| 1. |
- Anens, Elisabeth, et al.
(författare)
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Self-reported physical activity correlates in Swedish adults with multiple sclerosis : a cross-sectional study
- 2017
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Ingår i: BMC Neurology. - : Springer Science and Business Media LLC. - 1471-2377. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Background: The benefits of physical activity in persons with Multiple Sclerosis (MS) are considerable. Knowledge about factors that correlate to physical activity is helpful in order to develop successful strategies to increase physical activity in persons with MS. Previous studies have focused on correlates to physical activity in MS, however falls self-efficacy, social support and enjoyment of physical activity are not much studied, as well as if the correlates differ with regard to disease severity. The aim of the study was to examine associations between physical activity and age, gender, employment, having children living at home, education, disease type, disease severity, fatigue, self-efficacy for physical activity, falls self-efficacy, social support and enjoyment of physical activity in a sample of persons with MS and in subgroups with regard to disease severity.Methods: This is a cross-sectional survey study including Swedish community living adults with MS, 287 persons, response rate 58.2%. The survey included standardized self-reported scales measuring physical activity, disease severity, fatigue, self-efficacy for physical activity, falls self-efficacy, and social support. Physical activity was measured by the Physical Activity Disability Survey – Revised.Results: Multiple regression analyzes showed that 59% (F(6,3)=64.9, p=0.000) of the variation in physical activity was explained by having less severe disease (β=-0.30), being employed (β=0.26), having high falls self-efficacy (β=0.20), having high self-efficacy for physical activity (β=0.17), and enjoying physical activity (β=0.11). In persons with moderate/severe MS, self-efficacy for physical activity explained physical activity.Conclusions: Consistent with previous research in persons with MS in other countries this study shows that disease severity, employment and self-efficacy for physical activity are important for physical activity. Additional important factors were falls self-efficacy and enjoyment. More research is needed to confirm this and the subgroup differences.
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| 2. |
- Urell, Charlotte, 1971-, et al.
(författare)
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Lung function before and two days after open-heart surgery
- 2012
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Ingår i: Critical Care Research and Practice. - New York, USA : Hindawi Publishing Corporation. - 2090-1305 .- 2090-1313. ; 2012
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Tidskriftsartikel (refereegranskat)abstract
- Reduced lung volumes and atelectasis are common after open-heart surgery, and pronounced restrictive lung volume impairment has been found. The aim of this study was to investigate factors influencing lung volumes on the second postoperative day. Open-heart surgery patients (n = 107, 68 yrs, 80% male) performed spirometry both before surgery and on the second postoperative day. The factors influencing postoperative lung volumes and decrease in lung volumes were investigated with univariate and multivariate analyses. Associations between pain (measured by numeric rating scale) and decrease in postoperative lung volumes were calculated with Spearman rank correlation test. Lung volumes decreased by 50% and were less than 40% of the predictive values postoperatively. Patients with BMI >25 had lower postoperative inspiratory capacity (IC) (33 ± 14% pred.) than normal-weight patients (39 ± 15% pred.), (P = 0.04). More pain during mobilisation was associated with higher decreases in postoperative lung volumes (VC: r = 0.33, P = 0.001; FEV(1): r = 0.35, P ≤ 0.0001; IC: r = 0.25, P = 0.01). Patients with high BMI are a risk group for decreased postoperative lung volumes and should therefore receive extra attention during postoperative care. As pain is related to a larger decrease in postoperative lung volumes, optimal pain relief for the patients should be identified.
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| 3. |
- Urell, Charlotte, 1971-
(författare)
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Lung Function, Respiratory Muscle Strength and Effects of Breathing Exercises in Cardiac Surgery Patients
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Breathing exercises are widely used after cardiac surgery. The duration of exercises in the immediate postoperative period is not fully evaluated and only limited data regarding the effects of home-based breathing exercises after discharge from hospital have been published.Aim: The overall aim of this thesis was to evaluate the effects of deep breathing exercises with positive expiratory pressure (PEP) and describe lung function and respiratory muscle strength in patients undergoing cardiac surgery.Participants and settings: Adult participants (n=131) were randomised to perform either 30 or 10 deep breaths with PEP per hour during the first postoperative days (Study I): the main outcome was oxygenation, assessed by arterial blood gases, on the second postoperative day. In Study III, 313 adult participants were randomly assigned to perform home-based deep breathing exercises with PEP for two months after surgery or not to perform breathing exercises with PEP after the fourth to fifth postoperative day. The main outcome was lung function, assessed by spirometry, two months after surgery. Studies II and IV were descriptive and correlative and investigated pre and postoperative lung function, assessed by spirometry, and respiratory muscle strength, assessed by maximal inspiratory pressure, and maximal expiratory pressure.Results: On the second postoperative day, arterial oxygen tension (PaO2) and arterial oxygen saturation (SaO2) was higher in the group randomised to 30 deep breaths with PEP hourly. There was no improved recovery of lung function in participants performing home-based deep breathing exercises two months after cardiac surgery, compared to a control group. Subjective experience of breathing or improvement in patient perceived quality of recovery or health-related quality of life did not differ between the groups at two months. Lung function and respiratory muscle strength were in accordance with predicted values before surgery. A 50% reduction in lung function was shown on the second postoperative day. High body mass index, male gender and sternal pain were associated with decreased lung function on the second postoperative day. Two months postoperatively, there was decreased lung function, but respiratory muscle strength had almost recovered to preoperative values.
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| 4. |
- Urell, Charlotte, 1971-, et al.
(författare)
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Reliability of the Swedish version of the multidimensional outcome expectations for exercise scale (MOEES-SW) in a cardiac population.
- 2022
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Ingår i: Physiotherapy Theory and Practice. - : Informa UK Limited. - 0959-3985 .- 1532-5040. ; 38:11, s. 1779-1788
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Translate and adapt the Multidimensional Outcome Expectations for Exercise Scale (MOEES) into Swedish language and to explore psychometric properties, in terms of test-retest reliability, internal consistency as well as factor structure and floor and ceiling effects, of the Swedish version of MOEES in cardiac patients.Materials and methods:This prospective psychometrical study set in a Swedish cardiac rehabilitation outpatient clinic included 74 patients; age 318 years after acute coronary syndrome or that had undergone cardiac surgery. Translation and adaptation procedure of the MOEES followed established international guidelines. To evaluate test-retest reliability, relative (intra-class correlation coefficient ICC, 2.1)and absolute reliability (standard error of measurement (SEM) standard error of measurement % (SEM%), percentage of absolute agreement and Kappa coefficient for each item were calculated. Internal consistency was assessed with Cronbach´s alpha. The original 3-factor structure was tested with a confirmatory factor analysis. Floor and ceiling effects were calculated. Results: In total, 60 patients, mean age 65 years, were included in the study. The test-retest showed for the three outcome expectations subscales (Physical, Self-evaluative and Social) ICC-values of 0.40 (CI 95% 0.20-0.58), 0.57 (0.39-0.71) and 0.72 (0.57-0.83), respectively. In general, the Kappa coefficients were low and varied between 0.11 and 0.44. Two questions had low loadings in the confirmatory factor analysis (<0.5) , contributing to a weak fit of the model. There was no floor effect, but the subscales physical and self-evaluative outcome expectation showed ceiling effects. Conclusion:This is the first study to analyse test-retest reliability of the translated version of MOEES into Swedish in cardiac patients and shows need for further development of the instrument before use in clinical practice and research.
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