| 1. |
- Bunketorp, Lina, 1975, et al.
(författare)
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Evaluating the reliability of multi-item scales: a non-parametric approach to the ordered categorical structure of data collected with the Swedish version of the Tampa Scale for Kinesiophobia and the Self-Efficacy Scale.
- 2005
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Ingår i: Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977. ; 37:5, s. 330-4
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To compare the ability of a rank-invariant non-parametric method with that of kappa statistics to evaluate the reliability of the Swedish version of the Tampa Scale for Kinesiophobia and the Self-Efficacy Scale by identifying systematic and random disagreement. The aim was, further, to compare 2 different statistical approaches to obtain a global value from multi-item scales. DESIGN: A test-retest study. SUBJECTS: A total of 46 patients with whiplash-associated disorders were enrolled and 39 (85%) completed the test-retest assessment. METHODS: Data from the multi-item scales were summarized using both sum and median scores. Paired data were evaluated with a rank-invariant statistical method to identify systematic and random disagreement. Data were also evaluated with kappa statistics. RESULTS: The non-parametric approach demonstrated that the Swedish version of the Tampa Scale for Kinesiophobia and the Self-Efficacy Scale are reliable for patients with whiplash-associated disorders. In contrast to the rank-invariant method, kappa statistics provided no information on disagreement between the 2 test occasions. Median scoring improved reliability due to lack of disagreement while the sum scores method was characterized by random individual disagreement. CONCLUSION: This study has increased understanding of the advantages and limitations of 2 non-parametric statistical methods and, it is hoped, will contribute to the development of reliable measurements.
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| 2. |
- Bunketorp, Lina, 1975, et al.
(författare)
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Neck pain and disability following motor vehicle accidents--a cohort study.
- 2005
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Ingår i: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. - : Springer Science and Business Media LLC. - 0940-6719. ; 14:1, s. 84-9
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Tidskriftsartikel (refereegranskat)abstract
- The primary aim of the study was to compare the prevalence of neck pain and disability in a group exposed to motor vehicle accidents (MVAs) with those in the general population. The secondary aim was to assess the prevalence of a past history of exposure to an MVA with sequelae of neck pain in the general population. The exposed group consisted of 121 patients with neck complaints following an MVA in 1983. The control group, consisting of 1,491 subjects, was randomly selected, with attention to the distribution of age and gender in the exposed group. A neck-pain questionnaire was mailed to the subjects. In the control group, it included enquiry about a history of exposure to an MVA with sequelae of neck pain. The Neck Disability Index (NDI) was used to assess neck-related disability. In the exposed group 108 subjects (89%) responded, and in the control group 931 (62%) did. Seventeen years after the MVA, 59 subjects (55%) reported neck pain in the exposed group, with no gender differences. In the control group 270 (29%) reported neck pain with a higher frequency among women (34%) than men (19%) (p<0.01). There was a significant difference between the exposed group and the control group regarding the occurrence of neck pain (p<0.001). In the control group 34% recalled a history of an MVA, among whom one-third reported neck pain in connection with the accident and 28% had persistent neck pain referable to the accident. The exposed group scored significantly higher on the NDI (p<0.001) and reported significantly higher neck pain intensity than did the control group (p<0.001). In conclusion, a past history of exposure to an MVA with sequelae of neck pain appears to have a substantial impact on future persistent neck pain and associated disability.
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| 3. |
- Bunketorp, Lina, 1975, et al.
(författare)
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The effectiveness of a supervised physical training model tailored to the individual needs of patients with whiplash-associated disorders--a randomized controlled trial.
- 2006
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Ingår i: Clinical rehabilitation. - : SAGE Publications. - 0269-2155 .- 1477-0873. ; 20:3, s. 201-17
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate the effects of a physical training programme which is supervised and tailored to meet the needs of patients with subacute whiplash-associated disorders. DESIGN: A randomized controlled trial with follow-up at three and nine months after randomization. SETTING: An interdisciplinary rehabilitation centre. SUBJECTS: Forty-seven patients with subacute disorders following a whiplash trauma. INTERVENTIONS: Patients were randomized to a supervised training group or a self-administered home training group. MAIN MEASURES: Primary outcome measures were the Self-Efficacy Scale, the Tampa Scale for Kinesiophobia and the Pain Disability Index. Secondary outcome measures were neck pain intensity, sensory and affective dimensions of pain, pain location and duration, muscle tenderness, grip strength, cervical mobility, sick leave and analgesic consumption. RESULTS: Forty patients (85%) completed the intervention period, and the drop-outs were followed up by intention-to-treat. The results showed that supervised training was significantly more favourable than home training, with a more rapid improvement in self-efficacy (P = 0.03), fear of movement/(re)injury (P = 0.03) and pain disability (P = 0.03) at three months. Further, supervised training significantly reduced the frequency of analgesic consumption (P = 0.03). The improvements were partly maintained at nine months, even though there was no amelioration in pain and physical disorders. Despite the favourable outcome, supervised intervention did not reduce sick leave. CONCLUSIONS: The findings indicate a treatment approach that is feasible in the rehabilitation of patients with subacute whiplash-associated disorders in the short term, but additional research is needed to extend these findings and elucidate treatment strategies that also are cost effective.
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| 4. |
- Bunketorp, Lina, 1975, et al.
(författare)
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The perception of pain and pain-related cognitions in subacute whiplash-associated disorders: its influence on prolonged disability.
- 2006
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Ingår i: Disability and rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 28:5, s. 271-9
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To clarify the relations between the sensory, affective and cognitive dimensions of pain and to analyse what influence these components have on persistent disability in patients with subacute whiplash-associated disorders (WAD). METHOD: The data was obtained from an on-going randomised controlled trial (RCT) on 47 patients. The sensory dimension of pain was evaluated with a visual analogue scale (VAS) diary and a Painometer. The affective dimension was assessed using the Painometer. The Tampa Scale for Kinesiophobia (TSK) and the Self-Efficacy Scale (SES) were used as measures of pain-related cognitions. The Pain Disability Index (PDI) was used as the outcome measure. RESULTS: Forty patients (85%) completed the trial. The correlations between the sensory and affective dimensions of pain were non-significant, which indicates that they are two independent constructs that describe various dimensions of whiplash-related pain. High pain intensity and pain affect, more widespread pain, and high fear of movement/(re)injury corresponded to low self-efficacy. Multiple regression analyses showed that self-efficacy was the most important predictor of persistent disability contributing to 42% of the variation in the PDI score. CONCLUSION: The treatment approach for patients with subacute WAD should incorporate the multidimensional nature of pain and to prevent disability special effort should be made to enhance the patient's self-efficacy beliefs.
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| 5. |
- Carlsson, Jane, 1946, et al.
(författare)
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Fysioterapi vid huvudvärk hos barn och ungdomar
- 2009
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Ingår i: Migrän och spänningshuvudvärk hos barn och tonåringar, Bo Larsson (red). - Lund : Studentlitteratur. - 9789144048277 ; , s. 113-123
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Återkommande huvudvärk är ett av de vanligaste hälsoproblemen bland barn och tonåringar. Tecken finns också som tyder på att ofta förekommande huvudvärk under senare år har ökat i förekomst i dessa åldersgrupper. Den är också kopplad till ökad förekomst av andra kroppsliga besvär och psykiska problem, nedsatt funktion i vardagen och sämre livskvalitet. Prognosen på såväl kort som lång sikt är också osäker för dessa individer. De vanligaste formerna av återkommande huvudvärk bland barn och ungdom, som inte beror på annan bakomliggande kroppslig eller psykisk sjukdom, är migrän och spänningshuvudvärk. Under senare år har kunskapen om förekomst, prognos, orsaker till sådan huvudvärk och psykosociala faktorer avsevärt ökat liksom om vilken behandling med läkemedel, psykologiska eller fysioterapeutiska metoder som kan minska besvären. Föreliggande bok är en starkt omarbetad upplaga av den första som utgavs till smärtåret 1998. Avsikten har varit att uppdatera innehållet i ljuset av senare års forskning och starka kunskapsutveckling. Då återkommande huvudvärk hos barn och ungdom är ett negligerat och starkt underbehandlat hälsoproblem är det en förhoppning att boken kan bidra till att fler får effektiv hjälp av det som finns att erbjuda i hälsovården. Förhoppningsvis ger boken också ett bättre underlag i valet av lämpliga bedömings- och behandlingsmetoder för dem som möter barn och ungdom med återkommande huvudvärk. Boken riktar sig främst till personal inom hälso- och sjukvård, men vänder sig också till tonåringar med återkommande huvudvärk, föräldrar, lärare och andra som vill öka sin kunskap och förståelse om detta angelägna hälsoproblem.
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| 6. |
- Dahlöf, Carl, 1947, et al.
(författare)
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Huvudvärk - teori och klinik
- 2006
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Under senare år har större uppmärksamhet riktats mot neurologiska sjukdomars betydelse för folkhälsan eftersom det står klart att många stora hälsoproblem är orsakade av sjukdomar i hjärnan och dess nervsystem. Huvudvärk påverkar nästan alla någon gång och utgör ett problem för cirka 40 procent av befolkningen. Huvudvärk är en av de mest vanliga orsakerna till läkarbesök såväl inom primärvården som på neurologisk mottagning och representerar en stor socioekonomisk börda för såväl individ som samhälle. Huvudvärk är ett framträdande folkhälsoproblem i alla länder och dränerar produktiviteten, sjukvårdssystemet, samhället, individen och familjen på resurser. De socioekonomiska kostnaderna för huvudvärk är mycket höga, de uppskattades härom året till 10 miljarder ECU per år. Migrän och andra huvudvärksformer rankas på tredje plats efter slaganfall och demens och står för en tredjedel av den totala kostnaden för alla neurologiska sjukdomar i Europa. Författarnas ambition med föreliggande bok har varit att ge en balanserad och skäligt omfattande beskrivning av huvudvärk, nervsmärtor i hjärnan och ansiktssmärtor hos barn och vuxna med avseende på patofysiologi, diagnostik och behandling. Vi hoppas att denna lärobok ska vara till nytta för alla de inom sjukvården som behandlar huvudvärkspatienter och vill öka sina kunskaper inom denna högst intressanta del inom neurologin.
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| 7. |
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| 8. |
- Danielsson, Louise, 1979, et al.
(författare)
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Exercise in the treatment of major depression: A systematic review grading the quality of evidence
- 2013
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Ingår i: Physiotherapy Theory and Practice. - : Informa UK Limited. - 0959-3985 .- 1532-5040. ; 29:8, s. 573-585
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To examine the quality of evidence for exercise in the treatment of major depression, comparing specific study types; aerobic exercise vs. antidepressants, aerobic exercise vs. any physical activity, and aerobic exercise as augmentation therapy to treatment as usual vs. treatment as usual. Methods: Electronic searches for randomized controlled studies, reporting on treatment outcome in adults with major depression confirmed by a clinical interview. Quality of evidence was assessed using the Grading and Recommendations Assessment, Development and Evaluation and an additional risk of bias-protocol. Results: Fourteen eligible studies were retrieved, of which nine had low risk of bias. We found moderate quality of evidence that aerobic exercise has no significant effect compared to antidepressants. We found moderate quality of evidence that aerobic exercise at a moderate to high intensity has no significant effect compared to other forms of physical activity. We found low quality of evidence that exercise as augmentation to treatment as usual has a small effect - depression scores were on average 0.44 of a standard deviation lower - compared to treatment as usual. Conclusion: In general, exercise appears to be beneficial in the treatment of depression when used in combination with medication. A significant issue that is not well addressed in previous studies is the risks associated with exercise. Further, this review indicates that aerobic exercise is not more effective than other types of physical activity, pointing to a need to further investigate active components.
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| 9. |
- Danielsson, Louise, 1979, et al.
(författare)
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Exercise or basic body awareness therapy as add-on treatment for major depression: A controlled study
- 2014
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Ingår i: Journal of Affective Disorders. - : Elsevier BV. - 0165-0327. ; 168, s. 98-106
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Tidskriftsartikel (refereegranskat)abstract
- Background: While physical exercise as adjunctive treatment for major depression has received considerable attention in recent years, the evidence is conflicting. This study evaluates the effects of two different add-on treatments: exercise and basic body awareness therapy. Methods: Randomized controlled trial with two intervention groups and one control, including 62 adults on antidepressant medication, who fulfilled criteria for current major depression as determined by the Mini International Neuropsychiatric Interview. Interventions (10 weeks) were aerobic exercise or basic body awareness therapy (BBAT), compared to a single consultation with advice on physical activity. Primary outcome was depression severity, rated by a blinded assessor using the Montgomery Asberg Rating Scale (MADRS). Secondary outcomes were global function, cardiovascular fitness, self-rated depression, anxiety and body awareness. Results: Improvements in MADRS score (mean change= -10.3, 95% CI (-13.5 to -7.1), p=0.038) and cardiovascular fitness (mean change=2.4 ml oxygen/kg/min, 95% Cl (1.5 to 3.3), p=0.017) were observed in the exercise group. Per-protocol analysis confirmed the effects of exercise, and indicated that BBAT has an effect on self-rated depression. Limitations: The small sample size and the challenge of missing data. Participants' positive expectations regarding the exercise intervention need to be considered. Conclusions: Exercise in a physical therapy setting seems to have effect on depression severity and fitness, in major depression. Our findings suggest that physical therapy can be a viable clinical strategy to inspire and guide persons with major depression to exercise. More research is needed to clarify the effects of basic body awareness therapy.
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| 10. |
- Ekman, Inger, 1952, et al.
(författare)
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Person-centered care -ready for prime time.
- 2011
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Ingår i: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 10:4, s. 248-251
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Tidskriftsartikel (refereegranskat)abstract
- Long-term diseases are today the leading cause of mortality worldwide and are estimated to be the leading cause of disability by 2020. Person-centered care (PCC) has been shown to advance concordance between care provider and patient on treatment plans, improve health outcomes and increase patient satisfaction. Yet, despite these and other documented benefits, there are a variety of significant challenges to putting PCC into clinical practice. Although care providers today broadly acknowledge PCC to be an important part of care, in our experience we must establish routines that initiate, integrate, and safeguard PCC in daily clinical practice to ensure that PCC is systematically and consistently practiced, i.e. not just when we feel we have time for it. In this paper, we propose a few simple routines to facilitate and safeguard the transition to PCC. We believe that if conscientiously and systematically applied, they will help to make PCC the focus and mainstay of care in long-term illness.
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