| 1. |
- Ashman Kröönström, Linda, 1982, et al.
(författare)
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Symptoms, care consumption, and healthcare costs in hospitalized patients during the first wave of the COVID-19 pandemic.
- 2023
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Ingår i: PloS one. - 1932-6203. ; 18:9
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Tidskriftsartikel (refereegranskat)abstract
- We aimed to assess symptomatology post discharge from the hospital in patients with COVID-19 treated during the first wave of the COVID-19 pandemic, and to follow care consumption and healthcare costs six months post discharge.This study was a descriptive observational study over time. Data were retrieved from the Sahlgrenska University (SU) hospital registry for patients admitted to an SU hospital during March 2020 to August 2020. Of these, 1014 received a questionnaire approximately six weeks post discharge regarding symptoms. Data regarding care consumption were retrieved from the registry in the Region Västra Götaland for 529 (52.2%) patients who completed the questionnaire. Of these, 466 patients were included in the analysis of care consumption.There was a reported decrease in mobility from admission to discharge in both men (p = 0.02) and women (p = 0.01). The costs of inpatient care amounted to a total of 9 601 459.20 Euro (EUR). Symptoms were reported in 436 (93.6%) patients post discharge, of which weight loss during COVID-19 was most common in both men (n = 220, 77.5%) and women (n = 107, 58.8%). During six-month follow-up, 409 (87%) patients consumed care. Of the registered visits, 868 (27.1%) were related to a COVID-19 diagnosis. The total sum of outpatient care (i.e. visits with a registered COVID-19 diagnosis) was 77 311.30 EUR.At discharge from the hospital, there was a decrease in mobility. Most patients had remaining sequelae post discharge. At six months post discharge, nearly 90% of patients had consumed care, with approximately 20% related to COVID-19. This indicates a persisting need for rehabilitation post discharge from hospital in patients treated for COVID-19.
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| 2. |
- Limbäck Svensson, Gunilla, et al.
(författare)
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A structured physiotherapy treatment model can provide rapid relief to patients who qualify for lumbar disc surgery: A prospective cohort study.
- 2014
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Ingår i: Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1651-2081. ; 46:3, s. 233-240
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate a structured physiotherapy treatment model in patients who qualify for lumbar disc surgery. Design: A prospective cohort study. Patients: Forty-one patients with lumbar disc herniation, diagnosed by clinical assessments and magnetic resonance imaging. Methods: Patients followed a structured physiotherapy treatment model, including Mechanical Diagnosis and Therapy (MDT), together with graded trunk stabilization training. Study outcome measures were the Oswestry Disability Index, a visual analogue scale for leg and back pain, the Tampa Scale for Kinesiophobia, the European Quality of Life in 5 Dimensions Questionnaires, the Zung Self-Rating Depression Scale, the Self-Efficacy Scale, work status, and patient satisfaction with treatment. Questionnaires were distributed before treatment and at 3-, 12- and 24-month follow-ups. Results: The patients had already improved significantly (p<0.001) 3 months after the structured physiotherapy treatment model in all assessments: disability, leg and back pain, kinesiophobia, health-related quality of life, depression and self-efficacy. The improvement could still be seen at the 2-year follow-up. Conclusion: This study recommends adopting the structured physiotherapy treatment model before considering surgery for patients with symptoms such as pain and disability due to lumbar disc herniation.
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| 3. |
- Limbäck Svensson, Gunilla, et al.
(författare)
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High degree of kinesiophobia after lumbar disc herniation surgery.
- 2011
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Ingår i: Acta orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 82:6, s. 732-736
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose Several studies have investigated outcomes after disc surgery. However, the occurrence of kinesiophobia has not been investigated previously in patients after disc herniation surgery. In this cross-sectional study, we investigated kinesiophobia in patients who had been treated surgically for lumbar disc herniation, and we related the results to established outcome measures. Patients and methods 10?34 months after surgery, questionnaires were sent to 97 patients who had undergone standardized open discectomy. Outcome measures included Tampa scale for kinesiophobia (TSK); Oswestry disability index (ODI); European quality of life in 5 dimensions (EQ-5D); visual analog scale (VAS) for leg and back pain, work disability, and patient satisfaction; Zung self-rating depression scale (ZDS); pain catastrophizing scale (PCS); and a self-efficacy scale (SES). Results 36 of 80 patients reported having kinesiophobia. There were statistically significant differences in ODI, EQ-5D, VAS leg and back pain, ZDS, PCS, and SES between patients with and without kinesiophobia. Interpretation Half of the patients suffered from kinesiophobia 10?34 months after surgery for disc herniation. These patients were more disabled, had more pain, more catastrophizing thoughts, more symptoms of depression, lower self-efficacy, and poorer health-related quality of life than patients without kinesiophobia.
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| 4. |
- Limbäck Svensson, Gunilla, et al.
(författare)
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Patients' experience of health three years after structured physiotherapy or surgery for lumbar disc herniation
- 2013
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 45:3, s. 293-299
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To describe the experience of health among patients 3 years after treatment with a structured physiotherapy model or surgery for lumbar disc herniation. Design: A qualitative research study. Subjects/patients: Patients were referred to the orthopaedic clinic at Sahlgrenska University Hospital with sciatica due to lumbar disc herniation. Twenty patients who were eligible for surgery were treated either with a structured physiotherapy model or with surgery. Methods: Open-ended interviews were conducted and analysed using content analysis. Results: Findings were grouped into two themes: feeling of well-being and feeling of ill-being. In the group treated with structured physiotherapy there were a high number of codes in the feeling of well-being theme. In the group treated with surgery there were a high number of codes in the feeling of ill-being theme. Conclusion: Patients treated with structured physiotherapy or surgery experienced feelings of well-being and ill-being 3 years after treatment. Patients treated with physiotherapy and surgery described varying experiences of health 3 years after treatment for lumbar disc herniation. It can be speculated that the experience of well-being may be explained by the ability of structured physiotherapy treatments to empower patients.
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| 5. |
- Limbäck Svensson, Gunilla, et al.
(författare)
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Scorer för utvärdering av ryggbesvär
- 2009
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Ingår i: Svensk Idrottsmedicinsk Idrottsförening Tidskrift. ; :3, s. 14-16
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Tidskriftsartikel (refereegranskat)
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| 6. |
- Ahlqwist, Anna, et al.
(författare)
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Physical therapy treatment of back complaints on children and adolescents.
- 2008
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Ingår i: Spine. - 1528-1159. ; 33:20
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Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN: A randomized controlled trial was performed. OBJECTIVES: To evaluate how 2 different treatment options affect perception of health, pain, and physical functioning over time among children and adolescents with low back pain (LBP). SUMMARY OF BACKGROUND DATA: LBP among children and adolescents has increased. The literature shows that children with LBP also suffer from this condition as adults. Thus, it is important to prevent and treat LBP in children and adolescents. METHODS: Forty-five children and adolescents were consecutively randomized into one of 2 treatment groups and were studied for 12 weeks. Group 1 was given individualized physical therapy and exercise and a standardized self-training program and back education. Group 2 was given self-training program and back education but no individualized therapy. The children and adolescents were tested before and after the treatment period. Child Health Questionnaire Child Form 87, Roland & Morris Disability Questionnaire, Painometer, Back Saver Sit and Reach, and test of trunk muscle endurance were used to evaluate the interventions. RESULTS: Both groups improved statistically significant in most parameters over time. On comparison between the groups the physical function measured by Roland & Morris Disability Questionnaire and the duration of pain measured by Painometer improved statistically significant in Group 1. CONCLUSION: An individual assessment by a knowledgeable physiotherapist and an active treatment model improve how children and adolescents experience their back problems with respect to health and physical function, pain, strength, and mobility, regardless of whether treatment consists of a home exercise program with follow-up or home exercise combined with exercise and treatment supervised by a physiotherapist.
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| 7. |
- Andreasson, Ingrid, et al.
(författare)
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Daily life one year after corrective osteotomy for malunion of a distal radius fracture an interview study
- 2022
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Ingår i: Journal of Plastic Surgery and Hand Surgery. - : Medical Journals Sweden AB. - 2000-656X .- 2000-6764. ; 56:1, s. 16-22
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to explore the everyday life experiences of people one year after corrective osteotomy following a symptomatic, malunited, distal radius fracture. Semi-structured interviews were conducted with twenty respondents, median age 65 (22-81) years. The respondents were recruited consecutively. The interviews were subjected to qualitative content analysis. Three authors took part in the analysis. The result is presented as one theme, 'Daily life works again' with five categories: Relief of inconveniences and symptoms, Managing new symptoms and complications, Regaining abilities, Normalised social relationships, Increased wellbeing. The symptoms had declined in severity, some participants regarded themselves as fully restored and used their hand again without hesitation. Others were still bothered by their wrist occasionally and a few had to manage complications. The participants had regained the ability to perform many everyday life activities and reported increased independence and less irritation between spouses, as well as increased wellbeing. One year after a corrective osteotomy following malunion of a distal radius fracture, the patients' experiences represent a continuum. Some are still restricted by their wrist occasionally, the majority experience an increased ease in their performance of activities of daily life and some regard themselves as fully restored. The recovery has a positive impact on social relationships and the patients' wellbeing.
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| 8. |
- Andreasson, Ingrid, et al.
(författare)
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Functional outcome after corrective osteotomy for malunion of the distal radius: a randomised, controlled, double-blind trial
- 2020
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Ingår i: International Orthopaedics. - : Springer Science and Business Media LLC. - 0341-2695 .- 1432-5195. ; 44:7, s. 1353-1365
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Tidskriftsartikel (refereegranskat)abstract
- Purpose The purpose of this randomised, controlled, double-blind trial was to evaluate functional outcome during the first year after corrective osteotomy for malunited distal radius fractures, with or without filling the osteotomy void. Method Patients were randomised to receive a HydroSet bone substitute or no graft. Cortical contact was maintained and stabilisation of the osteotomy was carried out with a DiPhos R- or RM Plate. To evaluate subjective functional outcome, the Patient-Rated Wrist Evaluation (PRWE), the Quick Disabilities of the Arm, Shoulder and Hand Questionnaire (Q-DASH), the Canadian Occupational Performance Measure (COPM) and the RAND-36 were used. Moreover, range of motion and grip strength were measured by blinded evaluators. Evaluations were made pre-operatively and three, six and 12 months post-operatively. Results There were no significant differences between the groups at any time point post-operatively with respect to any of the PROMs that were used or range of motion or grip strength (p> 0.05). In both groups, there was a significant improvement at the 12-month follow-up compared with pre-operatively for the PRWE, the Q-DASH and the COPM satisfaction scores. The RAND-36 revealed no significant differences except for two domains, in which there was an improvement in the treatment group (p< 0.05). For grip strength and for range of motion in all movement directions, except dorsal extension, there was a significant improvement in both groups (p< 0.05). Conclusion There is no significant difference in functional outcome during the first year after corrective open-wedge distal radius osteotomy, where cortical contact is maintained, regardless of whether or not bone substitute to fill the void is used.
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| 9. |
- Andreasson, Ingrid, et al.
(författare)
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Life has become troublesome–my wrist bothers me around the clock: an interview study relating to daily life with a malunited distal radius fracture
- 2020
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 42:16, s. 2344-2350
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of this study was to explore the everyday life experiences of people suffering from a symptomatic, malunited, distal radius fracture. Method: Qualitative interviews were conducted with twenty respondents, median age 59 [16–85] years. The interviews were subjected to qualitative content analysis. Results: The result, presented as one main theme with categories and subcategories, describes the impact of the injury. Everyday life was affected in all participants, very much in a few highly valued activities such as sports and work, whenever the hand was used, or even at rest. This study indicates that the injury has an impact on the ability to move around, other parts of the body, sleep, emotions, self-perception and relationships. It also shows that the patients used several strategies to manage the situation. Conclusion: The malunion of a distal radius fracture has a negative impact on a wide range of daily activities, as well as other aspects of daily life. There is a need for information between caregivers and patients, and clear routines, once a malunion has occurred.Implications for rehabilitation The symptomatic malunion of a distal radius fracture should be acknowledged as a complex condition requiring comprehensive interventions Technical equipment, braces and new solutions on practical problems was necessary to manage everyday life and should be a focus of intervention for this patient group The consequences of the injury was not only restricted activity performance but also affected social relationships and emotions Information about fracture healing and how a malunion can occur, as well as information on how much the wrist can be loaded at different time points, is important to reduce anxiety. © 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group.
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| 10. |
- Andreasson, Ingrid, et al.
(författare)
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Long-term outcomes of corrective osteotomy for malunited fractures of the distal radius
- 2020
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Ingår i: Journal of Plastic Surgery and Hand Surgery. - : Medical Journals Sweden AB. - 2000-656X .- 2000-6764. ; 54:2, s. 94-100
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to investigate the long-term outcome after corrective osteotomy for malunion of distal radius fractures. Radiological findings, function, activity performance, pain, health-related quality of life and self-efficacy were studied. Evaluation of 37 patients 3-10 years after osteotomy fixated with a volar plate. Conventional radiographs were taken. Grip strength and range of motion were evaluated. Scores from the Patient Rated Wrist Evaluation (PRWE) were compared with normative values. The RAND-36 was used for evaluation of health-related quality of life and the General Self-Efficacy scale (S-GSE) for self-efficacy. Radial height, volar tilt, and ulnar variance improved postoperatively. In the long term, the corrections were maintained. Radiographs showed significantly more advanced osteoarthritis. Mean grip strength was 31 kg (SD 13) 89%, and range of motion varied between 80% and 95% compared to the uninjured side. The median PRWE was 12 points (0-99). The study group experienced higher levels of pain than reference values. There was a moderate correlation between the PRWE and volar tilt (rs = 0.453, p = .006) and grip strength (rs = 0.40, p = .014). At long-term follow-up functional outcome after a corrective osteotomy is generally good, but patients may experience some degree of pain. Corrective osteotomy might be considered for patients with a poor functional outcome after a distal radius fracture.
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| 11. |
- Asplin, Gillian, et al.
(författare)
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Concurrent validity and responsiveness of Traffic Light System-BasicADL (TLS-BasicADL)
- 2022
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Ingår i: European Journal of Physiotherapy. - : Informa UK Limited. - 2167-9169 .- 2167-9177. ; 24:6, s. 372-380
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To test validity and responsiveness of Traffic Light System-BasicADL (TLS-BasicADL). Method: Validity: Data according to TLS-BasicADL, modified Functional Independence Measure (FIM) and Barthel Index (BI) were collected from 50 patients with mixed medical diagnoses. Responsiveness: 106 patients following hip fracture assessed according to TLS-Basic ADL and modified Katz Index. Percentage change in TLS-BasicADL from pre-fracture status, to post-operatively, discharge and 1 month follow-up was calculated. TLS-BasicADL and modified Katz Index were also correlated at discharge and 1 month. For analysis of responsiveness, Spearman's rho coefficient (rs) was used and for distribution at item level, percentage change and sign test. Results: Validity: Strong-excellent correlations between TLS-BasicADL and modified FIM (0.65-0.95), TLS-BasicADL and modified BI (0.77-0.97) for individual items. Analysis of total scores revealed excellent correlations between instruments (0.96-0.98). Responsiveness: Significant differences between assessments for each item of TLS-BasicADL except upper hygiene, dressing and eating. Excellent correlation was found between TLS-BasicADL and modified Katz Index between pre-fracture - discharge (0.897) and moderate-strong (0.597) discharge - 1 month. Conclusion: TLS-BasicADL is shown to have acceptable concurrent validity for measuring basic mobility and self-care in elderly patients with mixed medical diagnoses and responsive for patients following hip fracture surgery.
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| 12. |
- Asplin, Gillian, et al.
(författare)
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Early coordinated rehabilitation in acute phase after hip fracture - a model for increased patient participation
- 2017
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Ingår i: Bmc Geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 17:240
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Tidskriftsartikel (refereegranskat)abstract
- Background: Studies have shown that patients with hip fracture treated in a Comprehensive Geriatric Care (CGC) unit report better results in comparison to orthopaedic care. Furthermore, involving patients in their healthcare by encouraging patient participation can result in better quality of care and improved outcomes. To our knowledge no study has been performed comparing rehabilitation programmes within a CGC unit during the acute phase after hip fracture with focus on improving patients' perceived participation and subsequent effect on patients' function. Methods: A prospective, controlled, intervention performed in a CGC unit and compared with standard care. A total of 126 patients with hip fracture were recruited who were prior to fracture; community dwelling, mobile indoors and independent in personal care. Intervention Group (IG): 63 patients, mean age 82.0 years and Control Group (CG): 63 patients mean age 80.5 years. Intervention: coordinated rehabilitation programme with early onset of patient participation and intensified occupational therapy and physiotherapy after hip fracture surgery. The primary outcome measure was self-reported patient participation at discharge. Secondary outcome measures were: TLS-BasicADL; Bergs Balance Scale (BBS); Falls Efficacy Scale FES(S); Short Physical Performance Battery (SPPB) and Timed Up and Go (TUG) at discharge and 1 month and ADL staircase for instrumental ADL at 1 month. Results: At discharge a statistically significant greater number of patients in the IG reported higher levels of participation (p < 0.05) and independence in lower body hygiene (p < 0.05) and dressing (p < 0.001). There were however no statistically significant differences at discharge and 1 month between groups in functional balance and confidence, performance measures or risk for falls. Conclusion: This model of OT and PT coordinated inpatient rehabilitation had a positive effect on patients' perceived participation in their rehabilitation and ADL at discharge but did not appear to affect level of recovery or risk for future falls at 1 month. A large proportion of patients remained at risk for future falls at 1 month in both groups highlighting the need for continued rehabilitation after discharge.
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| 13. |
- Asplin, Gillian, et al.
(författare)
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TLS-BasicADL: development and reliability of a new assessment scale to measure basic mobility and self-care
- 2014
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Ingår i: International Journal of Therapy and Rehabilitation. - : Mark Allen Group. - 1741-1645 .- 1759-779X. ; 21:9, s. 421-6
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To describe the development and test reliability of a new assessment scale for measuring basic mobility and self-care: the Traffic Light System-BasicADL (TLS-BasicADL). Subjects: Eighteen occupational and physiotherapists took part in inter-rater, and 25 in intra-rater, reliability testing. Thirty inpatients admitted to an acute geriatric/orthopaedic unit, aged ≥70 years participated in inter-rater testing, 5 of whom were included in intra-rater testing. Methods: TLS-BasicADL was constructed by members of the interdisciplinary team at a geriatric unit. Items were generated from existing instruments, pilot testing and consensus meetings. Inter-rater testing was performed by two therapists simultaneously. Intra-rater reliability was examined using video-taped films of 5 patients. Therapists viewed and assessed 5 patients, then retested 4 weeks later. For inter-rater testing percentage agreement (PA) and intra-class correlation coefficient (ICC) were used, and for intra-rater reliability, PA. Results: Analysis of reliability showed high inter-rater (PA=86%; ICC=0.90) and fair intra-rater reliability (PA=≥72%) for mobility items. Conclusion: The new interdisciplinary assessment, TLS-BasicADL for measuring function in older persons in the acute hospital setting is shown to have high inter-rater and fair intra-rater reliability.
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| 14. |
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| 15. |
- Bernhardsson, Susanne, 1958, et al.
(författare)
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Evaluation of an exercise concept focusing on eccentric strength training of the rotator cuff for patients with subacromial impingement syndrome
- 2011
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Ingår i: CLINICAL REHABILITATION. - 0269-2155. ; 25:1, s. 69-78
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Tidskriftsartikel (refereegranskat)abstract
- Abstract: Objective: To evaluate the effect on pain intensity and function of an exercise concept focusing on specific eccentric strength training of the rotator cuff in patients with subacromial impingement syndrome. Design: Single-subject research design with baseline and treatment phases (AB design). Setting: Home-based training programme supervised and supported by visits to physiotherapy clinic. Subjects: Ten patients, mean (SD) age 54 (8.6) years, symptom duration 12 (9.1) months. Intervention: Daily eccentric strengthening exercises of the rotator cuff during 12 weeks. Main measures: Primary outcome measures: Pain intensity, assessed with a visual analogue scale, and function, using the Patient-Specific Functional Scale. Secondary outcome measures: Shoulder function evaluated with the Constant score, and shoulder-related quality of life evaluated with the Western Ontario Rotator Cuff Index. Results: Pain intensity decreased significantly in eight of the ten subjects. Function improved significantly in all ten subjects. Constant score increased in nine subjects and Western Ontario Rotator Cuff Index increased in seven subjects. Mean Constant score for the whole group increased significantly from 44 to 69 points (P = 0.008). Mean Western Ontario Rotator Cuff Index increased from 51 to 71% (P = 0.021). Conclusion: A 12-week eccentric strengthening programme targeting the rotator cuff and incorporating scapular control and correct movement pattern can be effective in decreasing pain and increasing function in patients with subacromial impingement syndrome. A randomized controlled trial is necessary to provide stronger evidence of the method
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| 16. |
- Blomstrand, Johanna, et al.
(författare)
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Pain, hand function, activity performance and apprehensiveness, in patients with surgically treated distal radius fractures
- 2023
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Ingår i: Journal of Plastic Surgery and Hand Surgery. - : Medical Journals Sweden AB. - 2000-656X .- 2000-6764. ; 57:1-6, s. 247-252
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Tidskriftsartikel (refereegranskat)abstract
- Distal radius fracture (DRF) is a common injury, affecting both function and activity performance. Postoperative rehabilitation is an essential part of the treatment of a surgically treated DRF. The study aims were to assess pain, hand function, activity performance and apprehensiveness and their association, during the first three months after a surgically treated DRF. Eighty-eight patients with a DRF were assessed for pain, hand function, activity performance and apprehensiveness three days and two, six and 12 weeks after surgery. The results indicated that pain, range of motion (ROM), grip strength, apprehensiveness, and activity performance (PRWE) improved significantly between follow-ups (p < .001-.01). Apprehensiveness correlated moderately with activity performance on all visits (0.40-0.47, p < .01), which implies a correlation between the variables, but the regression model showed that the differences in the PRWE at twelve weeks cannot be explained by the differences in apprehensiveness or range of motion at cast removal. At 12 weeks, the study participants had regained almost 70% of their grip strength and 74-96% of the ROM of the uninjured hand. The study shows that, during the study period, the participants improved in both pain, hand function and activity performance, and indicates that a simple question on apprehensiveness in terms of using the injured hand in daily life could be an important factor in distal radius fracture rehabilitation.
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| 17. |
- Blomstrand, Johanna, et al.
(författare)
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The Michigan Hand Outcomes Questionnaire (MHQ-Swe) in patients with distal radius fractures-cross-cultural adaptation to Swedish, validation and reliability
- 2021
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Ingår i: Journal of Orthopaedic Surgery and Research. - : Springer Science and Business Media LLC. - 1749-799X. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The Michigan Hand Outcomes Questionnaire-MHQ-is a well-known self-assessment questionnaire, where patients' own perception in terms of recovery, pain and the ability to return to activities of daily living is assessed. The purpose of the study was to translate and culturally adapt the Michigan Hand Outcomes Questionnaire to Swedish and to test the validity and reliability in patients with surgically treated distal radius fractures. Methods: The cross-cultural adaptation and the translation process were conducted according to predefined guidelines. Seventy-eight patients with surgically treated distal radius fractures completed the translated version of the questionnaire on their six-week follow-up visit. Results: The translation and cross-cultural adaptation process revealed no major linguistic or cultural issues. The internal consistency of the MHQ-Swe ranged from 0.77 to 0.94 at test 1 and from 0.81 to 0.96 at test 2 for all subscales, which indicates good internal consistency in the subscales. The hand function subscale revealed the lowest results and work performance the highest. The ICCs showed excellent test-retest reliability, ranging from 0.77 to 0.90 on all MHQ subscales and 0.92 on total score. The highest results for the ICC were seen in the satisfaction subscale (ICC = 0.90), while the lowest were seen in the aesthetic subscale (ICC = 0.77). The correlation analysis between the MHQ-Swe, PRWE and VAS showed a generally moderate to high correlation for all the subscales. Conclusions: The Swedish version of the MHQ, the MHQ-Swe, showed good validity and reliability and it is therefore an appropriate and relevant questionnaire for use in patients with surgically treated distal radius fractures. Trial registration: FoU i VGR, Projectnumber: 208491, registered December 9, 2015.
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| 18. |
- Elden, Helen, 1959, et al.
(författare)
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Back pain in relation to pregnancy: A longitudinal 10-year follow-up of 369 women diagnosed with pelvic girdle pain during pregnancy
- 2013
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Ingår i: Advances in multidisciplinary research for better spinal/pelvic care. The 8th Interdiciplinary World Congress on Low Back & Pelvic Pain, Oct, 2013. Dubai.. - 9789081601603
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Konferensbidrag (refereegranskat)abstract
- Introduction PGP have been associated with muscular dysfunction, maternal factors, and pre-pregnancy low back pain, LBP, and/or pelvic girdle pain, PGP. It has also been stated that the pain and functional disturbances in relation to PGP must be reproducible by specific clinical tests. However, physical examinations have not been performed in long-time follow-ups of women with well-defined PGP during pregnancy and knowledge of potential predictors for long-standing LBP/PGP in these women is limited. Aim To describe the long-term development of back pain in women with well-defined PGP during pregnancy and, to identify potential predictors for persistent PGP and/or LBP in a long time perspective. Materials and Methods Women with well-defined PGP according to mechanical assessment of the, lumbar spine, pelvic pain provocation tests, standard history, pain drawings and European Guidelines who completed one of three treatment studies in 2000-2002, 2006-2007 or 2009-2011 answered a questionnaire. Women reporting pain from the pelvic girdle and/or lower back were physically examined. Results Of 534 eligible women, 380 (71%) answered the questionnaire. Data from 37 (9.7%) women were excluded from analysis due to pregnancy (n=15), systemic disease (n=11), participated in two of the studies (=n5) and declined examination (n=6). Forty-five women/343 (13%) had verified back pain. Of these women, 12/343 (3.5%) had LBP; 15/343 (4.4%) had PGP and 18/343 (5.2%) had combined back- and pelvic girdle pain. During pregnancy, predictors for persisting back pain were: Having a back pain history before pregnancy (p=0.0194), high pain intensity in the morning (Visual Analogue Scale, p=0.0097), impaired function (Oswestery Disability Index p=0.0127), low health related quality of life (Euro-qol, p=0.0097), use of an elastic pelvic belt (p=0.031), difficulty to turn over in bed (p=0.001) and early debut of PGP in pregnancy (p=0.029). Relevance of the number of positive pain provocation tests during pregnancy and at follow-up will also be presented. Relevance PGP can be physically compromising during pregnancy and cause anxiousness concerning childcare after delivery and later return to work and future work planning. It is therefore important to present a reliable prognosis to these women as early as possible, preferably during pregnancy. Discussion Considering the long follow up (10 years), the dropout-ratio in this study was acceptable and the results presented were in line with earlier publications about persistent LBP and PGP in a shorter perspective. Furthermore, the women were physically examined by skilled physiotherapists to confirm the diagnoses PGP and LBP in accordance with the European Guidelines. This increases the reliability of our findings, and we therefore believe that general conclusions can be drawn. A well founded prognosis for the later development of PGP and LBP found during pregnancy thus can be presented to the pregnant women covering the time from delivery up to a decade later. Conclusion: Most women (88%) with well-defined PGP during pregnancy recovered. The long time results confirm earlier short time findings that a back pain history before pregnancy, server PGP during pregnancy and early debut of PGP in pregnancy are risk factors for persisting pain several years postpartum. Implications Identification of women at risk for longstanding back pain seems possible in early pregnancy using physical examination and self-reports.
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| 19. |
- Elden, Helen, 1959, et al.
(författare)
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Predictors and consequences of long-term pregnancy-related pelvic girdle pain: a longitudinal follow-up study.
- 2016
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Ingår i: BMC musculoskeletal disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Pelvic girdle pain (PGP) is a multifactorial condition, which can be mentally and physically compromising both during and after pregnancy. However, long-term pregnancy-related PGP has been poorly investigated. This longitudinal follow-up study uniquely aimed to describe prevalence and predictors of PGP and its consequences on women's health and function up to 11years after pregnancy.A postal questionnaire was sent to 530 women who participated in 1 of 3 randomized controlled studies for PGP in pregnancy. Women who reported experiencing lumbopelvic pain were offered a clinical examination. Main outcome measure was the presence of long term PGP as assessed by an independent examiner. Secondary outcomes were: working hours/week, function (the Disability Rating Index, and Oswestry Disability Index), self-efficacy (the General Self-Efficacy Scale), HRQL (Euro-Qol 5D and EQ-Visual scale), anxiety and depression, (Hospital anxiety and depression scale,) and pain-catastrophizing (Pain Catastrophizing Scale), in women with PGP compared to women with no PGP.A total of 371/530 (70%) women responded and 37/ 371 (10%) were classified with long-term PGP. Pregnancy-related predictors for long-term PGP were number of positive pain provocation tests (OR=1.79), history of low back pain (LBP) (OR=2.28), positive symphysis pressure test (OR=2.01), positive Faber (Patrick's) test (OR=2.22), and positive modified Trendelenburg test (OR=2.20). Women with PGP had significantly decreased ability to perform daily activities (p<.001), lower self-efficacy (p=0.046), decreased HRQL (p<.001), higher levels of anxiety and depression (p<.001), were more prone to pain catastrophizing, and worked significantly fewer hours/week (p=0.032) compared to women with no PGP.This unique long-term follow up of PGP highlights the importance of assessment of pain in the lumbopelvic area early in pregnancy and postpartum in order to identify women with risk of long term pain. One of 10 women with PGP in pregnancy has severe consequences up to 11years later. They could be identified by number of positive pain provocation tests and experience of previous LBP. Access to evidence based treatments are important for individual and socioeconomic reasons.
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| 20. |
- Fagevik Olsén, Monika, 1964, et al.
(författare)
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Effects of a Training Intervention for Enhancing Recovery after Ivor-Lewis Esophagus Surgery: A Randomized Controlled Trial.
- 2017
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Ingår i: Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society. - : SAGE Publications. - 1799-7267. ; 106:2, s. 116-125
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Tidskriftsartikel (refereegranskat)abstract
- There is a risk of decreased physical function, quality of life and persistent pain after open surgery for esophageal cancer. There are currently no studies that evaluate the effect of any postoperative intervention, including physical exercises, after this type of surgery. The aim of the study was therefore to evaluate the effect of a training intervention after Ivor-Lewis resection of the esophagus.Patients scheduled for esophagus resection according to Ivor-Lewis were randomized to an intervention group or a control group. The training intervention started at discharge and lasted three months. Before discharge, patients were given three leaflets with exercises to increase range of motion in the affected area and exercises aiming to restore lung function and physical function. All exercises were described in detail and the patients carried out the ones in the first program under supervision. Before surgery and three months after discharge, the patients estimated their level of physical function, level of physical activity, and quality of life. They also underwent spirometry, measurements of range of motion in the rib cage, spine, and shoulders, and three functional tests. Comparisons of differences within and between the groups were made.A total of 43 of 64 randomized patients participated in the follow-up. Postoperatively, the patients in the intervention group had a significantly higher degree of physical function and less deteriorated range of motion in right shoulder flexion and thoracic left lateral flexion. There were no significant differences between the groups in lung function, pain, or quality of life.The results of the three-month intervention indicate that specific training can positively affect physical function and range of motion to preoperative values. The intervention was well tolerated, and no side effects were registered.
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| 21. |
- Fagevik Olsén, Monika, 1964, et al.
(författare)
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Increased joint pain after massive weight loss: Is there an association with joint hypermobility?
- 2017
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Ingår i: Surgery for Obesity and Related Diseases. - : Elsevier BV. - 1550-7289 .- 1878-7533. ; 13:5, s. 877-881
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Tidskriftsartikel (refereegranskat)abstract
- © 2017 American Society for Bariatric Surgery.Background: Obesity is associated with an increased risk of pain in weight-bearing joints. Although pain often decreases after obesity surgery, this is the reverse for some patients. Hypermobility is described as an excessive range of motion in joints and has been suggested to be a possible cause of joint pain. It is not known whether there is an association between increased joint pain after weight loss and hypermobility. Objectives: The objective of this study was to investigate whether there is an association between hypermobility and increased joint pain after massive weight loss. Setting: University hospital, Sweden. Methods: A survey including a screening questionnaire about hypermobility and questions about joint pain was sent to 149 people who had previously undergone bariatric surgery. Ninety-three people (72 women and 21 men) completed the questionnaire. Results: Nineteen of the respondents fulfilled the criteria for hypermobility. There were no significant differences between the groups with and without hypermobility regarding pain in weight-bearing joints before or after surgery. There was a significant difference between the groups with increased or novel pain in the ankles, shoulders, hands, and feet (P<.05) after the weight loss. Furthermore, the patients with hypermobility had increased or novel pain in a significantly higher number of weight-bearing joints, other joints, and joints in total (P< .05). Conclusion: Even with a small sample size, a tendency can be seen for people with hypermobility to experience increased joint pain after weight loss compared with those without hypermobility.
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| 22. |
- Fagevik Olsén, Monika, 1964, et al.
(författare)
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Self-administered tests as a screening procedure for pregnancy-related pelvic girdle pain
- 2009
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Ingår i: EUROPEAN SPINE JOURNAL. - : Springer Science and Business Media LLC. - 0940-6719 .- 1432-0932. ; 18:8, s. 1121-1129
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate sensitivity and specificity of self-administrated tests aimed at pain provocation of posterior and/or anterior pelvis pain and to investigate pain intensity during and after palpation of the symphysis. A total of 175 women participated in the study, 100 pregnant women with and 25 pregnant women without lumbopelvic back pain and 50 non-pregnant women. Standard pain provocation tests were compared with self assessed tests. All women were asked to estimate pain during and after palpation of the symphysis. For posterior pelvic pain, the self-test of P4 and Bridging test had the highest sensitivity of 0.90 versus 0.97 and specificity of 0.92 and 0.87. Highest sensitivity for self-test for anterior pelvic pain was pulling a mat 0.85. Palpation of symphysis was painful and persistency of pain was the longest among women who fulfilled the criteria for symphyseal pain. There were overall significant differences between the groups concerning intensity and persistency of pain (P andlt; 0.001). Our results indicate that pregnant women can perform a screening by provocation of posterior pelvic pain by self-tests with the new P4 self-test and the Bridging test. Palpation of the symphysis is painful and should only be used as a complement to history taking, pain drawing and pulling a MAT-test.
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| 23. |
- Fagevik Olsén, Monika, 1964, et al.
(författare)
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Validation of self-administered tests for screening for chronic pregnancy-related pelvic girdle pain
- 2021
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Many women develop pelvic girdle pain (PGP) during pregnancy and about 10% have chronic pain several years after delivery. Self-administered pain provocation tests are one way to diagnose and evaluate this pain. Their validity in post-partum women is not yet studied. The purpose of this study was to evaluate the validity of self-administered test for assessment of chronic pregnancy-related PGP several years after delivery. Methods: Women who previously have had PGP during pregnancy and who participated in one of three RCT studies were invited to a postal follow up of symptoms including performance of self-administered tests after two, 6 or 11 years later, respectively. In total, 289 women returned the questionnaire and the test-results. Of these, a sub-group of 44 women with current PGP underwent an in-person clinical examination. Comparisons were made between test results in women with versus without PGP but also, in the sub-group, between the self-administered tests and those performed during the clinical examination. Results: Fifty-one women reported PGP affecting daily life during the last 4 weeks, and 181 reported pain when performing at least one of the tests at home. Those with chronic PGP reported more positive tests (p < 0.001). There was no significant difference between diagnosis from the self-administered tests compared to tests performed during the in-person clinical examination (p = 0.305), either for anterior or posterior PGP. There were no significant differences of the results between the tests performed self-administered vs. during the clinical examination. Conclusion: A battery of self-administered tests combined with for example additional specific questions or a pain-drawing can be used as a screening tool to diagnose chronic PGP years after delivery. However, the modified SLR test has limitations which makes its use questionable.
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| 24. |
- Gutke, Annelie, et al.
(författare)
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The inter-rater reliability of a standardised classification system for pregnancy-related lumbopelvic pain
- 2010
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Ingår i: MANUAL THERAPY. - : Elsevier BV. - 1356-689X .- 1532-2769. ; 15:1, s. 13-18
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Tidskriftsartikel (refereegranskat)abstract
- Pregnancy-related lumbopelvic pain has varying clinical presentations and effects among subgroups. Different lumbopelvic pain subgroups require different specific management approaches which require the differentiation between lumbar and pelvic girdle pain (PGP). Thirty-one consecutive pregnant women with non-specific lumbopelvic pain were evaluated by two examiners and classified into lumbar pain, PGP, or combined pelvic girdle and lumbar pain. A standard history about different positions/activities of daily life such as bending, sitting, standing, walking, and lying, was followed by a standardised mechanical assessment of the lumbar spine (Mechanical Diagnosis and Therapy), including tests of repeated end-range movements to standing and lying, pelvic pain provocation tests (distraction test, posterior pelvic pain provocation test, Gaenslens test, compression test, and sacral thrust) a hip-rotation range-of-motion test, the active straight-leg-raising test, and a neurological examination. Agreement for the three syndromes (lumbar pain, PGP, or combined pelvic girdle and lumbar pain) was 87% (27/31), with a kappa coefficient of 0.79 (95% CI 0.60-0.98). It was possible to perform the classification procedure throughout pregnancy. There was substantial agreement between the two examiners for the classification of non-specific lUrnbopelvic pain into lumbar pain and PGP in pregnant women.
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| 25. |
- Hammarén, Elisabet, et al.
(författare)
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Factors of importance for dynamic balance impairment and frequency of falls in individuals with myotonic dystrophy type 1 - A cross-sectional study - Including reference values of Timed Up & Go, 10m walk and step test
- 2014
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Ingår i: Neuromuscular Disorders. - : Elsevier BV. - 0960-8966 .- 1873-2364. ; 24:3, s. 207-215
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Tidskriftsartikel (refereegranskat)abstract
- Patients with myotonic dystrophy type 1 suffer from gait difficulties including stumbles and falls. To identify factors of importance for balance impairment and fall-risk a mapping of functional balance was performed, in a cross-sectional study of 51 adults. Walking, balance, falls and muscle force were self-assessed and measured. Reference values of balance were established through measurements of 220 healthy subjects. Falls were more frequently observed in the patients who were more severely affected of muscle weakness than in mildly affected patients, p= 0.014. The number of falls showed negative correlation with balance confidence ( rs= -0.516, p<. 0.001). The ankle dorsiflexor force together with the time difference between comfortable and maximum speed in 10. m-walk proved to be significant factors for fall frequency. A ten Newton muscle force decrease showed 15% increase in odds ratio for frequent falls. One-second increase in time difference between comfortable and maximum walking speed showed 42% increase in odds ratio for frequent falls. In conclusion, assessing the ankle muscle force and the time difference in different walking speeds is important to detect risk of falling. The activities-specific balance confidence score reflects the consequences of the muscle force decrease. Certain patient strategies to diminish risk of falling could be due. © 2013 Elsevier B.V.
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