| 1. |
- 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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| 2. |
- 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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| 3. |
- 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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| 4. |
- 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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| 5. |
- Abbott, Allan, et al.
(författare)
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Analgesic prescriptions received by patients before commencing the BOA model of care for osteoarthritis: a Swedish national registry study with matched reference and clinical guideline benchmarking
- 2022
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 93, s. 51-58
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose - Swedish clinical guidelines for osteoarthritis (OA) prioritize patient education, exercise, and-if necessary-weight reduction before considering adjunct pharmacological intervention. Contrariwise, we investigated the proportion and type of dispensed analgesic prescriptions in Sweden received by patients during 3 years before commencing non-pharmacological primary care interventions for OA (2008-2016) compared with the general population. Furthermore, we analyzed the proportion of analgesic prescriptions dispensed before (2008-2012) compared with after (2012-2016) guideline publication in terms of concordance with clinical guideline recommendations. Patients and methods - Patients with hip or knee OA (n = 72,069) from the Better Management of OA national quality register receiving non-pharmacological interventions in primary care between 2008 and 2016 were included (OA cohort). An age, sex, and residence matched reference cohort (n = 216,207) was formed from the Swedish Total Population Register. Based on a period 3 years prior to inclusion in the OA cohort, Swedish Prescribed Drug Register data was linked to both the OA and reference cohorts. Results - Compared with the reference cohort, a distinctly larger proportion of the OA cohort had dispensed prescriptions for most types of analgesics, increasing exponentially each year prior to commencing non-pharmacological intervention. Since guideline publication, the proportion of the OA cohort having no dispensed prescription analgesics prior to non-pharmacological primary care intervention concordantly increased by 5.0% (95% CI 4.2-5.9). Furthermore, dispensed prescriptions concordantly decreased for non-selective NSAIDs -8.6% (CI -9.6 to -7.6), weak opioids -6.8% (CI -7.7 to -5.9), glucosamine -9.5% (CI -9.8 to -8.8). and hyaluronic acid -1.6% (CI -1.8 to -1.5) but discordantly increased for strong opioids 2.8% (CI 2.1-3.4) and glucocorticoid intra-articular injection for hip OA 2.1% (CI 1.0-3.1). Interpretation - In Sweden, dispensed prescription of analgesics commonly occurred before initiating non-pharmacological primary care interventions for OA but reduced modestly after guideline publication, which prioritizes non-pharmacological before pharmacological interventions. Additional modest improvements occurred in the stepped-care prioritization of analgesic prescription types. However, future strategies are required to curb an increase of strong opioids prescription for OA and glucocorticoid intra-articular injection for hip OA.
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| 6. |
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| 7. |
- Limbäck Svensson, Gunilla, et al.
(författare)
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BOA - Better manangement of patients with arthritis - National quality registry annual report 2018
- 2019
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- This is the ninth annual report of the BOA register and the ninth year of BOA as a national quality registry. The BOA registry collects clinician reported process measures and patient-reported outcomes. This to monitor the quality of primary health care for knee, hip and hand osteoarthritis according to Swedish national guideline recommendations. The annual report for 2018 provides a summary of these health quality indicators on a national and regional level. The annual report is available on the website, boa.registercentrum.se. The website also provides open online aggregate statistics for health care quality indicator on a national, regional and clinic level.Thank you to everyone who has worked in the past year to collect data, support patients and contribute to the use of the BOA register as a tool in improving health care. Thanks also to the Steering Group and regional contact persons for your invaluable work in managing the register.
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| 8. |
- Limbäck-Svensson, Gunilla, et al.
(författare)
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BOA - Bättre omhändertagande av patienter med artros. Årsrapport 2018
- 2019
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Detta är den nionde årsrapporten för BOA-registret och det nionde året för BOA som nationellt kvalitetsregister. Vi har glädjen att meddela att BOA-registret har höjts från certifieringsnivå 3 till 2 av Ledningsfunktionen för Nationella Kvalitetsregister. Detta visar att BOA kontinuerligt förbättras och anses hålla god kvalitet.BOA-registret syftar främst till att patienter som har artros ska få optimal grundbehandling. Registret ska mäta vårdkvalitet, patientrapporterat utfall och serva verksamheter med relevant information som hjälper dem att uppfylla målet om optimal grundbehandling. Patienter med artros erbjuds grundbehandling av fysioterapeuter och arbetsterapeuter inom primärvård.Data från BOA-registret påvisar variationer i omhändertagande och resultat av behandling av patienter med artros i höft, knä eller hand. Registret utvecklas hela tiden för att bättre kunna användas som ett värdefullt verktyg för utvärdering och förbättring av det kliniska arbetet.Årsrapporten 2018 kommer att finnas tillgänglig på hemsidan, boa.registercentrum.se, men den kommer inte att tryckas och distribueras. Läsarundersökningar har visat att årsrapporten läses av få, medan vår statistikportal med realtidsdata på enhetsnivå är frekvent besökt med runt 1000 sidvisningar per månad. Vi fortsätter med att lägga resurser på att utveckla statistikportalen och underlätta administrationen kring registreringen.Årsrapporten vänder sig i första hand till vårdpersonal som möter personer med artros, men även till övriga intresserade som vill fördjupa sig i statistiken från registret.Tack till alla er som under det gångna året arbetat med att samla in data, utbildat patienter och bidragit till att BOA-registret kan användas som ett verktyg i vården. Tack även till styrgrupp och kontaktpersoner för ert ovärderliga arbete med att driva registret.
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| 9. |
- Limbäck Svensson, Gunilla
(författare)
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Evaluation of a structured physiotherapy treatment model for patients with lumbar disc herniation
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Symptoms from lumbar disc herniation are common in the general population. Many discs heal spontaneously and the patient’s symptoms cease. When people have severe pain and sciatica, the recommendation is to start with physiotherapy treatment and pain medication for at least six to eight weeks before surgery is considered. There is, however, limited evidence relating to the effects of physiotherapy treatment for patients diagnosed with lumbar disc herniation. One common management method for patients with low back pain and sciatica is Mechanical Diagnosis and Therapy (MDT) or the McKenzie method, which aims to eliminate or minimise pain. However, MDT is seldom recommended for patients with disc herniation with a ruptured outer annulus, as the method is not expected to be effective on these patients. The overall aim of this thesis was to evaluate a structured physiotherapy treatment model for patients who qualified for lumbar disc surgery by having severe, long-standing pain and an MRI-verified lumbar disc herniation. Study I evaluated fear-of-movement/kinesiophobia in patients who were treated surgically for lumbar disc herniation. Study II evaluated a structured physiotherapy treatment model in patients who qualified for lumbar disc surgery. Study III described the experience of health among patients three years after treatment with either structured physiotherapy or surgery. Study IV evaluated the occurrence of centralisation of pain in relation to the patients’ disability, self-efficacy and kinesiophobia, after two weeks of McKenzie therapy. Study I showed that, 10-34 months after surgery for disc herniation, half the patients were classified as having kinesiophobia. These patients were more disabled, had more pain, more catastrophising thoughts, more symptoms of depression, lower self-efficacy and poorer health-related quality of life than patients who were not classified as having kinesiophobia. Study II showed that the patients had already improved significantly three 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 two-year follow-up. Study III showed that the patients, in the group treated with structured physiotherapy, expressed the most descriptions in feeling of well- being and they were physically active despite symptoms. In the group treated with surgery patients expressed more feeling of ill-being and were anxious and expressed that they avoided physical activity. Study IV showed that 21 of the 41 patients were classified as centralisers after two weeks of structured physiotherapy treatment. These patients had significantly less disability, less leg and back pain, higher self-efficacy and less kinesiophobia three months after treatment was started, compared with non-centralisers. Both the centralisers and the non-centralisers improved statistically over time with regard to several parameters. The overall conclusion from this thesis is that a structured physiotherapy treatment model for patients with pain and disability due to a lumbar disc herniation should be recommended before surgery is considered.
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