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Sökning: WFRF:(Landén Ludvigsson Maria)

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21.
  • Enthoven, Paul, et al. (författare)
  • VALIDITY, INTERNAL CONSISTENCY AND SELF-RATED CHANGE OF THE PATIENT ENABLEMENT INSTRUMENT IN PATIENTS WITH CHRONIC MUSCULOSKELETAL PAIN
  • 2019
  • Ingår i: Journal of Rehabilitation Medicine. - FOUNDATION REHABILITATION INFORMATION. - 1650-1977 .- 1651-2081. ; 51:8, s. 587-597
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: Patient enablement reflects patients understanding of and coping with illness. The aim of this study was to investigate the content validity, construct validity, internal consistency and selfrated change (SRC) of the Patient Enablement Instrument (PEI) in patients with whiplash-associated disorders, cervical radiculopathy and mixed chronic pain treated in different settings. Design: Psychometric analyses. Participants: Patients with disabling non-malignant chronic musculoskeletal pain. Methods: Participants answered questionnaires on disability (Neck Disability Index (NDI) or Functional Rating Index (FRI)), anxiety/depression (Hospital Anxiety and Depression Scale; HADS) and general health (EuroQol; EQ-5D). Content validity, construct validity (confirmatory factor analysis), internal consistency and cut-off for SRC were investigated for the PEI after treatment. The SRC value was the receiver operating characteristic (ROC) curve optimal cut-off point. Results: After treatment all items were completed by 516 patients (mean standard deviation (SD) age 45.1 years (SD 10.1), women 75% (n=385)). The 1-factor PEI model had approximate fit to the data. The internal consistency Cronbachs alpha was between 0.878 and 0.929 for the 3 groups. Correlations between the PEI and the NDI/FRI, HADS and EQ-5D were fair to good. The SRCROC for whiplash-associated disorders, cervical radiculopathy and mixed chronic pain groups was 5, 6 and 4 points in the PEI, respectively. Conclusion: The PEI showed fair content validity, construct validity and internal consistency. However, the scale needs further development to improve measurement of change.
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22.
  • Enthoven, Paul, et al. (författare)
  • Validity, internal consistency and self-rated change of the patient enablement instrument in patients with chronic musculoskeletal pain
  • 2019
  • Ingår i: Journal of Rehabilitation Medicine. - 1650-1977 .- 1651-2081. ; 51:8, s. 587-597
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: Patient enablement reflects patient's understanding of and coping with illness. The aim of this study was to investigate the content validity, construct validity, internal consistency and selfrated change (SRC) of the Patient Enablement Instrument (PEI) in patients with whiplash-associated disorders, cervical radiculopathy and mixed chronic pain treated in different settings.Design: Psychometric analyses. Participants: Patients with disabling non-malignant chronic musculoskeletal pain.Methods: Participants answered questionnaires on disability (Neck Disability Index (NDI) or Functional Rating Index (FRI)), anxiety/depression (Hospital Anxiety and Depression Scale; HADS) and general health (EuroQol; EQ-5D). Content validity, construct validity (confirmatory factor analysis), internal consistency and cut-off for SRC were investigated for the PEI after treatment. The SRC value was the receiver operating characteristic (ROC) curve optimal cut-off point.Results: After treatment all items were completed by 516 patients (mean standard deviation (SD) age 45.1 years (SD 10.1), women 75% (n=385)). The 1-factor PEI model had approximate fit to the data. The internal consistency Cronbach's alpha was between 0.878 and 0.929 for the 3 groups. Correlations between the PEI and the NDI/FRI, HADS and EQ-5D were fair to good. The SRCROC for whiplash-associated disorders, cervical radiculopathy and mixed chronic pain groups was 5, 6 and 4 points in the PEI, respectively.Conclusion: The PEI showed fair content validity, construct validity and internal consistency. However, the scale needs further development to improve measurement of change.
23.
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24.
  • Landén Ludvigsson, Maria, et al. (författare)
  • Evaluation of physiotherapists as primary assessors of patients with musculoskeletal disorders seeking primary health care
  • 2012
  • Ingår i: Physiotherapy. - Elsevier. - 0031-9406. ; 98:2, s. 131-137
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives To evaluate primary physiotherapist assessment and management of patients with musculoskeletal disorders in primary care, and to compare patient satisfaction with primary assessment by a physiotherapist or a general practitioner (GP). less thanbrgreater than less thanbrgreater thanDesign An observational, retrospective cohort study reviewing medical records, and a separate consecutive non-randomised study of patient satisfaction. less thanbrgreater than less thanbrgreater thanSetting Primary healthcare centre. less thanbrgreater than less thanbrgreater thanParticipants Four hundred and thirty-two patients with musculoskeletal disorders, primarily assessed by a physiotherapist. Fifty-one of these patients primarily assessed by a physiotherapist and 42 patients assessed by a GP answered a patient satisfaction questionnaire. less thanbrgreater than less thanbrgreater thanInterventions Primary assessment and management of patients with musculoskeletal disorders. less thanbrgreater than less thanbrgreater thanMain outcome measures Data from medical records within 3-month after the visit, and patient satisfaction questionnaire. less thanbrgreater than less thanbrgreater thanResults Eighty-five percent (367/432) of patients did not need to see a GP. Serious pathologies were found among the 6% (26/432) of patients who were referred to a GP by a physiotherapist, but no serious pathologies were found among the 9% (39/432) of patients who subsequently returned for a GP appointment for the same disorder. Patients assessed by a physiotherapist were more satisfied with the information received about their disorder and self-care than patients assessed by a GP. Patients also had higher confidence in the ability of physiotherapists to assess their disorder (P andlt; 0.002). less thanbrgreater than less thanbrgreater thanConclusion Physiotherapists can be considered primary assessors of patients with musculoskeletal disorders in primary care as few patients needed additional assessment by a GP, patients with confirmed serious pathologies were identified by the physiotherapists, and patients were satisfied with assessment by a physiotherapist.
25.
  • Landén Ludvigsson, Maria, et al. (författare)
  • Exercise, headache, and factors associated with headache in chronic whiplash : Analysis of a randomized clinical trial
  • 2019
  • Ingår i: Medicine (Baltimore, Md.). - 0025-7974 .- 1536-5964. ; 98:48
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Almost 40% of individuals with chronic whiplash-associated disorders (WAD) report headache after 5 years, making it one of the most common persistent symptoms besides neck pain, but randomized treatment studies are lacking. This study aimed to evaluate the effect of 3 different exercise approaches on headache in chronic WAD grades 2 and 3, and to identify potential factors associated with such headache, and whether they differ depending on 3 different aspects of such headache (current headache, maximum headache, or headache bothersomeness).METHODS: This was an analysis of a randomized clinical trial of people with chronic WAD and headache (n = 188), who were randomized to either 12 weeks of neck-specific exercise without (NSE) or with a behavioral approach (NSEB) or physical activity prescription (PPA). Data were collected at baseline and at 3, 6, and 12 months. Physical and psychosocial factors were tested for association with headache. Multivariate regression models and linear mixed models were used.RESULTS: The NSE/NSEB groups reported reduced headache both over time and compared to PPA. Up to 51% (NSE) and 61% (NSEB) reported at least 50% reduction in their headache at 12 months. The PPA group was not improved over time. Neck pain and dizziness were associated with headache regardless of aspect of headache. The only associated psychosocial factor was anxiety, which was associated with headache bothersomeness. Other factors were mainly physical, and up to 51% of the variance was explained.CONCLUSION: Headache in chronic WAD, may be reduced with neck-specific exercise with or without a behavioral approach. Chronic headache was associated with neck pain and dizziness regardless of aspect tested. Other factors associated with headache in chronic WAD were mainly physical rather than psychosocial.TRIAL REGISTRATION NUMBER: Clinical Trials.gov, no: NCT015285.
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26.
  • Landén Ludvigsson, Maria, 1967-, et al. (författare)
  • Exercise, headache, and factors associated with headache in chronic whiplash Analysis of a randomized clinical trial
  • 2019
  • Ingår i: Medicine (Baltimore, Md.). - Lippincott Williams & Wilkins. - 0025-7974 .- 1536-5964. ; 98:48
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Almost 40% of individuals with chronic whiplash-associated disorders (WAD) report headache after 5 years, making it one of the most common persistent symptoms besides neck pain, but randomized treatment studies are lacking. This study aimed to evaluate the effect of 3 different exercise approaches on headache in chronic WAD grades 2 and 3, and to identify potential factors associated with such headache, and whether they differ depending on 3 different aspects of such headache (current headache, maximum headache, or headache bothersomeness).Methods: This was an analysis of a randomized clinical trial of people with chronic WAD and headache (n = 188), who were randomized to either 12 weeks of neck-specific exercise without (NSE) or with a behavioral approach (NSEB) or physical activity prescription (PPA). Data were collected at baseline and at 3, 6, and 12 months. Physical and psychosocial factors were tested for association with headache. Multivariate regression models and linear mixed models were used.Results: The NSE/NSEB groups reported reduced headache both over time and compared to PPA. Up to 51% (NSE) and 61% (NSEB) reported at least 50% reduction in their headache at 12 months. The PPA group was not improved over time. Neck pain and dizziness were associated with headache regardless of aspect of headache. The only associated psychosocial factor was anxiety, which was associated with headache bothersomeness. Other factors were mainly physical, and up to 51% of the variance was explained.Conclusion: Headache in chronic WAD, may be reduced with neck-specific exercise with or without a behavioral approach. Chronic headache was associated with neck pain and dizziness regardless of aspect tested. Other factors associated with headache in chronic WAD were mainly physical rather than psychosocial.Trial registration number: Clinical Trials.gov, no: NCT015285
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27.
  • Landén Ludvigsson, Maria, et al. (författare)
  • Mechanical properties of the trapezius during scapular elevation in people with chronic whiplash associated disorders - A case-control ultrasound speckle tracking analysis
  • 2016
  • Ingår i: Manual Therapy. - CHURCHILL LIVINGSTONE. - 1356-689X. ; 21, s. 177-182
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Approximately 50% of people with Whiplash Associated Disorders (WAD) report longstanding symptoms. The upper trapezius is commonly painful yet its mechanical properties are not fully understood. Objectives: This study examined the deformation of different depths of the upper trapezius muscle during a scapular elevation task (shoulder shrugging) before and following loaded arm abduction. Design and Methods: A cross-sectional case-control study of 36 people (26 female and 10 male, mean age 38 (SD 11)) with chronic WAD and 36 controls, matched for age and gender. Real-time ultrasound recordings of upper trapezius were taken during both scapular elevation tasks. Post-process speckle tracking analysis was undertaken of three different sections of the upper trapezius muscle (superficial, middle, deep). Results: The WAD group had lower deformation of the superficial section of the upper trapezius compared to the control group in both concentric and eccentric phases of scapular elevation (p < 0.05) especially before the loaded arm abduction. After arm abduction, the deformation of the trapezius was reduced in both groups but only significantly in the WAD-group (p = 0.03). Within-group analysis revealed that the control group least engaged the deep section of upper trapezius during the task (p < 0.01). Conclusion: This study, measuring mechanical deformation of the upper trapezius during a scapular elevation task indicates that persons with WAD may display different patterns in engagement of the muscle sections than those in the control group. Further research is needed to replicate and understand the reasons for and implications of this possible change in motor strategy within upper trapezius. (C) 2015 Elsevier Ltd. All rights reserved.
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28.
  • Landén Ludvigsson, Maria, et al. (författare)
  • Neck-specific exercise program
  • 2015
  • Rapport (övrigt vetenskapligt)abstract
    • Description of neck specific exercise program as used by Maria Landén Ludvigsson, Anneli Peolsson, Gunnel Peterson in a randomized study comparing exercise approaches in chronic whiplash “Effects of neck-specific exercise with or without a behavioural approach in addition to prescribed physical activity for individuals with chronic whiplash-associated disorders: a prospective randomised study”
29.
  • Landén Ludvigsson, Maria, 1967- (författare)
  • Neck-specific exercise with or without a behavioural approach, or prescription of physical activity in chronic whiplash associated disorders
  • 2016
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • Background: Although 50% of those who suffer a whiplash injury still report neck pain after one year, there is a lack of knowledge about effective treatment for chronic whiplash associated disorders (WAD). Exercise is potentially useful, but the response to exercise in chronic WAD is highly variable between individuals and factors associated with good outcomes as well as the cost-effectiveness are unknown.Aim: The general aim of this thesis was to evaluate the effect on  self-reported disability/ functioning, pain and selfefficacy of three different exercise interventions in chronic WAD grade 2 and 3, and to determine the cost-effectiveness of these interventions.Material and methods: A total of 216 participants with chronic WAD took part in this randomized, assessor blinded, controlled, clinical trial. Participants were randomized to either neck-specific exercise without (NSE), or with a behavioural approach (NSEB), or prescription of physical activity (PPA) for 12 weeks. Evaluations of change scores and proportion of clinically relevantly improved participants regarding disability/functioning (Neck Disability Index (NDI)/Patient Specific Functional Scale (PSFS)), pain (Visual Analogue Scale of current neck pain (VAS-P), pain bothersomeness (VAS-B)) and Self-efficacy (Self-Efficacy Scale (SES)) were made after 3, 6, 12 and 24 months. Secondary analyses were made, regarding factors associated with clinically relevant improvements in disability, pain and regarding cost-effectiveness.Results: Disability was more improved in the NSE/NSEB groups (NDI, P=0.02) than the PPA group, which reported no improvement, at 3 and 6 months, results remaining at 12 and 24 months (p ≤ 0.02). Functioning (PSFS) was also more improved in the NSE/NSEB groups than the PPA group at 3 months, in the NSEB compared to the PPA group at 6 months, and the NSE compared to the PPA groups at 12 and 24 months. The proportion of participants reaching clinically relevant improvement regarding NDI and PSFS was also larger in the NSE/NSEB groups at all time points (P<0.05), except NDI at 3 months and PSFS at 24 months. There were no differences between groups in VAS-P, VASB or SES change scores. The proportion of participants with clinically relevant reduction in VAS-P and VAS-B was however higher (P<0.02) in the NSE/NSEB groups compared with the PPA group at 3 and 12 months. Self-efficacy was only improved in the NSE group but without any between-group differences. There were no significant differences in any outcomes between the NSE/NSEB groups.The only significant factor associated with both clinically relevant improvements in disability and neck pain both at 3 and 12 months was participation in the NSE group, with odds up to 5.3 times higher than in the PPA group. Different baseline features were associated with the improvements depending on the outcome and time point examined. From a societal perspective, NSE was the cost-effective option.Conclusion: Physiotherapist-led neck-specific exercise resulted in better outcomes than prescription of physical activity regarding disability, functioning, and pain. The observed benefits of adding a behavioural approach to neck-specific exercise were inconclusive, and NSE was the cost-effective option from a societal perspective. Factors associated with clinically relevant improvements after exercise interventions in chronic WAD differed whether disability or neck pain was the outcome, but also differed in the short and long term. Participation in the NSE group was the only factor associated with both outcomes after both 3 and 12 months.
30.
  • Landén Ludvigsson, Maria, et al. (författare)
  • The effect of three exercise approaches on health-related quality of life, and factors associated with its improvement in chronic whiplash-associated disorders analysis of a randomized controlled trial.
  • 2019
  • Ingår i: Quality of Life Research. - Springer. - 0962-9343. ; 28:2, s. 357-368
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: The aim was to evaluate whether neck-specific exercise, with (NSEB) or without (NSE) a behavioural approach, improves health-related quality of life (HRQoL) compared to physical activity prescription (PPA) in chronic whiplash-associated disorders (WAD) grades 2 and 3. A secondary aim was to identify factors associated with HRQoL and HRQoL improvement following exercise interventions.METHODS: This is a secondary analysis of a multicentre randomized clinical trial. Participants (n = 216) with chronic WAD grades 2 and 3 were randomized to 12 weeks of PPA or physiotherapist-led NSE or NSEB. The EQ-5D 3L/EQ-VAS and SF-36v2 physical (PCS) and mental (MCS) component summaries were collected together with several neck-related and psychosocial outcomes at baseline, after 3, 6 and 12 months, and were analysed with linear mixed models (all time points) and multivariate linear regressions (baseline, 6 months).RESULTS: NSE/NSEB resulted in better outcomes than PPA (EQ-VAS and SF-36 PCS, both groups, p < 0.01) but not in a higher EQ-5D score. Improvement over time was seen in EQ-5D/EQ-VAS for the NSEB group (p < 0.01), and for NSE/NSEB as measured with the PCS (p < 0.01). Factors associated with baseline HRQoL and change to 6 months in HRQoL (R2 = 0.38-0.59) were both neck-related and psychosocial (e.g. depression, work ability).CONCLUSION: Neck-specific exercise, particularly with a behavioural approach, may have a more positive impact on HRQoL than physical activity prescription in chronic WAD grades 2 and 3. HRQoL is however complex, and other factors also need to be considered. Factors associated with HRQL and improvements in HRQoL following exercise are multidimensional.TRIAL REGISTRATION NUMBER: ClinicalTrials.gov, No. NCT01528579.
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