| 1. |
- Månsson, Linda, et al.
(författare)
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Evaluation of Concurrent Validity between a Smartphone Self-Test Application and Clinical Tests for Balance and Leg Strength
- 2021
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Ingår i: Sensors. - : MDPI. - 1424-8220. ; 21:5
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Tidskriftsartikel (refereegranskat)abstract
- The evolving use of sensors to objectively assess movements is a potentially valuable addition to clinical assessments. We have developed a new self-test application prototype, MyBalance, in the context of fall prevention aimed for use by older adults in order to independently assess balance and functional leg strength. The objective of this study was to investigate the new self-test application for concurrent validity between clinical instruments and variables collected with a smartphone. The prototype has two test procedures: static standing balance test in two positions, and leg strength test performed as a sit-to-stand test. Thirty-one older adults were assessed for balance and functional leg strength, in an outpatient physiotherapy setting, using seven different clinical assessments and three sensor-tests. The results show that clinical instruments and sensor measurements correlate to a higher degree for the smartphone leg strength test. For balance tests, only a few moderate correlations were seen in the Feet Together position and no significant correlations for the Semi Tandem Stance. This study served as a first step to develop a smartphone self-test application for older adults to assess functional balance at home. Further research is needed to test validity, reliability, and user-experience of this new self-test application.
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| 2. |
- Aasa, Björn, et al.
(författare)
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Acuity of goal-directed arm movements and movement control : evaluation of differences between patients with persistent neck/shoulder pain and healthy controls
- 2022
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Ingår i: European Journal of Physiotherapy. - : Routledge. - 2167-9169 .- 2167-9177. ; 24:1, s. 47-55
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Tidskriftsartikel (refereegranskat)abstract
- Background: The main aim was to examine whether patients with persistent upper quadrant pain have higher end-point variability in goal directed pointing movements than pain-free controls when the pointing task is performed in total darkness and under full vision. An additional aim was to study associations between the magnitude of end-point variability and a clinical movement control test battery and self-rated functioning among patients.Methods: Seventeen patients and 17 age- and gender-matched pain-free controls performed a pointing task that evaluated end-point variability of repetitive shoulder movements in horizontal adduction and abduction with full vision, and abduction with no visual information, completed a movement control test battery of neck and shoulder control tests and answered questionnaires.Results: Patients had higher end point variability for horizontal abduction when performed with no visual information. For horizontal adduction the variability was higher, but only when it was controlled for movement time. No significant correlations were found between end-point variability and self-rated functioning, nor between end-point variability and neuromuscular control of the glenohumeral joint.Conclusions: This study provides preliminary evidence that patients with persistent neck/shoulder pain can partly compensate proprioceptive deficits in goal-directed arm movement when visual feedback is present.
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| 3. |
- Aasa, Björn, et al.
(författare)
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Do we see the same movement impairments? : the inter-rater reliability of movement tests for experienced and novice physiotherapists
- 2014
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Ingår i: European Journal of Physiotherapy. - : Informa UK Limited. - 2167-9169 .- 2167-9177. ; 16:16, s. 173-182
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Tidskriftsartikel (refereegranskat)abstract
- Study design: Inter-rater reliability study. Background: Physiotherapists (PTs) use clinical tests including movement tests to identify faulty movement patterns. Aims: To investigate the inter-rater-reliability of active movement tests in the cervical spine, shoulder joint and scapulo-thoracic joint, and to describe the reasons for judgment of a positive test. Methodology: Four PTs, two experienced and two recently educated (novice), rated performance of five movement tests for 36 participants. Twenty-one of the participants were patients under treatment because of neck and/or shoulder problems, while 15 participants declared no problem from this region of the body. All tests were video recorded and the ratings were done by observing the video recordings. First, the PTs judged the tests as negative (the movement being ideally performed) or positive (the movement not being ideally performed). Then, the PTs described why the movements that they judged positive were not being ideally performed, using a predefined protocol, which represented different movement quality aspects. The inter-rater reliability was calculated for each test using Kappa statistics between the two experienced and the two novice PTs, respectively, and between each of the experienced and each of the novice PTs. Major findings: The experienced PTs had a higher inter-rater reliability than the novice PTs. The reasons for considering a movement test being positive differed highly between the (novice) PTs. Principal conclusion: This study supports previous studies concluding that the observation of active movement tests is reliable when assessed by experienced PTs. Novice PTs might benefit from further supervision.
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| 6. |
- Björk, Maria, et al.
(författare)
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Validation of two brief instruments (the SURE and CollaboRATE) to measure shared decision-making in patients with restless legs syndrome
- 2023
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Ingår i: Journal of Sleep Research. - : John Wiley & Sons. - 0962-1105 .- 1365-2869.
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Tidskriftsartikel (refereegranskat)abstract
- Restless legs syndrome (RLS) is a common neurological disorder characterised by an urge to move arms and legs, usually associated with discomfort, pain, motor restlessness, and sleep disturbance. An individually adapted treatment is needed but difficult to optimise, which makes shared decision-making (SDM) important. However, brief validated instruments on how patients with RLS perceive their involvement in treatment decisions are lacking. Therefore, the aim was to validate two instruments, SURE (Sure of myself, Understand information, Risk-benefit ratio, Encouragement, i.e., to assess decisional conflict) and CollaboRATE (brief patient survey focused on SDM, i.e., to assess SDM), in patients with RLS. A cross-sectional design, including 788 participants with RLS (65% females, mean [SD] age 70.8 [11.4] years) from a national patient organisation for RLS, was used. A postal survey was sent out to collect data regarding weight, height, comorbidities, demographics, and RLS-related treatment data. The following instruments were included: the SURE, CollaboRATE, Restless Legs Syndrome-6 Scale, and eHealth Literacy Scale. Confirmatory factor analysis and Rasch models were used to assess the validity and reliability of the SURE and CollaboRATE. Measurement invariance, unidimensionality, and differential item functioning (DIF) across age, gender, and medication groups were assessed. The SURE and CollaboRATE were both identified as unidimensional instruments with satisfactory internal consistency. No DIF across age and gender was identified, while significant DIF was observed for both the SURE and CollaboRATE regarding medication use categories. However, both the SURE and CollaboRATE are potential instruments to be used in research, but also as reflection tools by healthcare professionals, patients, and students to explore and assess SDM, and support its development in clinical care.
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| 7. |
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| 9. |
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| 10. |
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| 11. |
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| 12. |
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| 13. |
- Knutsson, Susanne, et al.
(författare)
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The ethos brief index-validation of a brief questionnaire to evaluate wellness based on a holistic perspective in patients with restless legs syndrome
- 2024
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Ingår i: Sleep and Breathing. - : Springer. - 1520-9512 .- 1522-1709.
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Tidskriftsartikel (refereegranskat)abstract
- Purpose The aim of this study was to validate the Ethos Brief Index (EBI) in patients with Restless Legs Syndrome (RLS).Methods A cross-sectional design, including 788 subjects with RLS (65% women, 70.8 years, SD 11.3) from the Swedish RLS Association, was used. A postal survey was sent out to collect data regarding socio demographics, comorbidities, and RLS-related treatment data. Questionnaires included were EBI, the Restless Legs Syndrome-6 Scale (RLS-6), Restless Legs Syndrome-Quality of Life questionnaire (RLSQoL), the Insomnia Severity Index (ISI), and the Epworth Sleepiness Scale (ESS). The validity and reliability of the EBI were investigated using Rasch and confirmatory factor analysis (CFA) models. Measurement invariance, unidimensionality, and differential item functioning (DIF) across age and gender groups, as well as insomnia, daytime sleepiness, RLS-related QoL and RLS severity were assessed.Results The results supported the unidimensionality of the EBI in the CFA (i.e., explaining 61.5% of the variance) and the Rasch model. The reliability of the EBI was confirmed using composite reliability and Cronbach's alpha. No DIF was identified for gender, age, insomnia, daytime sleepiness, RLS severity or RLS-related QoL.Conclusion The EBI showed good validity and reliability and operated equivalently for male and female patients with RLS. Accordingly, healthcare professionals can use the EBI as a psychometrically sound tool to explore and identify patient-centered problems related to the whole life situation.
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| 14. |
- Knutsson, Susanne, 1967-, et al.
(författare)
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The ethos brief index-validation of a brief questionnaire to evaluate wellness based on a holistic perspective in patients with restless legs syndrome
- 2024
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Ingår i: Sleep and Breathing. - : Springer. - 1520-9512 .- 1522-1709.
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Tidskriftsartikel (refereegranskat)abstract
- Purpose The aim of this study was to validate the Ethos Brief Index (EBI) in patients with Restless Legs Syndrome (RLS).Methods A cross-sectional design, including 788 subjects with RLS (65% women, 70.8 years, SD 11.3) from the Swedish RLS Association, was used. A postal survey was sent out to collect data regarding socio demographics, comorbidities, and RLS-related treatment data. Questionnaires included were EBI, the Restless Legs Syndrome-6 Scale (RLS-6), Restless Legs Syndrome-Quality of Life questionnaire (RLSQoL), the Insomnia Severity Index (ISI), and the Epworth Sleepiness Scale (ESS). The validity and reliability of the EBI were investigated using Rasch and confirmatory factor analysis (CFA) models. Measurement invariance, unidimensionality, and differential item functioning (DIF) across age and gender groups, as well as insomnia, daytime sleepiness, RLS-related QoL and RLS severity were assessed.Results The results supported the unidimensionality of the EBI in the CFA (i.e., explaining 61.5% of the variance) and the Rasch model. The reliability of the EBI was confirmed using composite reliability and Cronbach's alpha. No DIF was identified for gender, age, insomnia, daytime sleepiness, RLS severity or RLS-related QoL.Conclusion The EBI showed good validity and reliability and operated equivalently for male and female patients with RLS. Accordingly, healthcare professionals can use the EBI as a psychometrically sound tool to explore and identify patient-centered problems related to the whole life situation.
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| 15. |
- Köpsén, Sofia, et al.
(författare)
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Midwives' and diabetes nurses' experience of screening and care of women with gestational diabetes mellitus : a qualitative interview study
- 2023
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Ingår i: Nursing Research and Practice. - : Hindawi Publishing Corporation. - 2090-1429 .- 2090-1437. ; 2023
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Tidskriftsartikel (refereegranskat)abstract
- Background: Gestational diabetes mellitus (GDM) is increasing and is associated with adverse outcomes for both mother and child. The metabolic demands of pregnancy can reveal a predisposition for type 2 diabetes mellitus (T2DM), and women with a history of GDM are more likely to develop T2DM than women with normoglycemic pregnancies.Aim: The aim of this study was to explore midwives' and diabetes nurses' experience of their role in screening, care, and follow-up of women with gestational diabetes mellitus and, further, to explore their opinions and thoughts about existing routines and guidelines.Method: Individual interviews were performed with ten diabetes nurses and eight midwives working in primary and special care. Qualitative content analysis was done according to Graneheim and Lundman.Results: The analysis of the interviews resulted in the overall theme "An act of balance between normalcy and illness, working for motivation with dilemmas throughout the chain of health care."Difficulties in carrying out the important task of handling GDM while at the same time keeping the pregnancy in focus were central. Women were described as highly motivated to maintain a healthy lifestyle during pregnancy with the baby in mind, but it seemed difficult to maintain this after delivery, and compliance with long-term follow-up with the aim of reducing the risk of T2DM was low. The women came to the first follow-up but did not continue with later contact. This was at a time when the women felt healthy and were focusing on the baby and not themselves. A lack of cooperation and easy access to a dietician and physiotherapist were pointed out as well as a wish for resources such as group activities and multiprofessional teams.
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| 16. |
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| 17. |
- Meander, Lina, et al.
(författare)
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Physical activity and sedentary time during pregnancy and associations with maternal and fetal health outcomes : an epidemiological study
- 2021
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Ingår i: BMC Pregnancy and Childbirth. - : BioMed Central (BMC). - 1471-2393 .- 1471-2393. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Physical activity is generally considered safe for the pregnant woman as well as for her fetus. In Sweden, pregnant women without contraindications are recommended to engage in physical activity for at least 30 min per day most days of the week. Physical activity during pregnancy has been associated with decreased risks of adverse health outcomes for the pregnant woman and her offspring. However, there are at present no recommendations regarding sedentary behavior during pregnancy. The aim was to examine the level of physical activity and sedentary time in a representative sample of the pregnant population in Sweden, and to explore potential effects on gestational age, gestational weight gain, birth weight of the child, mode of delivery, blood loss during delivery/postpartum, self-rated health during pregnancy and risk of pregnancy-induced hypertension and preeclampsia.METHODS: This was an epidemiological study using data from the prospective, population-based NorthPop study in Northern Sweden and information on pregnancy outcomes from the national Swedish Pregnancy Register (SPR). A questionnaire regarding physical activity and sedentary time during pregnancy was answered by 2203 pregnant women. Possible differences between categories were analyzed using one-way Analysis of variance and Pearson's Chi-square test. Associations between the level of physical activity/sedentary time and outcome variables were analyzed with univariable and multivariable logistic regression and linear regression.RESULTS: Only 27.3% of the included participants reported that they reached the recommended level of physical activity. A higher level of physical activity was associated with a reduced risk of emergency caesarean section, lower gestational weight gain, more favorable self-rated health during pregnancy, and a decreased risk of exceeding the Institute of Medicine's recommendations regarding gestational weight gain. Higher sedentary time was associated with a non-favorable self-rated health during pregnancy.CONCLUSIONS: Our study showed that only a minority of pregnant women achieved the recommended level of physical activity, and that higher physical activity and lower sedentary time were associated with improved health outcomes. Encouraging pregnant women to increase their physical activity and decrease their sedentary time, may be important factors to improve maternal and fetal/child health outcomes.
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| 18. |
- Otterstedt, Charlotte, et al.
(författare)
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Motor proficiency of persons with attention deficit hyperactivity disorder or autism spectrum disorder diagnosed in adulthood
- 2024
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Ingår i: Disability and Rehabilitation. - : Taylor & Francis Group. - 0963-8288 .- 1464-5165.
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To compare (1) motor proficiency of persons diagnosed in adulthood with attention deficit hyperactivity disorder (ADHD) or autism spectrum disorder (ASD) with normative values of motor proficiency, and (2) motor proficiency between persons with ADHD and those with ASD diagnosed in adulthood.Methods: A total of 153 adults (median age 32 years, 36% women) participated in this cross-sectional study. Fifty-three persons with predominately inattentive presentation (ADHD-I), 67 persons with combined presentation (ADHD-C), and 33 persons with ASD performed the Bruininks-Oseretsky Test of Motor Proficiency (BOT-2). One-sample binominal tests were used to compare motor proficiency against standardized norms of BOT-2 for young adults. One-way ANOVAs and Kruskal-Wallis tests were used to compare test outcomes between the groups.Results: The total sample showed significantly impaired motor proficiency in comparison to norms in all test domains (p < 0.001-0.006), except for fine motor skills. The ASD group showed significantly poorer body coordination compared with the ADHD-I and ADHD-C groups, with a moderate effect size (p = 0.003-0.02, η2 = 0.061).Conclusions: Motor proficiency is impaired in most persons with ADHD or ASD diagnosed in adulthood, suggesting that motor assessment should be included in clinical examinations of adults with suspected neurodevelopment disorders.
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| 19. |
- Rehn, Börje, 1967-, et al.
(författare)
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Flippade klassrum om människokroppens funktion för fysioterapeutstudenter
- 2017
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Ingår i: Universitetspedagogiska konferensen 2017. - Umeå : Universitetspedagogik och lärandestöd (UPL), Umeå universitet. ; , s. 91-91
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Människokroppens funktion handlar om grundläggande biologiska förutsättningar för att möjliggöra kroppsrörelser, båda för friska människor och de med rörelsehinder, ett signum för fysioterapi och fysioterapeututbildningar. Traditionellt har undervisning inom detta område skett genom katedralföreläsningar. Syftet med det här projektet var att implementera och utvärdera flippade klassrum om människokroppens funktion för fysioterapeutstudenter i termin 2. Förhoppningen var att den nya undervisningsformen skulle fördjupa lärandet. För ett antal områden har filmer producerats och lagts ut på Umu-play i lärplattformen Cambro. Dessa filmer skulle ses av studenterna innan träff med läraren. Filmerna tog upp huvuddragen kring områdena och en del kända svåra passager. Studenterna var i övrigt hänvisade till kurslitteratur och målbeskrivning. Vid träff med läraren strukturerades denna på olika sätt, så att studenterna tillsammans och med läraren kunde diskutera innehållet. Detta ansågs av lärarna vara den viktigaste och svåraste delen med flippade klassrum, men att det skapade dialog med studenterna. Några av studenterna gillade undervisningsformen, men den kräver att man är förberedd vid träff med läraren. Andra studenter föredrag vanliga föreläsningar. Projektet började i liten skala med förändring av några områden, men kommer att gälla fler områden i framöver.
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| 20. |
- Sandlund, Jonas, et al.
(författare)
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Acuity of goal-directed arm movements to visible targets in chronic neck pain
- 2008
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Ingår i: Journal of Rehabilitation Medicine. - : Foundation of Rehabilitation Information. - 1650-1977 .- 1651-2081. ; 40:5, s. 366-374
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate end-point acuity in goal-directed arm movements in subjects with chronic neck pain, while taking the trade-off between speed and accuracy into account, and to evaluate associations between reduced acuity and self-rated characteristics.Design: Single-blinded, controlled, comparative group study.Subjects: Forty-five subjects with chronic non-traumatic, non-specific neck pain (n = 24) and whiplash-associated disorders (n = 21). Healthy subjects served as controls (n = 22). The groups were age- and sex-matched.Methods: Subjects performed fast and accurate pointing movements to a visual target. Group differences in end-point variability, controlled for peak velocity, were evaluated. Associations between end-point variability and self-rated symptoms, functioning, self-efficacy and kinesiophobia were analysed.Results: End-point acuity, controlled for peak velocity, was reduced for both neck-pain groups. Similar spatial error patterns across all groups indicated no direction-specific reduction. For both neck-pain groups, associations were found between end-point acuity and neck movement deficits, physical functioning and, in whiplash, also balance and pain.Conclusion: Acuity of goal-directed arm movements can be reduced in chronic neck pain. Associations between acuity and self-rated characteristics support the clinical validity of the results and indicate that impaired neck function contributes to reduced end-point acuity. The results can be of importance for characterization and rehabilitation of neck disorders.
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| 21. |
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| 22. |
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| 23. |
- Sandlund, Jonas, et al.
(författare)
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Classification accuracy of motor control tests of the lumbar spine for subgroups of mechanical low back pain
- 2012
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Ingår i: Journal of Orthopaedic and Sports Physical Therapy. - : Journal of Orthopaedic & Sports Physical Therapy (JOSPT). - 0190-6011 .- 1938-1344. ; 42:10, s. A57-A57
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To investigate the classification accuracy of motor control testsof the lumbar spine in discriminating 5 subgroups of peripherally mediated mechanical low back pain (LBP) suggested in the classification system developed by Peter O’Sullivan.RELEVANCE: Identifying clinically relevant subgroups is considered a prioritized area of LBP research. The current study addresses the issue of using accurate, reliable, and standardized tests to guide such classifications.METHODS: Seventy subjects with nonspecific LBP were classified by anexpert clinician into 5 subgroups based on the direction of motor control impairment and the assumed mechanism underlying the pain disorder (ie, flexion, lateral shift, active extension, passive extension, andmultidirectional pattern). Thereafter, 5 standardized tests of motor control were performed under the supervision of 2 therapists blinded tothe subgroup classification: “waiters bow,” bilateral and unilateral sitting knee extension, and bilateral and unilateral prone knee flexion. Alack of ability to prevent a compensatory movement (motion give) when instructed to maintain neutral lumbar posture was judged as test failure. Multinomial logistic regression was used to analyze the association between tests and subgroups and to determine the tests’ joint classification accuracy.RESULTS: The motor control tests showed significant associations to thedifferent subgroups (χ2 = 37.08, P = .002, Nagelkerke pseudo R2 = 0.431)and displayed significant discriminative ability, increasing the classification accuracy substantially, 95% above chance level overall, and for allsubgroups except for the multidirectional pattern. The different subgroups were characterized by different association patterns, indicating different tests to be important for different subgroups.CONCLUSIONS AND CLINICAL IMPLICATIONS: The results indicate a clinical utility of the motor control tests and suggest them to be useful to supplement in subgroup classification of what traditionally have been considered nonspecific mechanical LBP. The findings also support the clinical validity of the approach to subgroup patients according to the direction of motorcontrol impairment.
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| 24. |
- Sandlund, Jonas, et al.
(författare)
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Consistency of individual motor variability patterns in repetitive precision work
- 2015
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Ingår i: Physiotherapy. - : Elsevier BV. - 0031-9406 .- 1873-1465. ; 101:Suppl. 1, s. e1334-e1335
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background:A longstanding hypothesis in physical therapy and occupational research is that workers repeating a task very stereotypically will be more prone to develop musculoskeletal disorders than workers that manage to vary postures and loads. Increased movement variability (MV), presumably, modify tissue loads, distribute stresses more equally, and thus reduce the cumulative load on any particular tissue. A handful of studies of MV have indicated less overuse injuries and faster recovery from musculoskeletal pain disorders. Even when repeating strictly controlled tasks individuals may differ in motor consistency, some showing higher levels of MV than others. However, whether the extent of MV is indeed a consistent individual trait across different tasks and different days is not known.Purpose:To investigate whether individual profiles of MV is stabile between days, the consistency of MV patterns from kinematic recordings, repeated across three days, was studied when performing repetitive upper-extremity precision work.Methods:A laboratory-based simulation of precision work; a 'pipetting' task paradigm, was developed in which liquid was repeatedly transferred from one tube to another, with a cycle time of 2.8s. Fourteen healthy female subjects, aged 20-45 years, right-handed and with experience in pipetting participated on 3 different days under identical conditions. Kinematic data were obtained using an electromagnetic motion capture system (FASTRAK). MV in shoulder elevation, elbow flexion and shoulder-elbow coordination were operationalized using cycle-to-cycle standard deviations across 20 pipetting cycles of kinematics parameters including joint range of motion, average and peak velocities, time to peak velocities, average angle and phase. Multivariate analysis was conducted using principal component analysis (PCA) (SIMCA+P, 12.0) to analyze relationships among variables and individual patterns in the data matrix of the recordings from day1. Thereafter, in order to confirm the observed structure of inter-individual MV patterns, classification of the data from day2 and day3 was performed using the parameters of the model from day1.Results:Four PCA components (Eigenvalues>1) accounted for 80 percent of the total variance in the model for day1. In the subsequent prediction model where data from day2 and 3 were projected into the model of day1, all subject observations except one could be predicted with 95% confidence (Hotelling T2). And individual data scores from all three days were clustered in relative proximity to each other, indicating consistency in MV between days.Conclusion(s):The findings indicate, even in this small and homogenous sample of young healthy females, that there may indeed be consistent individual traits in motor variability. A next step would be to answer whether these traits remain consistent if work factors such as work pace or precision are altered, and whether individual profiles of MV are associated with physiological responses related to risk for developing musculoskeletal disorders.Implications:Consistency of individual MV patterns substantiate previous notions that some people appear prone to repeat themselves while others tend to vary their motor behavior when performing the same task. Assessment of MV by physical therapists in research and practice could be valuable to further explore and address the relation of MV and musculoskeletal health.
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| 25. |
- Sandlund, Jonas, et al.
(författare)
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Differences in motor variability among individuals performing a standardized short-cycle manual task
- 2017
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Ingår i: Human Movement Science. - : Elsevier BV. - 0167-9457 .- 1872-7646. ; 51, s. 17-26
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Tidskriftsartikel (refereegranskat)abstract
- Motor variability (MV) has been suggested to be a determinant of the risk for developing musculoskeletal disorders in repetitive work. In this study we examined whether individuals consistently differed in the extent of motor variability when performing a standardized short-cycle manual task. On three separate days, arm kinematics was recorded in 14 healthy subjects performing a pipetting task, transferring liquid from a pick-up tube to eight target tubes with a cycle time of 2.8 s. Cycle-to-cycle standard deviations (SD) of a large selection of shoulder and elbow kinematic variables, were processed using principal component analysis (PCA). Thereafter, between-subjects and between-days (within-subject) variance components were calculated using a random effects model for each of four extracted principal components. The results showed that MV differed consistently between subjects (95% confidence intervals of the between-subjects variances did not include zero) and that subjects differed consistently in MV between days. Thus, our results support the notion that MV may be a consistent personal trait, even though further research is needed to verify whether individuals rank consistently in MV even across tasks. If so, MV may be a candidate determinant of the risk of developing fatigue and musculoskeletal disorders in repetitive occupational work.
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| 26. |
- Sandlund, Jonas
(författare)
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Position-matching and goal-directed reaching acuity of the upper limb in chronic neck pain : associations to self-rated characteristics
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Neck-shoulder pain is common in the general population and causes individual suffering as well as large costs for the society. Despite substantial efforts, there is still a shortage of methods for objective diagnosis and effective rehabilitation of such disorders. Thus, there is a great need to develop and evaluate new methods for these purposes. From clinical observations and recent research it has become evident that sensorimotor control can be impaired in people with neck-shoulder pain and may play a role in the pathogenesis of these disorders. In this thesis, precision of goal-directed arm movements, a previously unstudied class of movements in neck-shoulder pain, was studied. The main aim of the thesis was to investigate if people with chronic neck-shoulder pain have a reduced acuity of goal-directed movements of the upper extremity. A second aim was to study associations between reduced movement acuity and symptoms and self-rated characteristics. Upper limb repositioning acuity was assessed in blindfolded subjects performing tests of active, ipsilateral position-matching of two target positions (long and short) in movements constrained to horizontal-adduction of the shoulder. Reduced repositioning acuity, suggesting impaired shoulder proprioception, was found for both subjects with whiplash associated disorders (WAD) and non-specific neck-shoulder pain (NS). The degree of reduced acuity was shown to correlate with self-ratings of various health concepts, functioning and pain. A conspicuous finding was that there was lack of correlation between short and long target errors, along with the fact that associations between repositioning acuity and symptoms and self-rated characteristics was primarily found for the short target position. To further investigate the possible mechanisms underlying the disassociation between long and short target movement control, the association pattern between the outcome of several variants of ipsilateral position matching and velocity-discrimination tests, were studied. It was found that the perception of limb position in position-matching of short target locations appears to be predominantly based on movement velocity, whereas perception of limb position in movements to longer target locations may rely on a location-based perception mechanism. To extend the research on reduced upper extremity proprioception in neck-shoulder pain to a more natural movement situation, acuity of goal-directed pointing including full vision and 3D multi-joint movements was investigated in WAD, NS and healthy controls subjects. The results revealed a reduced acuity for both neck-pain groups. Moreover, distinct associations between end-point acuity and neck movement problems, limitations of some physical functions and, in WAD; some aspects of pain, were revealed. The findings demonstrate that the precision of upper limb movements can be reduced in chronic neck-shoulder pain. Substantial associations with symptoms and self-rated functioning suggest a clinical relevance of acuity measures of goal-directed arm movements. The findings indicate that tests of sensorimotor control can provide objective measures that may be useful in biopsychosocial profiling and characterization of subgroups of patients with chronic neck-shoulder pain, and that training target control of goal-directed movements should be considered in rehabilitation programs of people with these disorders.
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| 27. |
- Sandlund, Jonas, et al.
(författare)
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Predictive and discriminative value of shoulder proprioception tests for patients with whiplash-associated disorders
- 2006
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 38:1, s. 44-49
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate whether patients suffering from whiplash-associated disorders have impaired shoulder proprioception and whether the acuity of shoulder proprioception is reflected in the patients' symptoms and self-rated function. DESIGN: A comparative group design, including a correlation design for the patient group. SUBJECTS: Patients with chronic whiplash-associated disorders (n=37) and healthy subjects (n=41). The groups were matched for age and gender. METHODS: All subjects underwent a shoulder proprioception test involving active ipsilateral arm position-matching. Group difference was evaluated by multiple analysis of variance and analysis of variance. The patient group completed questionnaires addressing functioning and health and performed pain ratings. Associations between proprioceptive acuity and self-rated functioning and symptoms were studied by correlation and regression analyses. RESULTS: The patient group showed significantly lower acuity of shoulder proprioception. Moderate correlations were found between proprioceptive acuity and questionnaire scores representing physical functioning, so that low proprioceptive acuity was associated with low self-rated physical functioning. Scores representing pain-intensity did not correlate with proprioceptive acuity. CONCLUSION: The results show that, at the group level, patients with whiplash-associated disorders have impaired shoulder proprioception. The clinical relevance of this finding is strongly supported by the association between shoulder proprioceptive acuity and self-rated functioning in the patient group.
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| 28. |
- Sandlund, Jonas, et al.
(författare)
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Reduced shoulder proprioception in patients with whiplash associated disorders (WAD)
- 2004
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Ingår i: 8th International Federation of Orthopaedic Manipulative Therapists' Conference, Cape Town, South Africa.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- INTRODUCTION: Chronic whiplash associated disorders (WAD) are frequent in medical practice and are presented as a complex picture of neck -and shoulder pain along with numerous other symptoms. However, objective findings at physical examination are usually weak and thus the diagnosis of WAD is mostly based on the medical history and interpretation of personal information. Lately attention has focused on proprioceptive disturbances. Reasonably, vertigo, dizziness and fumbling often reported for WAD patients may be associated with alterations in proprioception. Our lab showed that experimentally induced pain directly impacts muscle spindle activity (MSA) in the muscles primarily affected, as well as in contralateral muscles. Since proprioception is mostly dependent upon MSA, pain originating from the neck region could potentially impair proprioception throughout the upper limbs. To validate proprioceptive testing as a diagnostic tool, the aims of the present study were to investigate: (1) shoulder proprioception, in the ability to reproduce a target position, in WAD patients compared to healthy controls; and (2) possible correlations between the degree of position matching error and subjective rating of health status, disability, self-efficacy and pain. METHODS: Participants were 38 WAD patients and 41 healthy subjects. From a start position of 50 degrees to the sagittal plane, shoulder horizontal-adduction movements of the right glenohumural joint to target positions of 18 and 30 degrees were conducted. The variable error (VE) of the position matching was used to assess the outcome. The patients also completed reports of their general health status (SF-36), disability due to pain (Pain disability index), pain-ratings (VAS) and self-efficacy beliefs (Self efficacy scale). RESULTS: The results showed a significantly higher VE in the WAD-group compared to the controls (p .< 0.001). VE and scores of the self-reports was found to correlate for all the questionnaires used. However, this was true only for the shorter (18 deg) target position. Put together in a step-wise multiple regression model the questionnaires could explain 46 percent of the position matching variance (p < 0.001), but again only when short target positions were focused. DISCUSSION AND CONCLUSION: A reduced ability to reproduce shoulder positions after active displacement implies a disturbance of the sensory motor function of patients with chronic WAD. According to our hypothesis, reduced proprioceptive function of muscle spindles could be responsible for this negative effect on precision and quality of movements. The correlation between position- matching errors and self-reports suggests that this in turn could be reflected in the person's everyday life. Correlations only for shorter target positions indicate that the control of different movement extents may depend on partly different mechanisms. The results may stimulate further research and the possibility of using proprioceptive tests to confirm symptoms and subjective disability in various musculo-skeletal disorders.
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| 29. |
- Sandlund, Monica, 1955-
(författare)
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Lärare med utländsk bakgrund : Sju yrkeslivsberättelser om möten med nya skolsammanhang
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Studiens övergripande syfte är att öka kunskapen om lärare med utländsk bakgrund och deras möte med den svenska skolan genom deras berättelser. Studien har sin grund i ett socialkonstruktionistiskt perspektiv med förståelsen att mening skapas i interaktion med andra. Berättandet ses här som en handling och en dominerande uttrycksform för identitetsskapande. I avhandlingen lyfts sju lärare fram genom deras yrkeslivsberättelser om den svenska mångkulturella skolan. Studien är en longitudinell undersökning och empirin består av fjorton livsberättelseintervjuer som gjorts i två omgångar med ett till fyra års mellanrum. Med hjälp av livsberättelseansatsen som teoretisk och metodologisk utgångspunkt analyseras följande frågeställningar: Vilka yrkesethos framträder i lärarnas berättelser om möten och relationer i den svenska skolan? Vilka positioner intar och tillskrivs lärarna i sina berättelser? Hur gestaltas legitimitet i lärarnas berättelser? Resultatet diskuteras i relation till teorier och diskurser om skola, lärarprofession, mångkulturella/interkulturella intentioner samt sociala strukturer. Studien visar att lärarna gör identitetsframträdanden i sina berättelser gällande legitimitet. Detta sker genom konstruktion, dekonstruktion och rekonstruktion av yrkesethos. I avhandlingen framkommer indikationer på att det i skolan förutsätts att det är de utländska lärarna som ska anpassa sig efter rådande normer och att toleransen för alternativa förhållningssätt är begränsade. Lärarna positionerar sig i berättelserna genom att både acceptera och göra motstånd mot kraven på konformitet.
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| 30. |
- Srinivasan, Divya, et al.
(författare)
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Motor variability traits among individuals performing repetitive precision work
- 2014
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Ingår i: Proceedings of the 11th International Symposium on Human Factors in Organizational Design and Management (ODAM), and 46th Annual Nordic Ergonomics Society Conference (NES). - Santa Monica, CA : The IEA Press. - 9788793130135 ; , s. 987-989
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Konferensbidrag (refereegranskat)abstract
- Motor variability (MV) refers to the intrinsic variability naturally present in the motor control system. Occurring even in the simplest movements, it is usually manifested as a difference in joint movements, joint coordination and/or muscle activities between successive repeats of a task which are identical in performance. Contrary to the traditional view that MV is detrimental to performance, it is now widely accepted that MV may actually have an important functional role in skill acquisition, and that skilled performance may, actually, be associated with increased MV. Further, MV is related to pain and fatigue, and may play a decisive role in rehabilitation (reviewed in Srinivasan & Mathiassen 2012). Hypothetically, individuals with a larger MV would be better protected against overuse injuries, and recover faster after disorders affecting motor performance. However, whether the extent of MV is, indeed, a consistent individual trait across different tasks is not known. The purpose of this study was to let individuals perform a laboratory-based simulation of repetitive upper-extremity precision work and determine:(i) Whether it is possible to systematically classify individuals according to the size of their MV in repetitive work;(ii) Whether classification of individuals in one working condition on one day persists even when some work-factors are slightly changed, and between different days when they perform the same work.Repetitive pipetting with a cycle time of 2.8s was performed in the laboratory by a group of 14 healthy female subjects, aged 20-45 years, right-handed and experienced in pipetting, on 3 different days under identical protocol and experimental conditions. Work factors such as work-pace, precision and cognitive load (on top of the pipetting work) were manipulated within each day. Kinematic data were obtained using electromagnetic motion capture systems (FASTRAK).MV in shoulder elevation, elbow flexion and shoulder-elbow coordination were operationalized using cycle-to-cycle standard deviations of motor parameters such as peak velocities, time lag of peak velocities, phase angle and inter-segmental phase angle. The resulting traits in individuals and the consistency of those traits across tasks and days will be presented.
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| 31. |
- Åhlander, Anna, et al.
(författare)
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Living (dys)regulated and alienated young masculinity : young men's embodied experiences of mental disorders and suicidality
- 2023
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Ingår i: Counselling and Psychotherapy Research. - : John Wiley & Sons. - 1473-3145 .- 1746-1405. ; 23:4, s. 893-905
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Mental disorders, such as depression and anxiety with interlinked suicidality, are the leading cause of health-related disability among young men. Knowledge of the interaction between emotional, bodily, social and gendered mental health processes in young men is limited and therefore needed.Aim: This study aimed to explore young men's lived embodied experiences of mental disorders and suicidality, and to conceptualise these by integrating affective–emotional, physiological, social and gendered processes.Methods: Semistructured individual interviews were conducted with 13 young men who had sought professional help for mental disorders and suicidality. Grounded theory (GT) was used with a social constructivist perspective.Results: The results comprise one core category - Living (dys)regulated and alienated young masculinity - with related categories “battling with the emotional body,” “suffering in social silence” and “balancing embodied darkness and distress.” The GT illustrates how young men navigate and manage their embodied and emotional suffering in a context of “regulative” masculine and social norms alongside insufficient social support.Conclusion: Our results suggest that young men's lived embodied experiences of mental disorders and suicidality can be understood as a dynamic process of internal and external “(dys)regulation and alienation.” The generated GT provides a broad tentative explanation model, contributing to theory development, and serves as a basis for gender-sensitive interventions - in both psychotherapy and physiotherapy - integrating body, mind and the social context.
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