| 1. |
- Halvarsson, Alexandra, et al.
(författare)
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StayBalanced: implementation of evidence-based fall prevention balance training for older adults-cluster randomized controlled and hybrid type 3 trial
- 2021
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Ingår i: Trials. - : BMC. - 1745-6215. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe StayBalanced programme has shown positive effects on fall prevention, balance control and fear of falling. Despite convincing evidence on the efficacy and effectiveness of balance training, there is a gap between research findings and what is provided in community-based and clinical health care settings. Therefore, transferring evidence-based balance training into clinical practice is needed.MethodsThis project, designed as a hybrid type 3 trial, is a cluster-randomized study with a mixed-method design, carried out in primary health care settings. The aim is to investigate the effectiveness of two different strategies to facilitate the implementation of an intervention, the StayBalanced balance training programme, in primary health care, including evaluation of relative changes and maintenance in patient outcomes between intervention arms over 24months. The StayBalanced programme will be launched through a website with information on the balance training and how to use it in clinical practice. One implementation strategy will include close facilitation, i.e. support and close follow-ups initiated by the researchers, in addition to access to the website. The other strategy simply includes access to the StayBalanced website. Outcome measures in the project consist of implementation outcomes, such as acceptability, feasibility, fidelity and sustainability of the StayBalanced programme. Outcomes at an individual level for older adults participating in the training will include fall-related concerns, health-related quality of life, balance performance, gait, physical activity, muscle strength in lower extremities, number of falls and compliance with training.DiscussionThis study will generate new understanding of effective strategies for transferring research to clinical practice and thereby reduce an important knowledge gap, as well as aid decision-making for future implementation of evidence-based methods. Furthermore, it will contribute to improved balance and gait, increased level of physical activity and function, and improved health-related quality of life for the individuals participating in the programme.Trial registrationClinicalTrials.govNCT02909374. Registered on September 21, 2016
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| 2. |
- Johansson, Hanna, et al.
(författare)
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Controlling the uncontrollable : Perceptions of balance in people with parkinson disease
- 2019
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Ingår i: Physical Therapy. - : Oxford University Press (OUP). - 0031-9023 .- 1538-6724. ; 99:11, s. 1501-1510
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Exercise improves balance in Parkinson disease (PD), yet the majority of people with the diagnosis are physically inactive. Insights gained from understanding how people with PD (PwPD) make sense of their symptoms and their ability to control them may inform the communication strategies and motivational approaches adopted by physical therapists. No previous study has qualitatively explored how PwPD perceive the concept of balance and the beliefs they hold concerning their ability to affect balance.OBJECTIVE: This study aimed to explore the meaning of balance for PwPD and the beliefs they hold regarding their ability to influence their balance in everyday life.DESIGN: The design is a qualitative study with an inductive approach.METHODS: In-depth interviews were conducted with 18 participants with PD (age range 46 to 83 years, Hoehn and Yahr range 1 to 4), and transcripts were analyzed using qualitative content analysis.RESULTS: Five main themes emerged from the analysis: remaining in control over the body; adapting behavior to deal with uncertainty; directing focus to stay one step ahead; resilience as a defense, and exercise beliefs and reservations. Interpretation of the underlying patterns in the main themes yielded the overarching theme of focus and determination to regain control over shifting balance.CONCLUSIONS: The concept of balance was perceived as both bodily equilibrium and mind-body interplay and was described in the context of remaining in control over one's body and everyday life. Cognitive resources were utilized in order to direct focus and attention during balance-challenging situations in a process involving internal dialogue. Even participants who did not express beliefs in their ability to affect balance through exercise used psychological resilience to counter the challenges of impaired balance.
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| 3. |
- Liljequist, David, et al.
(författare)
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Intraclass correlation - A discussion and demonstration of basic features
- 2019
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 14:7
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Tidskriftsartikel (refereegranskat)abstract
- A re-analysis of intraclass correlation (ICC) theory is presented together with Monte Carlo simulations of ICC probability distributions. A partly revised and simplified theory of the single-score ICC is obtained, together with an alternative and simple recipe for its use in reliability studies. Our main, practical conclusion is that in the analysis of a reliability study it is neither necessary nor convenient to start from an initial choice of a specified statistical model. Rather, one may impartially use all three single-score ICC formulas. A near equality of the three ICC values indicates the absence of bias (systematic error), in which case the classical (one-way random) ICC may be used. A consistency ICC larger than absolute agreement ICC indicates the presence of non-negligible bias; if so, classical ICC is invalid and misleading. An F-test may be used to confirm whether biases are present. From the resulting model (without or with bias) variances and confidence intervals may then be calculated. In presence of bias, both absolute agreement ICC and consistency ICC should be reported, since they give different and complementary information about the reliability of the method. A clinical example with data from the literature is given.
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| 4. |
- Roaldsen, Kirsti Skavberg
(författare)
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Factors influencing physical activity in patients with venous leg ulcer
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background and Aim: Venous leg ulcer is a chronic condition characterized by a cyclical pattern of healing and recurrence leading to pain, disability, inactivity and reduced health. Physical activity is beneficial for venous circulation and general health, but knowledge is needed of determinants of physical activity and of possibilities for patients with leg ulcer to be physically active. The overall aim of the present work was, in terms of the International Classification of Functioning, Disability and Health (ICF), to identify and illuminate factors influencing patients possibilities to be physically active, and to gain deeper understanding of how physical activity is perceived and understood in patients with present or previous venous leg ulcer. Patients and Methods: Thirty-four female patients aged 60 85 years and 27 agematched control subjects were recruited to Study I, which had a descriptive, crosssectional design. Clinical tests and structured interviews were used to collect the data. In Study II, a survey study with a descriptive, cross-sectional design, data were collected with a postal questionnaire from 98 patients, 62 women, aged 60 86 years. In Study III, an experimental, cross-sectional study, six patients and 22 control subjects, 2/12 women, aged 67 (58-83) years, were included. For data collection, clinical tests, structured interviews and treadmill walking were used. In Study IV, using a qualitative semistructured in-depth approach, interviews were conducted with 22 patients, 13 women, aged 75 (60-85) years. Results: In Study I, leg ulcer patients showed reduced ankle range of motion, calfmuscle strength, walking speed, mobility, primary and extended ADL and physical activity as compared to control subjects. Pain and functional limitations seemed to persist despite wound healing. Patients suffering from active ulceration were more negatively affected than their post-ulcer fellows. By contrast, general health and global life satisfaction were rated similarly by the two groups. In Study II, fear-avoidance beliefs were present in 83% of the patients and 41% had strong fear-avoidance beliefs. Odds ratios (OR) for low physical activity was about three times higher for patients with strong fear-avoidance beliefs (OR 3.1, 95% confidence interval 1.1 8.3; p = 0.027) than for patients with weak fear-avoidance beliefs. Study III showed that total ankle range of motion was decreased by 3-4% with multi-layer high-compression bandaging. Walking with compression showed no change in oxygen cost as compared to walking at the same speed without bandaging. In Study IV, four categories of descriptions of physical activity were identified; (i) self-management, (ii) instructions and support, (iii) fear of injury and (iv) a wish to stay normal. Patients displayed poor understanding of the underlying pathology and chronicity of the disease. No or contradictory information regarding physical activity was given patients from caregivers. Conclusions: Factors influencing physical activity were identified in most components of the ICF. Disabilities seemed to persist despite wound healing. Strong fear-avoidance beliefs were present and associated with low physical activity. Use of multi-layer highcompression bandaging decreased ankle range of motion but did not increase oxygen cost of walking. Whether or not the patients had understood the chronic nature of the underlying pathology was an important aspect of various ways of perceiving physical activity. Disabilities were found to impede, but not preclude physical activity. Certain environmental factors such as compression bandaging and inappropriate walking shoes and personal factors such as dysfunctional fear of movement and poor knowledge of the chronicity of the underlying disease were the greatest obstacles to physical activity.
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| 5. |
- Roaldsen, Kirsti Skavberg, et al.
(författare)
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Pediatric spinal cord injury rehabilitation : A protocol for an international multicenter project (SINpedSCI)
- 2022
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Ingår i: Journal of Pediatric Rehabilitation Medicine. - : IOS Press. - 1874-5393 .- 1875-8894. ; 15:2, s. 395-403
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Children and adolescents (<18 years old) who sustain a spinal cord injury (SCI) should ideally be managed in specialized rehabilitation services. This project aims to describe the organization of pediatric SCI in ten rehabilitation units in seven countries and to qualitatively explore psychosocial aspects of adolescents living with SCI. METHODS: A multicenter cross-sectional project is planned, using quantitative (web survey) and qualitative (interview) methods in ten rehabilitation units from Norway, Sweden, United States, Israel, PR China, Russia and Palestine. Individual interviews will be conducted with >= 20 adolescents aged 13-17 years at least 6 months post rehabilitation. RESULTS: Units involved will be described and compared, according to funding, attachment to an acute SCI unit, catchment area, number of beds, admittance and discharge procedures, availability of services, staff/patient ratio, content and intensity of rehabilitation programs, length of stay, measurement methods, follow-up services, health promotion services, and pediatric SCI prevention acts. The semi-structured interview guide will include experiences from acute care and primary rehabilitation, daily life, school, contact with friends, leisure time activities, peers, physical and psychological health, and the adolescents plans for the future. CONCLUSION: Based on the present protocol, this project is likely to provide new insight and knowledge on pediatric SCI rehabilitation and increase the understanding of pediatric SCI in adolescents and their families internationally.
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| 6. |
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| 7. |
- Sönnerfors, Pernilla, et al.
(författare)
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Access to, use, knowledge, and preferences for information technology and technical equipment among people with chronic obstructive pulmonary disease (COPD) in Sweden : A cross-sectional survey study
- 2021
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Ingår i: BMC Medical Informatics and Decision Making. - : BioMed Central. - 1472-6947. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The use of information technology can make pulmonary rehabilitation interventions in people with chronic obstructive pulmonary disease (COPD) more flexible and thereby has the potential to reach a larger proportion of the population. However, the success of using information technology in pulmonary rehabilitation is dependent on the end-user’s competence in information technology and access to the Internet. The aim was to describe the access to, and the use, knowledge, and preferences of information technology and technical equipment among people with COPD.Methods: Telephone interviews were conducted using a standardised questionnaire on information technology and technical devises addressing the household, access to and usage of the Internet, contact with authorities, e-commerce, security, the workplace, digital competence, and disabilities. Questions were also posed regarding participants’ views on a future eHealth tool for COPD, appropriate content, and the potential likelihood for them to use an eHealth tool for exercise training.Results: In total 137 persons agreed to participate, 17 dropped out resulting in 120 included participants (response rate 88%). The participants (86 women) were aged 51 to 92 years (mean: 72.5), and all severity grades of COPD according to GOLD A-D were represented. Over 90% had access to the Internet. Smartphones were used by 81%, and over 90% used apps. Participants had high knowledge of how to use the Internet, 91% had used the Internet during the last 3 months, 85% almost every day. The most common requests for a future eHealth tool for COPD were evidence-based and trustworthy information on COPD, (including medication, exercise training, inhalation and breathing techniques), communication (chat) with others and with health carers. Access to individually adjusted exercise training, and support, (motivation via prompts, chat rooms, digital information board) was also desired.Conclusions: The present study showed that people with COPD in Sweden have high access and ability to use the Internet and information technology. They are frequent users and most of them take part in the digital society, even to a higher extent than the general population. The results show that the use of an eHealth tool could be a suitable strategy for people with COPD.
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| 8. |
- Sönnerfors, Pernilla, et al.
(författare)
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Preferences for an eHealth tool to support physical activity and exercise training in COPD : a qualitative study from the viewpoint of prospective users
- 2023
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Ingår i: BMC Pulmonary Medicine. - : BioMed Central (BMC). - 1471-2466. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Despite well-known positive effects of pulmonary rehabilitation, access is limited. New strategies to improve access are advocated, including the use of eHealth tools.OBJECTIVES: The aim of this study was to explore prospective users' preferences for an eHealth tool to support the self-management of physical activity and exercise training in COPD.METHODS: A qualitative research design was applied. Data was collected in six, audio recorded, digital co-creation workshops, which were guided by a participatory and appreciative action and reflection approach. A total of 17 prospective users took part in the process, including people with COPD (n = 10), relatives (n = 2), health care givers (n = 4) and a patient organization representative (n = 1). During the workshops, pre-selected relevant topics to exploring end-users' preferences for eHealth support in self-management in COPD were discussed. The workshops were recorded and transcribed. Data was analysed using inductive qualitative content analysis.RESULTS: The overarching theme "fusing with, rather than replacing existing support structures" was uncovered when the two-sided relationship between positive expectations towards digital solutions and the fear of losing access to established rehabilitation systems, emerged in the discussions. Three categories were identified, focused on wishes for an evidence-based support platform of information about COPD, a well-designed eHealth tool including functionalities to motivate in the self-management of physical activity and exercise training, and requirements of various forms of support. Co-creators believed that there were clear benefits in combining the best of digital and existing support systems.CONCLUSIONS: Co-creators viewed an eHealth tool including support for physical activity and exercise training as a valuable digital complement to the now existing rehabilitation services. A future eHealth tool needs to focus on user-friendliness and prospective users's requests.
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