie utfördes i tre olika databaser, PubMed, Cinahl samt SPORTDiscus. Studien inkluderade randomiserade kontrollerade studier samt artiklar inom spannet av 15 år. Studier som innefattade ländryggs- och/eller bäckensmärta under graviditet samt fysisk aktivitet inkluderades. Urvalsprocess av relevanta artiklar utfördes enligt PRISMAS flödesschema. Kvalitetsgranskning gjordes enligt PEDro skalan. 

    Resultat: Tretton artiklar inkluderades i litteraturstudien efter litteratursökning samt relevansbedömning. Artiklarna bedömdes ha moderat till bra kvalitet enligt PEDro- skalan. Interventionerna var lika i flera av studierna men överlag skiljde sig flera av studiernas interventioner åt. Tio studier hade variationer av träningsprogram som intervention där tre studier följde American College of Obstetricians and Gynecologists (ACOG) och en studie följde Royal College of Obstetricians and Gynecologists (RCOG). Andra träningsinterventioner var Hatha yoga, pilates samt vattenträning. Resultat visade att fysisk aktivitet gav effekt i 10 av 13 studier sett på ländryggs- och/eller bäckensmärta.

    Konklusion: Resultatet att majoriteten av de granskade randomiserade kontrollerade studierna visade positiva effekter av fysisk aktivitet indikerar att fysisk träning i olika former kan vara positivt och kan rekommenderas till gravida med ländryggs- och/eller bäckensmärta. Då antalet inkluderade studier var lågt och typen av träning och träningsupplägg varierande är det svårt att dra säkra slutsatser om effekt av specifika träningsmetoder. Mer forskning inom området behövs för att kunna säkerhetsställa evidensen för fysisk träning som behandling för graviditetsrelaterad ländryggs- och/eller bäckensmärta.

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  • 47.
    Berglund, Josefin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Uusitalo, Emmy
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Fysioterapeuters erfarenheter och upplevelser av att ge råd och rehabilitering vid stressrelaterad ohälsa2020Independent thesis Basic level (degree of Bachelor), 180 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Mental ohälsa är globalt sett ett växande problem och behandlingsbehovet är stort. I Sverige är stressrelaterad ohälsa numera vanligare än muskuloskeletala besvär som tidigare varit den ledande orsaken till långtidssjukskrivning. Fysisk aktivitet har visat positiva effekter för personer med stressrelaterad ohälsa och många av deras symtom förknippas med fysisk inaktivitet, därför är fysioterapeutens roll viktig för denna grupp.

    Syfte: Syftet med denna studie var att undersöka fysioterapeuters erfarenheter och upplevelser av att ge råd och rehabilitering vid stressrelaterad ohälsa.

    Metod: Detta är en kvalitativ studie där datainsamling skett genom intervjuer med fem fysioterapeuter som mött personer med stressrelaterad ohälsa och som arbetar inom primärvård och företagshälsovård. Intervjuerna granskades och tolkades genom kvalitativ innehållsanalys där datan delades in i meningsenheter, koder, kategorier och till slut ett tema.

    Resultat: Analysen resulterade i fyra kategorierna; Skapa trygghet och kommunikation i mötet, Individanpassad fysisk aktivitet, Motivera individen till eget ansvar i rehabiliteringen, Teamarbete, handledning och utbildning bidrar till rehabiliteringen.

    Konklusion: Fysioterapeuters erfarenheter och upplevelser av att ge råd och rehabilitering vid stressrelaterad ohälsa var att utgå från individens situation och hitta aktiviteter individen finner glädje i att utföra. Individen behöver ta eget ansvar i sin rehabilitering och fysioterapeuten finns där som stöd. Handledning, ingå i team och utöka utbildning och kunskap bidrar till rehabiliteringen av personer med stressrelaterad ohälsa.

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  • 48.
    Berglund, Julia
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Larsson, Hanna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Fysioterapeutens roll inom teamet vid behandling av psykisk ohälsa hos unga vuxna: - En kvalitativ studie2021Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Psykisk ohälsa är i dagens samhälle vanligt, framförallt rapporteras det att allt fler barn och ungdomar får vård och behandling för psykiatriska diagnoser. Detta medför att vårdköerna växer och därmed ställs höga krav på hälso- och sjukvården. Det finns god evidens för fysioterapeutisk behandling vid psykisk ohälsa men fysioterapeuter inom området är fortfarande relativt få och deras roll i teamet behöver stärkas.

    Syfte: Syftet med denna studie var att utforska hur fysioterapeuten ser på sin roll inom teamet vid behandling av psykisk ohälsa hos unga vuxna.

    Metod: Tolv kvinnliga fysioterapeuter med arbetserfarenhet inom psykisk ohälsa intervjuades om sina upplevelser av att arbeta som fysioterapeut i ett team. Intervjuerna analyserades med kvalitativ innehållsanalys. 

    Resultat: Analyserna resulterade i temat: Betydelsefull behandlare och kollega - med ambitionen att förbli en självklar del av teamet och med tre kategorier: Ständig kamp att vara ambassadör för fysioterapi, En del av en helhet, samt Stärker det psykologiska via kropp och hälsa. Temat innebär att fysioterapeuten ansåg sig vara en betydelsefull behandlare som kunde stärka det psykiska måendet för patienter. Fysioterapeuten ansåg sig även vara en betydelsefull kollega som bidrog med ett kroppsligt perspektiv. Bristande kunskap från övriga professioner om fysioterapi och att känna sig ensam i sin roll bidrog till ambitionen att förbli en självklar del av teamet. 

    Konklusion: Fysioterapeuten såg på sin roll i teamarbetet som betydelsefull både för patienten och kollegorna, där ambitionen var att förbli en självklar del av teamet. För att uppnå detta behövs fler fysioterapeutkollegor och ökad kännedom om fysioterapeutens kompetens. Ökad medvetenhet om alla professioners kompetenser skulle inte enbart stärka fysioterapeutens roll utan även bidra till ett välfungerande teamarbete.

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  • 49.
    Bergman, Frida
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Edin, Kerstin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Renklint, Rebecka
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Olsson, Tommy
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Sörlin, Ann
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    The ability to benefit from an intervention to encourage use of treadmill workstations: Experiences of office workers with overweight or obesity2020In: PLOS ONE, E-ISSN 1932-6203, Vol. 15, no 1, article id e0228194Article in journal (Refereed)
    Abstract [en]

    One way to increase physical activity in offices is to install treadmill workstations, whereoffice workers can walk on a treadmill while performing their normal tasks. However, theexperiences of people using these treadmill workstations over a long period of time is notknown. In this 13-month study, we explored the experiences of office workers with treadmillworkstations available in their offices. After completing a larger randomized controlled trialwith 80 office workers ages 40 to 67 years with overweight or obesity, we interviewed 20 participantsfrom the intervention group, using a semi-structured interview guide. Data wereanalyzed using a grounded theory approach with constant comparison of emerging codes,subcategories, and categories, followed by connecting the categories to create a core category.The core category is described as the “Ability to benefit.” Although all participants hada rather high motivational level and pre-existing knowledge about the health benefits ofincreasing physical activity at work, they had different capacities for benefiting from the intervention.The categories are described as ideal types: the Convinced, the Competitive, theResponsible, and the Vacillating. These ideal types do not represent any single participantbut suggest generalized abstractions of experiences and strategies emerging from the codingof the interviews. One participant could easily have more than one ideal type. Becauseof differences in ideal type strategies and paths used throughout the course of the study,participants had different abilities to benefit from the intervention. Knowledge regarding theideal types may be applied to facilitate the use of the treadmill workstations. Because differentideal types might require different prompts for behavior change, tailored interventionstrategies directed towards specific ideal types could be necessary.

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  • 50.
    Bergqvist, Maria
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    The impact of visuospatial and executive function on activity performance and outcome after robotic or conventional gait training, long-term after stroke2021Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Introduction: Visuospatial and executive impairments have been associated with poor activity performance in the acute/subacute stages after stroke, not thoroughly evaluated long-term, or to specific interventions targeting walking ability. Exoskeletons, such as the Hybrid Assistive Limb (HAL) may be used to assist gait movements during gait training after stroke. 

    Aims: To examine the potential association between visuospatial and executive function and 1) aspects of activity performance (mobility, self-care and domestic life) and 2) outcome after robotic or conventional gait training, long term (1-10 years) after stroke. 

    Methods: The current sub-analysis evaluated associations, as part of a randomized controlled trial (RCT). Outcome measures included assessed visuospatial/executive function, executive function rated by a significant other, assessed mobility and self-perceived aspects of activity performance. 

    Results: 45 participants were included. Spearman’s rho showed significant correlations between assessed visuospatial/executive function and baseline activity performance (r=0.34-0.69, p<0.05). Rated executive function presented no significant correlations. Visuospatial/executive function showed a tendency interacting on long-term effect on walking distance, although not statistically significant. The HAL-group presented no association between visuospatial/executive function and long-term improvement, while the conventional group showed long-term improvement being associated to a higher visuospatial/executive function. 

    Conclusion: Assessed visuospatial/executive function was associated to activity performance, long-term after stroke, with a possible influence on effect of gait intervention. Tendencies indicated HAL-training suitable for people with visuospatial/executive impairments, showing long-term improvement, when the conventional group indicated improvement being associated to a higher visuospatial/executive function. Larger studies are needed to further evaluate this.

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