| 1. |
- Gustavsson, Catharina, et al.
(författare)
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What is required to facilitate implementation of Swedish physical activity on prescription? - interview study with primary healthcare staff and management
- 2018
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The method, Swedish Physical Activity on Prescription (SPAP), has been launched in Swedish healthcare to promote physical activity for prevention and treatment of lifestyle related health disorders. Despite scientific support for the method, and education campaigns, it is used to a limited extent by health professionals. The aim of the study was to describe the views of health professionals on perceived facilitators, barriers and requirements for successful implementation of SPAP in primary healthcare.METHODS: Eighteen semi-structured interviews with stakeholders in SPAP, i.e. ten people working in local or central management and eight primary healthcare professionals in two regional healthcare organisations, were analysed using qualitative content analysis.RESULTS: We identified an overarching theme regarding requirements for successful implementation of SPAP: Need for knowledge and organisational support, comprising four main categories: Need for increased knowledge and affirmative attitude among health professionals; Need for clear and supportive management; Need for central supporting structures; Need for local supporting structures. Knowledge of the SPAP method content and core components was limited. Confidence in the method varied among health professionals. There was a discrepancy between the central organisation policy documents declaring that disease preventive methods were prioritised and a mandatory assignment, while the health professionals asked for increased interest, support and resources from management, primarily time and supporting structures. There were somewhat conflicting views between primary healthcare professionals and managers concerning perceived barriers and requirements. In contrast to some of the management's beliefs, all primary healthcare professionals undisputedly acknowledged the importance of promoting physical activity, but they lacked time, written routines and in some cases competence for SPAP counselling.CONCLUSION: The study provides knowledge regarding requirements to facilitate the implementation of SPAP in healthcare. There was limited knowledge among health professionals regarding core components of SPAP and how to practise the method, which speaks for in-depth training in the SPAP method. The findings highlight the importance of forming policies and guidelines and establishing organisational supporting structures, and ensuring that these are well known and approved in all parts of the healthcare organisation.
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| 2. |
- Baldanzi, Gabriel, et al.
(författare)
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Accelerometer-based physical activity is associated with the gut microbiota in 8416 individuals in SCAPIS.
- 2024
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Ingår i: EBioMedicine. - : Elsevier. - 2352-3964. ; 100
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Previous population-based studies investigating the relationship between physical activity and the gut microbiota have relied on self-reported activity, prone to reporting bias. Here, we investigated the associations of accelerometer-based sedentary (SED), moderate-intensity (MPA), and vigorous-intensity (VPA) physical activity with the gut microbiota using cross-sectional data from the Swedish CArdioPulmonary bioImage Study.METHODS: In 8416 participants aged 50-65, time in SED, MPA, and VPA were estimated with hip-worn accelerometer. Gut microbiota was profiled using shotgun metagenomics of faecal samples. We applied multivariable regression models, adjusting for sociodemographic, lifestyle, and technical covariates, and accounted for multiple testing.FINDINGS: Overall, associations between time in SED and microbiota species abundance were in opposite direction to those for MPA or VPA. For example, MPA was associated with lower, while SED with higher abundance of Escherichia coli. MPA and VPA were associated with higher abundance of the butyrate-producers Faecalibacterium prausnitzii and Roseburia spp. We observed discrepancies between specific VPA and MPA associations, such as a positive association between MPA and Prevotella copri, while no association was detected for VPA. Additionally, SED, MPA and VPA were associated with the functional potential of the microbiome. For instance, MPA was associated with higher capacity for acetate synthesis and SED with lower carbohydrate degradation capacity.INTERPRETATION: Our findings suggest that sedentary and physical activity are associated with a similar set of gut microbiota species but in opposite directions. Furthermore, the intensity of physical activity may have specific effects on certain gut microbiota species.FUNDING: European Research Council, Swedish Heart-Lung Foundation, Swedish Research Council, Knut and Alice Wallenberg Foundation.
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| 3. |
- Elmgren Frykberg, Gunilla, 1957-, et al.
(författare)
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Temporal coordination of the sit-to-walk task in subjects with stroke and in controls
- 2009
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Ingår i: Archives of Physical Medicine and Rehabilitation. - : Elsevier BV. - 0003-9993 .- 1532-821X. ; 90:6, s. 1009-1017
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To explore events and describe phases for temporal coordination of the sit-to-walk (STW) task, within a semistandardized set up, in subjects with stroke and matched controls. In addition, to assess variability of STW phase duration and to compare the relative duration of STW phases between the 2 groups.Design: Cross-sectional.Setting: Research laboratory.Participants: A convenience sample of persons with hemiparesis (n=10; age 50–67y), more than 6 months after stroke and 10 controls matched for sex, age, height, and body mass index.Interventions: Not applicable.Main Outcome Measures: Relative duration of STW phases, SE of measurement in percentage of the mean, and intraclass correlation coefficients (ICCs).Results: Four STW phases were defined: rise preparation, transition, primary gait initiation, and secondary gait initiation. The subjects with stroke needed 54% more time to complete the STW task than the controls did. ICCs ranged from .38 to .66 and .22 to .57 in the stroke and control groups, respectively. SEs of measurement in percentage of the mean values were high, particularly in the transition phase: 54.1% (stroke) and 50.4% (controls). The generalized linear model demonstrated that the relative duration of the transition phase was significantly longer in the stroke group.Conclusions: The present results extend existing knowledge by presenting 4 new phases of temporal coordination of STW, within a semistandardized set-up, in persons with stroke and in controls. The high degree of variability regarding relative STW phase duration was probably a result of both the semistandardized set up and biological variability. The significant difference in the transition phase across the 2 groups requires further study.
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| 4. |
- Nilsson, Johnny, et al.
(författare)
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Kinematic, kinetic and electromyographic adaptation to speed and resistance in double poling cross country skiing
- 2013
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Ingår i: European Journal of Applied Physiology. - : Springer Science and Business Media LLC. - 1439-6319 .- 1439-6327. ; 113:6, s. 1385-1394
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Tidskriftsartikel (refereegranskat)abstract
- This study incorporated variations in speed and the horizontal resistance acting upon elite female skiers during double poling (DP) on a treadmill and specifically analyzed biomechanical adaptations to these variations. Whole body kinematics and pole force data were recorded and used to calculate the moment of force acting on the shoulder and elbow joints. Data were obtained with a 3D optoelectronic system using reflective markers at given anatomical landmarks. Forces along the long axis of the right pole were measured with a piezoelectric force transducer. Surface electrodes were used to record EMG activity in the rectus femoris, rectus abdominis, latissimus dorsi and triceps brachii muscles. In a first set of recordings, the participants double poled with zero elevation at five different speeds from 8 to 17 km h(-1). In a second set of recordings, horizontal resistance was added by weights (0.4-1.9 kg) attached to a pulley system pulling the skier posteriorly during DP at 14 km h(-1). Results showed increasing relative duration of the thrust phase with increasing resistance, but not with speed. Significant kinematic differences occurred with increase in both speed and resistance. The mean (+/- SD) horizontal force components ranged between 1.7 (+/- 1.3) and 2.8 (+/- 1.1) percent (%) bodyweight (BW) in the speed adaptation and 3.1 (+/- 0.6) and 4.0 (+/- 1.3) % BW in the adaptation to horizontal resistance. Peak muscle activity showed a central to peripheral (proximo-distal) activation sequence. The temporal cycle phase pattern in the adaptation to speed and horizontal resistance differed.
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| 5. |
- Åberg, Anna Cristina, et al.
(författare)
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Extraction of gait parameters from marker-free video recordings of Timed Up-and-Go tests : Validity, inter- and intra-rater reliability.
- 2021
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Ingår i: Gait & Posture. - : Elsevier. - 0966-6362 .- 1879-2219. ; 90, s. 489-495
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: We study dual-task performance with marker-free video recordings of Timed Up-and-Go tests (TUG) and TUG combined with a cognitive/verbal task (TUG dual-task, TUGdt).RESEARCH QUESTION: Can gait parameters be accurately estimated from video-recorded TUG tests by a new semi-automatic method aided by a technique for human 2D pose estimation based on deep learning?METHODS: Thirty persons aged 60-85 years participated in the study, conducted in a laboratory environment. Data were collected by two synchronous video-cameras and a marker-based optoelectronic motion capture system as gold standard, to evaluate the gait parameters step length (SL), step width (SW), step duration (SD), single-stance duration (SSD) and double-stance duration (DSD). For reliability evaluations, data processing aided by a deep neural network model, involved three raters who conducted three repetitions of identifying anatomical keypoints in recordings of one randomly selected step from each of the participants. Validity was analysed using 95 % confidence intervals (CI) and p-values for method differences and Bland-Altman plots with limits of agreement. Inter- and intra-rater reliability were calculated as intraclass correlation coefficients (ICC) and standard errors of measurement. Smallest detectable change was calculated for inter-rater reliability.RESULTS: Mean ddifferences between video and the motion capture system data for SW, DSD, and SSD were significant (p < 0.001). However, mean differences for all parameters were small (-6.4%-13.0% of motion capture system) indicating good validity. Concerning reliability, almost all 95 % CI of the ICC estimates exceeded 0.90, indicating excellent reliability. Only inter-rater reliability for SW (95 % CI = 0.892;0.973) and one rater's intra-rater reliability for SSD (95 % CI = 0.793;0.951) were lower, but still showed good to excellent reliability.SIGNIFICANCE: The presented method for extraction of gait parameters from video appears suitable for valid and reliable quantification of gait. This opens up for analyses that may contribute to the knowledge of cognitive-motor interference in dual-task testing.
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| 6. |
- Cedervall, Ylva, et al.
(författare)
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Timed Up-and-Go Dual-Task Testing in the Assessment of Cognitive Function : A Mixed Methods Observational Study for Development of the UDDGait Protocol
- 2020
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 17:5
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Tidskriftsartikel (refereegranskat)abstract
- New methods to screen for and identify early-stage dementia disorders are highly sought after. The purpose of this pilot study is to develop a study protocol for a dual-task test aimed at aiding the early detection of dementia disorders. We used the Timed Up-and-Go (TUG) test, which is a mobility task involving starting in a sitting position, standing up, walking three meters to cross a line on the floor, turning around, walking back and sitting down again. We combined TUG with the verbal task of naming different animals. Pilot study participants were 43 individuals with and without established dementia diagnoses who attended a clinic for memory assessment. Video-recorded test performances were systematically analysed. Deviant test performances concerning the interplay between test administration and participants' responses to the assessment instructions were revealed and led to refinements being made to the final study protocol. Exploration of the dual-task test outcome measures in a sub-sample of 22 persons, ten with and twelve without dementia, indicated that step-length and number of named animals after the turning point of the dual-task test might constitute appropriate measures for examining this kind of sample. We concluded that the refined study protocol is feasible for testing individuals undergoing initial memory assessments and healthy controls. Follow-up studies with larger samples are being carried out and will bring new knowledge to this area of research. It may also provide an opportunity for further studies exploring possibilities for broad clinical implementation.
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| 7. |
- Taljedal, Torun, et al.
(författare)
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Patterns of mental health problems and well-being in children with disabilities in Sweden : A cross-sectional survey and cluster analysis
- 2023
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Ingår i: PLOS ONE. - : NLM (Medline). - 1932-6203. ; 18:7
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Children with disabilities have an increased risk of mental health problems. Patterns of mental health problems and well-being may vary. AIMS: To identify patterns of mental health problems and well-being in children with disabilities in Sweden, and investigate the influence of parental background (migration, education), and child cognitive level. METHOD: In this cross-sectional study, cluster analysis was used to analyse parents' ratings of conduct problems, emotional symptoms, and prosocial behaviour on the Strengths and Difficulties Questionnaire (SDQ) in children with disabilities (n = 136). The influence of parental background (migration, education) and child cognitive level on cluster membership was explored through multinomial logistic regression. RESULTS: Five clusters of mental health patterns emerged. Three clusters had mean ratings near or past clinical cut-off for one each of the SDQ-subscales. One cluster had difficulties on all three subscales. Greater child cognitive difficulties increased the likelihood of low prosocial behaviour (OR 2.501, p < .001) and of difficulties on all three subscales (OR 2.155, p = .006). Parental background did not influence cluster membership. CONCLUSION: Children with disabilities display varying mental health patterns. Awareness of the complexity of mental health patterns among children with disabilities is important. Screening and support for emotional symptoms and prosocial behaviour deficits should be considered for children with conduct problems.
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| 8. |
- Åberg, Anna Cristina, et al.
(författare)
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Implementation of evidence-based prevention of falls in rehabilitation units : a staff's interactive approach
- 2009
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 41:13, s. 1034-1040
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To provide strategies to assist healthcare professionals in the area of rehabilitation to improve prevention of falls. DESIGN: A conceptual framework is described as a foundation for the proposal of 2 intertwined strategies, of intervention and implementation, which target the questions: Which strategies for intervention represent the current best evidence? and: How can these strategies be implemented and continuously developed? RESULTS: Strategies for multifactorial and multiprofessional fall preventive interventions are presented in terms of a "fall prevention pyramid model", including general, individualized, and acute interventions. A systematic global fall risk rating by the staff is recommended as an initial procedure. Fall event recording and follow-up are stressed as important components of local learning and safety improvement. Development of implementation strategies in 3 phases, focusing on interaction, facilitation and organizational culture, is described. CONCLUSION: A well-developed patient safety culture focusing on prevention of falls will, when successfully achieved, be seen by staff, patients and their significant others as being characteristic of the organization, and will be evident in attitudes, routines and actions. Moreover, it provides potential for positive side-effects concerning organizational and clinical improvements in additional areas.
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| 9. |
- Gullstrand, Lennart, et al.
(författare)
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Measurements of vertical displacement in running, a methodological comparison
- 2009
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Ingår i: Gait & Posture. - : Elsevier BV. - 0966-6362 .- 1879-2219. ; 30:1, s. 71-75
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Tidskriftsartikel (refereegranskat)abstract
- The aim was (1) to evaluate measurements of vertical displacements (V-disp) of a single point on sacrum as an estimate of the whole body centre of mass (CoM) V-disp during treadmill running and (2) to compare three methods for measuring this single point. These methods were based on a position transducer(PT), accelerometers (AMs) and an optoelectronic motion capture system. Criterion method was V-disp of the whole body CoM measured with the motion capture system. Thirteen subjects ran at 10, 12, 14, 16. 18, 20 and 22 km h(-1) with synchronous recordings with the three methods. Four measurements of the (V-disp) were derived: (1) V-disp of CoM calculated from a segment model consisting of 13 segments tracked with 36 reflective markets, (2) V-disp of the sacrum recorded with the PT, (3) V-disp of the sacrum Calculated from the AM, and (4) V-disp of the sacrum calculated as the mid point of two reflective markets (sacrum marker, SM) attached at the level of the sacral bone. The systematic discrepancy between the Measurements of sacrum V-disp and CoM V-disp varied between 0 and 1.5 mm and decreased with increasing running velocity and decreasing step duration. PT and SM measurements showed strong correlation, whereas the AM showed a variability increasing with velocity. The random discrepancy within each Subject was 7 mm for all three methods. In conclusion single-point recordings of the sacrum V-disp may be used to monitor changes in V-disp of CoM during treadmill running.
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| 10. |
- Halvorsen, Kjartan, et al.
(författare)
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Minimal marker set for center of mass estimation in running
- 2009
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Ingår i: Gait & Posture. - : Elsevier BV. - 0966-6362 .- 1879-2219. ; 30:4, s. 552-555
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Tidskriftsartikel (refereegranskat)abstract
- The purpose was to study the validity of a recently proposed method [Forsell C, Halvorsen K. A method for determining minimal sets of markers for the estimation of center of mass, linear and angular momentum. journal of Biomechanics 2009;42(3):361-5] for estimating the trajectory of the whole-body center of mass (CoM) in the case of running at: velocities ranging from 10 to 22 km h(-1). The method gives an approximation to the CoM using the position of fewer markers on the body than the standard method of tracking each segment of the body. Fourteen male athletes participated. A standard method for determining the CoM from a model of 13 segments and using the position of 36 markers was used as reference method. Leave-one-out cross-validation revealed errors that decreased with increasing number of markers used in the approximative method. Starting from four markers, the error in absolute position of the CoM decreased from 15 mm to 3 mm in each direction. For the velocity of the CoM the estimation bias was neglectable, and the random error decreased from 0.15 to 0.05 m s(-1). The inter-subject and intra-subject variability in the estimated model parameters increased with increasing number of markers. The method worked well also when applied to running at velocities outside the range of velocities in the data used to determine the model parameters. The results indicate that a model using 10 markers represents a good trade-off between simplicity and accuracy, but users must take into account requirements of their specific applications.
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