| 1. |
- Börsbo, Björn, 1952-, et al.
(författare)
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Catastrophizing, depression, and pain : Correlation with and influence on quality of life and health - A study of chronic whiplash-associated disorders
- 2008
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 40:7, s. 562-569
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aims of this study were: (i) to classify subgroups according to the degree of pain intensity, depression, and catastrophizing, and investigate distribution in a group of patients with chronic whiplash-associated disorders; and (h) to investigate how these subgroups were distributed and inter-related multivariately with respect to consequences such as health and quality of life outcome measures. Design: Descriptive cross-sectional study. Patients: A total of 275 consecutive chronic pain patients with whiplash-associated disorders who were referred to a university hospital. Methods: The following data were obtained by means of self-report questionnaires: pain intensity in neck and shoulders, background history, Beck Depression Inventory, the catastrophizing scale of Coping Strategy Questionnaire, Life Satisfaction Checklist, the SF-36 Health Survey, and the EuroQol. Results: Principal component analysis was used to recognize subgroups according to the degree of pain intensity, depression, and catastrophizing. These subgroups have specific characteristics according to perceived health and quality of life, and the degree of depression appears to be the most important influencing factor. Conclusion: From a clinical point of view, these findings indicate that it is important to assess patients for intensity of pain, depression, and catastrophizing when planning a rehabilitation programme. Such an evaluation will help individualize therapy and intervention techniques so as to optimize the efficiency of the programme.
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| 2. |
- Börsbo, Björn, 1952-
(författare)
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Relationships between Psychological Factors, Disability, Quality of Life and Health in Chronic Pain Disorders
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Chronic pain is a very common condition with a prevalence of 40-65% in the community. The high prevalence of chronic pain causes a lot of human suffering but also high societal costs. The development and maintenance of chronic pain constitutes a complex interplay between neurobiological, psychosocial and genetic factors. A biopsychosocial model of chronic pain has been suggested to make a comprehensive context of the understanding of this issue.The main aims of this thesis were to analyze the relationships of the different components of the biopsychosocial model of pain and to study the relative importance of pain, stress and different psychological factors on disability and health related quality of life.The thesis is based on two groups of patients. One group consists of 275 patients with chronic Whiplash Associated Disorder (WAD) and one group comprise 433 patients with WAD, fibromyalgia (FM) and patients with chronic pain related to Spinal Cord Injury (SCI). The patients were investigated by questionnaires assessing different aspects of pain, depression, anxiety, catastrophizing, self-efficacy, disability and Health Related Quality of Life (HRQL).The main results were that psychological factors (especially depression) correlated relatively strongly with perceived HRQL and disability. The degree of depression appeared to have the most important relationship to perceived HRQL. Despite the fact that the patients rated depression just mild or moderate, depression had a great importance for the outcome of HQRL and disability. Pain intensity and duration played, in the cross-sectional perspective, a minor role for perceived HRQL, whereas pain intensity related more to the outcome of perceived disability.From a clinical point of view it is important to assess the complex and unique situation of each individual with respect to depression, anxiety, self-efficacy and pain when planning treatment and rehabilitation in order to optimise the outcome of such programmes.
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| 3. |
- Börsbo, Björn, 1952-, et al.
(författare)
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The complex interplay between pain intensity, depression, anxiety and catastrophising with respect to quality of life and disability
- 2009
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 31:19, s. 1605-1613
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Tidskriftsartikel (refereegranskat)abstract
- Purpose. To identify subgroups of patients with chronic pain based on the occurrence of depression, anxiety and catastrophising and the duration of pain and pain intensity. In addition to this, the relationship between the subgroups with respect to background variables, diagnosis, pain-related disability and perceived quality of life are investigated. Methods. This study used 433 patients with chronic pain including 47 patients with spinal cord injury-related pain, 150 with chronic whiplash associated disorders and 236 with fibromyalgia. The participants answered a postal questionnaire that provided background data, pain intensity and duration and psychological and health-related items. Results. On the basis of depression, anxiety, catastrophising, pain intensity and duration, we identified subgroups of patients with chronic pain that differed with respect to perceived quality of life, disability and diagnosis. The psychological factors, especially depression, significantly influenced perceived quality of life and disability. Pain intensity and duration play a minor role with respect to quality of life, although pain intensity is associated to perceived disability. Conclusions. The results of this study highlight the importance of not looking at patients with chronic pain as a homogenous entity. A detailed assessment, including psychological factors with emphasis on depressive symptoms, might be essential for planning and carrying through treatment and rehabilitation.
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| 4. |
- Larsson, Barbro, 1952-, et al.
(författare)
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Surface electromyography and peak torque of repetitive maximum isokinetic plantar flexions in relation to aspects of muscle morphology
- 2006
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Ingår i: Journal of Electromyography & Kinesiology. - : Elsevier BV. - 1050-6411 .- 1873-5711. ; 16:3, s. 281-290
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Tidskriftsartikel (refereegranskat)abstract
- This study investigates the relationships between surface electromyography (EMG [Mean frequency of the power spectrum (MNF)]) and peak torque variables obtained during 100 maximum concentric plantar flexions with the right limb at 60 degrees s(-1) and different muscle morphological variables. Surface EMG was recorded from the right gastrocnemius lateralis and muscle biopsies were taken from the same site as the EMG electrodes were positioned. Muscle fibre area and fibre type composition were determined on serial muscle cross sections using both histochemistry (myofibrillar adenosine triphosphatase) and immunohistochemistry (monoclonal antibodies against specific myosin heavy chain isoforms). Forty-three female and nine male students participated in the study. Gastrocnemius lateralis contained predominantly type I fibres (50%) and type IIA fibres (40%) in both sexes and large individual differences were found. Principal component analysis (PCA) was used for the intercorrelation analyses, and projection to latent structures (PLS) was used for the multivariate regression analysis. MNF correlated positively with different fibre areas and with the proportion of type I fibres. Fibre areas and sex were the most important factors in the regression of maximum peak torque. High proportion of type I fibres and sex were the most important regressors of peak torque endurance normalised for lean body mass. More studies are needed to understand the complex interrelationships between intrinsic muscle properties and the frequency content of the surface EMG before theoretical models can be formulated that incorporate both fibre areas and fibre type proportions.
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| 5. |
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| 6. |
- Peolsson, Michael, et al.
(författare)
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Generalized pain is associated with more negative consequences than local or regional pain : A study of chronic whiplash-associated disorders
- 2007
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081 .- 0001-5555. ; 39:3, s. 260-268
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The main aims of this study were: (i) to determine, for chronic whiplash-associated disorders, whether widespread pain has more severe consequences for other symptoms and different aspects of perceived health than does local/regional pain; (ii) to investigate whether pain, depression, and symptoms not directly related to pain are intercorrelated and to what extent these symptoms correlate with catastrophizing according to the Coping Strategy Questionnaire. Design: Descriptive cross-sectional study. Patients: A total of 275 consecutive chronic pain patients with whiplash-associated disorders who were referred to a university hospital. Methods: Background history, Beck Depression Inventory, Coping Strategy Questionnaire, Life Satisfaction Checklist, the SF-36 Health Survey and EuroQol were used to collect data. Results: Spreading of pain was associated with negative consequences with respect to pain intensity and prevalence of other symptoms, life satisfaction/quality and general health. The subjects differ with respect to the presence of symptoms not directly related to pain. A minor part of the variation in Back Depression Inventory was explained by direct aspects of pain, indicating that, to some extent, generalization of pain is related to catastrophizing thoughts. Conclusion: Widespread pain was associated with negative consequences with respect to pain intensity, prevalence of other symptoms including depressive symptoms, some aspects of coping, life satisfaction and general health.
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| 7. |
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| 8. |
- Björk, Mathilda, 1977-
(författare)
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Aspects of Disability in Rheumatoid Arthritis : a five-year follow-up in the Swedish TIRA project
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Rheumatoid arthritis (RA) is a progressive disease, often leading to disability. Because the disease course develops rapidly during the first years after diagnosis, more knowledge is needed about the early disease course to minimize later disability. This thesis describes the course of disability in early RA such as hand function, pain intensity, activity limitation and sick leave. In addition, this thesis compares disability between women and men and compares disability between RA patients and referents.This thesis is primarily based on data from the 320 patients that were included in the multi-centre project in Sweden called ‘Early interventions in rheumatoid arthritis’ (TIRA). A wide range of outcome variables was registered between 1996 and 2006 during regular follow-ups from time for diagnosis through the eight-year follow-up. Outcome regarding disease activity and disability of RA patients still remaining in TIRA at the three and five year follow-up respectively are used in this thesis. Data concerning sick leave were obtained for the patients during six years (1993-2001) – three years before and three years after diagnosis. Referents were included in two of the studies. Data regarding disability in referents were obtained according to hand function and activity limitation using the Health Assessment Questionnaire (HAQ). Data for sick leave were obtained for six years in referents, for the same period as the RA patients.For most variables, disability in RA was most pronounced at time of diagnosis but before intervention started. Disability was then reduced already at the 3-month follow-up and thereafter affected but stable during the following five years. The exception was participation, reflected by sick leave, a variable that was stable from inclusion to three years from diagnosis. Activity limitation, pain intensity and sick leave in RA that represents different aspects of disability were explained by other aspects of disability and contextual factors rather than by disease activity. RA affects women and men differently in some aspects. Women had more severe course of activity limitations than men according to HAQ. Men were more affected than women in range of motion, although the differences were small in a clinical perspective. However, pain intensity and frequency of sick leave did not differ between women and men. Patients with RA have pronounced disability in relation to referents although several variables improve soon after diagnosis. This discrepancy refers to hand function as well as activity limitations and sick leave. The frequency of sick leave increased during the year before diagnosis in relation to referents and was thereafter high compared to sick leave in referents.
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| 9. |
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| 10. |
- Björk, Mathilda, et al.
(författare)
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Hand Function and Activity Limitation According to Health Assessment Questionnaire in Patients with Rheumatoid Arthritis and Healthy Referents : 5-Year Followup of Predictors of Activity Limitation (The Swedish TIRA Project)
- 2007
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Ingår i: Journal of Rheumatology. - Toronto, Ontario, Canada : Journal of Rheumatology Publishing Co. Ltd.. - 0315-162X .- 1499-2752. ; 34:2, s. 296-302
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This study identifies baseline predictors of future activity limitation in rheumatoid arthritis (RA). To reinforce the utility of instruments assessing functional ability/activity limitation, we used reference data from healthy referents. Methods: This study includes 189 patients (69% women) with recent-onset RA (onset of joint swelling not more than 12 months at diagnosis) in a prospective cohort ("the Swedish TIRA project") during 27 months from 1996 through 1998. Regular followups were done for a period of 5 years, and 123 healthy persons (50% women) were recruited as referents. Hand function was assessed by the "grip ability test (GAT)" and "signals of functional impairment" (SOFI). Grip force was measured with the electronic device GrippitTM. Activity limitation was assessed with the Swedish version of the Health Assessment Questionnaire (HAQ). Results: Throughout the study and for both sexes, GAT, grip force, SOFI-hand, and HAQ were significantly different for the patients compared to healthy referents. In the healthy referents, HAQ was mainly related to age and GAT, whereas in RA HAQ was most obviously linked to grip force. Five years after diagnosis only 8% of HAQ outcome was explained by the baseline measures: HAQ, grip force, SOFI-lower limb, sex, walking speed, and GAT. Conclusion: Our study provides valuable reference data for several functional ability and activity limitation measures. The HAQ score was explained by different variables in healthy referents compared to patients with RA. Five years after diagnosis only 8% of HAQ outcome was explained by the variables assessed at inclusion.
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