| 1. |
- Dedering, Asa, et al.
(författare)
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The Effects of Neck-Specific Training Versus Prescribed Physical Activity on Pain and Disability in Patients With Cervical Radiculopathy: A Randomized Controlled Trial
- 2018
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Ingår i: Archives of Physical Medicine and Rehabilitation. - : W B SAUNDERS CO-ELSEVIER INC. - 0003-9993 .- 1532-821X. ; 99:12, s. 2447-2456
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To compare the effects of a neck-specific training program to prescribed physical activity with both groups receiving a cognitive behavioral approach, on pain and disability in patients with cervical radiculopathy (CR). Design: Parallel-group randomized clinical trial with follow-up at 3, 6, 12, and 24 months. Setting: Recruitment and assessments of participants were performed at a university hospital. Interventions were performed in primary care setting at outpatient physiotherapy clinics. Participants: Patients (N=144) with CR were recruited to participate in this clinical trial. Interventions: Patients were randomly assigned to 3 months of either of a neck-specific training program or prescribed physical activity. Main Outcome Measures: Primary outcomes included self-rated neck and arm pain as collected by the visual analog scale (VAS). Secondary outcomes were self-rated headache measured with the VAS, the Neck Disability Index, the EuroQol 5D, the Fear Avoidance Beliefs Questionnaire, and the Hospital Anxiety and Depression Scale. Assessments were performed at baseline and at 3-, 6-, 12-, and 24-month follow-up periods. Results: Intention-to-treat and per-protocol analyses showed no significant interaction (group x time) or group effects. There were, however, significant time effects indicating improvement over time for both groups for all outcomes except for levels of depression. Conclusions: The study revealed that neck-specific training as well as prescribed physical activity both including additional cognitive behavioral approach decreased the pain in patients with CR, that is, participants improved regardless of the intervention received. There is a lack of consensus of how to best manage individuals with CR. However, our findings suggest that CR has a natural favorable long-term outcome when patients are prescribed neck-specific training and exercise in combination with a behavioral approach. (C) 2018 by the American Congress of Rehabilitation Medicine
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| 2. |
- Halvorsen, Marie, et al.
(författare)
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Dimensions Underlying Measures of Disability, Personal Factors, and Health Status in Cervical Radiculopathy A Cross-Sectional Study
- 2015
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Ingår i: Medicine. - : LIPPINCOTT WILLIAMS and WILKINS. - 0025-7974 .- 1536-5964. ; 94:24
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Tidskriftsartikel (refereegranskat)abstract
- This cross-sectional study sought to identify dimensions underlying measures of impairment, disability, personal factors, and health status in patients with cervical radiculopathy. One hundred twenty-four patients with magnetic resonance imaging-verified cervical radiculopathy, attending a neurosurgery clinic in Sweden, participated. Data from clinical tests and questionnaires on disability, personal factors, and health status were used in a principal-component analysis (PCA) with oblique rotation. The PCA supported a 3-component model including 14 variables from clinical tests and questionnaires, accounting for 73% of the cumulative percentage. The first component, pain and disability, explained 56%. The second component, health, fear-avoidance beliefs, kinesiophobia, and self-efficacy, explained 9.2%. The third component including anxiety, depression, and catastrophizing explained 7.6%. The strongest-loading variables of each dimension were "present neck pain intensity," "fear avoidance," and "anxiety." The three underlying dimensions identified and labeled Pain and functioning, Health, beliefs, and kinesiophobia, and Mood state and catastrophizing captured aspects of importance for cervical radiculopathy. Since the variables "present neck pain intensity," "fear avoidance," and "anxiety" had the strongest loading in each of the three dimensions; it may be important to include them in a reduced multidimensional measurement set in cervical radiculopathy.
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| 3. |
- Halvorsen, Marie
(författare)
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Pain related aspects of neck muscle performance, functioning and psychosocial factors in individuals with cervical radiculopathy
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The overall aim of the work presented in this thesis was to describe and explore pain-related aspects of neck muscle performance, functioning and psychosocial factors in individuals with cervical radiculopathy (CR). Methods: Participants were 157 patients with CR. Also Study II included 33 asymptomatic age-and gender-matched controls. Study I, a prospective randomized controlled pilot trial, investigated outcomes after anterior cervical discectomy and fusion (ACDF) with interbody cage with (n=17) or without (n=16) cervical collar in CR. In Study II and III, ventral and dorsal neck muscle fatigue was recorded with surface electromyography (EMG) during isometric endurance (NME) tests. Study II compared a CR group (n=46) with healthy controls (n=34). In Study III, results after neck-specific training or prescribed physical activity (n=50) were analyzed. Pain was estimated using visual analogue scales (VAS) and perceived fatigue rated with Borg CR-10 scales before, during and after the tests. Cross-sectional, Study IV, identified dimensions underlying measures of impairments, disability, personal factors, and health status in patients with CR (n=124). Results: Study I, Both groups improved in all outcome measures, with a significant improvement from baseline to two years after surgery. Cervical collar worn for six weeks postoperatively, were associated with enhanced neck function and less neck pain even at long-term. Study II showed altered neck muscle endurance investigated with greater negative median frequency slope, variability, side imbalance, lower endurance time, and higher experience of fatigue among in the CR group compared to the healthy controls. Patients with CR had significantly shorter endurance time. In Study III, significant improvement in flexor NME was found after training, but with no difference between training groups. For the neck-specific training group only, there less activation of the splenius capitis during neck flexion after 14 weeks and one year, indicating reduced co-activation of the neck muscles. In Study IV, the PCA model provided three-components: Pain and functioning, Health, beliefs, and kinesiophobia, and Mood state and catastrophizing. These accounted for 73% of the cumulative percentages. Conclusions: Cervical collar post-surgery can help deal with initial post-operative pain and reduce disability. Shorter endurance and higher experience of fatigue was perceived among patients with CR compared to healthy subjects. Exercises increased flexor NME regardless of exercise group. The neck-specific group indicated reduced compensation of antagonist muscles during flexion contraction. To capture a broad picture of patients with CR pain, their functioning, fear avoidance beliefs, and anxiety are important factors in a clinical perspective.
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| 4. |
- Halvorsen, Marie, et al.
(författare)
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SHORT- AND LONG-TERM EFFECTS OF EXERCISE ON NECK MUSCLE FUNCTION IN CERVICAL RADICULOPATHY: A RANDOMIZED CLINICAL TRIAL
- 2016
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Ingår i: Journal of Rehabilitation Medicine. - : FOUNDATION REHABILITATION INFORMATION. - 1650-1977 .- 1651-2081. ; 48:8, s. 696-704
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To compare short-and long-term changes in neck muscle endurance, electromyography measures of neck muscle activation and fatigue and ratings of fatigue and pain after neck-specific training or physical activity in people with cervical radiculopathy. Design: Randomized clinical trial. Subjects/patients: Seventy-five patients with cervical radiculopathy. Methods: Patients underwent neck-specific training in combination with a cognitive behavioural approach or prescribed physical activity over a period of 14 weeks. Immediately after the intervention and 12 months later, surface electromyography was recorded from neck flexor and extensor muscles during neck endurance tests. Time to task failure, amplitude and median frequency of the electromyography signal, and subjective fatigue and pain ratings were analysed in 50 patients who completed at least one follow-up. Results: A significant increase in neck flexor endurance time was observed for both groups at 14 weeks compared with baseline and this was maintained at the 12-month follow-up (pamp;lt;0.005). No change was identified for the slope of the median frequency. For the neck-specific training group, splenius capitis was less active during neck flexion at both follow-ups (pamp;lt;0.01), indicating reduced muscle co-activation. Conclusion: Both specific and general exercise increased neck flexor endurance, but neck-specific training only reduced co-activation of antagonist muscles during sustained neck flexion.
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| 5. |
- Åstrand, Anna, et al.
(författare)
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Poststroke Physical Activity Levels No Higher in Rehabilitation than in the Acute Hospital.
- 2016
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Ingår i: Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association. - : Elsevier BV. - 1532-8511. ; 25:4, s. 938-45
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Tidskriftsartikel (refereegranskat)abstract
- Returning to physical activity is a common goal for stroke survivors undergoing rehabilitation, and higher levels of activity have been linked to better gait and greater independence in activities of daily living. Our aim was to determine if inpatient rehabilitation settings promoted higher levels of physical activity in stroke survivors than an acute stroke unit setting.
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