| 1. |
- Anguille, Sébastien, et al.
(författare)
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Dendritic cell vaccination as postremission treatment to prevent or delay relapse in acute myeloid leukemia
- 2017
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Ingår i: Blood. - : American Society of Hematology. - 0006-4971 .- 1528-0020. ; 130:15, s. 1713-1721
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Tidskriftsartikel (refereegranskat)abstract
- Relapse is a major problem in acute myeloid leukemia (AML) and adversely affects survival. In this phase 2 study, we investigated the effect of vaccination with dendritic cells (DCs) electroporated with Wilms’ tumor 1 (WT1) messenger RNA (mRNA) as postremission treatment in 30 patients with AML at very high risk of relapse. There was a demonstrable antileukemic response in 13 patients. Nine patients achieved molecular remission as demonstrated by normalization of WT1 transcript levels, 5 of which were sustained after a median follow-up of 109.4 months. Disease stabilization was achieved in 4 other patients. Five-year overall survival (OS) was higher in responders than in nonresponders (53.8% vs 25.0%; P 5 .01). In patients receiving DCs in first complete remission (CR1), there was a vaccine-induced relapse reduction rate of 25%, and 5-year relapse-free survival was higher in responders than in nonresponders (50% vs 7.7%; P < .0001). In patients age £65 and >65 years who received DCs in CR1, 5-year OS was 69.2% and 30.8% respectively, as compared with 51.7% and 18% in the Swedish Acute Leukemia Registry. Long-term clinical response was correlated with increased circulating frequencies of polyepitope WT1-specific CD81 T cells. Long-term OS was correlated with interferon-g1 and tumor necrosis factor-a1 WT1-specific responses in delayed-type hypersensitivity-infiltrating CD81 T lymphocytes. In conclusion, vaccination of patients with AML with WT1 mRNA-electroporated DCs can be an effective strategy to prevent or delay relapse after standard chemotherapy, translating into improved OS rates, which are correlated with the induction of WT1-specific CD81 T-cell response. This trial was registered at www.clinicaltrials.gov as #NCT00965224.
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| 2. |
- Ardern, Clare, 1985-, et al.
(författare)
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2016 Consensus statement on return to sport from the First World Congress in Sports Physical Therapy, Bern
- 2016
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Ingår i: British Journal of Sports Medicine. - : BMJ PUBLISHING GROUP. - 0306-3674 .- 1473-0480. ; 50:14, s. 853-864
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Tidskriftsartikel (refereegranskat)abstract
- Deciding when to return to sport after injury is complex and multifactorial-an exercise in risk management. Return to sport decisions are made every day by clinicians, athletes and coaches, ideally in a collaborative way. The purpose of this consensus statement was to present and synthesise current evidence to make recommendations for return to sport decision-making, clinical practice and future research directions related to returning athletes to sport. A half day meeting was held in Bern, Switzerland, after the First World Congress in Sports Physical Therapy. 17 expert clinicians participated. 4 main sections were initially agreed upon, then participants elected to join 1 of the 4 groups-each group focused on 1 section of the consensus statement. Participants in each group discussed and summarised the key issues for their section before the 17-member group met again for discussion to reach consensus on the content of the 4 sections. Return to sport is not a decision taken in isolation at the end of the recovery and rehabilitation process. Instead, return to sport should be viewed as a continuum, paralleled with recovery and rehabilitation. Biopsychosocial models may help the clinician make sense of individual factors that may influence the athletes return to sport, and the Strategic Assessment of Risk and Risk Tolerance framework may help decision-makers synthesise information to make an optimal return to sport decision. Research evidence to support return to sport decisions in clinical practice is scarce. Future research should focus on a standardised approach to defining, measuring and reporting return to sport outcomes, and identifying valuable prognostic factors for returning to sport.
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| 3. |
- Cools, Ann M, et al.
(författare)
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The challenge of the sporting shoulder : From injury prevention through sport-specific rehabilitation toward return to play
- 2021
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Ingår i: Annals of Physical and Rehabilitation Medicine. - : Elsevier BV. - 1877-0657 .- 1877-0665. ; 64:4
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Forskningsöversikt (refereegranskat)abstract
- Shoulder injuries and sports-related shoulder pain are substantial burdens for athletes performing a shoulder loading sport. The burden of shoulder problems in the athletic population highlights the need for prevention strategies, effective rehabilitation programs, and a individually based return-to-play (RTP) decision. The purpose of this clinical commentary is to discuss each of these 3 challenges in the sporting shoulder, to assist the professional in: (1) preventing injury; (2) providing evidence-based practice rehabilitation and; (3) to guide the athlete toward RTP. The challenges for injury prevention may be found in the search for (the interaction between) relevant risk factors, develop valid screening tests, and implement feasible injury prevention programmes with maximal adherence from the athletes. Combined analytical and functional testing seems mandatory screening an athlete's performance. Many questions arise when rehabilitating the overhead athlete, from exercise selection, over the value of stretching, toward kinetic chain implementation and progression to high performance training. Evidence-based practice should be driven by the available research, clinical expertise and the patient's expectations. Deciding when to return to sport after a shoulder injury is complex and multifactorial. The main concern in the RTP decision is to minimize the risk of re-injury. In the absence of a "gold standard", clinicians may rely on general guidelines, based on expert opinion, regarding cutoff values for normal range of motion, strength and function, with attention to risk tolerance and load management.
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| 4. |
- Howells, Kristy, et al.
(författare)
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Physical play - How do we inspire and motivate young children to be physically active through play? : An international analysis of twelve countries’ national early years curriculum policies and practices for physical activity and physical play
- 2023
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Ingår i: Journal of Early Childhood Education Research. - 2323-7414. ; 12:1, s. 253-276
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Lifelong movement and physical activity (PA) patterns develop during early childhood. Therefore, educators (teachers and practitioners) in early childhood education and care (ECEC) should provide opportunities to support children’s play, PA, and movement development. The World Health Organization (2019) offers new recommendations for PA, for children under five years. The guidelines do not specify the ways ECEC staff can support PA through play. Therefore, this paper investigates, how physical play (PP) is enacted globally. An international policy and practice analysis of twelve countries, (Australia [Victoria], Belgium [Flanders], Canada [Alberta], China, Finland, Ireland, Italy, Portugal, Spain, Sweden, UK [England] and USA) was completed by analyzing the ECEC curricula and their implementation in different cultural contexts. A content analysis was undertaken by AIESEP Early Years SIG experts revealing that PP was not clearly defined. When defined, it was described as PA, and important for children’s holistic development. The majority of curricula did not state the length/time for PP. Three main strategies for implementing PP were found: a) pedagogical framework; b) active learning methods; and c) motor development. This international analysis highlights the global need for better ECEC staff support in acknowledging and implementing PP to aid children’s overall development, PA and wellbeing.
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| 5. |
- Hultenheim Klintberg, Ingrid, 1959, et al.
(författare)
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Consensus for physiotherapy for shoulder pain
- 2015
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Ingår i: International Orthopaedics. - : Springer Science and Business Media LLC. - 0341-2695 .- 1432-5195. ; 39:4, s. 715-720
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Tidskriftsartikel (refereegranskat)abstract
- Purpose Shoulder pain is a common disorder. Despite growing evidence of the importance of physiotherapy, in particular active exercise therapy, little data is available to guide treatment. The aim of this project was to contribute to the development of an internationally accepted assessment and treatment algorithm for patients with shoulder pain. Methods Nine physiotherapists with expertise in the treatment of shoulder dysfunction met in Sweden 2012 to begin the process of developing a treatment algorithm. A questionnaire was completed prior to the meeting to guide discussions. Virtual conferences were thereafter the platform to reach consensus. Results Consensus was achieved on a clinical reasoning algorithm to guide the assessment and treatment for patients presenting with local shoulder pain, without significant passive range of motion deficits and no symptoms or signs of instability. The algorithm emphasises that physiotherapy treatment decisions should be based on physical assessment findings and not structural pathology, that active exercises should be the primary treatment approach, and that regular re-assessment is performed to ensure that all clinical features contributing to the presenting shoulder pain are addressed. Consensus was also achieved on a set of guiding principles for implementing exercise therapy for shoulder pain, namely, a limited number of exercises, performed with appropriate scapulo-humeral coordination and humeral head alignment, in a graduated manner without provoking the presenting shoulder pain. Conclusion The assessment and treatment algorithm presented could contribute to a more formal, extensive process aimed at achieving international agreement on an algorithm to guide physiotherapy treatment for shoulder pain.
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| 6. |
- Schwank, Ariane, et al.
(författare)
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2022 Bern Consensus Statement on shoulder injury prevention, rehabilitation, and return to sport for athletes at all participation levels
- 2022
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Ingår i: Journal of Orthopaedic and Sports Physical Therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 0190-6011 .- 1938-1344. ; 52:1, s. 11-28
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Tidskriftsartikel (refereegranskat)abstract
- SYNOPSIS: There is an absence of high-quality evidence to support rehabilitation and return-to-sport decisions following shoulder injuries in athletes. The Athlete Shoulder Consensus Group was convened to lead a consensus process that aimed to produce best-practice guidance for clinicians, athletes, and coaches for managing shoulder injuries in sport. We developed the consensus via a 2-round Delphi process (involving more than 40 content and methods experts) and an in-person meeting. This consensus statement provides guidance with respect to load and risk management, supporting athlete shoulder rehabilitation, and decision making during the return-to-sport process. This statement is designed to offer clinicians the flexibility to apply principle-based approaches to managing the return-to-sport process within a variety of sporting backgrounds. The principles and consensus of experts working across multiple sports may provide a template for developing additional sport-specific guidance in the future. J Orthop Sports Phys Ther 2022;52(1):11-28. doi:10.2519/jospt.2022.10952.
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