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  • Lund, Maria Larsson, et al. (författare)
  • Perceived participation in life situations in persons with late effects of polio
  • 2008
  • Ingår i: Journal of Rehabilitation Medicine. - Uppsala : Taylor & Francis. - 1651-2081 .- 1650-1977. ; 40:8, s. 659-664
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To investigate how persons with late effects of polio perceive their participation and problems with participation in life situations and to determine the association between perceived problems with participation and sex, age, marital status, use of mobility aids and access to instrumental support. Design: Cross-sectional. Subjects: A total of 160 persons with prior polio 6-30 months after an individualized, goal-oriented, comprehensive inter-disciplinary rehabilitation programme. Methods: All subjects answered the Swedish version of the Impact on Participation and Autonomy Questionnaire. Results: A majority of the respondents perceived their participation as sufficient in most activities and 65% of the respondents perceived no severe problems with participation. The remaining 35% perceived 1-6 severe problems with participation. All 5 domains of participation were positively correlated with the 9 items for problem experience. Most restrictions in participation were reported in the domains of Family role, Autonomy outdoors, and Work and education. Insufficient instrumental support was most strongly associated with the perception of severe problems with participation. Conclusion: Rehabilitation programmes for persons with late effects of polio need to focus on areas of participation that are perceived as a problem by these persons and to promote access to a supportive environment to enhance their participation.
  • Mazzoni, Anne-Sophie, et al. (författare)
  • Exercise Adherence and Effect of Self-Regulatory Behavior Change Techniques in Patients Undergoing Curative Cancer Treatment : Secondary Analysis from the Phys-Can Randomized Controlled Trial
  • 2020
  • Ingår i: ; 19
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: Adherence to exercise interventions in patients with cancer is often poorly described. Further, it is unclear if self-regulatory behavior change techniques (BCTs) can improve exercise adherence in cancer populations. We aimed to (1) describe exercise adherence in terms of frequency, intensity, time, type (FITT-principles) and dropouts, and (2) determine the effect of specific self-regulatory BCTs on exercise adherence in patients participating in an exercise intervention during curative cancer treatment. Methods: This study was a secondary analysis using data from a Swedish multicentre RCT. In a 2x2 factorial design, 577 participants recently diagnosed with curable breast, colorectal or prostate cancer were randomized to 6 months of high (HI) or low-to-moderate intensity (LMI) exercise,withorwithoutself-regulatory BCTs (e.g., goal-setting and self-monitoring). The exercise program included supervised group-based resistance training and home-based endurance training. Exercise adherence (performed training/prescribed training) was assessed using attendance records, training logs and heart rate monitors, and is presented descriptively. Linear regression and logistic regression were used to assess the effect of self-regulatory BCTs on each FITT-principle and dropout rates, according to intention-to-treat. Results: For resistance training (groupswithvswithoutself-regulatory BCTs), participants attended on average 52% vs 53% of prescribed sessions, performed 79% vs 76% of prescribed intensity, and 80% vs 77% of prescribed time. They adhered to exercise type in 71% vs 68% of attended sessions. For endurance training (groupswithvswithoutself-regulatory BCTs), participants performed on average 47% vs 51% of prescribed sessions, 57% vs 62% of prescribed intensity, and 71% vs 72% of prescribed time. They adhered to exercise type in 79% vs 78% of performed sessions. Dropout rates (groupswithvswithoutself-regulatory BCTs) were 29% vs 28%. The regression analysis revealed no effect of the self-regulatory BCTs on exercise adherence. Conclusion: An exercise adherence rate >= 50% for each FITT-principle and dropout rates at similar to 30% can be expected among patients taking part in long-term exercise interventions, combining resistance and endurance training during curative cancer treatment. Our results indicate that self-regulatory BCTs do not improve exercise adherence in interventions that provide evidence-based support to all participants (e.g., supervised group sessions).
  • Michaelson, Peter, et al. (författare)
  • High load lifting exercise and low load motor control exercises as interventions for patients with mechanical low back pain : a randomized controlled trial with 24-month follow-up
  • 2016
  • Ingår i: Journal of Rehabilitation Medicine. - 1650-1977 .- 1651-2081. ; 48:5, s. 456-463
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: The aim of this study was to compare the effects of a high load lifting exercise with low load motor control exercises on pain intensity, disability and health-related quality of life for patients with mechanical low back pain. Design: A randomized controlled trial. Subjects: Patients with mechanical low back pain as their dominating pain mechanism. Methods: The intervention programme consisted of a high load lifting exercise, while the control group received low load motor control exercises over 8 weeks (12 sessions) with pain education included in both intervention arms. The primary outcome was pain intensity and disability, and the secondary outcome was health-related quality of life. Results: Each intervention arm included 35 participants, analysed following 2-, 12- and 24-month follow-up. There was no significant difference between the high load lifting and low load motor control interventions for the primary or secondary outcome measures. Between 50% and 80% of participants reported a decrease in perceived pain intensity and disability for both short-and long-term follow-up. Conclusion: No difference was observed between the high low load lifting and low load motor control interventions. Both interventions included retraining of movement patterns and pain education, which might explain the positive results over time.
  • Naili, Josefine, et al. (författare)
  • The impact of symptomatic knee osteoarthritis on gait pattern and its association with performance-based measures and patient-reported outcomes
  • 2017
  • Ingår i: Knee (Oxford). - : Elsevier. - 0968-0160 .- 1873-5800. ; 24:3, s. 536-546
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Limited knowledge exists regarding the impact of symptomatic knee osteoarthritis (OA) on the overall gait pattern; and whether gait deviations are associated with performance based measures (PBMs) and patient-reported outcomes (PROs). This cross-sectional study evaluated overall gait patterns in patients with knee OA using the Gait Deviation Index for kinematics (GDI) and kinetics (GDI-kinetic), and explored associations between gait deviations, PBMs, and PROs. Methods: Forty patients with knee OA and 25 age and gender-matched controls underwent three-dimensional gait analysis. Participants performed the Timed Up and Go (TUG), Five Times Sit-to-Stand (5STS), and Single Limb Mini Squat (SLMS) tests and completed a disease specific PRO. Associations between gait deviations, PBMs, and PROs were assessed by Pearson's correlation and multiple linear regression. Results: Patients with OA demonstrated significantly lower GDI and GDI-kinetic scores of the OA and contralateral limbs compared to controls; with GDI-kinetic scores on the contralateral limb more impacted than the OA limb. On the contralateral limb, GDI-kinetic score significantly correlated with TUG (r = -0.42) and 5STS (r = -033), while on the OA limb with TUG (r = -0.68), 5STS (r = -0.38), SLMS (r = -0.38), activities of daily living (r = -0.35) and Knee-related Quality of Life (r = -035). No significant associations existed between kinematic GDI scores, PBMs and PROs. Conclusion: The overall gait pattern, as represented by GDI and GDI-kinetic scores, in patients with symptomatic knee OA is affected both on the painful OA limb and the contralateral limb. The GDI and GDI-kinetic scores provide different information regarding function that is not revealed by PBMs or PROs.
  • PÉREZ-SUÁREZ, I, et al. (författare)
  • 2014
  • Konferensbidrag (refereegranskat)abstract
    • IntroductionLeptin signals in skeletal muscles through pathways which share some steps with the insulin and IGF1. We have recently shown that LEPR (OBR-170) is increased in the dominant arm of tennis players 1 and is reduced in deltoid and vastus lateralis (VL) of obese compared to control subjects 2. The aim of this study was to determine whether exercise up-regulates the protein abundance and phosphorylation status of the different molecular variations of the LEPR (OBR-170, 128, 98A or 98B) in human skeletal muscle. We hypothesized that exercise will up-regulate leptin signaling in skeletal muscle. MethodsFifteen overweight men underwent three experimental phases: pre-test (PRE); caloric restriction (3.2 Kcal/kg body Wt/d) + exercise (45min unilateral arm cranking/d + 8h walking/d) for 4 days (CRE); and control isoenergetic diet + reduced exercise for 3 days (CD). During CRE, the diet consisted solely of whey protein (PRO, n=8) or sucrose (SU, n=7) (0.8 g/kg body Wt/d). Muscle biopsies (135 biopsies in all) were obtained from the trained and untrained deltoid, and VL, after 12h fast at PRE, and end of CRE and CD. The molecular variants of LEPR (OBR-170, 128, 98A and 98B) were determined by western blot and LEPR mRNA by PCR.  ResultsSerum leptin was reduced by ~60% following CRE and CD (P<0.05). LEPRs were more abundant in arm than leg muscles. LEPR mRNA was increased in exercised muscles after CRE. OBR-170 was reduced after CRE and CD only in the control arm (P<0.05). OBR-128 was increased after CD in exercised extremities (P<0.05). OBR-98A was increased after CRE in trained arm, and after CD in legs (P<0.05). However, OBR-98B was increased after CRE and CD in both arms and exercised extremities (P<0.05), being these effects more pronounced in the PRO group (P<0.05). After CD, LEPR mRNA returned to basal levels while LEPR expression was increased in all muscles (P<0.05). The fraction of LEPR activated (Tyr1141 phosphorylated) was reduced in arms but not in leg muscles. LEPR phosphorylation was correlated with JAK2 (upstream) and STAT3 (downstream) phosphorylation (r=0.67-0.89, P<0.05). DiscussionCaloric restriction seems to reduce the abundance of LEPR, but this effect varies depending on specific molecular variants of the receptor. The reduction of LEPR is partly counteracted by exercise, likely contributing to increase muscle leptin sensitivity. Whey protein ingestion facilitates these effects. Resuming normal food ingestion after a period of severe energy deficit is accompanied by increased expression LEPR in skeletal muscle. 
  • Pietilä Holmner, Elisabeth, et al. (författare)
  • The effects of interdisciplinary team assessment and a rehabilitation program for patients with chronic pain
  • 2013
  • Ingår i: American Journal of Physical Medicine & Rehabilitation. - : Lippincott Williams & Wilkins. - 0894-9115 .- 1537-7385. ; 92:1, s. 77-83
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: The aim of this study was to evaluate the effects of interdisciplinary team assessment and a 4-wk rehabilitation program in chronic pain patients.Design: This was a longitudinal cohort study evaluating interdisciplinary pain rehabilitation measures in a specialist care setting. A total of 93 women (42.2 +/- 9.5 yrs) with chronic musculoskeletal pain (median pain duration, 8 yrs) were evaluated at assessment and at the start and end of the rehabilitation program. Pain intensity measured with a visual analog scale, pain dimensions measured with the Multidimensional Pain Inventory, and anxiety and depression measured with the Hospital Anxiety and Depression Scale were registered.Results: The participants exhibited significantly improved results of pain and pain-related measures. The results were seen both after the short-term intervention in the form of the interdisciplinary assessment and after the 4-wk rehabilitation program. The improvements seen after the assessment were not related to specific interventions, such as change of medication, and therefore seem to be a result of the interdisciplinary assessment concept as such.Conclusions: Both interdisciplinary assessment and rehabilitation program seem to be effective in chronic pain rehabilitation, at least for women. Further studies are needed to investigate potential sex differences, as well as content and duration for optimal pain rehabilitation programs.
  • Sjödin, Anna, et al. (författare)
  • Motionärer och elit har samma koll på kosten
  • 2013
  • Ingår i: Svensk Idrottsforskning. - : Centrum för Idrottsforskning. - 1103-4629. ; :4, s. 35-37
  • Tidskriftsartikel (populärvet., debatt m.m.)abstract
    • Elitspelare i innebandyns superliga har inte bättre kunskap än motionärer om vilka kostrekommendationer som gäller vid träning. Lägst kunskap har spelarna om kostens betydelse för uppladdningen. För att kunna prestera maximalt är det viktigt att kunna anpassa energi-, närings- och vätskeintag till sin idrott.
  • Sjögren, Per, et al. (författare)
  • Stand up for health-avoiding sedentary behaviour might lengthen your telomeres : secondary outcomes from a physical activity RCT in older people
  • 2014
  • Ingår i: British Journal of Sports Medicine. - : BMJ Publishing Group. - 0306-3674 .- 1473-0480. ; 48:19, s. 1407-1409
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Telomere length has been associated with a healthy lifestyle and longevity. However, the effect of increased physical activity on telomere length is still unknown. Therefore, the aim was to study the relationship between changes in physical activity level and sedentary behaviour and changes in telomere length. Methods Telomere length was measured in blood cells 6 months apart in 49, 68-year-old, sedentary, overweight individuals taking part in a randomised controlled physical activity intervention trial. The intervention group received individualised physical activity on prescription. Physical activity was measured with a 7-day diary, questionnaires and a pedometer. Sitting time was measured with the short version of The International Physical Activity Questionnaire. Results Time spent exercising as well as steps per day increased significantly in the intervention group. Reported sitting time decreased in both groups. No significant associations between changes in steps per day and changes in telomere length were noted. In the intervention group, there was a negative correlation between changes in time spent exercising and changes in telomere length (rho=-0.39, p=0.07). On the other hand, in the intervention group, telomere lengthening was significantly associated with reduced sitting time (rho=-0.68, p=0.02). Conclusions Reduced sitting time was associated with telomere lengthening in blood cells in sedentary, overweight 68-year-old individuals participating in a 6-month physical activity intervention trial.
  • Sköld, Camilla, et al. (författare)
  • Effects of functional electrical stimulation training for six months on body composition and spasticity in motor complete tetraplegic spinal cord-injured individuals.
  • 2002
  • Ingår i: Journal of Rehabilitation Medicine. - : Taylor & Francis. - 1650-1977 .- 1651-2081. ; 34:1, s. 25-32
  • Tidskriftsartikel (refereegranskat)abstract
    • The effect of functional electrical stimulation (FES) training on body composition, assessed by computed tomography, and the effect of spasticity, assessed by both objective and subjective measures, are evaluated. Fifteen motor-complete spinal-cord-injured men participated in the study. Eight of the 15 subjects undertook FES cycling 3 times weekly for 6 months. Whole body computed tomography scans evaluated changes in body composition. Simultaneous Modified Ashworth Scale and electromyography (EMG) measurements, resistive torque (Kin-Com) and EMG measurements, and self-ratings with Visual Analogue Scale during four consecutive days were used to evaluate changes in spasticity. Lower extremity muscle volume increased by an average of 1300 cm3 (p < 0.001) in the training group compared to the control group, who experienced no change. Otherwise no changes in body composition were seen. Significant correlations (Spearman) were found between individual EMG activity recordings and movement-provoked Modified Ashworth Scale ratings in 26% of the test situations, irrespective of group and time. The objective and subjective evaluation of movement-provoked passive (viscoelastic) and active (spasticity-related) resistance remained unchanged.
  • Stenberg, Gunilla, et al. (författare)
  • Patterns of reported problems in women and men with back and neck pain : similarities and differences
  • 2014
  • Ingår i: Journal of Rehabilitation Medicine. - 1650-1977 .- 1651-2081. ; 46:7, s. 668-675
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To examine similarities and differences in problem areas reported by women and men who seek physiotherapy for back or neck pain. Methods: Principal component analysis (PCA) was used to analyse questionnaire data including demographics, pain, domestic work, stress, health status, physical disability, psychosocial and physical workload, kinesiophobia and self-efficacy. Most of the questions were recruited from a number of scales, e.g. EuroQol (EQ-5D), Neck Disability Index (NDI), Oswestry Disability Questionnaire (ODQ), Tampa Scale for Kinesiophobia, and Functional-Efficacy-Scale. Results: A total of 118 patients (84 women, 34 men) completed the questionnaire. Men and women scored similarly on physical disability, functional self-efficacy and kinesiophobia, but women scored higher on stress reactions and pain intensity. PCA showed that questions about physical disability and functional self-efficacy comprised the first component and explained most of the variance in this patient group. Questions about stress and social support at work constituted the second component. Questions about domestic workload and pain comprised the third component. Gender differences were found in the second and third components. Conclusion: In general, women and men answered questions similarly, but there were differences: more women reported stress, pain and low support at work and more men reported a lower domestic workload.
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