| 61. |
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| 62. |
- Degerstedt, Frida, et al.
(författare)
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Inequity in physiotherapeutic interventions for children with Cerebral Palsy in Sweden - a national registry study
- 2020
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Ingår i: Acta Paediatrica. - : John Wiley & Sons. - 0803-5253 .- 1651-2227. ; 109:4, s. 774-782
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim of this study was to investigate the distribution of physiotherapeutic interventions for children with Cerebral Palsy in Sweden from an equity perspective, considering sex, country of birth and geographical region.METHOD: This national cross-sectional registry study includes children with Cerebral Palsy aged 0-18 years who participated in 2015 in the Swedish national quality registry, the Cerebral Palsy follow-up program, CPUP. Comparisons and associations between physiotherapeutic interventions and sex, country of birth and geographical regions were conducted using Chi2 and logistic regression analysis, controlling for cognitive level, level of motor function, age group and dominating symptom.RESULTS: Of the 2855 participants, 2201 (79%) had received physiotherapy. Children born in Sweden had 1.60 times higher odds (95% CI 1.10-2.33) of receiving physiotherapy compared with children born in foreign countries. Distribution of physiotherapeutic interventions differed significantly between geographical regions. No associations between sex and physiotherapeutic interventions were observed.CONCLUSION: The results of this study indicate inequity in care in Sweden towards children with Cerebral Palsy born in other counties. Further, physiotherapeutic interventions were not equally distributed in different.
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| 63. |
- Degerstedt, Frida, et al.
(författare)
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Unequal physical activity among children with cerebral palsy in Sweden : A national registry study
- 2021
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Ingår i: Health Science Reports. - : John Wiley & Sons. - 2398-8835. ; 4:3
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To examine the extent to which sex, country of birth, and functional aspects influence participation in physical education and physical leisure activity among children with cerebral palsy (CP) in Sweden.Methods: This national cross-sectional registry study included children with CP aged 6 to 18 years who participated in the Swedish national quality registry, the Cerebral Palsy Follow-up Program, CPUP, in 2015. Comparisons and associations between sex, country of birth, and functional aspects and physical leisure/physical education were examined using chi-squared and multivariable logistic regression analysis.Results: The study included 1935 children. Of them, 1625 (87%) reported participating in physical education and 989 (53%) reported participating in physical leisure activity. Children born in Sweden had higher odds of participating in physical education (OR: 1.99; 95% CI: 1.20-3.28) and physical leisure activity (OR: 2.51; 95% CI: 1.70-3.72) compared with children born outside Europe. Greater impairment of gross motor function was associated with lower participation levels. Boys participated slightly more frequently in leisure activities than girls.Conclusion: Enhancing social inclusion with regard to disability, birth country, and sex are important and achievable goals for policymakers and practitioners for promoting participation in physical activity for children and adolescents with CP.
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| 64. |
- Diarbakerli, E., et al.
(författare)
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Learning from the past to plan for the future: A scoping review of musculoskeletal clinical research in Sweden 2010-2020
- 2022
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Ingår i: Upsala Journal of Medical Sciences. - : Uppsala Medical Society. - 0300-9734 .- 2000-1967. ; 127:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aims of this study are to 1) determine the scope of musculoskeletal (MSK)-related clinical research in Sweden; 2) collate the amount of first-tier funding received; 3) discuss strategies and infrastructure supporting future MSK clinical trials in Sweden. Methods: A systematic scoping review protocol was applied in PubMed, Scopus, and SweCRIS databases. The articles were examined, and data were extracted in multiple stages by three blinded authors. Results: The search strategy resulted in 3,025 publications from 479 Swedish-affiliated authors. Primary health care was the basis for 14% of the publications, 84% from secondary health care, and 2% from occupational health care with a similar proportional distribution of first-tier research grant financing. Approximately one in six publications were randomized controlled trials (RCTs), while the majority were of observational cohort design. The majority of publications in primary and occupational health care were related to pain disorders (51 and 67%, respectively), especially diagnosis, prognosis, and healthcare organizational-related interventions (34%) and rehabilitation (15%) with similar proportional distribution of first-tier research grant financing. In secondary health care, rheumatic inflammatory disorder-related publications were most prevalent (30%), most frequently concerning diagnosis, prognosis, and healthcare organizational-related interventions (20%), attracting approximately half of all first-tier funding. Publications related to degenerative joint disorders (25%), fractures (16%), and joint, tendon, and muscle injuries (13%) frequently concerned surgical and other orthopedic-related interventions (16, 6, and 8%, respectively). Pain disorder-related publications (10%) as well as bone health and osteoporosis-related publications (4%) most frequently concerned diagnosis, prognosis, and healthcare organizational-related interventions (5 and 3%, respectively). Conclusions: Swedish-affiliated MSK disorder research 2010-2020 was predominantly observational cohort rather than RCT based. There was skewed first-tier funding allocation considering prevalence/incidence and burden of disease. Use of infrastructure supporting register-based RCTs, placebo-controlled RCTs, and hybrid effectiveness-implementation studies on prevention and clinical intervention is important strategies for the future in all healthcare sectors.
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| 65. |
- Diarbakerli, Elias, et al.
(författare)
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Swedish musculoskeletal researchers view on a collaborative network and future research priorities in Swedish healthcare
- 2024
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Ingår i: Musculoskeletal Care. - : John Wiley & Sons. - 1478-2189 .- 1557-0681. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Musculoskeletal disorders (MSK) are a global burden causing significant suffering and economic impact. Systematic identification and targeting of research questions of highest interest for stakeholders can aid in improving MSK disorder knowledge and management.Objective: To obtain Swedish MSK researchers' opinions and views on a collaborative Swedish MSK network (SweMSK) and identify future research areas of importance for Swedish MSK research.Methods: A web-based survey was conducted July to September 2021 to collect data from 354 Swedish MSK researchers. The survey focused on the need, objectives, and structure of a SweMSK network and identified prioritised areas for future MSK research.Results: The study included 141 respondents, of which 82 were associate professors or professors. The majority (68%) supported the creation of a new musculoskeletal network. The most supported element was increased collaboration regarding nationwide and multicenter studies. Respondents recommended the creation of a homepage and the establishment of national work groups with different specific interests as the primary elements of a new network.Conclusion: The results demonstrated a need and desire for increased national research collaboration and the creation of a new musculoskeletal network. The high academic experience and active research participation of the respondents suggest the need for MSK disorder knowledge and management improvement in Sweden. Therefore, the SweMSK network may help facilitate effective collaboration and research efforts that can contribute to the advancement of MSK disorder management and care. This study may provide valuable insights for policymakers, clinicians, and researchers to improve MSK disorder care and management in Sweden.
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| 66. |
- Djupsjöbacka, Mats, et al.
(författare)
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Correlation analysis of proprioceptive acuity in ipsilateral position-matching and velocity-discrimination.
- 2005
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Ingår i: Somatosensory & motor research. - : Informa UK Limited. - 0899-0220 .- 1369-1651. ; 22:1-2, s. 85-93
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Tidskriftsartikel (refereegranskat)abstract
- In order to plan and control movements the central nervous system (CNS) needs to continuously keep track of the state of the musculoskeletal system. Therefore the CNS constantly uses sensory input from mechanoreceptors in muscles, joints and skin to update information about body configuration on different levels of the CNS. On the conscious level, such representations constitute proprioception. Different tests for assessment of proprioceptive acuity have been described. However, it is unclear if the proprioceptive acuity measurements in these tests correlate within subjects. By using both uni- and multivariate analysis we compared proprioceptive acuity in different variants of ipsilateral active and passive limb position-matching and ipsilateral passive limb movement velocity-discrimination in a group of healthy subjects. The analysis of the position-matching data revealed a higher acuity of matching for active movements in comparison to passive ones. The acuity of matching was negatively correlated to movement extent. There was a lack of correlation between proprioceptive acuity measurements in position-matching and velocity-discrimination.
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| 67. |
- Domkin, Dmitry, et al.
(författare)
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Joint angle variability in 3D bimanual pointing : uncontrolled manifold analysis.
- 2005
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Ingår i: Experimental Brain Research. - : Springer Science and Business Media LLC. - 0014-4819 .- 1432-1106. ; 163:1, s. 44-57
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Tidskriftsartikel (refereegranskat)abstract
- The structure of joint angle variability and its changes with practice were investigated using the uncontrolled manifold (UCM) computational approach. Subjects performed fast and accurate bimanual pointing movements in 3D space, trying to match the tip of a pointer, held in the right hand, with the tip of one of three different targets, held in the left hand during a pre-test, several practice sessions and a post-test. The prediction of the UCM approach about the structuring of joint angle variance for selective stabilization of important task variables was tested with respect to selective stabilization of time series of the vectorial distance between the pointer and aimed target tips (bimanual control hypothesis) and with respect to selective stabilization of the endpoint trajectory of each arm (unimanual control hypothesis). The components of the total joint angle variance not affecting (V(COMP)) and affecting (V(UN)) the value of a selected task variable were computed for each 10% of the normalized movement time. The ratio of these two components R(V)=V(COMP)/V(UN) served as a quantitative index of selective stabilization. Both the bimanual and unimanual control hypotheses were supported, however the R(V) values for the bimanual hypothesis were significantly higher than those for the unimanual hypothesis applied to the left and right arm both prior to and after practice. This suggests that the CNS stabilizes the relative trajectory of one endpoint with respect to the other more than it stabilizes the trajectories of each of the endpoints in the external space. Practice-associated improvement in both movement speed and accuracy was accompanied by counter-intuitive lack of changes in R(V). Both V(COMP) and V(UN) variance components decreased such that their ratio remained constant prior to and after practice. We conclude that the UCM approach offers a unique and under-explored opportunity to track changes in the organization of multi-effector systems with practice and allows quantitative assessment of the degree of stabilization of selected performance variables.
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| 68. |
- Domkin, Dmitry
(författare)
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Perception and control of upper limb movement: Insights gained by analysis of sensory and motor variability
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Chronic neck-shoulder pain is associated with impairments of proprioception and motor control. Thus, assessment of proprioceptive and motor function may be powerful tools both for research and clinical practice. However, insufficient knowledge of certain features of human sensorimotor control hampers both development and interpretation of results of clinically relevant tests. For example, evidence is lacking which proprioception submodalities are reflected in common tests of proprioception. For testing motor function, a better understanding of the control of goal directed arm movements is needed. The purpose of the thesis was to gain further insights into the sensorimotor control of the upper limb in healthy subjects, with implications for clinical testing. The main aims were: (1) to study relationships of outcomes of different tests of shoulder proprioception and (2) to study control strategies in bimanual pointing tasks by analysis of the structure of joint angle variability with the Uncontrolled Manifold (UCM) method. Correlations between proprioceptive acuity in different variants of ipsilateral position-matching and velocity-discrimination were studied. The main finding was that two uncorrelated mechanisms based either on perception of position or movement might underlie perception of limb location in ipsilateral position-matching. The results provided important information for interpretation of common and development of novel tests of shoulder proprioception. The structure of joint angle variance was computed with respect to several task variables during bimanual pointing. Joint angle variability was decomposed in variance affecting and not affecting a task variable. The results showed that the variance in joint space was structured according to the predictions of the UCM hypothesis. It was also shown that the arms were united into one synergy to significantly larger degree than joints within each arm were united into single-arm synergies. It was concluded that the UCM approach might quantify components of motor variability during repetitive motor tasks.
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| 69. |
- Domkin, Dmitry, et al.
(författare)
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Structure of joint variability in bimanual pointing tasks
- 2002
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Ingår i: Experimental Brain Research. - : Springer Science and Business Media LLC. - 0014-4819 .- 1432-1106. ; 143, s. 11-23
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Tidskriftsartikel (refereegranskat)abstract
- Changes in the structure of motor variability during practicing a bimanual pointing task were investigated using the framework of the uncontrolled manifold (UCM) hypothesis. The subjects performed fast and accurate planar movements with both arms, one moving the pointer and the other moving the target. The UCM hypothesis predicts that joint kinematic variability will be structured to selectively stabilize important task variables. This prediction was tested with respect to selective stabilization of the trajectory of the endpoint of each arm (unimanual control hypotheses) and with respect to selective stabilization of the timecourse of the vectorial distance between the target and the pointer tip (bimanual control hypothesis). Components of joint position variance not affecting and affecting a mean value of a selected variable were computed at each 10% of normalized movement time. The ratio of these two components ( R(V)) served as a quantitative index of selective stabilization. Both unimanual control hypotheses and the bimanual control hypothesis were supported both prior to and after practice. However, the R(V) values for the bimanual control hypothesis were significantly higher than for either of the unimanual control hypothesis, suggesting that the bimanual synergy was not simply a simultaneous execution of two unimanual synergies. After practice, an improvement in both movement speed and accuracy was accompanied by counterintuitive changes in the structure of kinematic variability. Components of joint position variance affecting and not affecting a mean value of a selected variable decreased, but there was a significantly larger drop in the latter when applied on each of the three selected task variables corresponding to the three control hypotheses. We conclude that the UCM hypothesis allows quantitative assessment of the degree of stabilization of selected performance variables and provides information on changes in the structure of a multijoint synergy that may not be reflected in its overall performance.
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| 70. |
- Edin-Liljegren, A, et al.
(författare)
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Risk factors for cardiovascular diseases among Swedish Sami : a controlled cohort study
- 2004
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Ingår i: International Journal of Circumpolar Health. - 1239-9736 .- 2242-3982. ; 63:Suppl 2, s. 292-297
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate the occurrence of clinical, psychosocial and behavioural risk factors for cardiovascular diseases (CVD) among reindeer herding (RS) and non-reindeer herding Sami (NRS). STUDY DESIGN: A retrospective cohort study, comparing risk factors behind CVD between Sami and non-Sami, RS and NRS, and Sami men and women. METHODS: A cohort of 611 Swedish Sami (276 men and 335 women) was constructed from national population registers. A twice as large control cohort of non-Sami was created, matched by age, gender and area of residence. Information on risk factors was obtained from a database containing clinical and psychosocial-behavioural data from a regional CVD preventive programme for the period 1990-2001. RESULTS: The Sami and the non-Sami showed similar risk factor patterns. The main differences were related to working conditions and lifestyle factors of the RS. The RS men had lower blood pressure, were more physically active and had higher job demand and decision latitude. The RS women showed more negative scores on the indices of the job strain model. CONCLUSIONS: Previously reported differences in CVD mortality between Sami and non-Sami, and Sami men and women, can only partly be explained by different exposure to the psychosocial and behaviour risk factors investigated in this study.
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