| 1. |
- Gard, Gunvor
(författare)
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Increased focus on values. A tool in stress prevention?
- 2003
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Ingår i: Physiotherapy. - 1873-1465 .- 0031-9406. ; 89:5, s. 282-289
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose Can an increased focus on values in working life be a factor in stress prevention? Values are defined as the shared principles which guide behaviour in an organisation. The purpose of this study was to describe how patients with musculoskeletal pain perceive the importance of values in relation to coping with daily stress and in relation to health. Methods Patients receiving physiotherapy for various musculoskeletal disorders at three primary healthcare centres in the north of Sweden participated in the study, in total 95 patients. They answered a questionnaire covering values, work situation, coping behaviour and health and the relationship between these aspects. Results All patients perceived that it was important to have values to follow at work, such as doing one's best, setting priorities, following one's priorities and having open and direct communicationwith others. A significant positive relationship was shown between having motivating values and low emotion-focused strategies, in this case behavioural and cognitive coping strategies. A positive relationship was also shown between having motivating values and low occurrence of symptoms (good perceived health). Conclusion Values and effective coping strategies may be motivating factors preserving health.
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| 2. |
- Gard, Gunvor, et al.
(författare)
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Life-views of Physiotherapy students compared to medical and nursing students
- 2000
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Ingår i: Physiotherapy. - 0031-9406 .- 1873-1465. ; 86:11, s. 576-582
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Tidskriftsartikel (refereegranskat)abstract
- A life-view is an overall view of man and the world, forming a central value system and giving expression to a fundamental attitude. Research has shown that life-views are established early in childhood, are influenced by social environment and are relatively constant over time. An individual's view of life determines the response to reality and influences decision-making and treatment of other people. The aim of this study was to compare life-views and ethical standpoints of physiotherapy, nursing and medical students at the beginning of their professional education. All physiotherapy students beginning their education at Lund University during 1996 to 1998 answered a questionnaire developed by Josephsson (1994), in total 187 students. The life-views of the physiotherapy students were compared with those of 385 medical students from the Karolinska Institute in Stockholm and 36 student nurses from Luleå University who answered the same questionnaire, which required them to indicate their agreement or otherwise with statements reflecting different life-views. The result showed that all student groups had high or moderate levels of agreement with the sentences reflecting a religious and evolutionary life-view and low agreement with a scientific life-view in Josephsson's terms. When comparing the groups, medical students had the lowest and nursing students the highest agreement with the religious life-view. Physiotherapy students had the highest agreement with the evolutionary life-view. No significant differences were noted between physiotherapy and nursing students in religious, scientific or evolutionary life-views. Women had higher agreements than men with the religious life-view. Men had higher agreements than women with the scientific and evolutionary life-view. No significant differences were noted in life-views between younger and older students within any student group. All student groups were patient-centred in their opinions on clinical ethical questions.
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| 3. |
- Gard, Gunvor, et al.
(författare)
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Physical Therapists´ emotional expressions in interviews about factors important for interaction with patients
- 2000
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Ingår i: Physiotherapy. - 1873-1465 .- 0031-9406. ; 86:5, s. 229-240
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Tidskriftsartikel (refereegranskat)abstract
- Interactions between patients and physiotherapists have been studied by various researchers. Some results indicate that physiotherapists have an awareness of underlying emotions, but often respond only on an intellectual level. It seems that verbally expressed emotions may be important for interaction between physiotherapists and patients during treatment. Aim The aim of this study was to investigate how many and what verbally expressed emotions physiotherapists state during interviews between physiotherapists and patients. Method The study was a qualitative case study with cross-case analysis according to Shepard et al (1993) and Merriam (1988). Ten informants participated, all of them 'experts in interaction with patients', women, Swedish-speaking, and with at least five years' experience in primary health care. The physiotherapists' emotions were categorised according to Tomkins (1984) and Izard (1977) in the categories of interest/excitement, surprise/startle, enjoyment/joy, sadness, anger/rage, fear/terror, shame/humiliation, contempt and disgust. Results Positive emotions such as interest and joy were expressed most often in the interviews, in situations where physiotherapy had been successful, as joyful contacts with colleagues, or in situations where humour was used as a therapeutic instrument. Surprise, sadness and anger were expressed more seldom and contempt or disgust were not expressed at all in the interviews. Conclusion Verbal expressions of emotions in treatment situations in physiotherapy practice should be promoted more emphatically. This may start a reflective process in both patients and physiotherapists and deepen the understanding of the interaction.
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| 4. |
- Overmeer, Thomas, 1960-, et al.
(författare)
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Do physical therapists recognise established risk factors? : Swedish physical therapists' evaluation in comparison to guidelines
- 2004
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Ingår i: Physiotherapy. - Amsterdam : Elsevier. - 0031-9406 .- 1873-1465. ; 90:1, s. 35-41
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose The Swedish Council on Technology Assessment in Health Care has widely distributed the most recent Swedish evidence-based review on neck and back pain. In this review psychosocial factors were acknowledged as important risk factors for developing chronic pain. We surveyed physical therapists’ evaluation of risk factors for the development of chronic pain. The results were compared to the review of the Swedish Council on Technology Assessment in Health Care.Methods A postal questionnaire was sent to all 117 physical therapists working in primary care in Örebro County, Sweden.Results The survey was responded to by 102 physical therapists (87%). Over 50% of them indicated as important more than twice as many risk factors than are supported by the evidence-based review.More than 50% of the physical therapists pointed out all eight evidence-based factors described in the evidence-based review but they also indicated a median of 10 additional factors with little or no support in the literature. More than 80% of the physical therapists responded according to the recommendations of the evidence-based review concerning sick leave and instructions to patients regarding activities and pain relief. Forty-four physical therapists (43%) indicated that they could predict which patients would develop chronic pain in the future.Conclusions Physical therapists represented by this sample were well aware of the importance of psychosocial risk factors, but because of the large number of additional factors indicated it seems physical therapists lack specificity about which factors are important.
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| 5. |
- Aasa, Björn, et al.
(författare)
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A characterisation of pain, disability, kinesiophobia and physical capacity in patients with predominantly peripherally mediated mechanical low back pain
- 2011
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Ingår i: Physiotherapy. - 0031-9406 .- 1873-1465. ; 97:Suppl. 1, s. eS18-
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The specific objectives were to: 1) describe the level of pain intensity, disability, activity limitation, kinesiophobia and physical capacity in patients with predominantly peripherally mediated mechanical back pain, and 2) investigate whether differences between these patients in physical and psychosocial factors can be distinguished when the patients are further sub-grouped.Relevance: To improve assessment among patients with chronic low back pain (CLBP) it is important to investigate the prevalence of physical and psychosocial features in homogenous sub-groups.Participants: Seventy-one patients with CLBP, 20-60 years old, with peripherally mediated mechanical pain at the the moment for the study, were included and each patient was sub-classified into one of five sub-groups based on their pain behaviour and functional movement pattern (flexion n=20, flexion/lateral shift, n=11, active extension n=23 , passive extension n=8, and multidirectional pattern n=9).Methods: Data on pain intensity (Visual Analogue Scale), disability (the Roland and Morris Questionnaire), activity limitation (the Patient Specific Functional Scale), kinesiophobia (the Tampa Scale of Kinesiophobia) and physical capacity (lifting capacity and trunk extensor endurance) was collected.Analysis: Mean and standard deviation for parametric and median and interquartile range for non-parametric data were used for descriptive statistics. One-way ANOVA for normally distributed data and Kruskal-Wallis for non-normally distributed data were used for analyses of differences between the sub-groups. The subjects were also divided into two age-groups (20-40 and 41-60 years) and measures of physical capacity were compared to women and men at the ages of 34 and 50, respectively, in the general Swedish population using one sample T-test.Results: The patients reported low to moderate pain intensity (3.1/10±2.4), disability (RMDQ (7.27/24 ±4.2) and kinesiophobia (33.4/68 ±7) and these levels were lower than reported levels in other studies including more heterogenous groups of patients with CLBP. The patiens reported activity limitations (PSFS 13/30±23). Lifting capacity and trunk extensor endurance were significantly lower than in the general population in the youngest age-group. No significant differences in pain intensity, disability, kinesiophobia or physical capacity were found between the sub-groups.Conclusions: This research highlights that patients with predominantly peripherally mediated mechanical back pain may differ from other sub-groups of patients with CLBP (e.g., patients with central sensitization as dominating pain mechanism) regarding physical and psychosocial factors. The individual variation in pain intensity, disability, kinesiophbia and physical capacity among the patients indicates the importance to assess these factors in every patient. Due to the fact that there were few patients in the sub-groups, further research is necessary to explore whether there are differences, that we were not able to disingjish, between patients with different movement patterns.
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| 6. |
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| 7. |
- Abbott, Allan, et al.
(författare)
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The influence of psychological factors on pre-operative levels of pain intensity, disability and HRQOL in lumbar spinal fusion surgery patients
- 2010
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Ingår i: Physiotherapy. - : Elsevier. - 0031-9406 .- 1873-1465. ; 96:3, s. 213-221
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES:To assess the extent to which perceived pain and psychological factors explain levels of disability and health-related quality of life (HRQOL) in patients scheduled for lumbar fusion surgery, and to test the hypothesis that relationships between pain intensity, mental health, fear of movement/(re)injury, disability and HRQOL are mediated by cognitive beliefs and appraisals.DESIGN:Cross-sectional, correlation study.SETTING:Orthopaedic outpatient setting in a tertiary hospital.PARTICIPANTS:One hundred and seven chronic back pain patients scheduled for lumbar fusion surgery.MEASURES:Visual analogue scale for pain intensity, Short Form 36 mental health subscale, Tampa Scale for Kinesiophobia, Back Beliefs Questionnaire, Self-efficacy Scale, Coping Strategy Questionnaire, Oswestry Disability Index and European Quality of Life Questionnaire.RESULTS:The group effect of multiple mediators significantly influenced the relationships between pain intensity and mental health, fear of movement/(re)injury, functional disability and HRQOL. Pain catastrophising significantly mediated the relationship between pain intensity and mental health, control over pain significantly mediated the relationship between mental health and functional disability, self-efficacy and pain outcome expectancy significantly mediated the relationship between mental health and HRQOL, and self-efficacy also significantly mediated the relationship between pain intensity, fear of movement/(re)jury and functional disability. The model explained 28, 30, 52 and 42% of the variation in mental health, fear of movement/(re)injury, functional disability and HRQOL, respectively.CONCLUSIONS:This study highlights the strong influence and mediation roles of psychological factors on pain, mental health, fear of movement/(re)injury, disability and HRQOL in patients scheduled for lumber fusion. Future research should focus on screening as well as pre- and post-operative interventions based on these psychological factors for the potential improvement of lumber fusion surgery outcomes.Copyright 2010 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.
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| 8. |
- Alghadir, A. H., et al.
(författare)
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Effect of localised vibration on muscle strength in healthy adults : a systematic review
- 2018
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Ingår i: Physiotherapy. - : Elsevier. - 0031-9406 .- 1873-1465. ; 104:1, s. 18-24
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Forskningsöversikt (refereegranskat)abstract
- Objective To investigate the effects of local vibration on muscle strength in healthy adults.Data sources The electronic databases PubMed, CINAHL, Scopus and Web of Science were searched using a combination of the following keywords: vibration, vibration therapy, power, maximal voluntary contraction, performance, rate of force development and vibratory exercise. In addition, the Medical Subject Headings 'vibration', 'strength' and 'exercise' were used. The bibliographical search was limited to articles published in English.Study selection Trials that evaluated the effect of localised vibration on muscle strength in healthy humans were included.Data extraction Two independent evaluators verified the quality of the selected studies using the PEDro Scale and the Cochrane Collaboration's tool for assessing the risk of bias. Muscle strength was calculated for each intervention.Results In total, 29 full-text studies were assessed for eligibility. Eighteen studies did not match the inclusion criteria, and were excluded. The 11 studies included in this review had an average PEDro score of 5.36/10. Most of the studies reported significant improvements in muscle strength after the application of local vibration. There was considerable variation in the vibration training parameters and target muscle location.Conclusions The use of local vibration on the target muscle can enhance muscle strength in healthy adults. Further well-designed controlled studies are required to confirm the effect of local vibration training on muscle strength.
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| 9. |
- Anwer, Shahnawaz, et al.
(författare)
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Effect of whole body vibration training on quadriceps muscle strength in individuals with knee osteoarthritis : a systematic review and meta-analysis
- 2016
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Ingår i: Physiotherapy. - : Elsevier BV. - 0031-9406 .- 1873-1465. ; 102:2, s. 145-151
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Forskningsöversikt (refereegranskat)abstract
- Background Several studies have reported the effects of whole body vibration (WBV) training on muscle strength. This systematic review investigates the current evidence regarding the effects of WBV training on quadriceps muscle strength in individuals with knee osteoarthritis (OA). Data sources We searched PubMed, CINAHL, Embase, Scopus, PEDro, and Science citation index for research articles published prior to March 2015 using the keywords whole body vibration, vibration training, strength and vibratory exercise in combination with the Medical Subject Heading 'Osteoarthritis knee'. Study selection This meta-analysis was limited to randomized controlled trials published in the English language. Data extraction The quality of the selected studies was assessed by two independent evaluators using the PEDro scale and criteria given by the International Society of Musculoskeletal and Neuronal Interactions (ISMNI) for reporting WBV intervention studies. The risk of bias was assessed using the Cochrane collaboration's tool for domain-based evaluation. Isokinetic quadriceps muscle strength was calculated for each intervention. Results Eighteen studies were identified in the search. Of these, four studies met the inclusion criteria. Three of these four studies reached high methodological quality on the PEDro scale. Out of the four studies, only one study found significantly greater quadriceps muscle strength gains following WBV compared to the control group. Conclusions In three of the four studies that compared a control group performing the same exercise as the WBV groups, no additional effect of WBV on quadriceps muscle strength in individuals with knee OA was indicated.
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| 10. |
- Berglund, Lars, et al.
(författare)
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Which patients with persistent mechanical low back pain will respond to high load motor control training?
- 2011
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Ingår i: Physiotherapy. - 0031-9406 .- 1873-1465. ; 97:Suppl. 1, s. eS124-eS125
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of this study was to explore variables influencing success or failure of eight weeks of high load motor control training with the conventional deadlift exercise.Relevance: Researching viable exercises for rehabilitation of specific sub-groups of persistent low back pain is relevant for physical therapists in order to develop tailored treatment regimes for patients with persistent low back pain. This study contributes to this research by exploring which variables characterize the ideal patient for the conventional deadlift exercise.Participants: Thirty-five patients with persistent mechanical low back pain were recruited consecutively from two occupational health care services in Umeå, Sweden . Inclusion and exclusion criteria were designed to include patients with persistent mechanical low back pain.Methods: The study design was a prospective cohort study. The intervention consisted of eight weeks of training with the conventional deadlift exercise. To discriminate between patients with a successful or failed outcome of treatment, change in the patient-specific functional scale was used and a cut-off at 50 % improvement was set. Possible predictive variables collected at baseline included physical activity level, pain intensity (Visual Analogue Scale), activity limitation (the Roland and Morris Disability Questionnaire and the Patient-Specific Functional Scale), kinesiophobia (Tampa Scale of Kinesiophobia), specific anamnestic questions regarding patients' history and symptoms of low back pain, test of active movement control of the low back, trunk muscle endurance(Prone bridge test, Side-bridge test, Biering-Sörensen test) and lift strength (static two-hand lift test), two-point discrimination of the low back and ultrasound imaging of the mm. multifidi.Analysis: Student´s T-test for normally distributed continuous data, Mann Whitney for non-normally distributed continuous data and chi-square tests or Fisher´s Exact tests for categorical variables were used for analyses of differences between the success and the failure group.Results: No significant differences between groups were found in background, anamnestic or physical performance variables. After eight weeks of training, 15 patients (43 %) were categorized as treatment success and 20 patients (57 %) were categorized as treatment failure according to the cut-off set for the PSFS. The patients reported difficulty in performing a wide variation of activities, ranging from not being able to sit for longer than 15 minutes, to stand upright and watch their children play football games, and to not being able to run long distances, play football or perform different lifting tasks.Conclusions: We conclude that the conventional deadlift exercise may be considered a possible exercise to improve patients' activity limitations, if administered by a therapist experienced in resistance training and analyzing movement patterns. However, further research is needed to explore which variables can define patients in the successful and in the failure group, respectively.Implications: The results of this study imply that the conventional deadlift exercise can be used in treatment of patients with mechanical low back pain in order to increase activity limitation. However, it is still unclear on what grounds treatment with the conventional deadlift exercise is indicated to achieve these results.
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