| 1. |
- Almquist, Per Otto, et al.
(författare)
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Evaluation of an external device measuring knee joint rotation: an in vivo study with simultaneous Roentgen stereometric analysis.
- 2002
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Ingår i: Journal of Orthopaedic Research. - 1554-527X. ; 20:3, s. 427-432
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Tidskriftsartikel (refereegranskat)abstract
- An external device ("rottometer") specially designed to measure knee joint rotation was developed and evaluated with respect to its validity. Simultaneous measurements were made with the rottometer and Roentgen stereometric analysis (RSA) in five patients with implanted tantalum markers in the tibia and femur. Measurements of internal and external rotation were made at 90 degrees and 60 degrees of knee flexion using 3, 6 and 9 N m torques. The coefficients of determination (r2) between the results obtained with the rottometer and RSA were around 0.9 for the total rotation. The rottometer consistently overestimated the rotation by about 100% and this systematic error was most constant at 90 degrees flexion for the different torques. The magnitude of this error from soft tissue deformation as well as the rotatory movements in the hip, foot and ankle joints must be considered when using external devices to measure knee rotation in clinical studies. The most accurate registrations were found in 90 degrees flexion with 9 N m force (r2 = 0.94).
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| 2. |
- Almquist, Per Otto, et al.
(författare)
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Knee rotation in healthy individuals related to age and gender.
- 2012
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Ingår i: Journal of Orthopaedic Research. - : Wiley. - 1554-527X .- 0736-0266.
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Tidskriftsartikel (refereegranskat)abstract
- An external device ("the Rottometer") was especially designed to measure passive knee rotation in vivo. The device had earlier been evaluated with respect to it's validity and reliability. In the present study, we evaluated knee rotation in knee-healthy individuals and studied possible age and gender related differences. Measurements of total internal-external rotation were made at 90°, 60°, and 30° of flexion using 6 and 9 N m torques, as well as the examiner's apprehension of end-feel as displacing forces. The study group constituted of 120 healthy subjects (60 females and 60 males) with no prior or present knee disorders. The sample was divided into four age groups (15-30, 31-45, 46-60, and >60 years). The results showed no differences in knee rotation between the right and left knees or between the different flexion angles. The females showed 10-20% (p < 0.01) larger knee rotation than the males at all the three flexion angles and at all the three applied torques in all age-matched groups. In all age groups in both genders, the internal rotation accounted for 40-44% and the external for 56-60% of the total internal-external knee rotation. © 2012 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.
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| 3. |
- Almquist, Per O, et al.
(författare)
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Measurements of knee rotation-reliability of an external device in vivo.
- 2011
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Knee rotation plays an important part in knee kinematics during weight-bearing activities. An external device for measuring knee rotation (the Rottometer) has previously been evaluated for validity by simultaneous measurements of skeletal movements with Roentgen Stereometric Analysis (RSA). The aim of this study was to investigate the reliability of the device. METHOD: The within-day and test-retest reliability as well as intertester reliability of the device in vivo was calculated. Torques of 3, 6 and 9 Nm and the examiner's apprehension of end-feel were used at 90°, 60° and 30° of knee flexion. Intraclass Correlation Coefficient 2,1 (ICC 2,1), 95% confidence interval (CI) of ICC and 95% CI between test trials and examiners were used as statistical tests. RESULT: ICC2,1 ranged from 0.50 to 0.94 at all three flexion angles at 6 and 9 Nm as well as end-feel, and from 0.22 to 0.75 at 3 Nm applied torque. CONCLUSION: The Rottometer was a reliable measurement instrument concerning knee rotation at the three different flexion angles (90°, 60° and 30°) with 6 and 9 Nm applied torques as well as the examiner's apprehension of end-feel. Three Nm was not a reliable torque. The most reliable measurements were made at 9 Nm applied torque.
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| 4. |
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| 5. |
- Areskoug Josefsson, Kristina, et al.
(författare)
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Detecting decreased sexual health with MDHAQ-S
- 2013
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Ingår i: Health (Irvine). - 1949-4998 .- 1949-5005. ; :5, s. 38-47
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Tidskriftsartikel (refereegranskat)abstract
- There are instruments that measure sexual function or sexual health for persons with RA, but since sexual health is a sensitive issue, the hypothesis is that it would be easier to have a standard questionnaire that could indicate the need for communication about sexual health issues instead of an extra questionnaire with more detailed questions on sexual health. The aim of the study is to find out whether sexual health difficulties can be screened by factors included in the MDHAQ-S for persons with RA. This study explores the relation between factors included in the MDHAQ-S and the Sexual Health Questionnaire (QSH) using a mixed methods design combining quantitative and qualitative data. The MDHAQ-S covers sexual health issues, not only by using the question on sexual health, but also on other factors included in the questionnaire such as increased pain, fatigue, depression, anxiety, physical capacity, level of physical activity and body weight. To explore decreased sexual arousal, decreased sexual satisfaction and decreased sexual well-being, in-depth interviews must be held with persons with RA, either using a sexual health questionnaire or in a clinical interview.
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| 6. |
- Areskoug Josefsson, Kristina, et al.
(författare)
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Swedish version of the multi dimensional health assessment questionnaire – translation and psychometric evaluation
- 2013
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundHealth assessment measurements for patients with Rheumatoid arthritis (RA) have to be meaningful, valid and relevant. A commonly used questionnaire for patients with RA is the Stanford Health Assessment Questionnaire Disability Index (HAQ), which has been available in Swedish since 1988. The HAQ has been revised and improved several times and the latest version is the Multi Dimensional Health Assessment Questionnaire (MDHAQ). The aim of this study was to translate the MDHAQ to Swedish conditions and to test the validity and reliability of this version for persons with RA. MethodsTranslation and adaption of the MDHAQ were performed according to guidelines by Guillemin et al. The translated version was tested for face validity and test-retest in a group of 30 patients with RA. Content validity, criterion validity and internal consistency were tested in a larger study group of 83 patients with RA. Reliability was tested with test-retest and Cronbach´s alpha for internal consistency. Two aspects of validity were explored: content and criterion validity. Content validity was tested with a content validity index. Criterion validity was tested with concurrent validity by exploring the correlation between the MDHAQ-S and the AIMS2-SF. Floor and ceiling effects were explored. ResultsTest-retest with intra-class correlation coefficient (ICC) gave a coefficient of 0.85 for physical function and 0.79 for psychological properties. Reliability test with Cronbach´s alpha gave an alpha of 0.65 for the psychological dimension and an alpha of 0.88 for the physical dimension of the MDHAQ-S. The average sum of the content validity index for each item was of the MDHAQ-S was 0.94. The MDHAQ-S had mainly a moderate correlation with the AIMS2-SF, except for the social dimension of the AIMS2-SF, which had a very low correlation with the MDHAQ-S. ConclusionsThe MDHAQ-S was considered to be reliable and valid, but further research is needed concerning sensitivity to change.
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| 7. |
- Gard, Gunvor, et al.
(författare)
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Physical Therapists´ emotional expressions in interviews about factors important for interaction with patients
- 2000
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Ingår i: Physiotherapy. - 1873-1465 .- 0031-9406. ; 86:5, s. 229-240
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Tidskriftsartikel (refereegranskat)abstract
- Interactions between patients and physiotherapists have been studied by various researchers. Some results indicate that physiotherapists have an awareness of underlying emotions, but often respond only on an intellectual level. It seems that verbally expressed emotions may be important for interaction between physiotherapists and patients during treatment. Aim The aim of this study was to investigate how many and what verbally expressed emotions physiotherapists state during interviews between physiotherapists and patients. Method The study was a qualitative case study with cross-case analysis according to Shepard et al (1993) and Merriam (1988). Ten informants participated, all of them 'experts in interaction with patients', women, Swedish-speaking, and with at least five years' experience in primary health care. The physiotherapists' emotions were categorised according to Tomkins (1984) and Izard (1977) in the categories of interest/excitement, surprise/startle, enjoyment/joy, sadness, anger/rage, fear/terror, shame/humiliation, contempt and disgust. Results Positive emotions such as interest and joy were expressed most often in the interviews, in situations where physiotherapy had been successful, as joyful contacts with colleagues, or in situations where humour was used as a therapeutic instrument. Surprise, sadness and anger were expressed more seldom and contempt or disgust were not expressed at all in the interviews. Conclusion Verbal expressions of emotions in treatment situations in physiotherapy practice should be promoted more emphatically. This may start a reflective process in both patients and physiotherapists and deepen the understanding of the interaction.
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| 8. |
- Grahn, Birgitta E M, et al.
(författare)
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Motivated patients are more cost-effectively rehabilitated - A two-year prospective controlled study of patients with prolonged musculoskeletal disorders diagnosed in primary care
- 2000
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Ingår i: International Journal of Technology Assessment in Health Care. - 0266-4623 .- 1471-6348. ; 16:3, s. 849-863
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To compare the cost-effectiveness of a multidisciplinary rehabilitation program with traditional treatment within primary care in terms of the health-related duality of life (HRQOL) in patients with prolonged musculoskeletal disorders (MSD) on the one hand and the costs to society on the other. Predictors of total costs, such as motivation, socio-economic level, age, pain, and working environment, were investigated. Methods: A prospective, matched, controlled 2-year follow-up study was designed. The main outcome measures were HRQOL using the Nottingham Health profile (NHP) and patient-specific total costs due to society. The cost-effectiveness was expressed as a quotient of the total costs to society/NHP global score difference value. Results: Patients with prolonged MSD generate substantial total costs to society, chiefly in the area of indirect costs. Multidisciplinary rehabilitation improved HRQOL more cost-effectively. Motivation was revealed as a predictor of total costs. The relationship in savings in terms of indirect costs between the highly-motivated and the less-motivated patients was calculated at 4:1. Conclusions: The large group of patients with prolonged MSD generate substantial total costs, and even small reductions in direct and indirect costs could be of importance to society. The multidisciplinary rehabilitation program applied here was more cost-effective as compared with conventional treatment within primary care when it came to improving the patients perceived HRQOL. Motivation could be a predictor of total costs, which has to be addressed in the process of identifying the patient as a partner in the rehabilitation process.
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| 9. |
- Grahn, B.E.M., et al.
(författare)
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Rehabilitation benefits highly motivated patients : A six-year prospective cost-effectiveness study
- 2004
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Ingår i: International Journal of Technology Assessment in Health Care. - 0266-4623 .- 1471-6348. ; 20:2, s. 214-221
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To compare the six-year outcome of a multidisciplinary rehabilitation program with continued care within primary care in terms of health-related quality of life and cost-effectiveness. Furthermore, predictors of total costs to society were examined. Methods: A prospective, matched, controlled, six-year follow-up was designed. The study included 236 patients (42 men, 194 women) nineteen to sixty-one years of age with prolonged musculoskeletal disorders. The intervention comprised a four-week multidisciplinary rehabilitation and an active one-year follow-up based on a bio-psycho-social approach. The control group received continued care within primary care. The main outcome measures were quality of life measured using the Nottingham Health Profile, motivation identified by an interview and patient-specific total costs to society. Differences in mean costs between groups and cost-effectiveness were evaluated by applying nonparametric bootstrapping techniques. Results: Total costs per treated patient in the rehabilitation group and the control group were £43,464 (SD = 31,093) and £44,123 (SD = 33,333), respectively (p=.896). Multidisciplinary rehabilitation improved quality of life somewhat more cost-effectively. Motivation was revealed as a predictor of total costs. Conclusion: In the long-run, the evaluated multidisciplinary rehabilitation improved the highly motivated patients' quality of life most cost-effectively. The latently motivated patients may require rehabilitation, which is less intensive and with a longer duration, to improve their health in a whole-person perspective. The burden of prolonged musculoskeletal disorders to society was reaffirmed. Motivation could be a predictor of total costs, a factor which has to be taken into account in the examination procedure.
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| 10. |
- Grahn, Birgitta, et al.
(författare)
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Motivation for change and personal resources in patients with prolonged musculoskeletal disorders
- 2001
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Ingår i: Journal of Bodywork & Movement Therapies. - 1360-8592. ; , s. 160-160
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this qualitative 2-year follow-up study was to obtain a deeper understanding of motivation for change towards an active and independent life in patients with prolonged musculoskeletal disorders and to explore and identify personal resources that might influence such improvements. Data collection and analysis were performed according to the qualitative case study design. An initial conceptual framework was developed to bound and guide the study. Twenty patients were selected using purposive sampling with respect to motivational level (highly to latently motivated) to create a sample of maximum variety. Data were collected using repeated interviews and additional quantitative instruments (health-related quality of life, body image, movement ability, postural control, pain rating). The study comprised three data collection periods. Motivation for change was associated with the use of personal resources. The central themes to emerge were body awareness, self-focus, locus of control and coping ability. The results emphasized the indivisible unity of body and mind. The efficacy of rehabilitation might improve if the individual's own resources were taken into account.
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