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- Danielsson, Louise, 1979, et al.
(författare)
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Exercise in the treatment of major depression: A systematic review grading the quality of evidence
- 2013
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Ingår i: Physiotherapy Theory and Practice. - : Informa UK Limited. - 0959-3985 .- 1532-5040. ; 29:8, s. 573-585
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To examine the quality of evidence for exercise in the treatment of major depression, comparing specific study types; aerobic exercise vs. antidepressants, aerobic exercise vs. any physical activity, and aerobic exercise as augmentation therapy to treatment as usual vs. treatment as usual. Methods: Electronic searches for randomized controlled studies, reporting on treatment outcome in adults with major depression confirmed by a clinical interview. Quality of evidence was assessed using the Grading and Recommendations Assessment, Development and Evaluation and an additional risk of bias-protocol. Results: Fourteen eligible studies were retrieved, of which nine had low risk of bias. We found moderate quality of evidence that aerobic exercise has no significant effect compared to antidepressants. We found moderate quality of evidence that aerobic exercise at a moderate to high intensity has no significant effect compared to other forms of physical activity. We found low quality of evidence that exercise as augmentation to treatment as usual has a small effect - depression scores were on average 0.44 of a standard deviation lower - compared to treatment as usual. Conclusion: In general, exercise appears to be beneficial in the treatment of depression when used in combination with medication. A significant issue that is not well addressed in previous studies is the risks associated with exercise. Further, this review indicates that aerobic exercise is not more effective than other types of physical activity, pointing to a need to further investigate active components.
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| 3. |
- Danielsson, Louise, 1979, et al.
(författare)
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Exercise or basic body awareness therapy as add-on treatment for major depression: A controlled study
- 2014
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Ingår i: Journal of Affective Disorders. - : Elsevier BV. - 0165-0327. ; 168, s. 98-106
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Tidskriftsartikel (refereegranskat)abstract
- Background: While physical exercise as adjunctive treatment for major depression has received considerable attention in recent years, the evidence is conflicting. This study evaluates the effects of two different add-on treatments: exercise and basic body awareness therapy. Methods: Randomized controlled trial with two intervention groups and one control, including 62 adults on antidepressant medication, who fulfilled criteria for current major depression as determined by the Mini International Neuropsychiatric Interview. Interventions (10 weeks) were aerobic exercise or basic body awareness therapy (BBAT), compared to a single consultation with advice on physical activity. Primary outcome was depression severity, rated by a blinded assessor using the Montgomery Asberg Rating Scale (MADRS). Secondary outcomes were global function, cardiovascular fitness, self-rated depression, anxiety and body awareness. Results: Improvements in MADRS score (mean change= -10.3, 95% CI (-13.5 to -7.1), p=0.038) and cardiovascular fitness (mean change=2.4 ml oxygen/kg/min, 95% Cl (1.5 to 3.3), p=0.017) were observed in the exercise group. Per-protocol analysis confirmed the effects of exercise, and indicated that BBAT has an effect on self-rated depression. Limitations: The small sample size and the challenge of missing data. Participants' positive expectations regarding the exercise intervention need to be considered. Conclusions: Exercise in a physical therapy setting seems to have effect on depression severity and fitness, in major depression. Our findings suggest that physical therapy can be a viable clinical strategy to inspire and guide persons with major depression to exercise. More research is needed to clarify the effects of basic body awareness therapy.
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- Ekman, Inger, 1952, et al.
(författare)
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Person-centered care -ready for prime time.
- 2011
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Ingår i: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 10:4, s. 248-251
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Tidskriftsartikel (refereegranskat)abstract
- Long-term diseases are today the leading cause of mortality worldwide and are estimated to be the leading cause of disability by 2020. Person-centered care (PCC) has been shown to advance concordance between care provider and patient on treatment plans, improve health outcomes and increase patient satisfaction. Yet, despite these and other documented benefits, there are a variety of significant challenges to putting PCC into clinical practice. Although care providers today broadly acknowledge PCC to be an important part of care, in our experience we must establish routines that initiate, integrate, and safeguard PCC in daily clinical practice to ensure that PCC is systematically and consistently practiced, i.e. not just when we feel we have time for it. In this paper, we propose a few simple routines to facilitate and safeguard the transition to PCC. We believe that if conscientiously and systematically applied, they will help to make PCC the focus and mainstay of care in long-term illness.
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- Lansinger, Birgitta, 1948, et al.
(författare)
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Health-related quality of life in persons with long-term neck pain after treatment with qigong and exercise therapy respectively
- 2013
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Ingår i: European Journal of Physiotherapy. - : Informa UK Limited. - 2167-9169 .- 2167-9177. ; 15:3, s. 111-117
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Tidskriftsartikel (refereegranskat)abstract
- The aims of this study were to evaluate health-related quality of life (HRQoL) in individuals with long-term, non-specific neck pain before and after treatment with qigong versus exercise therapy and to compare their HRQoL with an age and sex-matched reference population. A total of 122 persons were randomly assigned to either qigong or exercise therapy. HRQoL was measured with the 36-item Short Form Health Survey (SF-36) and pain intensity was assessed with a visual analogue scale (VAS) before and immediately after treatment, and at 12-month follow-up. Both treatment groups improved on all subscales; however, no differences were observed between the treatment groups either before or after treatment. Those who experienced pain relief (at least 10 mm change on VAS; 53%) also significantly improved from baseline on all SF-36 subscales. Persons with chronic neck pain had significantly lower scores on all SF-36 subscales than normative reference values both before and after treatment. The results of this study indicate no differences between qigong and exercise therapy in HRQoL outcome; however, broad HRQoL improvements seem to be contingent on significant pain reduction. As pain reduction was achieved in roughly half of the study group, more work is needed to refine these therapies, to identify neck pain persons most likely to benefit from them and to develop other physiotherapy treatment strategies suitable to non-responders.
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- Lindberg, Jeanette, 1987, et al.
(författare)
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The effects of whole-body vibration training on gait and walking ability - A systematic review
- 2012
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Ingår i: Physiotherapy Theory and Practice. - 0959-3985. ; 28:7, s. 485-498
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Tidskriftsartikel (refereegranskat)abstract
- Background: Whole-body vibration (WBV) training has been introduced in the last decade and become a popular training method and may increase muscle performance. Objectives: To evaluate the evidence degree of the effect of WBV training on gait and walking ability by a critical examination of scientific studies. In addition, a minor objective was to compare two quality indexes. Method: Literature search in Scopus; quality assessments with The Risk of Bias and The PEDro Scale; and evidence appraisal according to GRADE. Result: Ten studies with varying populations using gait-related measurements after at least 1-month WBV intervention were included. Only two studies report significant positive effects. This is defined as low-quality evidence. Eighty percent and 90% of the studies were rated as high quality according to The PEDro Scale and The Risk of Bias, respectively. Discussion: The low-quality evidence indicates a need for further research. A standardized training protocol would make comparisons and conclusions of WBV training more reliable and feasible. Conclusion: There is low-quality evidence for WBV training having effects on gait and walking ability. Further research is needed. The evidence did not alter between the quality indexes.
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- Söderberg, Elisabeth, et al.
(författare)
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Subjective well-being in patients with chronic tension-type headache: effect of acupuncture, physical training, and relaxation training.
- 2011
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Ingår i: The Clinical journal of pain. - 1536-5409. ; 27:5, s. 448-56
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Forskningsöversikt (refereegranskat)abstract
- Episodic tension-type headache is a common problem affecting approximately 2 of 3 of the population. The origin of tension-type headache is multifactorial, but the pathogenesis is still unclear. In some individuals episodic tension-type headache transforms into chronic tension-type headache (CTTH). Subjective symptoms related to the central nervous system might affect patients subjective well-being and quality of life.
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| 8. |
- Varkey, Emma, et al.
(författare)
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Exercise as migraine prophylaxis: a randomized study using relaxation and topiramate as controls.
- 2011
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Ingår i: Cephalalgia. - : SAGE Publications. - 0333-1024 .- 1468-2982. ; 31:14, s. 1428-38
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Tidskriftsartikel (refereegranskat)abstract
- AIM: Scientific evidence regarding exercise in migraine prophylaxis is required. Therefore this study aimed to evaluate the effects of exercise in migraine prevention. METHODS: In a randomized, controlled trial of adults with migraine, exercising for 40 minutes three times a week was compared to relaxation according to a recorded programme or daily topiramate use, which was slowly increased to the individual's highest tolerable dose (maximum 200 mg/day). The treatment period lasted for 3 months, and migraine status, quality of life, level of physical activity, and oxygen uptake were evaluated. The primary efficacy variable was the mean reduction of the frequency of migraine attacks during the final month of treatment compared with the baseline. RESULTS: Ninety-one patients were randomized and included in the intention-to-treat analysis. The primary efficacy variable showed a mean reduction of 0.93 (95% confidence interval (CI) 0.31-1.54) attacks in the exercise group, 0.83 (95% CI 0.22-1.45) attacks in the relaxation group, and 0.97 (95% CI 0.36-1.58) attacks in the topiramate group. No significant difference was observed between the groups (p = 0.95). CONCLUSION: Exercise may be an option for the prophylactic treatment of migraine in patients who do not benefit from or do not want to take daily medication.
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| 9. |
- Varkey, Emma, et al.
(författare)
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Forskning pågår: Behandling av huvudvärk ur ett sjukgymnastiskt perspektiv
- 2010
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Ingår i: Fysioterapi. - 1653-5804. ; :1, s. 36-41
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Tidskriftsartikel (refereegranskat)abstract
- Huvudvärk är ett av de vanligast förekommande sjukdomssymtomen. Det finns 140 former av huvudvärk, varav de mest kända är migrän och huvudvärk av spänningstyp (HST). För att ställa diagnos är anamnesen den viktigaste källan och där kan en huvudvärksdagbok vara till god hjälp. Vid behandling av migrän och huvudvärk av spänningstyp är information, råd kring livsstil samt samtal kring utlösande faktorer en viktig grund. Vidare finns flera ickefarmakologiska behandlingsmetoder väl dokumenterade, varav de mest välutvärderade metoderna är beteendemedicinska behandlingsstrategier samt akupunktur.
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