| 1. |
- Arkkukangas, Marina, et al.
(författare)
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Evaluation of the electro-dress Mollii (R) to affect spasticity and motor function in children with cerebral palsy : Seven experimental single-case studies with an ABAB design
- 2022
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Ingår i: Cogent Engineering. - : TAYLOR & FRANCIS AS. - 2331-1916. ; 9:1
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Tidskriftsartikel (refereegranskat)abstract
- There are limited non-invasive treatment options in the home environment for children with cerebral palsy (CP); thus, evaluating such treatment options is needed. We aimed to evaluate the effect of an innovative full-body suit approach for non-invasive surface electrical stimulation ES, the electro-dress Mollii (R). The full-body suit was primarily designed to reduce spasticity and improve motor function through the mechanism of reciprocal inhibition among children with CP. This study involved seven experimental single-case studies with an ABAB design. Seven studies were performed among children aged 4-17 years. The primary outcome (spasticity) was analyzed using graphed data with a visual inspection, and median values were analyzed for secondary outcomes (mobility, sitting, upper limb activity, sleep, pain, and adherence to treatment). The study protocol was recorded at clinicaltrials.gov (NCT04078321). Seven studies were analyzed, and the treatment with the electro-dress had little or no impact on the outcomes: spasticity, mobility, sitting, upper limb activity, sleep, and pain, in any of these seven studies. In conclusion, multiple ES treatment with the innovative electro-dress Mollii (R) revealed little or no observable changes on primary outcome (spasticity) in any of the seven studies. Further the possible impact on motor function is recommended to be further evaluated in future studies
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| 2. |
- Arkkukangas, Marina, et al.
(författare)
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Risk factors for fall-related injuries among community-dwelling men and women over 70 years of age, based on social cognitive theory : results from a population study
- 2021
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Ingår i: European Journal of Physiotherapy. - : Taylor & Francis. - 2167-9169 .- 2167-9177. ; 23:4, s. 221-226
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Healthcare professionals', especially physiotherapists' role as promoters, preventers and rehabilitators play a significant role in prevention of falls. The purpose of this study was to gain knowledge on the risk factors which are associated with fall-related injuries among community dwelling men and women, based on Social Cognitive Theory (SCT) concepts. Patients and methods: The study includes 13,151 people who responded to a postal survey questionnaire in 2017. The random sample consisted of men and women aged 70 years and older. Multivariate regression models were used to explore associations between theory-based risk factors and fall-related injuries. Results: A total of 16% (1951 people) reported a fall-related injury during the past 12 months. For men, a total of seven risk factors were associated with fall-related injury: age, pain (neck/shoulder), incontinence, depression, help in daily living, education and sedentary behaviour. For women, a total of nine risk factors were associated with fall-related injury: age, pain (extremities and neck/shoulder), tiredness, incontinence, appetite, economy, accommodation and participation in social activities. Conclusions: This study identified risk factors from all aspects of the SCT, serving as a clinically useful theory in addition to traditional fall preventive actions. Gender differences should be considered when designing fall prevention strategies.
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| 3. |
- Berglund, K. M., et al.
(författare)
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Prevalence of pain and dysfunction in the cervical and thoracic spine in persons with and without lateral elbow pain
- 2008
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Ingår i: Manual Therapy. - : Elsevier BV. - 1356-689X .- 1532-2769. ; 13:4, s. 295-299
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to Survey the prevalence of pain in the cervical and thoracic spine (C2-T7) in persons with and Without lateral elbow pain. Thirty-one subjects with lateral elbow pain and 31 healthy controls participated in the study. The assessment comprised a pain drawing, provocation tests of the cervical and thoracic spine, a neurodynamic test of the radial nerve, and active cervical range of motion. Seventy percent of the subjects with lateral elbow pain indicated pain in the cervical or thoracic spine, as compared to 16% in the control group (p< ;0.001). The frequency of pain responses to the provocation tests of the cervical and thoracic spine was significantly higher (p< ;0.05) in the lateral elbow pain (LEP) group, as was the frequency of pain responses to the neurodynamic test of the radial nerve (p< ;0.001). Cervical flexion and extension range of motion was significantly lower (p< ;0.01) in the LEP group. The results indicate a relation between lateral elbow pain and pain in the vertebral spine (C2-T7). The cervical and thoracic spine should be included in the assessment of patients with lateral elbow pain.
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| 4. |
- Cederbom, Sara, 1973-, et al.
(författare)
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A behavioral medicine intervention for community-dwelling older adults with chronic musculoskeletal pain : Protocol for a randomized controlled trial
- 2017
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Ingår i: Journal of Pain Research. - : Dove Medical Press Ltd.. - 1178-7090. ; 10, s. 845-853
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Tidskriftsartikel (refereegranskat)abstract
- Background: Chronic musculoskeletal pain is a major health problem among older adults, particularly those who live alone and/or those who are dependent on formal care. Chronic pain is associated with mobility problems, falls, fear of falling, catastrophizing thoughts, and a lower quality of life. Research shows that physical therapy interventions based on behavioral medicine approaches are beneficial for middle-aged adults with chronic pain. However, there appears to be no previous randomized controlled trials (RCTs) based on this theoretical framework that have examined the effect on older adults with chronic musculoskeletal pain who live alone at home and are dependent on formal care to manage their everyday lives. The aim of the planned study is to evaluate the effect of an individually tailored integrated physical therapy intervention based on a behavioral medicine approach compared with the effect of standard care. Methods/design: The planned study is an RCT that will include one intervention and one control group involving a total of 150 adults aged ≥75 years with chronic musculoskeletal pain who live alone at home and are dependent on formal care to manage their everyday lives. The intervention will involve a 12-week home-based individually tailored intervention that will be designed to enhance the participants’ ability to perform everyday activities by improving physical function and reducing pain-related disability and beliefs. The control group will be given standard care, including general advice about physical activity. The participants will be assessed at baseline and at 3 and 6 months after baseline. The primary outcome will be pain-related disability and physical performance. Discussion: The intervention, if effective, will have the potential to be the basis of the first evidence-based guidelines for physical therapists who work with older adults with chronic musculoskeletal pain.
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| 5. |
- Cederbom, Sara, et al.
(författare)
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A behavioral medicine intervention for older women living alone with chronic pain - a feasibility study
- 2014
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Ingår i: Clinical Interventions in Aging. - 1176-9092 .- 1178-1998. ; 9, s. 1383-1397
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Tidskriftsartikel (refereegranskat)abstract
- Background: To be an older woman, live alone, have chronic pain, and be dependent on support are all factors that may have an impact on daily life. One way to promote ability in everyday activities in people with pain-related conditions is to use individualized, integrated behavioral medicine in physical therapy interventions. How this kind of intervention works for older women living alone at home, with chronic pain, and dependent on formal care to manage their everyday lives has not been studied. The aim was to explore the feasibility of a study and to evaluate an individually tailored integrated behavioral medicine in physical therapy intervention for the target group of women. Materials and methods: The study was a 12-week randomized trial with two-group design. Primary effect outcomes were pain-related disability and morale. Secondary effect outcomes focused on pain-related beliefs, self-efficacy for exercise, concerns of falling, physical activity, and physical performance. Results: In total, 23 women agreed to participate in the study and 16 women completed the intervention. The results showed that the behavioral medicine in physical therapy intervention was feasible. No effects were seen on the primary effect outcomes. The experimental intervention seemed to improve the level of physical activity and self-efficacy for exercise. Some of the participants in both groups perceived that they could manage their everyday life in a better way after participation in the study. Conclusion: Results from this study are encouraging, but the study procedure and interventions have to be refined and tested in a larger feasibility study to be able to evaluate the effects of these kinds of interventions on pain-related disability, pain-related beliefs, self-efficacy in everyday activities, and morale in the target group. Further research is also needed to refine and evaluate effects from individualized reminder routines, support to collect self-report data, safety procedures for balance training, and training of personnel to enhance self-efficacy.
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| 6. |
- Cederbom, Sara, et al.
(författare)
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Chronic pain among older women living alone. A study focusing on disability and morale.
- 2014
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Ingår i: European Journal of Physiotherapy. - 2167-9169 .- 2167-9177. ; 16:3, s. 139-150
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To investigate 1)how older women who are living alone perceive chronic musculoskeletal pain,Activities of Daily Living (ADL), physical activity, affective distress,pain-related beliefs, pain management, and rate pain-related disability andmorale, 2) the relationships betweendemographic variables, ADL, physical activity, affective distress, pain-relatedbeliefs, and pain management with pain-related disability and morale.Method: The study had across-sectional and correlational design. Sixty women, living alone with chronicpain and community support aged ≥65 years were included.Results: The women were on average 81 years old and had lived with pain forabout 21.5 years. They reported low scores of affective distress,catastrophizing thoughts and self-efficacy, high scores of fear of movement,low degrees of pain-related disability, and low levels of morale. The multiple regression analysisshowed that only catastrophizing thoughts significantlyexplained the variation in pain-related disability, and both affective distress and catastrophizing thoughtssignificantly explained the variation in morale. Conclusion: These older women livingalone with chronic pain reported similar prevalence ofchronic pain and pain-related disability but lower morale when comparingthe results with similar studies about older people in the same age group orolder people who are in need of help to manage their daily life. The only variable that was independely associated to bothpain-related disability and morale was catastrophizing. Further researchshould focus on identifying catastrophizing thougts,and also on developing a rehabilitation program based on a biopsychosocialperspective with the goal to decrease catastrophizing, pain-relateddisability, and increase morale for this target group
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| 7. |
- Cederbom, Sara, et al.
(författare)
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Home Help Service Staffs' Descriptions of Their Role in Promoting Everyday Activities Among Older People in Sweden Who Are Dependent on Formal Care.
- 2017
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Ingår i: Journal of Applied Gerontology. - : SAGE Publications. - 0733-4648 .- 1552-4523. ; 36:8, s. 971-992
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Tidskriftsartikel (refereegranskat)abstract
- The study aimed to explore how home help service staff described their role in improving the abilities of older people, in particular, older women with chronic pain who are dependent on formal care, to perform everyday activities. Three focus group interviews were conducted, and a qualitative inductive thematic content analysis was used. The analysis resulted in one theme: struggling to improve the care recipients' opportunities for independence but being inhibited by complex environmental factors. By encouraging the care recipients to perform everyday activities, the staff perceived themselves to both maintain and improve their care recipients' independence and quality of life. An important goal for society and health care professionals is to improve older people's abilities to "age in place" and to enable them to age independently while maintaining their quality of life. A key resource is home help service staff, and this resource should be utilized in the best possible way.
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| 8. |
- Demmelmaier, Ingrid, 1960-
(författare)
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Behaviours, Beliefs and Back Pain : Prognostic Factors for Disability in the General Population and Implementation of Screening in Primary Care Physiotherapy
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The overall aim of this thesis was to study prognostic factors for prolonged disability in back pain in the general population and physiotherapists’ screening for prolonged disability, applying a social cognitive learning perspective. Methods and results: Studies I and II were based on a survey in the general population in Sweden. Study I included 1024 individuals aged 20-50 years, reporting non-specific back pain. Four groups (n = 100, 215, 172 and 537) based on duration and recurrence of back pain were formed and compared. After controlling for pain intensity, catastrophising and expectations of future pain were positively correlated to pain duration. Perceived social support was negatively correlated to pain duration. Study II was longitudinal over 12 months and analysed one group reporting first-episode back pain (n = 77), and one group reporting long-term back pain (n = 302). Future pain intensity and disability were predicted by initial levels of pain and disability and pain-related cognitions in both groups. Study III examined the inter-rater reliability of a research protocol for assessment of physiotherapists’ telephone screening for prolonged disability. The results demonstrated sufficient inter-rater reliability. Study IV evaluated the effect of a tailored skills training intervention on physiotherapists’ screening for prolonged disability in back pain. Four physiotherapists in primary care participated in four quasi-experimental single-subject studies. Effects were seen in all participants, with increased screening of prognostic factors and less time spent on detailed discussions about back pain. Conclusions: The identification of mainly cognitive explanatory variables indicates the relevance of a social cognitive perspective of back pain-related disability (studies I and II). Physiotherapists’ telephone screening for prolonged disability in back can be reliably assessed (study III). It is suggested that interventions based on social cognitive theory are effective in producing change in specified clinical behaviours in physiotherapists (study IV).
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| 9. |
- Demmelmaier, Ingrid, et al.
(författare)
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Biopsychosocial predictors of pain, disability, health care consumption, and sick leave in first-episode and long-term back pain : A longitudinal study in the general population
- 2010
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Ingår i: International Journal of Behavioral Medicine. - : Springer Science and Business Media LLC. - 1070-5503 .- 1532-7558. ; 17:2, s. 79-89
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Tidskriftsartikel (refereegranskat)abstract
- Background: Long-term outcome in back pain is related mainly to cognitive factors such as pain-related beliefs and expectations. Most research has been performed on patient samples. Purpose: This study aimed at investigating changes over time in reported back pain, pain intensity, disability, health care consumption and sick leave as well as biopsychosocial factors over a 12 month-period. A second aim was to identify predictors of reported pain, pain intensity, disability, health care consumption and sick leave. Method: As parts of a large back pain sample from a general population (n = 1024), two groups – one with first-episode pain (n = 77) and one with long-term pain (n = 302) – responded twice to a self-administered questionnaire. Among participants reporting pain at both assessments, changes over time were analysed and predictive models were tested. Results: Generally, the results demonstrated overall stability in the self-reports over time. However, reported pain decreased in both groups, while pain catastrophizing and pain expectations increased in the first-episode group. Pain intensity and disability were predicted in regression models including four cognitive factors and initially reported levels of pain intensity and disability. Conclusion: The significance of pain-related beliefs and expectations both in early and later stages of a back pain condition is pointed out. The results in this study based on a sample from the general population are in line with previous research on patient samples.
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| 10. |
- Demmelmaier, Ingrid, et al.
(författare)
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Physiotherapists' telephone consultations regarding back pain : a method to analyze screening of risk factors
- 2010
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Ingår i: Physiotherapy Theory and Practice. - London : Informa Healthcare. - 0959-3985 .- 1532-5040. ; 26:7, s. 468-475
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Tidskriftsartikel (refereegranskat)abstract
- Background and aimsThere is a gap between guidelines and clinical management of risk factors for prolonged disability in back pain. The aims of this study were; 1) to evaluate the inter-rater reliability of a research protocol designed to analyse screening of physical and psychosocial risk factors for prolonged disability in back pain during telephone consultations, and; 2) to describe the overall content and the nature and extent of physical and psychosocial risk factors assessed by physiotherapists in telephone consultations for diagnostic screening of patients with back pain. Method The material consisted of 17 initial telephone consultations regarding back pain recorded by five physiotherapists. A research protocol covering eight evidence-based risk factors was developed. Three raters performed separate analyses according to the protocol.ResultsIntraclass correlation of how many risk factors that were investigated was 0.82 (p<0.001.) Kappa values (pair-wise) of which risk factors that were screened were 0.79, 0.73 and 0.66 (p<0.001). A median of 2 risk factors were screened in each consultation; most frequent was signs of spinal pathology/radiating pain, followed by sick leave, disability, coping with pain and negative beliefs. Rating of pain intensity, depression and expectations of long-term pain were not screened. ConclusionsThe method of analysis appears reliable. It will be used in an intervention study that evaluates to what extent physiotherapists can learn to screen in concordance with guidelines in initial telephone consultations.
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