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| 4. |
- Tegner, Yelverton, et al.
(författare)
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A performance test to monitor rehabilitation and evaluate anterior cruciate ligament injuries
- 1986
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Ingår i: American Journal of Sports Medicine. - : SAGE Publications. - 0363-5465 .- 1552-3365. ; 14:2, s. 156-159
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Tidskriftsartikel (refereegranskat)abstract
- A performance test simulating components of sports was devised to evaluate dysfunction after ACL injury. The test included a one-leg hop, running in a figure of eight (straight running and turn running measured separately), running up and down a spiral staircase, and running up and down a slope. Twenty-six men with ACL injury, most of them soccer players, and 66 uninjured male soccer players were studied. Patients with ACL injury performed significantly less well than the uninjured players. Test items of special interest were turn running in the figure of eight, stair running, and slope running, all of which place high demand on the knee. It is concluded that a performance test of this design is useful for monitoring rehabilitation and for evaluating the patient's condition. Before sports can be resumed at the original level, normal strength and normal performance should be regained.
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| 5. |
- Tegner, Yelverton, et al.
(författare)
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Strengthening exercises for old cruciate ligament tears
- 1986
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Ingår i: Acta Orthopaedica Scandinavica. - : Medical Journals Sweden AB. - 0001-6470. ; 57:2, s. 130-134
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Tidskriftsartikel (refereegranskat)abstract
- Fifty-three consecutive patients with troublesome old cruciate ligament lesions underwent a 3-month thigh and calf muscle training program. Before training, the diagnosis was established by arthroscopy and clinical examination under anesthesia. Significant improvement in strength, performance, knee score, and activity level took place; the majority were improved and declined surgery. A period of strength training is recommended before the decision to undertake surgery for cruciate ligament injury.
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| 7. |
- Briggs, Karen K, et al.
(författare)
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The reliability, validity, and responsiveness of the Lysholm score and Tegner activity scale for anterior cruciate ligament injuries of the knee
- 2009
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Ingår i: American Journal of Sports Medicine. - : Sage Publications. - 0363-5465 .- 1552-3365. ; 37:5, s. 890-897
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Tidskriftsartikel (refereegranskat)abstract
- Background: In 1982, the Lysholm score was first published as a physician-administered score in the American Journal of Sports Medicine. The Tegner activity scale was published in 1985.Hypothesis: The Lysholm and Tegner scores are valid as patient-administered scores and responsive at early time points after treatment of anterior cruciate ligament tears.Study Design: Cohort study (Diagnosis); Level of evidence, 1. Methods: All patients were treated for an anterior cruciate ligament tear. For responsiveness, the Lysholm score (n = 1075) and Tegner activity level (n = 505) were measured preoperatively and 6, 9, 12, and 24 months postoperatively. For test-retest (n = 50), scores were measured at 2 years postoperatively and again within 4 weeks by questionnaire. For criterion validity (n = 170), patients completed the Short Form-12 and the International Knee Documentation Committee score in addition to Lysholm and Tegner instruments. For all other analyses, preoperative Lysholm score (n = 1783) or Tegner activity levels (n = 687) were collected.Results: There was acceptable test-retest reliability for both the Lysholm (intraclass correlation coefficient = 0.9) and Tegner (intraclass correlation coefficient = 0.8) scores. The minimum detectable change for Lysholm was 8.9 and for Tegner was 1. The Lysholm demonstrated acceptable internal consistency. The Lysholm correlated with the International Knee Documentation Committee (r = .8) and the Short Form-12 (r = .4), and Tegner correlated with the Short Form-12 (r = .2). Both scores had acceptable floor and ceiling effects and all hypotheses were significant. The Lysholm and Tegner were responsive to change at each of the time points.Conclusion: After 25 years of changes in treatment of anterior cruciate ligament injuries, the Lysholm knee score and the Tegner activity scale demonstrated acceptable psychometric parameters as patient-administered scores and showed acceptable responsiveness to be used in early return to function after anterior cruciate ligament treatment.
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| 8. |
- Burman, Erik, et al.
(författare)
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Concussed athletes are more prone to injury both before and after their index concussion : A data base analysis of 699 concussed contact sports athletes
- 2016
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Ingår i: BMJ Open Sport and Exercise Medicine. - : BMJ Publishing Group Ltd. - 2055-7647. ; 2:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Ice hockey and football players suffering concussions might have an increased risk for injuries afterwards. We aimed to investigate if concussions predisposed athletes for subsequent sport injuries.Methods: Patient data were obtained from a data base established at the University Hospital in Umea, Sweden. Athletes who had suffered a concussion were included if they had been aged between 15 and 35 years of age, and played ice hockey, football (soccer), floorball and handball. They were studied in terms of all new or previous injuries during 24 months before and after their concussion. Results were compared with a control group of athletes from the same four sports with an ankle injury.Results: Athletes with a concussion were more likely to sustain injuries compared with the control group, both before (OR 1.98. 95% CI 1.45 to 2.72) and after the concussion (OR 1.72. 95% CI 1.26 to 2.37). No increase in frequency of injury was found after a concussion compared with before. This was true for athletes in all four sports and for both sexes.Conclusions: This study indicates that athletes sustaining a concussion may have a more aggressive or risk-taking style of play than their counterparts. Our data do not suggest that a concussion injury, per se, leads to subsequent injuries.
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| 10. |
- Chaplin, John, et al.
(författare)
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Varför ska du använda PROMIS? : Nytt system för patientrapporterad utfallsmått
- 2018
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- PROMIS är ett itembanksystem för hälso- och sjukvården. Syftet är att erbjuda moderna, patientrapporterade mått som kan användas för flertalet patientgrupper till en mycket låg kostnad och med ett nationellt supportsystem.En itembankär en modern form av elektronisk enkät som kan innehålla ett stort antal enkätfrågor. Ett datorprogram väljer ut de mest lämpade frågorna till varje person utifrån dennes svar på föregående frågor, på så sätt enkäten individanpassas.
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| 11. |
- Cristiani, Riccardo, et al.
(författare)
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Meniscal ramp lesions : rediscovering the past
- 2022
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Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer. - 0942-2056 .- 1433-7347. ; 30, s. 3929-3931
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 12. |
- Eriksson, Lisbeth, et al.
(författare)
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Physiotherapy at a distance : a controlled study of rehabilitation at home after a shoulder joint operation
- 2009
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Ingår i: Journal of Telemedicine and Telecare. - : Sage Publications. - 1357-633X .- 1758-1109. ; 15:5, s. 215-220
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Tidskriftsartikel (refereegranskat)abstract
- We explored the benefit of video communication in home rehabilitation after shoulder joint replacement and compared it to referral for physiotherapy in the conventional way. A total of 22 patients were included in the study. The intervention group (n = 10) had training at home under the supervision of a physiotherapist at the hospital using videoconferencing. The control group (n = 12) had physiotherapy training in a conventional way in their home town. All patients had the same postoperative, three-phase-programme for two months. The outcome measures were a Visual Analogue Scale (VAS) for pain, range of motion (ROM), shoulder function ability (Constant score and SRQ-S) and health-related quality of life (SF-36). Questions about areas of priority for improvement and general satisfaction with the shoulder were also included. The telemedicine group received a greater number of treatments compared to the control group. After the intervention, there were significant improvements in VAS-pain, Constant score and SRQ-S for both groups. The telemedicine group improved significantly more in all three measurements than the control group (P < 0.001 for all). When changes from baseline to follow-up were compared, the telemedicine group improved significantly more in terms of decrease in pain (P = 0.004) and vitality (P = 0.001) than the control group. Despite some limitations, there seem to be clear benefits from physiotherapy at a distance with a telemedicine technique that allows patients to obtain access to physiotherapy at home.
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| 13. |
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| 14. |
- Höög, Elisabet, 1962-
(författare)
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Navigera i ständig förändring : facilitering av utvecklingsarbete inom vård och omsorg
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund Vård och omsorg arbetar under höga krav på kvalitet och säkerhet i sin verksamhet. Många förbättringsområden är kända, och nya tillkommer hela tiden. Vårdens och omsorgens organisationer arbetar hårt för att möta de utmaningar, krav och möjligheter de ställs inför. Många metoder och förslag på lösningar finns att tillgå, men det har visat sig svårt att med säkerhet veta vad som fungerar, och i vilket sammanhang. Kanske är frågorna om hur och varför någonting fungerar, eller ej, ännu viktigare att söka svar på. Avhandlingen riktar sitt fokus mot facilitering av förändring och utvecklingsarbete i vårdens och omsorgens organisationer. Omfattande forskning finns kring stöd och facilitering av utvecklings- och förbättringsarbete för små grupper, främst i kärnverksamheten. Forskning om systemövergripande och organiserad facilitering av utvecklingsarbete är inte lika vanligt förekommande. Genom att i min avhandling följa tre fall, där faciliterande grupperingar var aktiva under pågående systemövergripande ansatser för utveckling och förändring, önskar jag att jag kan bidra till ökad kunskap om utmaningar för och potentialen i att skapa förutsättningar för sådana faciliterande funktioner.Metoder Avhandlingen bygger på fyra studier från tre empiriska fall. I samtliga fall studerades faciliterande grupperingar med uppdrag att stödja systemövergripande utvecklingsarbete i en geografisk region med många aktörer, organisationer och verksamheter, enheter, avdelningar och beslutsnivåer. De flesta av respondenterna tillhörde någon av de faciliterande grupperingarna, men data samlades också in från andra nyckelaktörer, aktiva i utvecklingsarbete. Datainsamlingen omfattade semistrukturerade intervjuer, processdagböcker, observationer och dokument. Avhandlingen bygger på innehållsanalys av kvalitativa data. Den innehållsanalys som tillämpats innefattar en systematisk och replikerbar teknik för att innehållskategorisera stora mängder data genom att tillämpa fasta definitioner och regler för kategorisering. För att stärka validiteten tillämpades triangulering av data från flera källor. För ökad reliabilitet har flera bedömare oberoende analyserat samma data när så varit möjligt.Resultat Analysen av data från de tre fallen visar på stora utmaningar, men också lovande utsikter för stöd till förändring och utvecklingsarbete i vård och omsorg med hjälp av faciliterande grupperingar. Resultaten kan sammanfattas i fyra perspektiv: de faciliterande grupperingarnas interna relationer, roller och arbete; relationen mellan de faciliterande grupperingarna och de organisationer och verksamheter de arbetade med; förutsättningarna som skapades för facilitering inom organisationerna; och utvecklingen av faciliterande funktioner med kapacitet att fungerar som ett stöd för det uppdrag som organisationen har att utföra.Slutsatser För att leda och stödja ett uthålligt förändrings- och utvecklingsarbete inom vård och omsorg behövs solid och mångfacetterad information och kunskap, förståelse för många typer av processer, och en flexibilitet som gör det möjligt att arbeta i ständig förändring och i en verklighet som uppvisar stor variation. Det förefaller finnas en stor potential i att använda faciliterande grupperingar med uppdrag att stödja utvecklingsarbete. För att kunna nyttja potentialen i sådana funktioner krävs kapacitet både inom grupperingarna och inom organisationen. Att bygga kapacitet för en fungerande faciliterande funktion omfattar både internt arbete i den faciliterande grupperingen och arbete på alla nivåer i organisationen. Något som omfattar planering, genomförande och uppföljningssystem där det dagliga arbetet och arbetet med att utveckla är sammanvävt och systematiskt. Det är idag oklart var nödvändig analys och reflektion kring utvecklingsarbete i ett systemövergripande perspektiv sker. Faciliterande grupperingar skulle kunna utgöra navet för en sådan kontinuerlig process om de äger kapacitet, mandat och förtroende att fylla den funktionen.
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| 15. |
- Höög, Elisabet, 1962-, et al.
(författare)
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Quality improvement in large health care organizations : searching for system-wide and coherent monitoring and follow-up strategies
- 2016
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Ingår i: Journal of Health Organization & Management. - : Emerald Group Publishing Limited. - 1477-7266 .- 1758-7247. ; 30:1, s. 133-153
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The purpose of this paper is to investigate the obstacles and challenges associated with organizational monitoring and follow-up (M & F) processes related to health care quality improvement (QI) and development.Design/methodology/approach: A longitudinal case study of a large health care organization during a system-wide QI intervention. Content analysis was conducted of repeated interviews with key actors and archival data collected over a period of four years.Findings: The demand for improved M & F strategies, and what and how to monitor were described by the respondents. Obstacles and challenges for achieving M & F strategies that enables system-wide and coherent development were found in three areas: monitoring, processing, and feedback and communication. Also overarching challenges were found.Practical implications: A model of important aspects of M & F systems is presented that can be used for analysis and planning and contribute to shared cognition of such systems. Approaches for systematic analysis and follow-up of identified problems have to be developed and fully incorporated in the organization’s measurement systems. A systematic M & F needs analytic and process-oriented competence, and this study highlights the potential in an organizational function with capacity and mandate for such tasks.Originality/value: Most health care systems are flooded with a vast amount of registers, records, and measurements. A key issue is how such data can be processed and refined to reflect the needs and the development process of the health care system and how rich data can be used for improvement purposes. This study presents key organizational actor’s view on important factors to consider when building a coherent organizational M & F strategy.
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| 16. |
- Itthipanichpong, Thun, et al.
(författare)
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Validity and Reliability of the Thai Versions of the Lysholm Knee Scoring Scale and Tegner Activity Scale
- 2023
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Ingår i: The Orthopaedic Journal of Sports Medicine. - : Sage Publications. - 2325-9671. ; 11:2
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Tidskriftsartikel (refereegranskat)abstract
- Background: Functional or quality of life questionnaires are important tools in clinical investigations. The Lysholm Knee Scoring Scale and Tegner Activity Scale are knee-specific questionnaires that are widely used to assess knee function.Purpose: To translate both questionnaires into Thai and to assess the validity and reliability of the Thai versions of the Lysholm and adjusted Tegner scales.Study Design: Cohort study (diagnosis); Level of evidence, 3.Methods: The Lysholm and Tegner scales were translated into Thai by using the forward-backward translation protocol. Because cultural modifications were made to the sports used to measure activity on the Tegner scale, the authors of this study refer to the Thai version as the “Thai adjusted Tegner scale.” The reliability and validity of the translated scales were evaluated by obtaining the responses of 60 consecutive patients (mean age, 40.5 years; 34 male, 26 female); the patients also completed the Thai version of the International Knee Documentation Committee Subjective Knee Form (IKDC-SKF). Criterion validity was tested by correlating the scores from both translated questionnaires with those from the Thai IKDC-SKF, while reliability was assessed by measuring test-retest reliability and internal consistency.Results: The Thai Lysholm scale showed a strong correlation with the Thai IKDC-SKF (r = 0.89), while the Thai adjusted Tegner scale showed a moderate correlation with the Thai IKDC-SKF (r = 0.60). The intrarater and test-retest reliability measures were excellent for the Thai Lysholm (intraclass correlation coefficient [ICC], 0.94 and 0.98, respectively) and moderate to good for the Thai adjusted Tegner (ICC, 0.73 and 0.86, respectively). The internal consistency for the Thai Lysholm was acceptable at all the time points (Cronbach alpha, 0.71-0.73).Conclusion: The Thai Lysholm and Thai adjusted Tegner scales adequately retained the characteristics of the original versions. They can be considered reliable instruments for Thai patients with knee-related problems.
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| 22. |
- Lysholm, Jack, et al.
(författare)
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In memoriam Jan Gillquist 1934–2016
- 2016
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Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 24:9, s. 1-2
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 23. |
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| 24. |
- Lysholm, Jack, et al.
(författare)
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Knee injury rating scales
- 2008
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Ingår i: Acta Orthopaedica. - : Informa Healthcare. - 1745-3674 .- 1745-3682. ; 78:4, s. 445-453
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Tidskriftsartikel (refereegranskat)
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| 25. |
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| 26. |
- Lysholm, Jack, et al.
(författare)
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Strong development of research based on national quality registries in Sweden
- 2019
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Ingår i: Upsala Journal of Medical Sciences. - : Taylor & Francis Group. - 0300-9734 .- 2000-1967. ; 124:1, s. 9-11
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present paper is to describe how the use of national quality registries (NQRs) for research has evolved over the past decade in Sweden. All Swedish NQRs have reported their scientific activity (publications per year in peer-reviewed scientific journals) to the Swedish Association of Local Authorities and Regions since 2009, and the present report is based on available data from 2009-2016. The yearly number of publications of the 69 registries active in 2009 has increased from 121 to 496 in 2016. Seventeen of these registries published more than 10 papers in 2016; however, 12 NQRs did not publish any papers in 2016. An additional 77 papers were published in 2016 by the 34 NQRs started after 2009. In summary, there has been a strong development of quality registry-based research in Sweden over the last decade. However, there is still room for further increase of the use of research based on NQRs in Sweden.
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| 27. |
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| 29. |
- Mikaelsson, Katarina, et al.
(författare)
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Physical capacity in physically active and non-active adolescents
- 2011
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Ingår i: Journal of Public Health. - : Springer Nature. - 2198-1833 .- 1613-2238 .- 0943-1853. ; 19:2, s. 131-138
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of this study was to investigate differences in physical capacity between physically active and non-active men and women among graduates from upper secondary school.Subject and methods: Research participants were graduates (38 women and 61 men) from upper secondary school. Physical activity was determined using the International Physical Activity Questionnaire, and participants were dichotomously characterized as being physically active or physically non-active according to the recommendations of the World Health Organization (WHO). Aerobic capacity was measured using the Åstrand cycle ergometer test. Participants also underwent tests of muscular strength and balance.Results: Maximum oxygen uptake differed significantly between physically active and non-active men (mean ± SD 3.6±0.7 vs 3.0±0.6 l/kg, p=0.002) and women (3.0± 0.6 vs 2.5±0.3 l/kg, p=0.016). There was a difference among physically active and non-active men regarding push-ups (37.1±9.0 vs 28.5±7.0, p<0.001) and sit-ups (59.2±30.2 vs 39.6±19.4, p=0.010). No significant differences were found regarding vertical jump or grip strength among men, any of the muscle strength measurements among women, and balance (in any sex).Conclusion: Activity levels had impact on aerobic capacity in both sexes, but did not seem to have the same impact on muscular strength and balance, especially in women.
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| 30. |
- Mikaelsson, Katarina, et al.
(författare)
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Relationship between physical capacity and physical activity in adolescents
- 2012
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Ingår i: Gazzetta Medica Italiana. - 0393-3660 .- 1827-1812. ; 171:5, s. 639-651
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Tidskriftsartikel (refereegranskat)abstract
- Aim. Physical activity and physical capacity are important health related parameters for all age-groups. Yet, little is known about the relationship between physical activity and physical capacity amongst adolescents about to leave compulsory education. The aim of the study was to investigate how physical capacities are related to self-reported energy expenditure on physical activities at different levels of physical activity and amount of time spent sitting among graduates of upper secondary school. Methods. In total, 99 third grade students participated from upper secondary school. Levels of physical activity and the amount of time spent sitting were assessed using the International Physical Activity Questionnaire (IPAQ). The energy expenditure was calculated based on the activity determined by the IPAQ. The participants' physical capacity was tested using VO2max, muscle strength and balance measures. The relationship between physical activity and physical capacity was addressed using linear regression models. Results. There was significant relationship between Total METs and aerobic capacity (R2 = 0.15), push-ups (R2 = 0.08) and sit-ups (R2 = 0.07). A stronger significant relationship was revealed for activity performed on Vigorous activity METs for aerobic capacity (R2 = 0.23), push-ups (R2 = 0.18) and sit-ups (R2 = 0.10). The regression analyses for Moderate activity METs, Walking activity METs and time spent Sitting showed no significant relationship to any measures of physical capacity. Conclusion. For adolescents, the intensity of physical activity is of importance for achieving high aerobic capacity, and the amount of time spent sitting does not influence physical capacity.
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| 31. |
- Nordvall, Helena, et al.
(författare)
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Are distal radius fractures due to fragility or to falls? : A consecutive case-control study of bone mineral density, tendency to fall, risk factors for osteoporosis, and health-related quality of life
- 2007
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 78:2, s. 271-277
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Tidskriftsartikel (refereegranskat)abstract
- Background A fracture of the distal radius is considered to indicate an increased risk of future fractures, especially a hip fracture. The main causes may be osteoporosis or a tendency to fall, separately or in combination. Methods 93 women and 5 men with a recent radius fracture and the same number of controls were measured with a heel-DXL and asked to complete one questionnaire on their quality of life (SF-36), and one on risk factors. Results The mean T-score of the patients was –2.1, and for the controls it was –1.9 (p = 0.3). The patients aged over 64 years had a history of falling more often than the corresponding controls (p = 0.01), but there was no difference in T-score. By contrast, patients 45-64 years of age showed a non-significant, lower T-score (p = 0.09), but there was no difference concerning their history of falling. For all other risk factors, no differences were found between the patients and the controls. There were significant differences between the patients and the controls in some of the functions in the SF-36, due to the radius fracture. Interpretation This study indicates that the underlying cause of a distal radius fracture may be different in patients aged 45–64 years and those who are more than 64 years old.Read More: http://informahealthcare.com/doi/abs/10.1080/17453670710013799
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| 32. |
- Nordvall, Helena, 1950-, et al.
(författare)
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Can a risk factor questionnaire for osteoporosis and functional tests predict low bone mineral density or falls in patients with a distal radius fracture?
- 2009
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Ingår i: Advances in Physiotherapy. - : Informa UK Limited. - 1403-8196 .- 1651-1948. ; 11:2, s. 71-80
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Tidskriftsartikel (refereegranskat)abstract
- In a prospective cohort study, 141 patients with a recent radius fracture [135 women (66±9.2 years) and six men (72±6.3 years)] were studied using bone mineral density (BMD) measurements, a risk factor questionnaire, a fall diary, functional tests of dynamic and static balance, and a one-leg rise from a chair test. The mean BMD T-score was -1.97. The results of the one-leg rise test were significantly associated with dynamic and static balance, but none of the functional tests was associated with the number of falls. Forty of 117 patients fell prospectively, 77 of them did not. Decreased height and cigarette smoking were the only risk factors, which significantly predicted low BMD. All risk factors were estimated to explain osteopenia and osteoporosis to an extent of 27%. The functional tests and the risk factor questionnaire seem to be of limited value for identifying people with a radius fracture who are at risk of falling or to have early osteoporosis. If functional tests on musculoskeletal function are considered for older and more frail, the one-leg rise test may be sufficient. Keywords: Bone mineral density (BMD); functional tests; one-leg rise test; radius fracture; risk factors for osteoporosis
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| 33. |
- Nordvall, Helena, 1950-
(författare)
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Factors in secondary prevention subsequent to distal radius fracture : Focus on physical function, co-morbidity, bone mineral density and health-related quality of life
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In Sweden approximately 25000 distal radius fractures occur annually, which is 37 % of all fractures related to osteoporosis. In this thesis, risk factors for osteoporosis, bone mineral density (BMD) and health-related quality of life (the SF-36) were compared in patients who suffered a distal radius fracture after low energy trauma with a control group matched on the basis of age, gender, and municipality of residence. The aim was also to analyse, among these patients, whether a risk factor questionnaire, tests on dynamic and static balance and a one-leg rise test could identify those, who have osteopenia or osteoporosis, and run a risk of new falls. Moreover, in a three-year follow-up, mortality, the need for in- and outpatient care, and health-related quality of life after radius fracture were investigated and compared between the patients and matched controls. Finally, the effect of a preventive intervention program including patient education and self-training was evaluated. Falls were reported in a risk factor questionnaire and in a fall diary. The patients aged 45-64 years showed lower, although not statistically significant, BMD, compared with the controls of the same age, but there was no difference concerning their history of falls. In contrast, the patients aged 64 years or older had a history of falling more often than the corresponding controls, but no difference in BMD was found. For all other risk factors, except falls, no differences were found between the patients and the controls. The results of the one-leg rise test were associated with those of dynamic and static balance, but none of the functional tests were associated with the number of falls. Decreased height and cigarette smoking were the only risk factors, which predicted osteopenia and osteoporosis. Five patients, although none of the controls, died during the study time. The patients needed statistically significantly more episodes as inpatients than the controls. The patients also had lower SF-36, Role Physical scores, than the controls at three months. This difference disappeared by the time of the follow-up. Both the patients, who participated in a four-week intervention program, “the osteoporosis school” followed by a one-year home-based exercise program, and the controls showed statistically significantly improved dynamic and static balance, ability to walk backwards and to stand on one leg with eyes open and closed at the end of the study. However, no significant differences were found between the patients and the controls in any of the tests, in BMD or in the number of the falls. The thesis shows that, except for the falls in patients aged over 64 years, there were no significant differences between patients and controls with respect to BMD and other risk factors related to osteoporosis. Consequently, in patients aged 45-64 years and older, the underlying cause of a distal radius fracture is more related to falls than to osteoporosis. Furthermore, the thesis shows that the functional tests and the risk factor questionnaire seem to be of limited value for identifying 8 people with a radius fracture, who are at risk of falling or have osteopenia or osteoporosis. If, in spite of this, functional tests on musculoskeletal function are considered for testing of functional ability in patients with a recent radius fracture, the one leg-rise test may be sufficient. There seems to be an increased mortality and morbidity necessitating inpatient care among patients with a recent radius fracture. The osteoporosis school had no significant effect on BMD, balance, muscle strength or falls in this thesis. Therefore, the lack of proven efficacy of the osteoporosis school for the secondary prevention of distal radius fractures highlights the need for more and long-term randomised controlled follow-up studies in this specific population.
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| 34. |
- Nordvall, Helena, 1950-, et al.
(författare)
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Pay attention to co-morbidity after a recent radius fracture : a longitudinal case-control study
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Material and methods: Mortality and co-morbidity, as in the number of visits to in- or outpatient care facilities, were studied in 73 patients during the first three years after a radius fracture compared to controls, and health-related quality of life, using the SF-36 initially and three years later. Results: Four patients died but none among the controls, during the study period. There were statistically significantly more in-patient visits among the patients, due to other reasons than the radius fracture, but fewer out-patients visits at the hospital. The patients had a significantly lower Role Physical score in the SF-36 about three months after the fracture. This difference disappeared three years later.Conclusions: A higher need for in-patient care, indicating a worse general health, has to be taken into consideration when secondary prevention programs for patients with a radius fracture are designed and implemented.
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| 35. |
- Nordvall, Helena, 1950-, et al.
(författare)
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Secondary prevention after distal radius fracture : a prospective observational study of the effect of an exercise intervention
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- This prospective observational study evaluated the effect of a four-week educational and exercise program, entitled the osteoporosis school. Two hundred and thirteen women with a distal radius fracture (mean age 66 years) were invited and 41 of them (mean age 64 years) accepted to join an exercise group (exercisers), 172 (mean age 66 years) declined and became a control group (non-exercisers). The intervention was followed by a one-year self-administrated exercise program. Bone mineral density (BMD), functional tests of dynamic and static balance, and leg strength were evaluated before and after the one-year intervention period and falls were registered in a fall diary. No statistically significant mean difference was found in dynamic or static balance between the exercisers and the non-exercisers. However, both groups showed improved balance (walking backwards and standing on one leg with eyes open over the study time (p<0.01). After the intervention, no significant difference was found between the groups in the one-leg rise test (p=0.494). The mean T-score was -1.859 at the baseline and -1.951 after intervention for the exercisers, and -2.0 and -2.064 for the non-exercises. There was no statistically significant difference in prospective falls between the exercisers and the non-exercisers (p= 0.272). Twelve of 41 exercisers (29.3%) and 37 of 172 non-exercisers (21.5%) reported one or more falls. Conclusion: Only 19% of the patients with a recent radius fracture accepted to participate in the osteoporosis school. The osteoporosis school with a 12-month home-based exercise program had no established effect on BMD, balance, leg strength or falls. This lack of proven efficacy for the secondary prevention of distal radius fractures, highlights the need for further research on better and more controlled interventions and for long-term randomised controlled follow-up studies.
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| 36. |
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| 37. |
- Nyberg, Gusten, et al.
(författare)
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Subsequent traumatic injuries after a concussion in elite ice hockey : A study over 28 years
- 2015
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Ingår i: Current Research: Concussion. ; 2:3, s. 109-112
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Concussion is a frequent injury in contact sports. Following a concussion, balance and neurocognitive function have been shown to be affected for >6 days. OBJECTIVE: To analyze whether athletes who have sustained a concussion are at an increased risk for subsequent traumatic injuries. METHODS: A cohort study was performed to investigate all concussions that were sustained in one Swedish elite hockey club over 28 seasons. All injuries and absences were registered prospectively. Players who sustained a concussion were followed-up for seven, 21 and 42 days with respect to new injuries and were compared with a group of players with knee distortions/knee medial collateral ligament injuries. RESULTS: Players who sustained a cerebral concussion did not have an increased risk for subsequent injuries compared with players who experienced a knee injury; however, concussed athletes experienced significantly more serious subsequent injuries (absence >28 days) within 21 days after return to play. Discussion: The authors were unable to confirm whether players who return to play following a concussion are at a higher risk for subsequent new injuries. However, a significantly increased risk for a severe subsequent injury after a concussion may exist. There may also be a possibly increased risk for subsequent injury among players who sustained >1 concussion during the study period. CONCLUSION: The authors were unable to confirm their hypothesis; however, the possibility of a higher risk for a more serious injury following a concussion requires further study.
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| 38. |
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| 39. |
- Odensten, Magnus, et al.
(författare)
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Knee function and muscle strength following distal ileotibial band transfer for antero-lateral rotatory instability
- 1983
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Ingår i: Acta Orthopaedica Scandinavica. - : Medical Journals Sweden AB. - 0001-6470. ; 54:6, s. 924-928
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Tidskriftsartikel (refereegranskat)abstract
- In a prospective study, 60 consecutive patients underwent a distal iliotibial band transfer for anterolateral knee instability. Knee function was evaluated with a score system, static stability tests and a standardized test including thigh muscle measurements, a one-leg-jump-test and a figure-of-8 running test. At the 40-month follow-up there was a significant increase in the mean knee score. The quadriceps in the treated leg was significantly weaker than in the non-operated leg, and the quadriceps strength was significantly correlated to the knee score. The functional outcome after operation was generally unsatisfactory. Few patients attained normal values in all tests, primarily because of poor restoration of stability.
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| 40. |
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| 41. |
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| 42. |
- Röding, Fredrik, et al.
(författare)
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Epidemiologic patterns of injuries treated at the emergency department of a Swedish medical center
- 2015
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Ingår i: Injury Epidemiology. - : Springer. - 2197-1714. ; 2:3, s. ?-
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Tidskriftsartikel (refereegranskat)abstract
- Background: The injury spectrum published in the literature has mainly been presented for a certain age group, as elderly or for a certain type of injury, as fracture and often restricted to in-hospital care cases. Our objective was to give an overview of the major types of injuries for all age groups and trends in the adult population.Methods: We analyzed 68,159 adult injury events, which occurred between 1999 and 2008 and was treated at the Emergency Department of Umea University Hospital. All these injuries are registered in a database. The injuries were analyzed depending on frequency, type of injury, and activity at the time of injury. Incidence rates were calculated using population data from Statistics Sweden.Results: Injury event incidence varied between 614 (2004) and 669 (2007) per 10,000 persons. The most common injury was a fracture, although contusions and wounds were also frequent. Fractures were responsible for almost three quarters of hospital days related to injury. The risk for fractures increased with age, as did contusions and concussions, whereas sprains decreased with age. Fracture incidence increased among the 50- to 59-year age group for both women and men. Fall-related injuries increased significantly for middle-aged adults. Sports-related and work injuries decreased, while injuries occurring during leisure time increased the most.Conclusion: A fracture is the most frequent type of injury for adults and accounts for the largest proportion of the trauma care burden. Contusions are also common and responsible for a significant proportion of the in-hospital days. Injuries caused by a fall increased among middle-age adults imply a need for an extension of fall prevention programs.
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| 43. |
- Röding, Fredrik, 1969-
(författare)
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Injuries are not accidents! : an emergency-department population-based epidemiological study of injuries with special reference to trauma recidivism hip fractures and geriatric falls
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Injury is a major public health problem. In rich countries fall injures now kill more people than all other injury mechanisms together, because of global ageing and large-scale sustainable injury prevention programs for all other injury mechanisms but falls. Injuries from falls in the young are often trivial, but in old people falls may have devastating consequences.We used the Umeå Injury Database, 1993 – 2014, 220,014 injury events attended to by the emergency department: e.g., type of injury, localization, mechanism, activity and severity. Logistic regression was used to evaluate injury trends, Cox regression for associations between injury type, severity and recidivism.Fractures were responsible for 1⁄4 of all injuries and for 3⁄4 of trauma inpatient days. Fractures and contusions became more common with increasing age while sprains and wounds decreased with age. Injuries due to fall increased during the study period.Recurrent injuries accounted for some 40%, mostly in young men and in old women. Prior fractures and sprains were strongest predictors for recurrent serious injuries.The hip fracture incidence fell for the most important age/sex groups during the 22-year period, but the total number increased with 3,5%, due to an increasing elderly population. 40% of all hip fracture patients had sustained a previous injury. Multiple previous injuries also increase the risk of future hip fracture. No less than 12% hip fracture patients suffered a new one. With age, injury pattern changed, with more lower extremity fractures that also were more proximally located. Soft tissue injuries to the head/face also increased, also indicating that the ability to reduce and spread the impact of the kinetic energy is a key factor in geriatric trauma, in addition to tissue strengthThe most common, expensive and devastating injury mechanism, falls, are still outrageously neglected, especially concerning injury prevention, which has been so successful in reducing road traffic- and workplace-related deaths. Why? A common misconception is the primitive belief is that fall injuries are fated and therefore inevitable. There are also few economic and legal drivers to prevent falls, especially recurrent ones. Another reason is that GDPR has prohibited the injury database. Statistics on fall injuries are necessary for targeting preventive interventions. Without spying, no clue. On-line feedback of official statistics should be used to monitor the results. There are no technical, just legal hurdles. The Swedish parliament has since 1997 flagged a zero vision for road traffic injuries; in 2015 the government also launched a more modest goal for a 50% reduction of falls in the elderly. So far, nothing has happened...
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| 44. |
- Röding, Fredrik, et al.
(författare)
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Trauma recidivism at an emergency department of a Swedish medical center
- 2016
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Ingår i: Injury Epidemiology. - : Springer Science and Business Media LLC. - 2197-1714. ; 3
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: To inform targeted prevention, we studied patterns of trauma recidivism and whether a first injury predicts the risk for a recurrent injury.METHODS: In a population-based study of 98,502 adult injury events 1999-2012, at the emergency department of Umeå University Hospital, Sweden, we compared non-recidivists with recidivists in terms of patients' sex, age, type of injury and severity of the injury.RESULTS: Thirty-six percent of all patients suffered recurrent injuries, which were associated with a higher proportion of inpatient care and more hospital days. Young men and elderly women were at the highest risk for trauma recidivism. At 20 to 24 years, men had a 2.4 (CI 95 % 2.3-2.5) higher risk than women, a 90 years old woman had almost a 10-fold higher risk for another moderate/severe injury than a 20 years old one. A fracture were associated with a hazard ratio of 1.28 (CI 95 % 1.15-1.42) among men younger than 65 years and 1.31 (CI 95 % 1.12-1.54) for men older than 65 years for a subsequent moderate/severe injury. For women younger than 65 years a fracture was associated with a hazard ratio of 1.44 (CI 95 % 1.28-1.62) for a subsequent moderate/severe injury. A sprain carries a higher risk for a new moderate/severe injury for both men and women and in both age groups; the hazard ratio was 1.13 (CI 95 % 1.00-1.26) for men younger than 65 years, 1.42 (CI 95 % 1.01-1.99) for men older than 65 years, 1.19 (CI 95 % 1.05-1.35) for women younger than 65 years and 1.26 (CI 95 % 1.02-1.56) for women older than 65 years. A higher degree of injury severity was associated with a higher risk for a new moderate/severe injury.CONCLUSION: Trauma recidivism is common and represents a large proportion of all injured. Age and sex are associated with the risk for new injury. Injury types and severity, also have implications for future injury.
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| 45. |
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| 46. |
- Tegner, Yelverton, et al.
(författare)
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A test for evaluation of knee function
- 1984
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Ingår i: Acta Orthopaedica Scandinavica. - 0001-6470. ; 55:1, s. 111-112
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 47. |
- Tegner, Yelverton, et al.
(författare)
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Akut operation vid karpaltunnelsyndrom
- 1983
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 80:36, s. 3189-
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 48. |
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| 49. |
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| 50. |
- Tegner, Yelverton, et al.
(författare)
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Derotation brace and knee function in patients with anterior cruciate ligament tears
- 1985
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Ingår i: Arthroscopy. - 0749-8063 .- 1526-3231. ; 1:4, s. 264-267
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Tidskriftsartikel (refereegranskat)abstract
- In this article we have tested a ready-made brace to evaluate whether it could improve function in the anterior cruciate ligament injured patient. All patients had their full extent of injury mapped out at arthroscopy. We believe that arthroscopy before treatment for a torn anterior cruciate ligament injury is necessary in order to treat meniscus lesions that could interfere with the rehabilitation. In this study, 26 patients were unstable with a positive pivot-shift, and 16 patients were operated on and thus stable. All patients performed a performance test with and without the brace in a randomized order. Before the start of the investigation, we postulated that patients with a quadriceps atrophy who were unstable would improve their function with the derotation brace. We could not find any effects of the brace in this study. The brace did not significantly improve function in the group of patients who were unstable with a quadriceps atrophy. On the other hand, the brace did not impair function in the patients. We conclude that to be able to improve knee function in the unstable knee, other modes of treatment than bracing are necessary. Bracing should be seen as a complement to these other treatments.
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