| 2931. |
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| 2932. |
- Johansson, Henrik, 1965-, et al.
(författare)
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Breathing Exercises with Positive Expiratory Pressure after Abdominal Surgery The Current Phys : The Current Physical Therapy Practice in Sweden
- 2013
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Ingår i: Journal of Anesthesia & Clinical Research. - : OMICS Publishing Group. - 2155-6148. ; 4:6
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: In Sweden breathing exercises with Positive Expiratory Pressure (PEP) are commonly recommended for the prevention of pulmonary complications after abdominal surgery. Scientific documentation of the effects of PEP treatment is limited. The aim of this national survey was to describe the current physical therapy practice of PEP treatment after abdominal surgery in Sweden. Methods: A questionnaire was sent by e-mail to the 45 physical therapists who work with abdominal surgery patients in all seven university hospitals in Sweden. The questionnaire contained questions about the usage of PEP after abdominal surgery. Results: In total, 24 (54%) of the physical therapists answered the questionnaire. All reported using PEP as a treatment option after abdominal surgery. The most commonly used PEP device was the Blow bottle system and the PEP ventil system connected to a mouthpiece. Recommendations regarding treatment frequency and implementation varied significantly across respondents. The number of breaths per treatment varied considerably. Conclusion: All respondentsreported using PEP as a postoperative treatment on abdominal surgery wards. The treatment is most often recommended hourly during the first postoperative days. The common first-choice PEP devices were the Blow bottle system, Pep/Rmt set with mouthpiece or mask, Breathing exerciser/PEP valve system 22, and the Mini-PEP.
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| 2933. |
- Johansson, Hanna, et al.
(författare)
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Controlling the uncontrollable : Perceptions of balance in people with parkinson disease
- 2019
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Ingår i: Physical Therapy. - : Oxford University Press (OUP). - 0031-9023 .- 1538-6724. ; 99:11, s. 1501-1510
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Exercise improves balance in Parkinson disease (PD), yet the majority of people with the diagnosis are physically inactive. Insights gained from understanding how people with PD (PwPD) make sense of their symptoms and their ability to control them may inform the communication strategies and motivational approaches adopted by physical therapists. No previous study has qualitatively explored how PwPD perceive the concept of balance and the beliefs they hold concerning their ability to affect balance.OBJECTIVE: This study aimed to explore the meaning of balance for PwPD and the beliefs they hold regarding their ability to influence their balance in everyday life.DESIGN: The design is a qualitative study with an inductive approach.METHODS: In-depth interviews were conducted with 18 participants with PD (age range 46 to 83 years, Hoehn and Yahr range 1 to 4), and transcripts were analyzed using qualitative content analysis.RESULTS: Five main themes emerged from the analysis: remaining in control over the body; adapting behavior to deal with uncertainty; directing focus to stay one step ahead; resilience as a defense, and exercise beliefs and reservations. Interpretation of the underlying patterns in the main themes yielded the overarching theme of focus and determination to regain control over shifting balance.CONCLUSIONS: The concept of balance was perceived as both bodily equilibrium and mind-body interplay and was described in the context of remaining in control over one's body and everyday life. Cognitive resources were utilized in order to direct focus and attention during balance-challenging situations in a process involving internal dialogue. Even participants who did not express beliefs in their ability to affect balance through exercise used psychological resilience to counter the challenges of impaired balance.
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| 2934. |
- Johansson, Hanna, et al.
(författare)
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Exercise-induced neuroplasticity in Parkinson's disease : A metasynthesis of the literature
- 2020
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Ingår i: Neural Plasticity. - : Hindawi Limited. - 2090-5904 .- 1687-5443. ; 2020
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Forskningsöversikt (refereegranskat)abstract
- Parkinson's disease (PD) is a neurodegenerative disorder for which there is currently only symptomatic treatment. During the last decade, there has been an increased interest in investigating physical exercise as a neuroprotective mechanism in PD. Animal studies have suggested that exercise may in fact induce neuroplastic changes, but evidence in humans is still scarce. A handful of reviews have previously reported on exercise-induced neuroplasticity in humans with PD, but few have been systematic, or have mixed studies on both animals and humans, or focused on one neuroplastic outcome only. Here, we provide a systematic review and metasynthesis of the published studies on humans in this research field where we have also included different methods of evaluating neuroplasticity. Our results indicate that various forms of physical exercise may lead to changes in various markers of neuroplasticity. A narrative synthesis suggests that brain function and structure can be altered in a positive direction after an exercise period, whereas a meta-analysis on neurochemical adaptations after exercise points in disparate directions. Finally, a GRADE analysis showed that the current overall level of evidence for exercise-induced neuroplasticity in people with PD is very low. Our results demonstrate that even though the results in this area point in a positive direction, researchers need to provide studies of higher quality using more rigorous methodology.
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| 2935. |
- Johansson, Jonas, et al.
(författare)
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Increased postural sway during quiet stance as a risk factor for prospective falls in community-dwelling elderly individuals
- 2017
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Ingår i: Age and Ageing. - : Oxford University Press. - 0002-0729 .- 1468-2834. ; 46:6, s. 964-970
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Tidskriftsartikel (refereegranskat)abstract
- Objective: fall-related injuries constitute major health risks in older individuals, and these risks are projected to increase in parallel with increasing human longevity. Impaired postural stability is a potential risk factor related to falls, although the evidence is inconclusive, partly due to the lack of prospective studies. This study aimed to investigate how objective measures of postural sway predict incident falls.Design, setting and participants: this prospectively observational study included 1,877 community-dwelling individuals aged 70 years who participated in the Healthy Ageing Initiative between June 2012 and December 2015.Measurements: postural sway was measured during eyes-open (EO) and eyes-closed (EC) trials using the Wii Balance Board. Functional mobility, muscle strength, objective physical activity and cognitive performance were also measured. Participants reported incident falls 6 and 12 months after the examination.Results: during follow-up, 255 (14%) prospective fallers were identified. Division of centre of pressure (COP) sway lengths into quintiles revealed a nonlinear distribution of falls for EO trial data, but not EC trial data. After adjustment for multiple confounders, fall risk was increased by 75% for participants with COP sway lengths ≥400 mm during the EO trial (odds ratio [OR] 1.75, 95% confidence interval [CI] 1.09-2.79), and approximately doubled for sway lengths ≥920 mm during the EC trial (OR 1.90, 95% CI 1.12-3.22).Conclusion: objective measures of postural sway independently predict incident falls in older community-dwelling men and women. Further studies are needed to evaluate whether postural sway length is of interest for the prediction of incident falls in clinical settings.
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| 2936. |
- Johansson, Karin, et al.
(författare)
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A randomized study comparing manual lymph drainage with sequential pneumatic compression for treatment of postoperative arm lymphedema
- 1998
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Ingår i: Lymphology. - 0024-7766. ; 31:Jun, s. 56-64
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Tidskriftsartikel (refereegranskat)abstract
- We compared manual lymph drainage (MLD) with sequential pneumatic compression (SPC) for treatment of unilateral arm lymphedema in 28 women previously treated for breast cancer. After 2 weeks of therapy with a standard compression sleeve (Part I) with maintenance of a steady arm volume, each patient was randomly assigned to either one of two treatment regimens (Part II). MLD was performed according to the Vodder technique for 45 min/day and SPC was performed with a pressure of 40-60 mmHg for 2 hours/day. Both treatments were carried out for 2 weeks. Arm volume was measured by water displacement. Arm mobility, strength, and subjective assessments were also determined. Lymphedema was reduced by 49 ml (7% reduction) (p = 0.01) in the total group during Part I. During Part II, the MLD group decreased by 75 ml (15% reduction) (p < 0.001) and the SPC group by 28 ml (7% reduction) (p = 0.03). The total group reported a decrease of tension (p = 0.004) and heaviness (p = 0.01) during Part I. During Part II, only the MLD group reported a further decrease of tension (p = 0.01) and heaviness (p = 0.008). MLD and SPC each significantly decreased arm volume but no significant difference was detected between the two treatment methods.
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| 2937. |
- Johansson, Karin, et al.
(författare)
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Arm Lymphoedema, Shoulder Mobility and Muscle Strength after Breast Cancer Treatment ? A Prospective 2-year Study
- 2001
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Ingår i: Advances in Physiotherapy. - : Informa UK Limited. - 1651-1948 .- 1403-8196. ; 3:2, s. 55-66
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Tidskriftsartikel (refereegranskat)abstract
- Arm lymphoedema and impaired shoulder mobility and muscle strength are well known side-effects to breast cancer treatment. The aim of this prospective study was to follow closely and describe the arm volume, range of motion of the shoulder and muscle strength of the shoulder and hand after breast cancer treatment in order to form a basis for further studies in the area including physiotherapy intervention. Sixty-one women treated for breast cancer with axillary dissection, with or without postoperative radiotherapy, were examined preoperatively and monthly until 6 months after the operation with 1- and 2-year follow-ups. 1 month after the operation, results revealed decrease in range of motion, after 2 months increase in arm volume difference and after the first 6 months decrease in muscle strength of shoulder adductors, flexors and internal rotators. A greater increase in arm volume difference and decrease in shoulder abduction, flexion and external rotation were noted throughout the follow-up period for the group receiving radiotherapy to the axdefinition illa area. Postoperative physiotherapeutic management needs to pay special attention to early impairments after breast cancer treatment particularly to the group receiving radiotherapy to the axilla area. Physiotherapeutic treatment might be introduced during the period when radiotherapy is being given.
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| 2938. |
- Johansson, Karin, et al.
(författare)
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Effects of compression bandaging with or without manual lymph drainage treatment in patients with postoperative arm lymphedema
- 1999
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Ingår i: Lymphology. - 0024-7766. ; 32:Sep, s. 103-110
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Tidskriftsartikel (refereegranskat)abstract
- We examined the effects of low stretch compression bandaging (CB) alone or in combination with manual lymph drainage (MLD) in 38 female patients with arm lymphedema after treatment for breast cancer. After CB therapy for 2 weeks (Part I), the patients were allocated to either CB or CB + MLD for 1 week (Part II). Arm volume and subjective assessments of pain, heaviness and tension were measured. The mean lymphedema volume reduction for the total group during Part I was 188 ml (p < 0.001), a mean reduction of 26% (p < 0.001). During Part II the volume reduction in the CB + MLD group was 47 ml (p < 0.001) and in CB group 20 ml. These differences were not significant (p = 0.07). A percentage reduction of 11% (p < 0.001) in the CB + MLD group and 4% in the CB group was significantly different (p = 0.04). In both the CB and the CB + MLD group, a decrease of feeling of heaviness (p < 0.006 and p < 0.001, respectively) and tension (p < 0.001 for both) in the arm was found, but only the CB + MLD group showed decreased pain (p < 0.03). Low stretch compression bandaging is an effective treatment giving volume reduction of slight or moderate arm lymphedema in women treated for breast cancer. Manual lymph drainage adds a positive effect
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| 2939. |
- Johansson, Karin, et al.
(författare)
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Factors associated with the development of arm lymphedema following breast cancer treatment: a match pair case-control study.
- 2002
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Ingår i: Lymphology. - 0024-7766. ; 35:2, s. 59-71
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Tidskriftsartikel (refereegranskat)abstract
- We examinedfactors that may influence the development of arm lymphedema following breast cancer treatment including the specific mode of therapy, patient occupation and life style. Medical record data and a questionnaire were used to collect information after surgery concerning such issues as wound seroma, infection, adjuvant treatment, vessel string (phlebitis), body mass index, smoking habits and stress. Occupational workload was assessed after surgery whereas housework, exercise, hobbies and body weight were assessed both before and after surgery. Seventy-one breast cancer treated women with arm lymphedema lasting more than 6 months but less than 2 years were matched to women similarly treatedfor breast cancer but without arm lymphedema (controls). The matching factors included axillary node status, time after axillary dissection, and age. In the lymphedema group, there was a higher body mass index at time of surgery (p=0.03) as well at time of study (p=0.04). No differences were found in occupational workload (n=38) or housework, but the lymphedema group reduced their spare time activities including exercise after surgery compared with the controls (p<0.01). In conclusion, women treated for breast cancer with axillary node dissection with or without adjuvant radiotherapy could maintain their level of physical activity and occupational workload after treatment without an added risk of developing arm lymphedema. On the other hand, a higher BMI before and after operation increases the lymphedema risk.
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| 2940. |
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