| 1. |
- Bäcklund, Catharina, 1971-
(author)
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Promoting physical activity among overweight and obese children : Effects of a family-based lifestyle intervention on physical activity and metabolic markers
- 2010
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Doctoral thesis (other academic/artistic)abstract
- Background Overweight and obesity in childhood is associated with physical, psychological and social consequences. Physical inactivity is regarded as one of the main factors that have contributed to the increase in childhood obesity through out the world. Overweight and obesity as well as physical activity level are shown to track from childhood to adolescence and adulthood, thereby influencing not only the current health status but also long-term health. The general purpose of this thesis was to evaluate the effect of a 2-year family-based lifestyle intervention on physical activity and metabolic health among children with overweight and obesity. Methods Children with overweight or obesity living in northern Sweden were recruited to the study. In total 105 children, mean age 10.5 years (SD±1.09), were randomized into either an intervention or a control group. The intervention group was offered as a 2-year family-based lifestyle intervention; the 1st year consisted of 14 group sessions and during the 2nd year the intervention was web-based. The control group did not participate in any intervention sessions, but performed all measurements. Physical activity was measured in all children using SenseWear Pro2 Armband (SWA) during 4 consecutive days before, in the middle and after the intervention, data regarding anthropometrics and blood values were collected in the same periods. Twenty-two of the children wore SWA during 14 days before the intervention in order to validate energy expenditure (EE) estimated by SWA against EE measured with double labelled water. Results The SWA, together with software version 5.1, proved to be a valid device to accurately estimate EE at group level of overweight and obese children. There were no statistically significant differences between the groups neither before nor after the intervention regarding physical activity and screen-time. All children significantly decreased their time being active ≥3 METs during the study period. After the study period, significantly fewer in the control group achieved the national physical activity recommendation, and they had significantly increased their screen-time. However, these changes were not seen within the intervention group. The intervention group had a significantly lower apolipoprotein B/A1 compared to the control group at 1-year measurement; no other significant differences were found regarding metabolic markers. No statistical difference was found between the groups regarding body mass index after the 2-year study period. Conclusion Even though a comprehensive program, the 2-year family-based lifestyle intervention had limited effects on physical activity and metabolic health in overweight and obese children. SWA is a device that can be used in future studies to measure energy expenditure among free-living overweight or obese children.
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| 2. |
- Oldfors Engström, Lena, 1948-
(author)
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Att förstå patienters bristande deltagande i individualiserat rehabiliteringsprogram
- 2002
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Licentiate thesis (other academic/artistic)abstract
- The aim of this investigation was to elucidate and describe those patients who had discontinued their participation and/or paticipated infrequently in physiotherapy treatment based on their own activity and responsibility. The ambition was to understand the phenomenon of compliance/adherence from various perspectives in behavioural as well as social science.In study I the phenomenon compliance/adherence was studied in relation to Health Locus of Control and Health Belief variables. This study was based on a questionnaire that was answered by all patients before beginning of treatment. Questions concerning the patients´conceptions about both health locus of control and health beliefs were the focus.The definitions of compliance/adherence were completed treatment period and exercise frequency, respectively. Those patients who completed the treatment were also studied regarded exercise frequency.The results of study I showed that those who discontinued their treatment reported a higher perceived threat from their health condition (higher level of dysfunction (higher pain intensity) and a higher perceived severity of their health condition (higher level of dysfunction, worse general health) than those who completed treatment. The results also showed that those who exercised once a week or less often valued the significance of the caring situation as lower (HLC), perceived a higher threat from their health condition (higher pain intensity), a higher severity of their health condition (higher level of dysfunction, worse general health, greater distrution of impairment), more barriers to treatment (lower expectations), and had certain differences in demographic variables (younger individuals, more women) than those who exercised more often (HB).Study II investigated patients´descriptions of their reasons for discontinuing the treatment, whether those reasons varied, and if so how they varied. Sixteen patients who had discontinued their treatment were interviewed with open-ended questions. The inteviews began with a question about the background to the physiotherapy treatment. There were questions concerning carrying out the treatment as well as concerning what they thought about their impairment. The patients were also asked about their priotities in daily life, as these wre presumed to be anobstacle to the treatment over a shorter or longer period of time. The third domain concerned how they experiebced the patient/physiotherapist relationship. The interviews were anlysed qualitatively.Analysis of study II resulted in four different descriptions of reasons for treatment discontinuation. A) It was about time to end treatment and continue on alone. B) The treatment was not the most important activity to spend time on. C) An agreement with the physiothreapist to discontinue treatment due to lack of effect. D) No viewpoint as to why they discontinued the treatment. In further analysis of category D, this group appeared to experience varoius forms of powerlessness. They felt their trustworthiness was often questioned. They experienced frustration in their life situation as others made the important descisions and they themselves had little to say.They defended themselves by talking about their own conceptions of the reasons for their impairment and what should be done about them. In comparing category D with categories A, B, C it was found that those in the latter three categories experienced varying degrees of control in different situations, whereas those in category D did not experience a feeling of control.Conclusion: The concept of compliance in physiotherapy is ambiguous. The concept involves one part defining what will concern the other part. It is clear that the physiotherapist and the patient do not always agree about the aim of the treatment. Instead, we should develop the concept of concordance in encounters with the patients and abandon the reasoning of compliance.
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| 3. |
- Bäcklund, Catharina, 1971-, et al.
(author)
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Effect of a 1-year lifestyle intervention on physical activity in overweight and obese children
- 2011
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In: Advances in Physiotherapy. - : Informa UK Limited. - 1403-8196 .- 1651-1948. ; 13:3, s. 87-96
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Journal article (peer-reviewed)abstract
- This study evaluated the effect of a family-based multifactor intervention programme on physical activity among overweight or obese children. Children (n = 105, mean age 10.6 ± 1.07 years) with overweight or obesity were randomized into an intervention or control group. The intervention group participated in a 1-year programme aiming at lifestyle changes regarding food habits and physical activity. All children's physical activity was measured using SenseWear Armband at baseline and after 1 year. The children in both groups had a physical activity level (PAL) of 1.67 (0.27) at baseline. When comparing the intervention and control groups, no significant differences were found in physical activity outcome variables after 1 year of intervention. Contrarily to the hypotheses, both groups decreased their energy expenditure and time spent at >3 MET, and there was no change in steps and screen time after 1 year. Despite extensive efforts, the intervention showed no significant positive effect on overweight and obese children's PAL. Further studies are needed to obtain more knowledge on how to maintain or increase the PAL successfully among overweight and obese children.Read More: http://informahealthcare.com/doi/abs/10.3109/14038196.2011.566353
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| 4. |
- Bäcklund, Catharina, 1971-, et al.
(author)
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Effects on physical activity of a 2-year lifestyle intervention in overweight and obese children
- 2011
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In: Advances in Physiotherapy. - : Informa UK Limited. - 1403-8196 .- 1651-1948. ; 13:3, s. 97-109
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Journal article (peer-reviewed)abstract
- The aim was to examine the effect on physical activity of a 2-year family-based lifestyle intervention among overweight and obese Swedish children 8–12 years of age; 105 children were randomized to either intervention or control group. The intervention group was offered a 2-year lifestyle programme. Physical activity was measured using SenseWear Pro2 Armband during 4 consecutive days before and after the intervention. When comparing the intervention and control groups, no significant differences were found in the physical activity outcome variables after 2 years of intervention. However, the intervention group decreased their number of steps per day by 13%, p = 0.003 but had an unchanged screen time, whereas the control group had an unchanged number of steps but increased their screen time by 15%, p = 0.02, from baseline to 2-year measurement. There were no significant change in the intervention group, whereas significantly fewer children in the control group achieved the physical activity recommendations at 2-year measurement (88%) compared with at baseline (98%), p = 0.007. Future interventions regarding physical activity among overweight and obese children are of great importance even though the present one showed limited effects. In the continuing work, a greater effect may be received with an extended and more intense intervention regarding physical activity, focusing on reducing sedentary time rather than increasing the physical activity level.Read More: http://informahealthcare.com/doi/abs/10.3109/14038196.2011.562540
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| 5. |
- Moshi, Haleluya, 1978-, et al.
(author)
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Traumatic spinal cord injury in the north-east Tanzania : describing incidence, etiology and clinical outcomes retrospectively
- 2017
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In: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 10:1
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Journal article (peer-reviewed)abstract
- Background: Causes, magnitude and consequences of traumatic spinal cord injury depend largely on geography, infrastructure, socioeconomic and cultural activities of a given region. There is a scarcity of literature on profile of traumatic spinal cord injury to inform prevention and rehabilitation of this health condition in African rural settings, particularly Tanzania. Objective: To describe the incidence, etiology and clinical outcomes of traumatic spinal cord injury and issues related to retrospective study in underdeveloped setting.Methods: Records for patients with traumatic spinal cord injury for five consecutive years (2010–2014) were obtained retrospectively from the admission wards and health records archives of the Kilimanjaro Christian Medical Center. Sociodemographic, cause, complications and patients’ condition on discharge were recorded and analyzed descriptively.Results: The admission books in the wards registered 288 new traumatic spinal cord injury cases from January 2010 to December 2014. Of the 288 cases registered in the books, 224 were males and 64 females with mean age 39.1(39.1 ± 16.3) years and the majority of individuals 196(68.1%) were aged between 16 and 45 years. A search of the hospital archives provided 213 full patient records in which the leading cause of injury was falls 104(48.8%) followed by road traffic accidents 73(34.3%). Cervical 81(39.9%) and lumbar 71(34.74%) spinal levels were the most affected. The annual incidence for the Kilimanjaro region (population 1,640,087) was estimated at more than 26 persons per million population. The most docu- mented complications were pressure ulcers 42(19.7%), respiratory complications 32(15.0%) and multiple complications 28(13.1%). The mean length of hospital stay was 64.2 ± 54.3 days and the mortality rate was 24.4%.Conclusion: Prevention of traumatic spinal cord injury in North-east Tanzania should consider falls (particularly from height) as the leading cause, targeting male teenagers and young adults. Pressure ulcers, respiratory complications, in-hospital mortality and availability of wheelchairs should be addressed.
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| 6. |
- Arnadottir, Solveig, 1968-
(author)
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Physical activity, participation and self-rated health among older community-dwelling Icelanders : a population-based study
- 2010
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Doctoral thesis (other academic/artistic)abstract
- Background: The main objective of this study was to investigate older people’s physical activity, their participation in various life situations, and their perceptions of their own health. This included an exploration of potential influences of urban versus rural residency on these outcomes, an evaluation of the measurement properties of a balance confidence scale, and an examination of the proposed usefulness of the International Classification of Functioning, Disability and Health (ICF) as a conceptual framework to facilitate analysis and understanding of selected outcomes.Methods: The study design was cross-sectional, population-based, with random selection from the national register of one urban and two rural municipalities in Northern Iceland. There were 186 participants, all community-dwelling, aged 65 to 88 years (mean = 73.8), and 48% of the group were women. The participation rate was 79%. Data was collected in 2004, in face-to-face interviews and through various standardized assessments. The main outcomes were total physical activity; leisure-time, household, and work-related physical activity; participation frequency and perceived participation restrictions; and self-rated health. Other assessments represented aspects of the ICF body functions, activities, environmental factors and personal factors. Moreover, Rasch analysis methods were applied to examine and modify the Activities-specific Balance Confidence (ABC) scale and the ICF used as a conceptual framework throughout the study.Results: The total physical activity score was the same for urban and rural people and the largest proportion of the total physical activity behavior was derived from the household domain. Rural females received the highest scores of all in household physical activity and rural males were more physically active than the others in the work-related domain. However, leisure-time physical activity was more common in urban than rural communities. A physically active lifestyle, urban living, a higher level of cognition, younger age, and fewer depressive symptoms were all associated with more frequent participation. Rural living and depressive symptoms were associated with perceived participation restrictions. Moreover, perceived participation restrictions were associated with not being employed and limitations in advanced lower extremity capacity. Both fewer depressive symptoms and advanced lower extremity capacity also increased the likelihood of better self-rated health, as did capacity in upper extremities, older age, and household physical activity. Rasch rating scale analysis indicated a need to modify the ABC to improve its psychometric properties. The modified ABC was then used to measure balance confidence which, however, was found not to play a major role in explaining participation or self-rated health. Finally, the ICF was useful as a conceptual framework for mapping various components of functioning and health and to facilitate analyses of their relationships.Conclusions: The results highlighted the commonalities and differences in factors associated with participation frequency, perceived participation restrictions, and self-rated health in old age. Some of these factors, such as advanced lower extremity capacity, depressive symptoms, and physical activity pattern should be of particular interest for geriatric physical therapy due to their potential for interventions. While the associations between depressive symptoms, participation, and self-rated health are well known, research is needed on the effects of advanced lower extremity capacity on participation and self-rated health in old age. The environment (urban versus rural) also presented itself as an important contextual variable to be aware of when working with older people’s participation and physically active life-style. Greater emphasis should be placed on using Rasch measurement methods for improving the availability of quality scientific measures to evaluate various aspects of functioning and health among older adults. Finally, a coordinated implementation of a conceptual framework such as ICF may further advance interdisciplinary and international studies on aging, functioning, and health.
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| 7. |
- Blomqvist, Sven, et al.
(author)
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Test-retest reliability, smallest real difference and concurrent validity of six different balance tests on young people with mild to moderate intellectual disability
- 2012
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In: Physiotherapy. - : Elsevier BV. - 0031-9406 .- 1873-1465. ; 98:4, s. 313-319
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Journal article (peer-reviewed)abstract
- Objectives Some studies have reported that people with intellectual disability may have reduced balance ability compared with the population in general. However, none of these studies involved adolescents, and the reliability and validity of balance tests in this population are not known. The purpose of this study was to examine the reliability of six different balance tests and to investigate their concurrent validity.Design Test-retest reliability assessment.Settings All subjects were recruited from a special school for people with intellectual disability in Bollnas, Sweden.Participants Eighty-nine adolescents (35 females and 54 males) with mild to moderate intellectual disability with a mean age of 18 years (range 16 to 20 years).Interventions All subjects followed the same test protocol on two occasions within an 11-day period.Main outcomes Balance test performances.Results Intraclass correlation coefficients greater than 0.80 were achieved for four of the balance tests: Extended Timed Up and Go Test, Modified Functional Reach Test, One-leg Stance Test and Force Platform Test. The smallest real differences ranged from 12% to 40%; less than 20% is considered to be low. Concurrent validity among these balance tests varied between no and low correlation.Conclusion The results indicate that these tests could be used to evaluate changes in balance ability over time in people with mild to moderate intellectual disability. The low concurrent validity illustrates the importance of knowing more about the influence of various sensory subsystems that are significant for balance among adolescents with intellectual disability.(C) 2011 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.
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| 8. |
- Näslund, Annika, et al.
(author)
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Postural adjustments during reaching in children wth severe spastic diplegia wearing Dafos
- 2007
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In: 15th International Congress of the World Confederation for Physical Therapy. - : WCPT.
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Conference paper (other academic/artistic)abstract
- PURPOSE: The aim of this study was to investigate the coordination among reaching kinematics, ground reaction forces and muscle activity in standing in children with severe spastic diplegia wearing dynamic ankle-foot orthoses (DAFOs)and compare the results to age matched non-disabled children. RELEVANCE: Assessment and evaluation are essential because children with spastic diplegia, classified at level III-IV according to GMFCS (Gross Motor Function Classification System), often recieve DAFOs as an adjunct to physiotherapy in order to improve sitting, standing and walking. PARTICIPANTS: All children with spastic diplegia using DAFOs in a county in northern Sweden and had regular follow-ups of their ortohoses, were invited. Six participants at GMFCS level III-IV formed the study group and six age- and sex-matched children with normal motor development served as a control group. METHODS: Bilaterally ground reaction forces and the ankle muscle activity aswell as the reach hand kinematics were investigated by the means of two AMTI forceplates, surface electromyography (EMG)and two-camera optoelectronic system (ELITE). Kinematic, EMG and forceplate signals were recorded simultaniously. The children reached for a cup filled with candy while standing on two forceplates. Reflective markers were placed on the hand and cup. In this study, standing support provided by the parent on the pelvis or by contact of the non-reach hand on the table was necessary during the standing task. ANALYSIS: Because of the small participant number and the heterogeneity of the group with pronounced difficulties in locomotion, the results are presented on group as well as on subject level. RESULTS: Children with severe spastic diplegia, wearing DAFOs, demonstrated that movement quality of upward and forward reach velocity differed regarding temporal phasing and amplitudes of velocity peaks compared to the controls. Furthermore, children with severe spastic diplegia, wearing DAFOs, lacked a coordinated muscle activity pattern and make use of postural adjustments characterized by co-activation of agonist and antagonist muscles. However, the controls demonstrated coordinated muscle activity and an interplay of the ground reaction forces on reach and non-reach side. CONCLUSIONS: In conclusion DAFOs appear to provide some benefit for children with spastic diplegia GMFCS, level III-IV, by the use of postural adjustments for balance control during a reaching movement in standing. An intervention study would be of interest, to assess whether DAFOs could be valuable in the learning of processes considering postural adjustments , since postural control is a result of both maturation and learning. IMPLICATIONS: Children with severe spastic diplegia wearing DAFOs can despite different support conditions practice reaching while standing and thereby promote motor learning of postural adjustments to improve the ability to use the hands in daily standing activities.
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| 9. |
- Blomqvist, Sven, et al.
(author)
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Postural stability, physical activity, aerobic capacity and their associations for young people with and without intellectual disabilities
- 2014
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In: European Journal of Adapted Physical Activity. - 1803-3857. ; 7:1, s. 22-30
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Journal article (other academic/artistic)abstract
- Previous studies show that people with intellectual disability (ID) appear to have impaired postural stability, a lower level of physical activity, and lower aerobic capacity compared to persons without ID, limitations that could affect their health. This study investigates these physical functions and their associations in a group of young people with ID compared to an age-matched group without ID. In total, this cross-sectional study included 106 high school students (16-20 years): 57 students with mild to moderate ID and 49 agematched students without ID (control group). Tests were performed for postural stability, level of physical activity, and aerobic capacity. Both females and males with ID had significantly lower estimated maximum oxygen uptake (l O2/min) (p< 0.001 for females and p=0.004 for males) and a lower aerobic capacity expressed relative to body weight (ml O2/ kg*min) (p< 0.001 for females and p=0.012 for males) compared to age-matched peers. Analyses of associations were made using the Pearson’s correlation coefficient and multivariate linear regression analysis. No significant associations could be found. Physical status appears impaired for young people with ID and functions, such as postural stability, should be evaluated separately
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| 10. |
- Blomqvist, Sven, 1964-, et al.
(author)
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Physical exercise frequency seem not to influence postural balance but trunk muscle endurance in young persons with intellectual disability
- 2017
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In: Journal of Physical Education and Sports Management. - : American Research Institute for Policy Development. - 2373-2156 .- 2373-2164. ; 4:2, s. 38-47
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Journal article (peer-reviewed)abstract
- Background The influence of various physical exercise frequencies on postural balance and muscle performance among young persons with intellectual disability (ID) is not well understood.Method Cross-sectional data from 26 elite athletes were compared with 37 students at a sports school and to 57 students at a special school, all diagnosed with mild to moderate ID and with different exercise frequencies. Data were also compared with a group of 149 age-matched participants without ID.Results There were no significant differences in postural balance between young ID groups regardless of physical exercise frequency, all of them had however impaired postural balance compared to the non-ID group. The group with high exercise performed better than the other ID groups in the trunk muscle endurance test.Conclusions It appears as if physical exercise frequency don’t improve postural balance but endurance in the trunk muscles for young persons with ID.
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