| 1. |
- Mårtensson, Lena, 1953, et al.
(författare)
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Patients with fibromyalgia and their conception of health after an intervention programme
- 1995
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Ingår i: Scandinavian Journal of Occupational Therapy. - Abingdon : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 2, s. 113-120
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Tidskriftsartikel (refereegranskat)abstract
- Fibromyalgia is a well-known syndrome interpreted as general muscular pain in the whole body and as pressure soreness in the so-called tender points. The cause of the syndrome is not yet clear and it has therefore been difficult to find proper treatment. The aim of this study was to describe how patients with fibromyalgia conceived their health after having taken part in an intervention programme based on ego-strengthening psychotherapy and the salutogenetic model. The intervention was performed by an occupational therapist and a physiotherapist. In this study, 10 patients were interviewed and data were analysed by the phenomenographic method. Four different catagories of health conceptions became evident as a result of the intervention; receiving confirmation, creating distance to things, gaining insight, and gaining control. The results showed that the patients had increased their sense of meaningfulness, comprehensibility and manageability of the pain syndrome, which led to improved health. Due to the fact that this kind of intervention requires comparatively small resources in terms of staff and financial expenditure it is suitable in small clinics, e.g. health care centres. Further research should be aimed at finding out whether this intervention also suits patients with other diagnoses or whether treatment in larger groups might produce equally favourable results. © 1995 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted.
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| 2. |
- Mårtensson, Lena, 1953, et al.
(författare)
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Evaluation of a Biopsychosocial Rehabilitation Programme in Primary Healthcare for Chronic Pain Patients
- 1999
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Ingår i: Scandinavian Journal of Occupational Therapy. - London : Taylor & Francis. - 1103-8128 .- 1651-2014. ; 6, s. 157-165
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Tidskriftsartikel (refereegranskat)abstract
- The responsibility of primary healthcare for treatment and rehabilitation of chronic pain patients has increased in the last decade. Experiences of multidisciplinary, behavioural treatments in pain clinics have demonstrated positive effects. The aim of the study was to evaluate a biopsychosocial rehabilitation programme in primary healthcare for chronic pain patients. The study included 70 chronic pain patients, who participated in an intervention based on ego-strengthening psychotherapy, led by an occupational therapist and a physiotherapist. The study was performed by Visual Analogue Scale (VAS) and a questionnaire as well as statistically analysed. The results showed increased general well-being (p < 0.01) and ability of pain management (p < 0.001) together with decreased level of perceived complaints (p < 0.001). The intervention was also associated with positive changes in personality, physical and cognitive factors. The results suggest that the biopsychosocial rehabilitation programme is useful in primary healthcare. Further studies should be carried out into the effects of such a rehabilitation programme in controlled randomized designs
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| 3. |
- Wikström, Ingegerd, et al.
(författare)
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How people with rheumatoid arthritis perceive leisure activities : A qualitative study
- 2005
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Ingår i: Musculoskeletal Care. - London : Whurr Publishers. - 1478-2189 .- 1557-0681. ; 3:2, s. 74-84
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To explore how people with rheumatoid arthritis (RA) perceive leisure activities. METHOD: A phenomenographic approach using semi-structured interviews to explore the impact of RA on leisure pursuits was used. RESULTS: Three descriptive categories containing 11 conceptions emerged: (1) Experiencing constraints included four conceptions: seeing limitations, needing time, finding balance, being dependent. (2) Experiencing coherence included four conceptions: accepting feelings participating in a social context, being active, having insight. (3) Finding solutions included three conceptions: choosing, planning, and adapting. CONCLUSIONS: This study emphasizes the limited choices and problems people with RA had participating in leisure activities, as well as its impact on self-esteem.
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| 4. |
- Wikström, Ingegerd, et al.
(författare)
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Reliability, validity and responsiveness of a new leisure index : The Patient-Specific Leisure Scale (PSLS)
- 2009
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Ingår i: Musculoskeletal Care. - London : Whurr Publishers. - 1478-2189 .- 1557-0681. ; 7:3, s. 178-193
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Tidskriftsartikel (refereegranskat)abstract
- Objectives:To investigate the reliability, validity and responsiveness of a new Patient-Specific Leisure Scale (PSLS), constructed to identify goals and outcomes for individual patients with rheumatoid arthritis (RA).Methods:Forty-nine patients with RA were used to evaluate test-retest reliability, and 100 consecutive RA patients were used for construct validity. Twenty-five RA patients, commencing with treatment on tumour necrosis factor (TNF) inhibitors, were evaluated before the start and after three months of therapy, to test responsiveness. The most important leisure activity (as judged by the patients) was used when evaluating reliability and validity. The perceived difficulty with each activity was scored from 0 to 10 (0 = able to perform activity without difficulty, 10 = unable to perform activity).Results: Test-retest reliability indicated a good agreement (0.62-0.87) using weighted kappa. Construct validity was demonstrated by modest positive correlation between leisure activity and Health Assessment Questionnaire (HAQ) (rs = 0.27, p = 0.005) visual analogue scale (VAS) pain (rs = 0.28, p = 0.004) VAS global (rs = 0.22, p = 0.027), VAS fatigue (rs = 0.24, p = 0.013), joint index of 28 swollen joints (rs = 0.22, p = 0.027) and negative correlations with short-form-36 (SF-36) physical functioning (rs = -0.18, p = 0.008), bodily pain (rs = -0.31, p < 0.001), general health (rs = -0.23, p = 0.019), vitality (rs = -0.31, p < 0.001), social function (rs = -0.24, p = 0.016) and role-emotional (rs = -0.28, p = 0.005). Mean improvement for the most important leisure activity was 1.36, (p = 0.036, 95% confidence interval 0.10-2.62). Standardized response mean and effect size for the most important activity in PSLS was 1.05 and 0.72, respectively, and for HAQ 0.34 and 0.28, respectively.Conclusions:PSLS appears to be feasible, reliable, valid and responsive for measuring leisure activities in RA. It provides both an individual result which is useful in clinical work, and results at a group level.
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| 5. |
- Thorstensson, Carina
(författare)
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Exercise and Functional Performance in Middle-aged Patients with Knee Osteoarthritis
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall purpose of this thesis was to explore the impact of exercise and functional performance on development and treatment of knee osteoarthritis in the middle aged. In this thesis, I have studied a population based cohort of middle-aged subjects (35-54 years, 42 % women) with chronic knee pain at baseline, to evaluate the longitudinal effect of muscle weakness on knee osteoarthritis development, the relationship between muscle function and joint load and the effects of exercise on joint load. I have also studied the effect of exercise on pain and function in another middle-aged cohort (36-65 years, 51 % women) with moderate to severe knee osteoarthritis, and explored their conceptions of exercise as treatment. In the first study, 148 subjects with chronic knee pain underwent radiographic examination and tests of functional performance at baseline. 94 of them had no radiographic signs of knee osteoarthritis. Five years later they had new radiographs taken and 41/94 (44 %) had developed incident knee osteoarthritis. I found that reduced functional performance, assessed by maximum number of one-leg rises from a stool, predicted knee osteoarthritis development. The result was controlled for the previously known risk factors of age, BMI and pain. In the second study, I used 3-dimensional motion analysis to explore the possibility of altering joint load by exercise. The medial compartment joint load (peak adduction moment) during maximum number of one-leg rises was assessed in 13 subjects with early radiographic signs of knee osteoarthritis from the cohort in study one, before and after 8 weeks of exercise. Two subjects were lost to follow up for reasons not related to the knee. The peak adduction moment could be reduced by exercise, and a high maximum number of one-leg rises was associated with lower levels of peak adduction moment. The third study included 61 subjects with moderate to severe radiographic knee osteoarthritis. They were randomized to 6 weeks of intensive exercise or to a control group. The effects of exercise were assessed using questionnaires. No effects were seen on pain or self estimated function, however, the quality of life improved. The individual response to exercise ranged from clinically significant improvement to clinically significant worsening. As an attempt to understand this large inter individual response to exercise, I designed the fourth study, where I interviewed 16 of the 30 patients in the exercise group about their conceptions of exercise as treatment. The interviews were analysed using qualitative methodology, and it was revealed that all patients were aware of the general health benefits of exercise, but had doubts about exercise as treatment of osteoarthritis even if they had perceived pain relief and improvement in physical function from the exercise intervention. The pain experienced during exercise caused the patients to believe that exercise was harmful to their knees, and some of them would prefer not to exercise at all. They thought that exercise should be introduced early during the course of the disease, and all of them expressed the need of continuous encouragement and support to adhere to exercise. From this thesis I conclude that reduced muscle function is a risk factor of knee osteoarthritis development among middle aged subjects with knee pain. Reduced muscle function is associated with increased joint load, which seem to be modifiable by exercise. Initial pain when starting exercise, or occasional pain from exercise, should be treated by combining exercise with pain relief such as analgesics or acupuncture. Pain contributes to the difficulty patients have determining the degree of benefit or damage related to exercise, and thus causes feelings of anxiety and helplessness (paper IV). Pain also seems to interfere with the possibility of achieving increased functional performance (paper II, III, IV).
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| 6. |
- Brorsson, Sofia, 1973-, et al.
(författare)
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A new force measurement device for evaluating finger extension function in the healthy and rheumatoid arthritis hand
- 2008
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Ingår i: Technology and Health Care. - Amsterdam : IOS Press. - 0928-7329 .- 1878-7401. ; 16:4, s. 283-292
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Tidskriftsartikel (refereegranskat)abstract
- Although often neglected, finger extension force is of great importance for developing grip strength. This paper describes the design and evaluation of a new finger extension force measurement device (EX-it) based on the biomechanics of the hand. Measurement accuracy and test-retest reliability were analysed. The device allows measurements on single fingers as well as all the fingers (excluding the thumb) of both healthy and deformed hands. The coefficient of variation in the device was 1.8% of the applied load, and the test-retest reliability showed a coefficient of variation no more than 7.1% for healthy subjects. This study also provides reference values for finger extension force in healthy subjects and patients with rheumatoid arthritis (RA). Significant differences were found in extension strength between healthy subject and RA patients (men, p < 0.05 and women, p < 0.001). EX-it provides objective and reliable data on the extension force capacity of normal and dysfunctional hands and can be used to evaluate the outcome of therapeutic interventions after hand trauma or disease
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| 7. |
- Brorsson, Sofia, 1973-, et al.
(författare)
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A six-week hand exercise programme improves strength and hand function in patients with rheumatoid arthritis
- 2009
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Ingår i: Journal of Rehabilitation Medicine. - Basingstoke : Taylor & Francis. - 1650-1977 .- 1651-2081. ; 41:5, s. 338-342
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:To evaluate the effects of hand exercise in patients with rheumatoid arthritis, and to compare the results with healthy controls.METHODS:Forty women (20 patients with rheumatoid arthritis and 20 healthy controls) performed a hand exercise programme. The results were evaluated after 6 and 12 weeks with hand force measurements (with a finger extension force measurement device (EX-it) and finger flexion force measurement with Grippit). Hand function was evaluated with the Grip Ability Test (GAT) and with patient relevant questionnaires (Disability of the Arm, Shoulder, and Hand (DASH) and Short Form-36). Ultrasound measurements were performed on m. extensor digitorum communis for analysis of the muscle response to the exercise programme. RESULTS: The extension and flexion force improved in both groups after 6 weeks (p < 0.01). Hand function (GAT) also improved in both groups (p < 0.01). The rheumatoid arthritis group showed improvement in the results of the DASH questionnaire (p < 0.05). The cross-sectional area of the extensor digitorum communis increased significantly in both groups measured with ultrasound. CONCLUSION:A significant improvement in hand force and hand function in patients with rheumatoid arthritis was seen after 6 weeks of hand training; the improvement was even more pronounced after 12 weeks. Hand exercise is thus an effective intervention for rheumatoid arthritis patients, leading to better strength and function.
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| 8. |
- Brorsson, Sofia
(författare)
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Biomechanical studies of finger extension function. Analysis with a new force measuring device and ultrasound examination in rheumatoid arthritis and healhty muscles
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aims: The overall aim of this thesis was to further our understanding of extensor muscles and their role for hand function. The aims of the studies were: To develop and evaluate a new device for finger extensor force measurements. To evaluate ultrasound as a tool for assessment of muscle architecture. To determine the correlation between extensor muscle force and hand function. To evaluate the degree of impaired finger extensor force in rheumatoid arthritis (RA) and the correlation to impaired hand function. To analyse the effect of hand exercise in RA patients and healthy subjects with ultrasound and finger extension force measurements. Method: A new finger extension force measuring device was developed and an ultrasound based method was used to be able to objectively measure the finger extension force and analyze the static and dynamic extensor muscle architectures. Measurements were made of healthy volunteers (n=127) and RA patients (n=77) during uninfluenced and experimental conditions. A hand exercise program was performed and evaluated with hand force measurements, hand function test, patient relevant questionnaires (DASH and SF-36) and ultrasound measurements. Results: The new finger extension force measurement device was developed and then validated with measurements of accuracy as well as test-retest reliability. The coefficient of variation was 1.8 % of the applied load, and the test-retest reliability showed a coefficient of variation no more than 7.1% for healthy subjects. Ultrasound examination on m. extensor digitorum communis (EDC) showed significant differences between healthy men and healthy women as well as between healthy women and RA patients. The extension and flexion force improved in both groups after six weeks of hand exercise (p<0.01). Hand function improved in both groups (p<0.01). The RA group showed improvement in the results of the DASH questionnaire (p<0.05). The cross-sectional area of the EDC increased significantly in both groups. Conclusions: A new finger extension force measuring device has been developed which provides objective and reliable data on the extension force capacity of normal and dysfunctional hands and is sufficiently sensitive to evaluate the effects of hand exercise. US provide useful information about muscle architecture. A significant improvement of hand strength and hand function in RA patients was seen after six weeks of hand training, the improvement was even more pronounced after 12 weeks. Hand exercise is thus an effective intervention for RA patients, providing better strength and function.
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| 9. |
- Bååth, Lars B.
(författare)
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Analys av avgaser med mikrovågspektroskopi
- 2004
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Rapport (refereegranskat)abstract
- Inom projektet har hittills genomförts följande aktiviteter:Inhämtat teoretiska kunskaper inom området mikrovågsteknikGenomfört studier avseende vilka molekyler som är av intresse för stål- och metallindustrin att mäta på.Kontrollerat mot JPL databas samt NBS om dessa molekyler finns definierade i mikrovågsområdet av det elektromagnetiska spektret och då på vilka frekvenser.Designat och tillverkat en sensor, bestående av antenner, mixer samt LO, som klarar av att mäta vid de relevanta molekylära frekvenserna.Testat och utvärderat sensortekniken på laboratorienivå avseende signalkarak- täristik.Genomfört pilotförsök på MEFOS: i. Höga gastemperaturer; ii. Olika gaskoncentrationerGenomförtverksförsök: i. LKAB, Rotary Kiln; ii. Boliden Mineral, KopparkonverterUtvärderat försöksdata
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| 10. |
- Thorstensson, Carina A., et al.
(författare)
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Six-week high-intensity exercise program for middle-aged patients with knee osteoarthritis : a randomized controlled trial [ISRCTN20244858]
- 2005
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Ingår i: BMC Musculoskeletal Disorders. - London : BioMed Central. - 1471-2474. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- Background: Studies on exercise in knee osteoarthritis (OA) have focused on elderly subjects. Subjects in this study were middle-aged with symptomatic and definite radiographic knee osteoarthritis. The aim was to test the effects of a short-term, high-intensity exercise program on self-reported pain, function and quality of life. Methods: Patients aged 36-65, with OA grade III (Kellgren & Lawrence) were recruited. They had been referred for radiographic examination due to knee pain and had no history of major knee injury. They were randomized to a twice weekly supervised one hour exercise intervention for six weeks, or to a non-intervention control group. Exercise was performed at ≥ 60% of maximum heart rate (HR max). The primary outcome measure was the Knee injury and Osteoarthritis Outcome Score (KOOS). Follow-up occurred at 6 weeks and 6 months. Results: Sixty-one subjects (mean age 56 (SD 6), 51 % women, mean BMI 29.5 (SD 4.8)) were randomly assigned to intervention (n = 30) or control group (n = 31). No significant differences in the KOOS subscales assessing pain, other symptoms, or function in daily life or in sport and recreation were seen at any time point between exercisers and controls. In the exercise group, an improvement was seen at 6 weeks in the KOOS subscale quality of life compared to the control group (mean change 4.0 vs. -0.7, p = 0.05). The difference between groups was still persistent at 6 months (p = 0.02). Conclusion: A six-week high-intensive exercise program had no effect on pain or function in middle-aged patients with moderate to severe radiographic knee OA. Some effect was seen on quality of life in the exercise group compared to the control group. © 2005 Thorstensson et al; licensee BioMed Central Ltd.
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