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1.	Westgård, Theresa, et al. (author) Comprehensive geriatric assessment pilot of a randomized control study in a Swedish acute hospital : a feasibility study 2018 In: Pilot and Feasibility Studies. - : Springer Science and Business Media LLC. - 2055-5784. ; 4 Journal article (peer-reviewed)abstract Background: Comprehensive geriatric assessment (CGA) represent an important component of geriatric acute hospital care for frail older people, secured by a multidisciplinary team who addresses the multiple needs of physical health, functional ability, psychological state, cognition and social status. The primary objective of the pilot study was to determine feasibility for recruitment and retention rates. Secondary objectives were to establish proof of principle that CGA has the potential to increase patient safety.Methods: The CGA pilot took place at a University hospital in Western Sweden, from March to November 2016, with data analyses in March 2017. Participants were frail people aged 75 and older, who required an acute admission to hospital. Participants were recruited and randomized in the emergency room. The intervention group received CGA, a person-centered multidisciplinary team addressing health, participation, and safety. The control group received usual care. The main objective measured the recruitment procedure and retention rates. Secondary objectives were also collected regarding services received on the ward including discharge plan, care plan meeting and hospital risk assessments including risk for falls, nutrition, decubitus ulcers, and activities of daily living status.Result: Participants were recruited from the emergency department, over 32 weeks. Thirty participants were approached and 100% (30/30) were included and randomized, and 100% (30/30) met the inclusion criteria. Sixteen participants were included in the intervention and 14 participants were included in the control. At baseline, 100% (16/16) intervention and 100% (14/14) control completed the data collection. A positive propensity towards the secondary objectives for the intervention was also evidenced, as this group received more care assessments. There was an average difference between the intervention and control in occupational therapy assessment - 0.80 [95% CI 1.06, - 0.57], occupational therapy assistive devices - 0.73 [95% CI 1.00, - 0.47], discharge planning -0.21 [95% CI 0.43, 0.00] and care planning meeting 0.36 [95% CI-1.70, -0.02]. Controlling for documented risk assessments, the intervention had for falls - 0.94 [95% CI 1.08, - 0.08], nutrition - 0.87 [95% CI 1.06, - 0.67], decubitus ulcers - 0.94 [95% CI 1.08, - 0.80], and ADL status - 0.80 [95% CI 1.04, - 0.57].Conclusion: The CGA pilot was feasible and proof that the intervention increased safety justifies carrying forward to a large-scale study.Trial registration: Clinical Trials ID: NCT02773914. Registered 16 May 2016.
2.	Benkel, Inger, et al. (author) Palliativ vård 2016 Book (other academic/artistic)
3.	Peolsson, Anneli, et al. (author) Return to work a bumpy road : a qualitative study on experiences of work ability and work situation in individuals with chronic whiplash-associated disorders 2021 In: BMC Public Health. - : BioMed Central. - 1471-2458. ; 21:1 Journal article (peer-reviewed)abstract BACKGROUND: Work resumption is a big challenge in the rehabilitation process for individuals with whiplash-associated disorders (WAD). To better meet the needs of individuals with WAD in their return to work process, more knowledge on their experiences and perspectives is needed. The aim of this study was to explore the experiences of work ability and the work situation of individuals who participated in a neck-specific exercise programme for chronic WAD.METHODS: This qualitative study has an exploratory and descriptive design based on data collected through open-ended interviews with 17 individuals with chronic WAD. Data were analysed inductively using conventional content analysis.RESULTS: Analysis of the data yielded the following five categories related to the participants' narratives on their experiences of work ability and their work situation: Return to work - a process of setbacks and bureaucracy; The need to be understood by health care professionals, and to receive a treatment plan; Individual resources are important for work ability; The consequences of reduced work ability; and Working conditions are important for work ability.CONCLUSION: Individuals with chronic WAD often struggle to return to work. Emotional and practical support from stakeholders is imperative and needs to be strengthened. Participating in a neck-specific exercise programme, including being acknowledged and receiving information about WAD, could positively affect the work ability of WAD sufferers. This study has provided management strategies to improve the ability to work for individuals with chronic WAD, and highlights the need to incorporate a healthy and sustainable return to work in the rehabilitation of individuals with WAD, thereby making their return to work a success.
4.	Falk Erhag, Hanna, et al. (author) A Multidisciplinary Approach to Capability in Age and Ageing 2022 Book (other academic/artistic)abstract This open access book provides insight on how to interpret capability in ageing – one’s individual ability to perform actions in order to reach goals one has reason to value – from a multidisciplinary approach. With for the first time in history there being more people in the world aged 60 years and over than there are children below the age of 5, the book describes this demographic trends as well as the large global challenges and important societal implications this will have such as a worldwide increase in the number of persons affected with dementia, and in the ratio of retired persons to those still in the labor market. Through contributions from many different research areas, it discussed how capability depends on interactions between the individual (e.g. health, genetics, personality, intellectual capacity), environment (e.g. family, friends, home, work place), and society (e.g. political decisions, ageism, historical period). The final chapter by the editors summarizes the differences and similarities in these contributions. As such this book provides an interesting read for students, teachers and researchers at different levels and from different fields interested in capability and multidisciplinary research.
5.	Dahlin-Ivanoff, Synneve, 1950 (author) Fokusgruppsdiskussioner 2011 In: Handbok i kvalitativa metoder. - 9789147094462 ; , s. 71-82 Book chapter (other academic/artistic)
6.	Wickford, Jenny, 1979, et al. (author) Physiotherapy in Afghanistan - Needs and challenges for development. 2008 In: Disabil Rehabil.. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 30:4, s. 305-313 Journal article (peer-reviewed)abstract Purpose. The aim of this paper is to describe and analyse the current situation of the physiotherapy component of the Rehabilitation of Afghans with Disability (RAD) programme, in order to identify the needs and challenges for further development. Method. The study was conducted as a field study with an anthropological approach by means of participant observation, unstructured and semi-structured interviews and photography. Results. The therapists in RAD work in isolation with little opportunity for further education or professional development. Their approach is mainly medical, where the work is dictated by the patients' expectations and doctors' recommendations. They use primarily passive methods of treatment, and their work is affected by cultural, religious and situational factors. They demonstrate a low capacity of clinical reasoning in their practical work. Conclusions. There is a need for further development of physiotherapy in Afghanistan. Active and individually adapted treatment methods, clinical reasoning processes and evidence-based practice should be encouraged. There are several challenges in this, based on Afghan culture and traditions, gender issues, religious factors, an authoritative society, a medical approach in treatment, and isolation and limitations in access to information. By means of an Action Research project the physiotherapists could be included in further development and research to promote a sustainable and culturally relevant development.
7.	Barenfeld, Emmelie, 1981, et al. (author) Becoming more of an insider: benefits and challenges of person-centred care delivered at a distance 2021 In: Virtual NKG 25 Nordic Gerontology Congress in June 2 - 4 2021.. Conference paper (other academic/artistic)
8.	Strömbäck, Ulrica, et al. (author) The second myocardial infarction: Higher risk factor burden and earlier second myocardial infarction in women compared with men. The Northern Sweden MONICA study 2017 In: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 16:5, s. 418-424 Journal article (peer-reviewed)abstract BACKGROUND: Several studies have examined various parameters and experiences when patients suffer their first myocardial infarction (MI), but knowledge about when they suffer their second MI is limited.AIM: To compare risk factors for MI, that is, diabetes, hypertension and smoking, for the first and second MI events in men and women affected by two MIs and to analyse the time intervals between the first and second MIs.METHODS: A retrospective cohort study of 1017 patients aged 25-74 years with first and second MIs from 1990 through 2009 registered in the Northern Sweden MONICA registry.RESULTS: More women than men have diabetes and hypertension and are smokers at the first MI. Similar differences between the genders remain at the time of the second MI for diabetes and hypertension, although both risk factors have increased. Smoking decreased at the second MI without any remaining difference between genders. Women suffer their second MI within a shorter time interval than men do. Within 16 months of their first MI, 50% of women had a second MI. The corresponding time interval for men was 33 months.CONCLUSION: Patients affected by an MI should be made aware of their risk of recurrent MI and that the risk of recurrence is highest during the first few years after an MI. In patients affected by two MIs, women have a higher risk factor burden and suffer their second MI earlier than men do and thus may need more aggressive and more prompt secondary prevention.
9.	Berg, Charlotte, et al. (author) One Health : Samspelet mellan human-, djur- och ekosystemhälsa 2022 In: Vård, omsorg och rehabilitering utomhus. - Lund : Studentlitteratur AB. - 9789144142364 ; , s. 97-112 Book chapter (other academic/artistic)abstract Sambandet mellan människors, djurs och ekosystems hälsa är viktigt för att målet "En gemensam hälsa" skall uppnås. I detta kapitel förklarar vi vad One Health är, vilka teorier som ligger bakom One Health, vilka centrala begrepp och perspektiv som är viktiga för området och forskning om kopplingen mellan människors och djurs hälsa, människors och miljöns hälsa, samt djurens och miljöns hälsa. Vi tar upp olika aspekter rörande lantbruksdjur, sällskapsdjur och vilda djur och hur det sätt vi föder upp och sköter dem på påverkar miljön, och i det långa loppet även människor. Vi beskriver hur djurs sjukdomar kan påverka människors hälsa och omvänt, samt One Health-perspektivets koppling till vård, omsorg och rehabilitering utomhus.
10.	Landén Ludvigsson, Maria, et al. (author) Mechanical properties of the trapezius during scapular elevation in people with chronic whiplash associated disorders : A case-control ultrasound speckle tracking analysis 2016 In: Manual Therapy. - : Elsevier BV. - 1356-689X .- 1532-2769. ; 21, s. 177-182 Journal article (peer-reviewed)abstract Background: Approximately 50% of people with Whiplash Associated Disorders (WAD) report longstanding symptoms. The upper trapezius is commonly painful yet its mechanical properties are not fully understood.Objectives: This study examined the deformation of different depths of the upper trapezius muscle during a scapular elevation task (shoulder shrugging) before and following loaded arm abduction. Design and Methods: A cross-sectional case-control study of 36 people (26 female and 10 male, mean age 38 (SD 11)) with chronic WAD and 36 controls, matched for age and gender. Real-time ultrasound recordings of upper trapezius were taken during both scapular elevation tasks. Post-process speckle tracking analysis was undertaken of three different sections of the upper trapezius muscle (superficial, middle, deep).Results: The WAD group had lower deformation of the superficial section of the upper trapezius compared to the control group in both concentric and eccentric phases of scapular elevation (p < 0.05) especially before the loaded arm abduction. After arm abduction, the deformation of the trapezius was reduced in both groups but only significantly in the WAD-group (p = 0.03). Within-group analysis revealed that the control group least engaged the deep section of upper trapezius during the task (p < 0.01).Conclusion: This study, measuring mechanical deformation of the upper trapezius during a scapular elevation task indicates that persons with WAD may display different patterns in engagement of the muscle sections than those in the control group. Further research is needed to replicate and understand the reasons for and implications of this possible change in motor strategy within upper trapezius.
11.	Peolsson, Anneli, et al. (author) Function in Patients With Cervical Radiculopathy or Chronic Whiplash-Associated Disorders Compared With Healthy Volunteers 2014 In: Journal of Manipulative and Physiological Therapeutics. - : Elsevier. - 0161-4754 .- 1532-6586. ; 37:4, s. 211-218 Journal article (peer-reviewed)abstract ObjectiveThe purposes of this study were to examine whether any differences in function and health exist between patients with cervical radiculopathy (CR) due to disk disease scheduled for surgery and patients with chronic whiplash-associated disorders (WADs) and to compare measures of patients' physical function with those obtained from healthy volunteers.MethodsThis is a cross-sectional study of patients with CR (n = 198) and patients with chronic WAD (n = 215). Patient data were compared with raw data previously obtained from healthy people. Physical measures included cervical active range of motion, neck muscle endurance, and hand grip strength. Self-rated measures included pain intensity (visual analog scale), neck disability (Neck Disability Index), self-efficacy (Self-Efficacy Scale), and health-related quality of life (EuroQol 5-dimensional self-classifier).ResultsPatient groups exhibited significantly lower performance than the healthy group in all physical measures (P < .0005) except for neck muscle endurance in flexion for women (P > .09). There was a general trend toward worse results in the CR group than the WAD group, with significant differences in neck active range of motion, left hand strength for women, pain intensity, Neck Disability Index, EuroQol 5-dimensional self-classifier, and Self-Efficacy Scale (P < .0001).ConclusionsPatients had worse values than healthy individuals in almost all physical measures. There was a trend toward worse results for CR than WAD patients.
12.	Weimer, A. K., et al. (author) Physical Activity in People Age 80 Years and Older as a Means of Counteracting Disability, Balanced in Relation to Frailty 2012 In: Journal of Aging and Physical Activity. - : Human Kinetics. - 1063-8652 .- 1543-267X. ; 20:3, s. 317-331 Journal article (peer-reviewed)abstract The aim of this study was to describe experiences of physical activity, perceived meaning, and the importance of and motives and barriers for participation in physical activity in people 80 years of age and older. A qualitative design with focus-group methodology was used. The sample consisted of 20 communityliving people age 80–91 yr. Data analyses revealed 4 themes: physical activity as a part of everything else in life, joie de vivre, fear of disease and dependence, and perceptions of frailty. Our results suggest that physical activity was not seen as a separate activity but rather as a part of activities often rated as more important than the physical activity itself. Thus, when designing physical activity interventions for elderly people, health care providers should consider including time for social interaction and possibilities to be outdoors. Moreover, assessment of physical activity levels among elderly people should include the physical activity in everyday activities.
13.	Falk Erhag, Hanna, et al. (author) Concluding Remarks 2022 In: A Multidisciplinary Approach to Capability in Age and Ageing. - Chem : Springer. - 9783030780654 ; 18:2, s. 143-144 Book chapter (other academic/artistic)
14.	Areskoug-Josefsson, Kristina, et al. (author) Health care students' attitudes toward addressing sexual health in their future profession : Validity and reliability of a questionnaire 2016 In: International Journal of Sexual Health. - : Informa UK Limited. - 1931-7611 .- 1931-762X. ; 28:3, s. 243-250 Journal article (peer-reviewed)abstract Objectives: To test the reliability and validity of the Students' Attitudes Towards Addressing Sexual Health Questionnaire (SA-SH), measuring students' attitudes toward addressing sexual health in their future professions.Method: A cross-sectional online survey (22 items) were distributed to 186 nursing, occupational therapy and physiotherapy students in Sweden, April 2015. Validity and reliability were tested.Results: The construct validity analysis led to three major factors: present feelings of comfortableness, future working environment, and fear of negative influence on future patient relations. The construct validity, internal consistency reliability, and intrarater reliability showed good results.Conclusion: The SA-SH is valid and reliable.
15.	Areskoug Sandberg, Elin, et al. (author) Saliva Cortisol in Girls With Functional Abdominal Pain Disorders : A Randomized Controlled Dance and Yoga Intervention. 2022 In: Frontiers in Pediatrics. - : Frontiers Media S.A.. - 2296-2360. ; 10 Journal article (peer-reviewed)abstract INTRODUCTION: Functional abdominal pain disorders (FAPDs) are common among girls and has been associated with stress. Cortisol is one of the major stress hormones. Dance and yoga have been shown to reduce abdominal pain among girls with FAPDs.AIM: To investigate the effect of an 8-month intervention with dance and yoga on cortisol levels in saliva among girls with FAPDs.METHODS: A total of 121 girls aged 9-13 years with irritable bowel syndrome (IBS) or functional abdominal pain were included in the study. Participants were randomized into an intervention group and a control group. The intervention group attended a combined dance and yoga session twice a week for 8 months. Saliva samples were collected during 1 day, in the morning and evening, at baseline, and at 4 and 8 months. Subjective pain and stress were assessed as well.RESULTS: No significant effects on saliva cortisol levels between groups were observed after completion of the intervention at 8 months. However, evening cortisol and evening/morning quotient were significantly reduced at 4 months in the intervention group compared to the control group (p = 0.01, p = 0.004). There was no association between cortisol quota and pain or stress.CONCLUSION: Improvements in cortisol levels were seen in the intervention group at 4 months but did not persist until the end of the study. This indicates that dance and yoga could have a stress-reducing effect during the ongoing intervention.
16.	Bykachev, Kirsi, et al. (author) Improving psychiatry services for children and adolescents with eHealth in peripheral areas 2016 Conference paper (other academic/artistic)
17.	Bykachev, Kirsi, et al. (author) Multi-professional collaboration and consultation : Improving child and adolescent psychiatry with eHealth 2016 Conference paper (other academic/artistic)
18.	Gustavsson, Linda, et al. (author) Sore throat and pressure differences in ventilation in women after intubation with an endotrachealtube size 6,5 or 7,0 2013 Conference paper (other academic/artistic)
19.	Gustavsson, Linda, et al. (author) Sore throat in women after intubation with 6.5 or 7.0 mm endotracheal tube : a quantitative study 2014 In: Intensive & Critical Care Nursing. - : Elsevier BV. - 0964-3397 .- 1532-4036. ; 30:6, s. 318-324 Journal article (peer-reviewed)abstract Background: Women experience more sore throats than men after endotracheal intubation.Aim: The aim of this study was to investigate the incidence of self-rated sore throat immediately,and 2—4 hours postoperatively, in women after elective gynaecological surgery under generalanaesthesia using an endotracheal tube (ETT) size 6.5 or 7.0 mm in inner diameter.Method: Eighty-two female participants who had undergone elective gynaecological surgeryparticipated, 44 and 38 were intubated with size 6.5 mm ETT and 7.0 mm ETT respectively.They estimated the occurrence of sore throat preoperatively and postoperatively, according toa 4-point Likert scale. Statistical data were analysed using the Package for Social Science (SPSS)19.Results: Sore throat was present in 29.5% of participants who were intubated with size 6.5 mmETT immediately postoperatively and in 39.5% of those who were intubated with size 7.0 mmETT.Conclusion: Nurses specialising in the supervision of daily care specific to the intubated patientshould note and alleviate sore throat as part of their nursing care.
20.	Kostenius, Catrine, et al. (author) Experiences of using eHealth to improve psychiatry services for children andadolescents in peripheral areas 2017 In: Ninth International Congress of Arctic Social Sciences. Conference paper (peer-reviewed)
21.	Pietilä Holmner, Elisabeth, et al. (author) ”The acceptance” of living with chronic pain – an ongoing process: A qualitative study of patient experiences of multimodal rehabilitation in primary care 2018 In: Journal of Rehabilitation Medicine. - : FOUNDATION REHABILITATION INFORMATION. - 1650-1977 .- 1651-2081. ; 50:1, s. 73-79 Journal article (peer-reviewed)abstract Objective: To explore patient experiences of participating in multimodal pain rehabilitation in primary care. Subjects: Twelve former patients (7 women and 5 men) in multimodal rehabilitation in primary care were interviewed about their experiences of multimodal rehabilitation. Methods: The interviews were analysed using qualitative content analysis. Results: Analysis resulted in 4 categories: (i) from discredited towards obtaining redress; (ii) from uncertainty towards knowledge; (iii) from loneliness towards togetherness; and (iv) "acceptance of pain": an ongoing process. The results show that having obtained redress, to obtain knowledge about chronic pain, and to experience fellowship with others with the same condition were helpful in the acceptance process. However, there were patients who found it difficult to reconcile themselves with a life with chronic pain after multimodal rehabilitation. To find what was "wrong" and to have a medical diagnosis and cure were important. Conclusion: Patients in primary care multimodal rehabilitation experience a complex, ongoing process of accepting chronic pain. Four important categories were described. These findings will help others to understand the experience and perspective of patients with chronic pain who engage in multimodal rehabilitation.
22.	Strömbäck, Ulrica, et al. (author) The second myocardial infarction: Women have a higher risk factor burden and suffer a second myocardial infarction earlier than men do. The Northern Sweden MONICA study 2017 In: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 16:Suppl. 1, s. S62-S63 Journal article (peer-reviewed)
23.	Strömbäck, Ulrica, et al. (author) Time from onset of symptoms to medical presence at the first and at the second myocardial infarction: a comparative study 2013 In: Acta Anaesthesiologica Scandinavica. - 0001-5172 .- 1399-6576. ; 57:Suppl. 120, s. 27- Journal article (other academic/artistic)
24.	Wiklund, Robert, et al. (author) Risk factors for hip fracture in very old people : a population-based study 2016 In: Osteoporosis International. - : Springer Science and Business Media LLC. - 0937-941X .- 1433-2965. ; 27:3, s. 923-931 Journal article (peer-reviewed)abstract Knowledge of risk factors for hip fracture among very old people is limited. Walking indoors with help from ≤1 person, Parkinson's disease, currently smoking, delirium in the previous month, underweight, and age were associated with increased risk of hip fracture and could be important for preventive strategy development.INTRODUCTION: The purpose of this study is to investigate risk factors for hip fracture among a representative sample of very old people.METHODS: In total, 953 participants from the Umeå 85+/Gerontological Regional Database population-based cohort study were interviewed and assessed during home visits. Associations of baseline characteristics with hip fracture during the maximum 5-year follow-up period were analyzed using Cox proportional hazards regression.RESULTS: Participants had a mean age of 89.3 ± 4.7 years; 65.8 % were women, 36.8 % lived in residential care facilities, 33.6 % had dementia, and 20.4 % had histories of hip fracture. During a mean follow-up period of 2.7 years, 96 (10.1 %) individuals sustained hip fracture. Walking indoors with help from no more than one person (hazard ratio [HR] = 8.57; 95 % confidence interval [CI], 1.90-38.71), Parkinson's disease (HR = 5.12; 95 % CI, 1.82-14.44), currently smoking (HR = 4.38; 95 % CI 2.06-9.33), delirium in the previous month (HR = 2.01; 95 % CI, 1.15-3.49), underweight (body mass index <22; HR = 1.74, 95 % CI, 1.09-2.77), and age (HR = 1.09; 95 % CI, 1.04-1.14) were associated independently with an increased risk of hip fracture. Hip prosthesis at baseline decreased the risk of hip fracture (HR = 0.37; 95 % CI, 0.15-0.91), but only for those with bilateral hip prostheses.CONCLUSIONS: Seven factors were associated independently with incident hip fracture during follow-up in this sample of very old people. These factors could have important clinical implications in identifying persons at high risk of hip fracture, as well as in the development of effective preventive strategies.
25.	Guerra, Matheus, et al. (author) Effects of a 10-Week Physical Activity Intervention on Asylum Seekers' Physiological Health 2022 In: Brain Sciences. - : MDPI. - 2076-3425. ; 12:7 Journal article (peer-reviewed)abstract Introduction: The rise in armed conflicts has contributed to an increase in the number of asylum seekers. Prolonged asylum processes may negatively affect asylum seekers' health and lead to inactivity. Studies show that physical activity interventions are associated with improvements in health outcomes. However, there are a limited number of studies investigating the associations of physical activity on asylum seekers' health. Methods: Participants (263 males and 204 females), mostly from Syria, were assessed before and after a 10-week intervention for VO2 max, body mass index (BMI), skeletal muscle mass (SMM), body fat, and visceral fat. Linear mixed models were used to test differences within groups, and a linear regression model analysis was performed to test whether physiological variables predicted adherence. Results: Participants' VO2 max increased: males by 2.96 mL/min/kg and females 2.57 mL/min/kg. Increased SMM percentages were seen in both genders: females by 0.38% and males 0.23%. Visceral fat area decreased: males by 0.73 cm(2) and females 5.44 cm(2). Conclusions: Participants showed significant increases in VO2 max and SMM and decreased visceral fat. This study provides an insight into asylum seekers' health and serves as a starting point to new interventions in which physical activity is used as a tool to promote and improve vulnerable populations' health.
26.	Klompstra, Leonie, 1982- (author) Physical activity in patients with heart failure : motivations, self-efficacy and the potential of exergaming 2016 Doctoral thesis (other academic/artistic)abstract Background: Adherence to recommendations for physical activity is low in patients with heart failure (HF). It is essential to explore to what extent and why patients with HF are physically active. Self-efficacy and motivation for physical activity are important in becoming more physically active, but the role of self-efficacy in the relationship between motivation and physical activity in patients with HF is unknown. Alternative approaches to motivate and increase self-efficacy to exercise are needed. One of these alternatives might be using exergames (games to improve physical exercise). Therefore, it is important to obtain more knowledge on the potential of exergaming to increase physical activity.The overall aim was to describe the physical activity in patients with HF, with special focus on motivations and self-efficacy in physical activity, and to describe the potential of exergaming to improve exercise capacity.Methods: Study I (n = 154) and II (n = 101) in this thesis had a cross-sectional survey design. Study III (n = 32) was a 12-week pilot intervention study, including an exergame platform at home, with a pretest-posttest design. Study IV (n = 14) described the experiences of exergaming in patients who participated in the intervention group of a randomized controlled study in which they had access to an exergame platform at home.Results: In total, 34% of the patients with HF had a low level of physical activity, 46% had a moderate level, 23% reported a high level. Higher education, higher selfefficacy, and higher motivation were significantly associated with a higher amount of physical activity. Barriers to exercise were reported to be difficult to overcome and psychological motivations were the most important motivations to be physically active. Women had significantly higher total motivation to be physically active. Self-efficacy mediated the relationship between exercise motivation and physical activity; motivation leads to a higher self-efficacy towards physical activity.More than half of the patients significantly increased their exercise capacity after 12 weeks of using an exergame platform at home. Lower NYHA-class and shorter time since diagnosis were factors significantly related to the increase in exercise capacity. The mean time spent exergaming was 28 minutes per day. Having grandchildren and being male were related to more time spent exergaming.The analysis of the qualitative data resulted in three categories describing patients’ experience of exergaming: (i) making exergaming work, (ii) added value of exergaming, (iii) no appeal of exergaming.Conclusion: One-third of the patients with HF had a low level of physical activity in their daily life. Level of education, exercise self-efficacy, and motivation were important factors to take into account when advising patients with HF about physical activity. In addition to a high level of motivation to be physically active, it is important that patients with HF have a high degree of exercise self-efficacy.Exergaming has the potential to increase exercise capacity in patients with HF. The results also showed that this technology might be suitable for some patients while others may prefer other kinds of physical activity.
27.	Schantz, Peter, 1954-, et al. (author) Perspectives on exercise intensity, volume, step characteristics and health outcomes in walking for transport 2022 In: Frontiers In Public Health. - : Frontiers Media S.A.. - 2296-2565. ; , s. 1-19 Journal article (peer-reviewed)abstract Background: Quantification of movement intensity and energy utilization, together with frequency of trips, duration, distance, step counts and cadence, is essential for interpreting the character of habitual walking for transport, and its potential support of health. The purpose of the study is to illuminate this with valid methods and novel perspectives, and to thereby provide a new basis for characterizing and interpreting walking in relation to health outcomes.Methods: Habitual middle-aged commuting pedestrians (males = 10, females= 10) were investigated in the laboratory at rest and with maximal treadmill and cycle ergometer tests. Thereafter, levels of oxygen uptake, energy expenditure, ventilation, heart rate, blood lactate, rated perceived exertion, cadence, number of steps, duration, distance, and speed were recorded during the normal walking commute of each participant in Greater Stockholm, Sweden. The number of commutes per week over the year was self-reported.Results: Walking in the field demanded about 30% more energy per km compared to level treadmill walking. For both sexes, the walking intensity in field was about 46% of maximal oxygen uptake, and energy expenditure amounted to 0.96 kcal · kg−1 · km−1. The MET values (males: 6.2; females:6.5) mirrored similar levels of walking speed (males: 5.7; females: 5.9 km · h−1) and levels of oxygen uptake (males: 18.6; females: 19.5mL · kg−1 · min−1). The average number of MET-hours per week in a typical month was 22 for males and 20 for females. This resulted in a total weekly energy expenditure of∼1,570 and 1,040 kcal for males and females, respectively. Over the year, the number of walking commutes and their accumulated distance was ∼385 tripsand 800 km for both sexes.Conclusion: Walking in naturalistic field settings demands its own studies. When males and females walk to work, their relative aerobic intensities and absolute energy demands for a given distance are similar. It is equivalent to the lower part of the moderate relative intensity domain.The combination of oxygen uptake, trip duration and frequency leads to high and sustained levels of MET-hours as well as energy expenditure per week over the year, with a clear health enhancing potential. Based on this study we recommend 6000 transport steps per day, or equivalent, during five weekdays, over the year, in order to reach optimal health gains.
28.	Svanberg, Mikael, 1958-, et al. (author) Impact of emotional distress and pain-related fear on patients with chronic pain : Subgroup analysis of patients referred to multimodal rehabilitation 2017 In: Journal of Rehabilitation Medicine. - : Foundation for Rehabilitation Information. - 1650-1977 .- 1651-2081. ; 49:4, s. 354-361 Journal article (peer-reviewed)abstract Objective: Multimodal rehabilitation programmes (MMRP) for chronic pain could be improved by determining which patients do not benefit fully. General distress and pain-related fear may explain variations in the treatment effects of MMRP.Design: Cohort study with a cross-sectional, prospective part.Patients: Chronic musculoskeletal pain patients referred to 2 hospital-based pain rehabilitation clinics.Methods: The cross-sectional part of this study cluster analyses patients (n = 1,218) with regard to distress and pain-related fear at first consultation in clinical pain rehabilitation and describes differences in external variables between clusters. The prospective part follows the subsample of patients (n = 260) participating in MMRP and describes outcome post-treatment.Results: Four distinct subgroups were found: (i) those with low levels of distress and pain-related fear; (ii) those with high levels of pain-related fear; (iii) those with high levels of distress; and (iv) those with high levels of distress and pain-related fear. These subgroups showed differences in demographics, pain characteristics, quality of life, and acceptance, as well as the degree of MMRP participation and MMRP outcome.Conclusion: Among patients with chronic pain referred to MMRP there are subgroups with different profiles of distress and pain-related fear, which are relevant to understanding the adaptation to pain and MMRP outcome. This knowledge may help us to select patients and tailor treatment for better results.
29.	Kaelin, Vera C., et al. (author) Artificial intelligence in rehabilitation targeting the participation of children and youth with disabilities : Scoping review 2021 In: Journal of Medical Internet Research. - : JMIR Publications. - 1438-8871. ; 23:11 Research review (peer-reviewed)abstract Background: In the last decade, there has been a rapid increase in research on the use of artificial intelligence (AI) to improve child and youth participation in daily life activities, which is a key rehabilitation outcome. However, existing reviews place variable focus on participation, are narrow in scope, and are restricted to select diagnoses, hindering interpretability regarding the existing scope of AI applications that target the participation of children and youth in a pediatric rehabilitation setting.Objective: The aim of this scoping review is to examine how AI is integrated into pediatric rehabilitation interventions targeting the participation of children and youth with disabilities or other diagnosed health conditions in valued activities.Methods: We conducted a comprehensive literature search using established Applied Health Sciences and Computer Science databases. Two independent researchers screened and selected the studies based on a systematic procedure. Inclusion criteria were as follows: participation was an explicit study aim or outcome or the targeted focus of the AI application; AI was applied as part of the provided and tested intervention; children or youth with a disability or other diagnosed health conditions were the focus of either the study or AI application or both; and the study was published in English. Data were mapped according to the types of AI, the mode of delivery, the type of personalization, and whether the intervention addressed individual goal-setting.Results: The literature search identified 3029 documents, of which 94 met the inclusion criteria. Most of the included studies used multiple applications of AI with the highest prevalence of robotics (72/94, 77%) and human-machine interaction (51/94, 54%). Regarding mode of delivery, most of the included studies described an intervention delivered in-person (84/94, 89%), and only 11% (10/94) were delivered remotely. Most interventions were tailored to groups of individuals (93/94, 99%). Only 1% (1/94) of interventions was tailored to patients’ individually reported participation needs, and only one intervention (1/94, 1%) described individual goal-setting as part of their therapy process or intervention planning.Conclusions: There is an increasing amount of research on interventions using AI to target the participation of children and youth with disabilities or other diagnosed health conditions, supporting the potential of using AI in pediatric rehabilitation. On the basis of our results, 3 major gaps for further research and development were identified: a lack of remotely delivered participation-focused interventions using AI; a lack of individual goal-setting integrated in interventions; and a lack of interventions tailored to individually reported participation needs of children, youth, or families.
30.	Khetani, Mary A., et al. (author) Early intervention service intensity and young children's home participation 2020 In: BMC Pediatrics. - : BioMed Central (BMC). - 1471-2431. ; 20:1 Journal article (peer-reviewed)abstract Background: Young children with developmental disabilities and delays spend significant amounts of time at home, show decreased participation in home-based activities, and receive home-based early intervention services to improve participation in activities. Yet, knowledge about the relationship between EI service use and children’s home participation in activities remains poorly understood but needed for program improvement. The purpose of this study was to understand the relationships between EI service use and children’s home participation.Methods: In a cross-sectional design, data were gathered from caregivers (N = 139) who enrolled in a pilot trial of the Young Children’s Participation in Environment Measure (YC-PEM) electronic patient-reported outcome (e-PRO), as implemented within 1 month of their child’s next EI progress evaluation. A series of path analytic models were used to estimate EI service intensity as a predictor of parent-reported young children’s home participation 1) frequency, 2) level of involvement, and 3) desired change, adjusting for family and child social and functional characteristics. Models included caregiver perceptions of home environmental support to test its indirect (i.e., mediation) effects on the relationship between EI service intensity and each of the three home participation dimensions.Results: All three models fit the data well (comparative fit index = 1.00). EI service intensity was not a significant predictor of participation frequency. However, EI service intensity had a significant direct effect on a child’s participation according to level of involvement and desired change, explaining between 13.3–33.5% of the variance in home participation. Caregiver perceptions of environmental support had a small yet significant indirect effect on the relationship between EI service intensity and level of involvement and desired change; these models explained between 18.5–38.1% of the variance in home participation.Conclusions: EI service intensity has important links with involvement in and desired change for home-based activities. Caregiver perceptions of environmental support appears to be a factor in the relationship between EI service intensity and home participation. Results warrant longitudinal replication with a control group, which would be possible with the implementation of the YC-PEM e-PRO in a routine EI clinical workflow.
31.	Oh, Hui Xian, et al. (author) The effectiveness of self-management interventions with action-taking components in improving health-related outcomes for adult stroke survivors: a systematic review and meta-analysis 2022 In: Disability and Rehabilitation. - : Informa UK Limited. - 1464-5165 .- 0963-8288. ; 44:25, s. 7751-7766 Research review (peer-reviewed)abstract Purpose This systematic review and meta-analysis aims to synthesise the evidence of the effectiveness of self-management interventions with action-taking components in improving self-efficacy, health-related quality of life, basic and instrumental activities of daily living, and depression for adult stroke survivors. Materials and methods Nine electronic databases were searched for relevant studies, including grey literature and ongoing studies. Randomised controlled trials targeting adult stroke survivors comparing health-related outcomes of patients receiving self-management interventions with action-taking components to usual care, placebo, or no-treatment were included. Screening, data extraction, and methodological quality assessment were conducted by two reviewers. Meta-analyses were performed. Overall quality of evidence was assessed using the GRADE tool. Results A total of seventeen studies were included. Meta-analyses showed that the intervention may result in a slight increase in self-efficacy (SMD = 0.29, 95% CI [0.07-0.52], p = 0.010, I-2 = 47%) and basic activities of daily living (SMD = 0.31, 95% CI [0.16-0.46], p < 0.001, I-2 = 0%), but not for the other outcomes. Conclusions Self-management interventions with action-taking components may result in a slight improvement in self-efficacy and rehabilitation of basic activities of daily living. Future research should investigate which core self-management skill, or combination of them, is most effective in improving short-term and long-term outcomes.
32.	Penzenstadler, Birgit, et al. (author) Take a deep breath: Benefits of neuroplasticity practices for software developers and computer workers in a family of experiments 2022 In: Empirical Software Engineering. - : Springer Science and Business Media LLC. - 1382-3256 .- 1573-7616. ; 27:4 Journal article (peer-reviewed)abstract Context Computer workers in general, and software developers specifically, are under a high amount of stress due to continuous deadlines and, often, over-commitment. Objective This study investigates the effects of a neuroplasticity practice, a specific breathing practice, on the attention awareness, well-being, perceived productivity, and self-efficacy of computer workers. Method The intervention was a 12-week program with a weekly live session that included a talk on a well-being topic and a facilitated group breathing session. During the intervention period, we solicited one daily journal note and one weekly well-being rating. We created a questionnaire mainly from existing, validated scales as entry and exit survey for data points for comparison before and after the intervention. We replicated the intervention in a similarly structured 8-week program. The data was analyzed using Bayesian multi-level models for the quantitative part and thematic analysis for the qualitative part. Results The intervention showed improvements in participants' experienced inner states despite an ongoing pandemic and intense outer circumstances for most. Over the course of the study, we found an improvement in the participants' ratings of how often they found themselves in good spirits as well as in a calm and relaxed state. We also aggregate a large number of deep inner reflections and growth processes that may not have surfaced for the participants without deliberate engagement in such a program. Conclusion The data indicates usefulness and effectiveness of an intervention for computer workers in terms of increasing well-being and resilience. Everyone needs a way to deliberately relax, unplug, and recover. A breathing practice is a simple way to do so, and the results call for establishing a larger body of work to make this common practice.
33.	Areskoug-Josefsson, Kristina, et al. (author) Health Care Students’ Attitudes Towards Working with Sexual Health in Their Professional Roles : Survey of Students at Nursing, Physiotherapy and Occupational Therapy Programmes 2016 In: Sexuality and Disability. - : Springer Science and Business Media LLC. - 0146-1044 .- 1573-6717. ; 34:3, s. 289-302 Journal article (peer-reviewed)abstract The aim of this study was to explore differences and similarities in health care students’ attitudes towards working with and communicating with patients about sexual health issues in their future professions. The aim was also to explore whether the students’ gender, age and future professions were influencing factors and whether there was a change in attitude depending on educational levels, gender, age and future professions. The study also aimed to explore the potential development of those differences and similarities in attitudes between health care students having achieved different levels of education and training in their future professions. A cross-sectional quantitative study was performed with an online survey distributed to nursing, occupational therapy and physiotherapy students. The students believed that they needed increased sexual health education and increased communication skills about sexual health. Gender and future profession are factors that significantly affect the attitudes of the students towards working with sexual health. Nursing and occupational therapy students have a more positive attitude towards addressing sexual health in their future professions than do physiotherapy students. Further research is needed in this field to improve competence in sexual health for all student groups, particularly physiotherapy students. Further research is also needed to explore the significance of gender regarding education in sexual health and attitudes towards working with sexual health.
34.	Bala, Sidona-Valentina, et al. (author) The experience of care at nurse-led rheumatology clinics 2012 In: Musculoskeletal Care. - : Wiley. - 1478-2189 .- 1557-0681. ; 10:4, s. 202-211 Journal article (peer-reviewed)abstract Objective To describe how people with rheumatoid arthritis (RA) experience the care provided by Swedish nurse-led rheumatology outpatient clinics. Methods Eighteen adult people with a diagnosis of RA who had had at least three documented contact sessions with a nurse-led clinic were interviewed. The interviews were analysed with qualitative content analysis. Results Care was expressed in three categories: social environment, professional approach and value-adding measures. A social environment including a warm encounter, a familial atmosphere and pleasant premises was desired and contributed to a positive experience of care. The nurses' professional approach was experienced as empathy, knowledge and skill, as well as support. The care was described as person centred and competent, as it was based on the individual's unique experience of his/her disease and needs. The nurses' specialist knowledge of rheumatology and rheumatology care was highly valued. The offered care represented added value for the participants, instilling security, trust, hope and confidence. It was perceived as facilitating daily life and creating positive emotions. The nurse-led clinics were reported to be easily accessible and provided continuity of the care. These features were presented as fundamental guarantees for health care safety. Conclusion The experiences emphasized the need for a holistic approach to care. In this process, the organization of care and the role and skills of the nurse should be focused on the individual's needs and perspectives. The social environment, professional approach and value-adding measures are particularly relevant for optimal care at nurse-led rheumatology outpatient clinics.
35.	Brogårdh, Christina, et al. (author) Psychometric properties of the Walking Impact Scale (Walk-12) in persons with late effects of polio 2021 In: PM&R. - : Wiley-Blackwell. - 1934-1482 .- 1934-1563. ; 13:3, s. 297-306 Journal article (peer-reviewed)abstract BACKGROUND: Many persons with late effects of polio (LEoP) perceive walking limitations in everyday life. A common rating scale to assess walking limitations is the Walking Impact Scale (Walk-12). However, there is limited knowledge about its psychometric properties.OBJECTIVE: To investigate the psychometric properties of Walk-12 in persons with LEoP.DESIGN: Rasch model analysis of cross-sectional data.SETTING: University Hospital.PARTICIPANTS: A total of 325 persons with LEoP (175 women; mean age 70 ± 10 yr).MAIN OUTCOME MEASUREMENT: The Walk-12, comprising 12 items with five response categories ranging from 1 (not at all) to 5 (extremely).METHODS: Data of Walk-12 were collected by a postal survey. The Rasch model analysis was used to analyze unidimensionality of the scale, local dependency, targeting, hierarchical order of items, Differential Item Functioning (DIF), response category functioning and reliability (Person Separation Index, PSI). Raw score transformation to interval measurements was also performed.RESULTS: The analysis revealed that Walk-12 was multidimensional and suffered from some local dependency. Targeting was compromised among persons with less and worse walking limitations. Hierarchically, the most difficult item to perform was "running" and the easiest was "walking indoors with support". There was a minor DIF for gender in one item ("support when walking outdoors"). Reliability was high (PSI = 0.94). Disordered response category thresholds were found for three items; when merging the middle response categories for these items model fit slightly improved and unidimensionality was achieved.CONCLUSION: The Walk-12, in its current version, does not fully meet the rigorous psychometric Rasch measurement standards in persons with LEoP. Further development of the scale is warranted, including merging response categories and complementing Walk-12 with objective measures of gait in order to improve targeting. As these limitations can be considered minor, the current version of Walk-12 can still be useful for research and clinical practice. This article is protected by copyright. All rights reserved.
36.	Gosman-Hedström, Gunilla, 1947 (author) Vårdalinstitutets tematiska rum om stroke 2007 In: Förbundet Sveriges Arbetsterapeuter At - Forum och Nordisk kongress för arbetsterapeuter. Stockholm 19-20 April, Sweden. Conference paper (peer-reviewed)
37.	Lönnberg, Lena, 1964- (author) Lifestyle counselling in primary health care for patients with high cardiovascular risk : Aspects of a 1-year structured lifestyle programme promoting healthier lifestyle habits to reduce future risk of cardiovascular disease 2022 Doctoral thesis (other academic/artistic)abstract While the effects of lifestyle habits on hypertension or type 2 diabetes mellitus (T2DM) are well established, few lifestyle programmes in primary care directed towards patients with high cardiovascular risk have been evaluated.Aims To describe and elaborate on how participation in a 1-year lifestyle programme supported changes in lifestyle habits and altered the risk of cardiovascular disease (CVD) as well as explore patients’ and community health nurses’ (CHNs’) experiences of lifestyle change and counselling.Methods The 1-year lifestyle programme consisted of five appointments with a CHN for patients diagnosed with hypertension, T2DM or impaired glucose tolerance (n = 448). Focuse was on lifestyle habits that were related to patients’ diagnosis. Different behaviour change techniques were used to support lifestyle changes. Blood sampling and anthropometrical measurements were obtained at baseline and 1-year follow-up. The design of Studies I and II was observational and based on data that were consecutively collected between 2009 and 2014, whereas Studies III and IV had a qualitative design. Qualitative content analyses were performed based on data from individual interviews with patients (n = 16) and a focus group interview of CHNs (n = 3).Results Study I: Favourable changes in physical activity, dietary habits and smoking were detected after participation in the programme. Study II: Significant improvements were demonstrated for all cardiovascular risk factors and the estimated 10-year CVD risk after participation in the programme. Study III: Patients’ experiences of lifestyle changes indicated that increased knowledge of lifestyle habits, gaining trust in oneself and support from others were important elements in the adoption of lifestyle changes. Study IV: The informants expressed that counselling should be based on a partnership, include goal setting and repeated measurements, and incorporate long-term support after the completion of the lifestyle programme.Conclusion This thesis adds to the knowledge on how lifestyle counselling can be designed and implemented in primary care. The findings show that patients with a new diagnosis of hypertension or T2DM are at high risk for future CVD and a structured lifestyle programme can contribute to improved lifestyle habits and a reduced 10-year CVD risk.
38.	Nilsagård, Ylva, et al. (author) Evaluation of a single session with cooling garment for persons with multiple sclerosis-a randomized trial 2006 In: Disability and Rehabilitation. - : Informa UK Limited. - 1748-3107 .- 1748-3115. ; 1:4, s. 225-233 Journal article (peer-reviewed)abstract Purpose. This research investigates the objective and subjective effects of wearing the Rehband® cooling garment. Method. A multi-centre, randomized crossover study was conducted regarding 43 heat-sensitive persons with multiple sclerosis (MS), comparing active treatment with placebo. Subjects were tested immediately before and after intervention. Ten- (10TW) and 30-metre timed walk (30TW), oral temperature, spasticity, standing balance and timed up and go (TUG) and nine-hole peg test (NHPT) performance were measured. A study-specific questionnaire was used to evaluate subjective experiences. Results. Active treatment produced statistically significant objective improvement in 10TW, 30TW, one-legged stance, tandem stance (right) and TUG; statistically significant subjective improvement was also found in fatigue, spasticity, weakness, balance, gait, transfers, ability to think clearly and time to recover. The coherence between the objective and subjective results indicates clinical relevance from the subjects' perspective. There were no statistically significant differences between treatments in terms of oral temperature, spasticity (measured by the modified Ashworth scale), tandem stance (left), step test or NHPT, or subjective signs such as difficulty in dressing, dysarthria or pain. Conclusions. Active cooling with a Rehband® vest is likely to have a positive effect on everyday life in heat-sensitive persons with MS.
39.	Pihl, Emma, et al. (author) Exercise in elderly patients with chronic heart failure in primary care : Effects on physical capacity and health-related quality of life 2011 In: European Journal of Cardiovascular Nursing. - London : Sage Publications. - 1474-5151 .- 1873-1953. ; 10:3, s. 150-158 Journal article (peer-reviewed)abstract INTRODUCTION: Chronic heart failure (CHF) limits exercise capacity which influences physical fitness and health-related quality of life (HRQoL). AIM: The aim was to determine the effects on physical capacity and HRQoL of an exercise programme in elderly patients with CHF in primary care.METHODS: An exercise intervention was conducted as a prospective, longitudinal and controlled clinical study in primary care in elderly patients with CHF. Endurance exercise and resistance training were conducted as group-training at the primary care centre and as home training. Follow-up on physical capacity and HRQoL was done at 3, 6 and 12 months.RESULTS: Exercise significantly improved muscle endurance in the intervention group (n=29, mean age 76.2years) compared to the control group (n=31, mean age 74.4years) at all follow-ups except for shoulder flexion right at 12months (shoulder abduction p=0.006, p=0.048, p=0.029; shoulder flexion right p=0.002, p=0.032, p=0.585; shoulder flexion left p=0.000, p=0.046, p=0.004). Six minute walk test improved in the intervention group at 3months (p=0.013) compared to the control group. HRQoL measured by EQ5D-VAS significantly improved in the intervention group at 3 and 12months (p=0.016 and p=0.034) and SF-36, general health (p=0.048) and physical component scale (p=0.026) significantly improved at 3months compared to the control group. CONCLUSION: This study shows that exercise conducted in groups in primary care and in the patients' homes could be used in elderly patients with CHF. The combination of endurance exercise and resistance training has positive effects on physical capacity. However, the minor effects in HRQoL need further verification in a study with a larger study population. ©Sage Publications
40.	Dahlin-Ivanoff, Synneve, 1950, et al. (author) Comprehensive geriatric assessment of frail older people: ideals and reality 2018 In: Journal of Interprofessional Care. - : Informa UK Limited. - 1356-1820 .- 1469-9567. ; 32:6, s. 728-734 Journal article (peer-reviewed)abstract We explored different professionals’ views on and experiences of comprehensive geriatric assessment (CGA) of frail older people. Forty-six professionals working in hospitals, primary care, or municipal health and social care participated in 10 focus groups. Professional groups comprised of occupational therapists, physiotherapists, nurses, physicians, and social workers. Participants shared an ideal image of how the CGA of frail elderly people should be conducted. Experience-based competence was more often used as an assessment tool than standardized tests. The ideal image contrasted with reality, listening to the needs expressed, with the person’s problems, needs, and priorities in the foreground, as described by the categories: a need that can be met; different perspectives on needs; needs can be hidden; and needs assessment is affected by the collaboration around the person, by the context, and by the dialogue. The health and social care professionals’ first priority is to make a person-centred tailor-made comprehensive geriatric assessment and not be bound to instruments. Clear guidelines need to be developed, stating which profession assesses what, when and how in order to ensure that person-centred needs are assessed including structures and procedures for how communication and collaboration within the team as well as between the organizations are achieved in order to perform a good person-centred CGA.
41.	Munthe, Christian, 1962 (author) Att dela kakan rättvist i vården: den etiska betydelsen av storlek och innehåll 2010 In: Föredrag vid samlingsdag för enheten för arbetsterapi och sjukgymnastik vid Sahlgrenska Universitetssjukhuset, Göteborg, 21 Januari, 2010. Other publication (other academic/artistic)
42.	Munoz-Novoa, Maria, et al. (author) Upper Limb Stroke Rehabilitation Using Surface Electromyography: A Systematic Review and Meta-Analysis 2022 In: Frontiers in Human Neuroscience. - : Frontiers Media SA. - 1662-5161. ; 16 Research review (peer-reviewed)abstract Background: Upper limb impairment is common after stroke, and many will not regain full upper limb function. Different technologies based on surface electromyography (sEMG) have been used in stroke rehabilitation, but there is no collated evidence on the different sEMG-driven interventions and their effect on upper limb function in people with stroke. Aim: Synthesize existing evidence and perform a meta-analysis on the effect of different types of sEMG-driven interventions on upper limb function in people with stroke. Methods: PubMed, SCOPUS, and PEDro databases were systematically searched for eligible randomized clinical trials that utilize sEMG-driven interventions to improve upper limb function assessed by Fugl-Meyer Assessment (FMA-UE) in stroke. The PEDro scale was used to evaluate the methodological quality and the risk of bias of the included studies. In addition, a meta-analysis utilizing a random effect model was performed for studies comparing sEMG interventions to non-sEMG interventions and for studies comparing different sEMG interventions protocols. Results: Twenty-four studies comprising 808 participants were included in this review. The methodological quality was good to fair. The meta-analysis showed no differences in the total effect, assessed by total FMA-UE score, comparing sEMG interventions to non-sEMG interventions (14 studies, 509 participants, SMD 0.14, P 0.37, 95% CI –0.18 to 0.46, I2 55%). Similarly, no difference in the overall effect was found for the meta-analysis comparing different types of sEMG interventions (7 studies, 213 participants, SMD 0.42, P 0.23, 95% CI –0.34 to 1.18, I2 73%). Twenty out of the twenty-four studies, including participants with varying impairment levels at all stages of stroke recovery, reported statistically significant improvements in upper limb function at post-sEMG intervention compared to baseline. Conclusion: This review and meta-analysis could not discern the effect of sEMG in comparison to a non-sEMG intervention or the most effective type of sEMG intervention for improving upper limb function in stroke populations. Current evidence suggests that sEMG is a promising tool to further improve functional recovery, but randomized clinical trials with larger sample sizes are needed to verify whether the effect on upper extremity function of a specific sEMG intervention is superior compared to other non-sEMG or other type of sEMG interventions.
43.	Sharma, Sonia, et al. (author) A new instrument for assessing work-related body mechanics and strain in the general population 2023 In: Journal of Pain. - : Elsevier. - 1526-5900 .- 1528-8447. ; 24:2, s. 237-250 Journal article (peer-reviewed)abstract Clinical pain is often linked to poor body mechanics, with individuals sometimes presenting multiple painful disorders. Such disorders may be influenced by behaviors that affect the general resiliency and health of the musculoskeletal system. We aimed to develop a self-reported scale using the Malmö Diet and Cancer Study questions on work-related body mechanical exposures. An expert panel identified 41 variables having content validity for musculoskeletal problems. Exploratory factor analysis was conducted on a random selection of 50% of the cohort (n=6,789 adults); the remaining was reserved for confirmatory factor analyses (CFA), item response theory (IRT) item calibration, and differential item functioning investigations. Supported by standard measure development methods and fit criteria, the final unidimensional item bank contains 13 items. Overall CFA statistics (root mean square error of approximation=0.09; comparative fit index=0.96; Tucker-Lewis index=0.96; standardized root mean residuals=0.05) indicated excellent single-factor model fit and appropriateness of IRT modeling and calibration. Expert review and item information values (score-precision) guided selection of an 8-item short form with acceptable score-level reliabilities (≥0.70) for T-scores=39-80+. This measure provides reliable assessment of body mechanics strain in adults and can be useful when evaluating different contributions to musculoskeletal problems affecting pain-treatment success in future clinical research. Perspective: This article presents the development and psychometric properties of a new measure, "Work-related Body Mechanics and Strain Scale (WR-BMSS)." The scale has 13-items or alternatively an 8-item short form. This measure could potentially help clinicians who seek to assess how musculoskeletal problems may contribute to patient pain and disability.
44.	Ekvall Hansson, Eva, et al. (author) Gait flexibility among older persons significantly more impaired in fallers than non-fallers-a longitudinal study 2021 In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:13, s. 1-13 Journal article (peer-reviewed)abstract Gait disorders are a relevant factor for falls and possible to measure with wearable devices. If a wearable sensor can detect differences in gait parameters between fallers and non-fallers has not yet been studied. The aim of this study was to measure and compare gait parameters, vestibular function, and balance performance between fallers and non-fallers among a group of older persons. Participants were senior members (n = 101) of a Swedish non-profit gymnastic association. Gait parameters were obtained using an inertial measurement unit (IMU) that the participants wore on the leg while walking an obstacle course and on an even surface. Vestibular function was assessed by the Head-shake test, the Head impulse test, and the Dix-Hallpike maneuver. Balance was assessed by the Timed Up and Go, the Timed Up and Go manual, and the Timed Up and Go cognitive tests. Falls during the 12-month follow-up period were monitored using fall diaries. Forty-two persons (41%) had fallen during the 12-month follow-up. Fallers had more limited ability to vary their gait (gait flexibility) than non-fallers (p < 0.001). No other differences between fallers and non-fallers were found. The use of gait flexibility, captured by an IMU, seems better for identifying future fallers among healthy older persons than Timed Up and Go or Timed Up and Go combined with a cognitive or manual task.
45.	Fristedt, Sofi, et al. (author) Factors Influencing the Use of Evidence-Based Practice among Physiotherapists and Occupational Therapists in Their Clinical Work 2016 In: The Internet Journal of Allied Health Sciences & Practice. - : NSUWorks. - 1540-580X. ; 14:3 Journal article (peer-reviewed)abstract Background: Evidence-based practice (EBP) is a process through which research is applied in daily clinical practice. Occupational therapists (OTs) and physiotherapists (PTs) are expected to work in line with EBP in order to optimise health care resources. This expectation is too seldom fulfilled. Consequently, research findings may not be implemented in clinical practice in a timely manner, or at all. To remedy this situation, additional knowledge is needed regarding what factors influence the process of EBP among practitioners. The purpose of the present study was to identify factors that influence the use of EBP and the experienced effects of the use of EBP among PTs and OTs in their clinical work. Method: This was a qualitative interview study that consisted of six group interviews involving either OTs or PTs employed by the Jönköping County Council in the South of Sweden. Resulting data were analysed using content analysis. Results: The analysis resulted in the following categories: “definition of evidence and EBP”, “sources of evidence”, “barriers to acquiring evidence and to using evidence in clinical work”, “factors that facilitate the acquisition of evidence and the use of evidence in clinical work”, and “personal experiences of using EBP”. Basing clinical practice on scientific evidence evoked positive experiences, although an ambivalent view towards acting on clinical experience was evident. Participants reported that time for and increased knowledge about searching for, evaluating, and implementing EBP were needed. Conclusion: Because OTs are more oriented towards professional theories and models, and PTs are more focused on randomised controlled trials of interventions, different strategies appear to be needed to increase EBP in these two professions. Management support was considered vital to the implementation of EBP. However, the personal obligation to work in line with EBP must also be emphasised; the participants apparently underestimate its importance.
46.	Gerdle, Björn, et al. (author) Who benefits from multimodal rehabilitation - an exploration of pain, psychological distress, and life impacts in over 35,000 chronic pain patients identified in the Swedish Quality Registry for Pain Rehabilitation 2019 In: Journal of Pain Research. - : DOVE Medical Press Ltd.. - 1178-7090. ; 12, s. 891-908 Journal article (peer-reviewed)abstract Background: Chronic pain patients frequently suffer from psychological symptoms. There is no consensus concerning the prevalence of severe anxiety and depressive symptoms and the strength of the associations between pain intensity and psychological distress. Although an important aspect of the clinical picture is understanding how the pain condition impacts life, little is known about the relative importance of pain and psychological symptoms for individual's life impact. The aims of this study were to identify subgroups of pain patients; to analyze if pain, psychological distress, and life impact variables influence subgrouping; and to investigate how patients in the subgroups benefit from treatments.Methods: Background variables, pain aspects (intensity/severity and spreading), psychological distress (depressive and anxiety symptoms), and two life impact variables (pain interference and perceived life control) were obtained from the Swedish Quality Registry for Pain Rehabilitation for chronic pain patients and analyzed mainly using advanced multivariate methods.Results: Based on >35,000 patients, 35%-40% had severe anxiety or depressive symptoms. Severe psychological distress was associated with being born outside Europe (21%-24% vs 6%-8% in the category without psychological distress) and low education level (20.7%-20.8% vs 26%-27% in the category without psychological distress). Dose relationships existed between the two psychological distress variables and pain aspects, but the explained variances were generally low. Pain intensity/severity and the two psychological distress variables were significantly associated (R2=0.40-0.48; P>0.001) with the two life impact variables (pain interference and life control). Two subgroups of patients were identified at baseline (subgroup 1: n=15,901-16,119; subgroup 2: n=20,690-20,981) and the subgroup with the worst situation regarding all variables participated less in an MMRP (51% vs 58%, P<0.001) but showed the largest improvements in outcomes.Conclusion: The results emphasize the need to assess both pain and psychological distress and not take for granted that pain involves high psychological stress in the individual case. Not all patients benefit from MMRP. A better matching between common clinical pictures and the content of MMRPs may help improve results. We only partly found support for treatment resistance in patients with psychological distress burden.
47.	Jörgensen, Sophie, et al. (author) Depressive symptoms among older adults with long-Term spinal cord injury : Associations with secondary health conditions, sense of coherence, coping strategies and physical activity 2017 In: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 49:8, s. 644-651 Journal article (peer-reviewed)abstract Objectives: To assess the presence of depressive symptoms among older adults with long-Term spinal cord injury and investigate the association with sociodemographic and injury characteristics; and to determine how potentially modifiable factors, i.e. secondary health conditions, sense of coherence, coping strategies and leisure-Time physical activity, are associated with depressive symptoms. Design: Cross-sectional study. Subjects: A total of 122 individuals (70% men, injury levels C1-L5, American Spinal Injury Association Impairment Scale A-D), mean age 63 years, mean time since injury 24 years. Methods: Data from the Swedish Aging with Spinal Cord Injury Study, collected using the Geriatric Depression Scale-15, the 13-item Sense of Coherence Scale, the Spinal Cord Lesion-related Coping Strategies Questionnaire and the Physical Activity Recall Assessment for people with Spinal Cord Injury. Associations were analysed using multivariable linear regression. Results: A total of 29% reported clinically relevant depressive symptoms and 5% reported probable depression. Sense of coherence, the coping strategy Acceptance, neuropathic pain and leisure-Time physical activity explained 53% of the variance in depressive symptoms. Conclusion: Older adults with long-Term spinal cord injury report a low presence of probable depression. Mental health may be supported through rehabilitation that strengthens the ability to understand and confront life stressors, promotes acceptance of the injury, provides pain management and encourages participation in leisure-Time physical activity.
48.	Andersen, Pia, et al. (author) Patients' experiences of physical activity on prescription with access to counsellors in routine care : a qualitative study in Sweden 2019 In: BMC Public Health. - : BioMed Central. - 1471-2458. ; 19 Journal article (peer-reviewed)abstract BackgroundPhysical activity on prescription (PAP) has been implemented in several countries, including Sweden, to support patients who might benefit from increased physical activity. This study explores the experiences of recipients of PAP in routine health care in Sweden that offers the recipients support from physical activity counsellors. The aim was to explore influences on engagement in physical activity by PAP recipients' from a long-term perspective.MethodsWe conducted individual semi-structured interviews using a topic guide with a purposively selected sample of 13 adult PAP recipients 1.5 to 2.5years after PAP. Interviews were recorded, transcribed verbatim and analysed through inductive and deductive content analysis. The questions were informed by Capability-Opportunity-Motivation-Behaviour (COM-B), which was also used as a framework to analyse the data by means of categorizing the factors (influences on the behaviour).ResultsTen factors (i.e. sub-categories) that influenced the participants' engagement in physical activity were identified. PAP recipients' capability to engage in physical activity was associated with adapting the PAP to the individual's physical capacity and taking into account the individual's previous experiences of physical activity. PAP recipients' opportunity to engage in physical activity was related to receiving a prescription, receiving professional counselling and follow-up from a physical activity counsellor, collaboration between prescriber and counsellor, having access to appropriate activities, having a balanced life situation and having support from someone who encouraged continued physical activity. PAP recipients' motivation to engage in physical activity was associated with the desire to improve his or her health condition and finding activities that encouraged continuation.ConclusionsPAP recipients' engagement in physical activity was influenced by their capability, opportunity and motivation to undertake this behaviour. Numerous extraneous factors influence capability and motivation. Physical activity counsellors were found to be important for sustained activity because they use an individual approach to counselling and flexible follow-up adapted to each individual's need of support.
49.	Pauelsen, Mascha, et al. (author) Concussion in ice hockey : A Cohort Study Across 29 Seasons 2017 In: Clinical Journal of Sports Medicine. - : Wolters Kluwer. - 1050-642X .- 1536-3724. ; 27:3, s. 283-287 Journal article (peer-reviewed)abstract Objective: The aim of this study was to analyse the concussion incidence rate ratios (IRR) across 29 seasons in a Swedish Hockey League team.Design: Cohort study over 29 seasons within one Swedish elite series ice hockey team. Participants: All players who were part of one Swedish elite ice hockey team during the research period gave consent for participation in the study.Independent Variables: Exposure to top level Swedish ice hockey. Main Outcome Measures: Incidence rate ratio for concussion as well as rehabilitation periods due to concussion were calculated and analysed.Results: During the research period, 267 players in total were part of the team. A total of 1638 traumatic injuries were registered of which 162 were concussions. Incidence rates ranged from 0/1,000 games during the first season to 118/1,000 games for the final recorded season. The incidence rate ratio was 1.06 (CI = 1.03-1.10) for the entire research period. A shift towards longer rehabilitation periods was discovered.Conclusions: This study showed a significant increase of concussion incidence rate and a trend towards longer rehabilitation periods due to concussion. Possible risk factors were discussed. Risk behaviour and rehabilitation protocols should be prioritized areas in the research of concussion in ice hockey.
50.	Röijezon, Ulrik, et al. (author) An Initial Study on the Coordination of Rod and Line Hauling Movements in Distance Fly Casting 2017 In: Annals of Applied Sport Science. - : Asian Exercise and Sport Science Association. - 2476-4981 .- 2322-4479. ; 5:2, s. 61-72 Journal article (peer-reviewed)abstract Background. The double haul is a unique feature of single-handed fly casting and is used in both fly fishing and fly casting competition. The movement behaviour during the double haul has not been investigated in previous research.Objectives. Describe the coordination of the rod and line hauling movements during distance fly casting.Methods. Elite fly casters performed distance casting with four different fly rod and fly line set-ups used in fly fishing and fly casting competition. Rod and hauling movements were measured with a 3D motion analysis system.Results. The rod and line hauling movements were coordinated in an order whereby peak translational speed of the rod occurs prior to the peak speed of the angular rotation of the rod, and the peak speed of the angular rotation of the rod occurs prior to the peak speed of the line haul. This was consistent for all cast sequences, i.e., the back and forward false casts and the delivery cast, and for all four equipment set-ups, i.e., a shooting-head line cast with a relatively stiff fly rod and a long-belly line cast with three different fly rods with different stiffness and action curves. Results also showed differences in movement coordination between cast sequences and rod and line set-ups.Conclusion. Among elite casters, single-handed fly casting with double haul is coordinated in an order of events whereby the peak speed occurs first for the translation of the rod, then for the rotation of the rod and finally for the line haul.

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