| 1. |
- Bendrik, Regina, et al.
(författare)
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Follow-up of individualised physical activity on prescription and individualised advice in patients with hip or knee osteoarthritis : A randomised controlled trial.
- 2024
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Ingår i: Clinical Rehabilitation. - : Sage Publications. - 0269-2155 .- 1477-0873. ; 38:6, s. 770-782
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Compare the long-term effects of two different individualised physical activity interventions in hip or knee osteoarthritis patients.DESIGN: Randomised, assessor-blinded, controlled trial.SETTING: Primary care.SUBJECTS: Patients with clinically verified hip or knee osteoarthritis, <150 min/week with moderate or vigorous physical activity, aged 40-74.INTERVENTION: The advice group (n = 69) received a 1-h information and goalsetting session for individualised physical activity. The prescription group (n = 72) received information, goalsetting, individualised written prescription, self-monitoring, and four follow-ups.MAIN MEASURES: Physical activity, physical function, pain and quality of life at baseline, 6, 12 and 24 months.RESULTS: There were only minor differences in outcomes between the two groups. For self-reported physical activity, the advice group had improved from a mean of 102 (95% CI 74-130) minutes/week at baseline to 214 (95% CI 183-245) minutes/week at 24 months, while the prescription group had improved from 130 (95% CI 103-157) to 176 (95% CI 145-207) minutes/week (p = 0.01 between groups). Number of steps/day decreased by -514 (95% CI -567-462) steps from baseline to 24 months in the advice group, and the decrease in the prescription group was -852 (95% CI -900-804) steps (p = 0.415 between groups). Pain (HOOS/KOOS) in the advice group had improved by 7.9 points (95% CI 7.5-8.2) and in the prescription group by 14.7 points (95% CI 14.3-15.1) from baseline to 24 months (p = 0.024 between groups).CONCLUSIONS: There is no evidence that individualised physical activity on prescription differs from individualised advice in improving long-term effects in patients with hip or knee osteoarthritis.
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| 2. |
- Bendrik, Regina, et al.
(författare)
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Physical activity on prescription in patients with hip or knee osteoarthritis : A randomized controlled trial.
- 2021
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Ingår i: Clinical Rehabilitation. - : Sage Publications. - 0269-2155 .- 1477-0873. ; 35:10, s. 1465-1477
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate whether physical activity on prescription, comprising five sessions, was more effective in increasing physical activity than a one-hour advice session after six months.DESIGN: Randomized, assessor-blinded, controlled trial.SETTING: Primary care.SUBJECTS: Patients with clinically verified osteoarthritis of the hip or knee who undertook less than 150 minute/week of moderate physical activity, and were aged 40-74 years.INTERVENTIONS: The advice group (n = 69) received a one-hour session with individually tailored advice about physical activity. The physical activity on prescription group (n = 72) received individually tailored physical activity recommendations with written prescription, and four follow-ups during six months.MAIN MEASURES: Patients were assessed at baseline and six months: physical activity (accelerometer, questionnaires); fitness (six-minute walk test, 30-second chair-stand test, maximal step-up test, one-leg rise test); pain after walking (VAS); symptoms (HOOS/KOOS); and health-related quality of life (EQ-5D).RESULTS: One hundred four patients had knee osteoarthritis, 102 were women, and mean age was 60.3 ± 8.3 years. Pain after walking decreased significantly more in the prescription group, from VAS 31 ± 22 to 18 ± 23. There was no other between groups difference. Both groups increased self-reported activity minutes significantly, from 105 (95% CI 75-120) to 165 (95% CI 135-218) minute/week in the prescription group versus 75 (95% CI 75-105) to 150 (95% CI 120-225) in the advice group. Also symptoms and quality of life improved significantly in both groups.CONCLUSION: Individually tailored physical activity with written prescription and four follow-ups does not materially improve physical activity level more than advice about osteoarthritis and physical activity.TRIAL REGISTRATION: ClinicalTrials.gov (NCT02387034).
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| 3. |
- Danielsson, Louise, 1979, et al.
(författare)
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Work-directed rehabilitation or physical activity to support work ability and mental health in common mental disorders: a pilot randomized controlled trial
- 2020
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Ingår i: Clinical Rehabilitation. - : SAGE Publications. - 0269-2155 .- 1477-0873. ; 34:2, s. 170-181
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate feasibility and potential effectiveness of work-directed rehabilitation in people with common mental disorders. Design: Pilot randomized controlled trial. Setting: Primary healthcare, Sweden. Subjects: Working adults (n=42) of mean age 46.2±11.1years with depression or anxiety disorder. Interventions: Eight weeks of work-directed rehabilitation (n=21) or physical activity (n=21). Work-directed rehabilitation included sessions with a physiotherapist and/or an occupational therapist, to develop strategies to cope better at work. Physical activity included a planning session and access to a local gym. Main measures: Feasibility: attendance, discontinuation and adverse events. Measurements were the Work Ability Index, the Global Assessment of Functioning, the Montgomery–Asberg Depression Rating Scale, the Beck Anxiety Inventory and the World Health Organization—Five Well-Being Index. Results: Attendance to rehabilitation sessions was 88% (n=147/167) and discontinuation rate was 14% (n=3/21). No serious adverse events were reported. Within both groups, there was a significant improvement in Work Ability Index score (mean change: 3.6 (95% confidence interval (CI): 0.45, 6.7) in work-directed rehabilitation and 3.9 (95% CI: 0.9, 7.0) in physical activity) with no significant difference between groups. For the other outcomes, significant improvements were found within but not between groups. Per-protocol analysis showed a trend toward the antidepressant effect of work-directed rehabilitation compared to physical activity (mean difference in depression score −3.1 (95% CI: −6.8, 0.4), P=0.075). Conclusion: Work-directed rehabilitation was feasible to persons with common mental disorders and improved their work ability and mental health. Comparable improvements were seen in the physical activity group. Suggested modifications for a larger trial include adding a treatment-as-usual control.
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| 4. |
- Delgado, Bruno, et al.
(författare)
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The effects of early rehabilitation on functional exercise tolerance in decompensated heart failure patients : Results of a multicenter randomized controlled trial (ERIC-HF study)
- 2022
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Ingår i: Clinical Rehabilitation. - : Sage Publications. - 0269-2155 .- 1477-0873. ; 36:6, s. 813-821
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Tidskriftsartikel (refereegranskat)abstract
- Objective To analyze (1) the effect of an aerobic training program on functional exercise tolerance in decompensated heart failure (DHF) patients; (2) to assess the effects of an aerobic training program on functional independence; and (3) dyspnea during activities of daily living. Design A randomized controlled clinical trial with follow-up at discharge. Settings Eight hospitals. Recruitment took place between 9/ 2017 and 3/2019. Group Assignments Patients with DHF who were admitted to the hospital, were randomly assigned to usual rehabilitation care guideline recommended (control group) or aerobic training program (exercise group). Main outcome Functional exercise tolerance was measured with a 6-min walking test at discharge. Results In total 257 patients with DHF were included, with a mean age of 67 +/- 11 years, 84% (n = 205) had a reduced ejection fraction and the hospital stay was 16 +/- 10 days. At discharge, patients in the intervention group walked further compared to the control group (278 +/- 117m vs 219 +/- 115m, p < 0.01) and this difference stayed significant after correcting for confounders (p < 0.01). A significant difference was found favoring the exercise group in functional independence (96 +/- 7 vs 93 +/- 12, p = 0.02) and dyspnea associated to ADL (13 +/- 5 vs 17 +/- 7, p < 0.01) and these differences persisted after correcting for baseline values and confounders (functional independence p < 0.01; dyspnea associated with ADL p = 0.02). Conclusion The ERIC-HF program is safe, feasible, and effective in increasing functional exercise tolerance and functional independence in hospitalized patients admitted due to DHF.
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| 5. |
- Hernández-Moreno, Laura, et al.
(författare)
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Is perceived social support more important than visual acuity for clinical depression and anxiety in patients with age-related macular degeneration and diabetic retinopathy? : Är uppfattat socialt stöd viktigare än synskärpa för klinisk depression och ångest hos patienter med åldersrelaterad makulär degeneration och diabetesretinopati?
- 2021
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Ingår i: Clinical Rehabilitation. - : Sage Publications. - 0269-2155 .- 1477-0873. ; 35:9, s. 1341-1347
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Tidskriftsartikel (refereegranskat)abstract
- Objective:To investigate whether visual acuity has the same importance as a factor of depression and anxiety comparing with other psychological variables, particularly perceived social support, in patients diagnosed with age-related eye diseases, with and without low vision.Design:Observational cross-sectional study.Setting:Patients attending outpatient appointments at the department of ophthalmology of a general hospital in Portugal.Subjects:Patients with age-related macular degeneration and patients with diabetic retinopathy attending routine hospital appointments were recruited for this study.Measures:Anxiety and depression were measured using the hospital anxiety and depression scale and perceived social support using the multidimensional scale of perceived social support. Visual acuity was measured with ETDRS charts.Results:Of the 71 patients, 53 (75%) were diagnosed with diabetic retinopathy, 37 (52%) were female and age (mean±SD) was 69±12 years. Acuity in the better seeing eye was 0.41±?0.33logMAR. The mean anxiety score was 4.38±3.82 and depression 4.41±3.39. Clinically significant levels of anxiety were found in 21% (n=15) of the participants and depression in 18%(n=13). The total social support score was 5.29±0.61. Significant multivariate regression models were found for anxiety (R2=0.21, P=0.016) and for depression (R2=0.32, P<0.0001). Social support was independently associated with levels of anxiety and with levels of depression. Gender was independently associated with levels of anxiety.Conclusion:This study suggests that patients? perceived social support might be more important than visual acuity as a factor of clinical depression and anxiety in a sample of age-related eye disease patients.
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| 6. |
- Joseph, C, et al.
(författare)
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Predictors of improved balance performance in persons with Parkinson's disease following a training intervention: analysis of data from an effectiveness-implementation trial
- 2020
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Ingår i: Clinical rehabilitation. - : SAGE Publications. - 1477-0873 .- 0269-2155. ; 34:6, s. 837-844
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Tidskriftsartikel (refereegranskat)abstract
- (1) To determine associated factors of improved balance performance after a 10-week HiBalance intervention period, and (2) to determine effects of the programme on modifiable factors found above, considering both groups. Design: Pre-posttest substudy founded on the outcomes evaluation of an effectiveness-implementation trial. Participants: Sixty-one participants were allocated the HiBalance training, while 56 were controls. Intervention: Participants received a 10-week, two times weekly, progressive balance training, that is, HiBalance intervention, led by physical therapists. The intervention was group based and gradually incorporated dual-tasking over the training period. Participants also performed, unsupervised, a 1×/week home exercise programme. Main outcome: The Mini-Balance Evaluation Systems Test (Mini-BESTest) assessed balance performance, and those having improved by ⩾2 points were classified as positive responders. Balance confidence was the secondary outcome. Results: Fifty-three (87%) participants completed the intervention and 32 (60%) improved their balance scores by ⩾2 points in the intervention group, with 11 (24%) in the control group. The multivariable logistic regression analysis revealed two independently associated factors of improved balance, which included balance confidence (odds ratio (OR) = 0.95; 95% confidence interval (CI) = 0.90–0.99) and attendance of ⩾80% of training sessions (OR = 10.10; 95% CI = 1.71–59.60). The final model demonstrated good fit and acceptable discrimination (area under the curve = 0.84). Secondary analysis revealed a fair relationship (Rho = 0.30; P = 0.044) between improvements in balance confidence and balance performance in the intervention but not control group. Conclusion: Two personal factors were significantly associated with a higher likelihood of improvement in clinically measured balance performance. The HiBalance intervention appears to benefit those with lower balance confidence.
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| 7. |
- Laitalainen Törnudd, Maria, et al.
(författare)
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The perceptions of nurses and physicians in primary care of rehabilitation for frail older adults
- 2024
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Ingår i: Clinical Rehabilitation. - : SAGE PUBLICATIONS LTD. - 0269-2155 .- 1477-0873.
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To investigate the perceptions of primary care nurses and physicians of the potential contributions of physiotherapists (PTs) and occupational therapists (OTs) in the treatment of frail older persons, as well as the obstacles to, and opportunities for, collaboration.Design A qualitative study.Participants and setting Nurses (n = 9) and physicians (n = 8) in primary care in the county council [14 women (82%)] with experience working with older people.Method Interview study conducted with a semi-structured interview guide. Analyses were carried out with content analysis with an inductive approach.Results The analysis resulted in six categories: knowledge of physiotherapy and occupational therapy interventions; what triggers the need for physiotherapy and occupational therapy?; the availability of rehabilitation interventions; teamwork opportunities and difficulties; motivating the patient; the site of the rehabilitation.Conclusions Close and clear collaboration between nurses and physicians and PTs and OTs is an important factor in ensuring that rehabilitation interventions provide the greatest possible benefit to the patient. Improving communication between different healthcare providers and clarifying the contact routes is a prerequisite for patients to be able to get the rehabilitation they need. More research is needed to determine the best approach to achieving this goal.
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| 8. |
- Pohl, Petra, et al.
(författare)
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Group-based music intervention in Parkinsons disease : findings from a mixed-methods study
- 2020
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Ingår i: Clinical Rehabilitation. - : Sage Publications. - 0269-2155 .- 1477-0873. ; 34:4, s. 533-544
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate a group-based music intervention in patients with Parkinsons disease. Design: Parallel group randomized controlled trial with qualitative triangulation. Setting: Neurorehabilitation in primary care. Subjects: Forty-six patients with Parkinsons disease were randomized into intervention group (n = 26), which received training with the music-based intervention, and control group (n = 20) without training. Interventions: The intervention was delivered twice weekly for 12 weeks. Main measures: Primary outcome was Timed-Up-and-Go subtracting serial 7s (dual-task ability). Secondary outcomes were cognition, balance, concerns about falling, freezing of gait, and quality of life. All outcomes were evaluated at baseline, post-intervention, and three months post-intervention. Focus groups and individual interviews were conducted with the intervention group and with the delivering physiotherapists. Results: No between-group differences were observed for dual-task ability. Between-group differences were observed for Falls Efficacy Scale (mean difference (MD) = 6.5 points; 95% confidence interval (CI) = 3.0 to 10.0, P = 0.001) and for Parkinson Disease Questionnaire-39 items (MD = 8.3; 95% CI = 2.7 to 13.8, P = 0.005) when compared to the control group post-intervention, but these were not maintained at three months post-intervention. Three themes were derived from the interviews: Expectations versus Results, Perspectives on Treatment Contents, and Key Factors for Success. Conclusion: Patient-reported outcomes and interviews suggest that the group-based music intervention adds value to mood, alertness, and quality of life in patients with Parkinsons disease. The study does not support the efficacy in producing immediate or lasting gains in dual-tasking, cognition, balance, or freezing of gait.
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| 9. |
- Rennie, L., et al.
(författare)
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Highly challenging balance and gait training for individuals with Parkinson's disease improves pace, rhythm and variability domains of gait - A secondary analysis from a randomized controlled trial
- 2021
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Ingår i: Clinical Rehabilitation. - : SAGE Publications. - 0269-2155 .- 1477-0873. ; 35:2, s. 200-212
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Evaluate immediate and long-term effects of highly challenging balance and gait training on pace-, rhythm-, variability-, asymmetry-, and postural control domains of gait for individuals with Parkinson's disease (PD). Design: Randomized controlled trial - a secondary analysis. Setting: University hospital setting. Participants: One-hundred older adults with mild to moderate PD (Hoehn & Yahr 2 and 3). Intervention: Training group (n = 51): 10 weeks (3 times/week) of intensive balance and gait training, incorporating dual tasks. Control group (n = 49): care as usual. Main outcome measures: Spatiotemporal gait variables collected during normal and fast walking on a pressure-sensitive mat. A linear mixed model was used to evaluate training effects post intervention and at the 6 and 12 month follow-up. Results: Immediate training effects in the pace domain of gait were increased step velocity (normal speed: 8.2 cm/s,P = 0.04; fast: 10.8 cm/s,P < 0.01), increased step length (normal speed: 3 cm,P = 0.05; fast: 2.3 cm,P = 0.05) and reduced swing time variability (fast speed: -2.5 ms,P = 0.02). In the rhythm domain reduced step time (fast speed: -19.3 ms,P = 0.02), stance time (normal: -24.3 ms,P = 0.01; fast: -29.6 ms,P = 0.02) and swing time (fast speed: -8.7 ms,P = 0.04) was seen. Relative to the variability domain, the training decreased step time variability (fast: -2.8 ms,P = 0.02) and stance time variability (fast: -3.9 ms,P = 0.02). No training effects were retained at 6 months. Conclusions: Highly challenging balance and gait training improved pace, rhythm and variability aspects of PD gait in the short-term, but effects are not retained long-term.
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| 10. |
- Svingen, Jonas, et al.
(författare)
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A smartphone application to facilitate adherence to home-based exercise after flexor tendon repair: A randomised controlled trial
- 2021
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Ingår i: Clinical Rehabilitation. - : SAGE PUBLICATIONS LTD. - 0269-2155 .- 1477-0873. ; 35:2, s. 266-275
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Evaluate the effect of a smartphone application on exercise adherence, range of motion and self-efficacy compared to standard rehabilitation after repair of the flexor digitorum profundus tendon. Design: Prospective multi-centre randomised controlled trial. Setting: Four hand surgery departments in Sweden. Subjects: A total of 101 patients (35 women) (mean age 37.5 +/- 12.8) were randomised to control (n = 49) or intervention group (n = 52). Intervention: A smartphone application to facilitate rehabilitation. Main outcome measures: Adherence assessed with the Sport Injury Rehabilitation Adherence Scale at two and six weeks (primary outcome). Secondary outcomes were self-reported adherence in three domains assessed at two and six weeks, self-efficacy assessed with Athlete Injury Self-Efficacy Questionnaire at baseline, two and six weeks. Range of motion and perceived satisfaction with rehabilitation and information were assessed at 12 weeks. Results: Twenty-five patients were lost to follow-up. There was no significant between group difference in Sport Injury Rehabilitation Adherence Scale at two or six weeks, mean scores (confidence interval, CI 95%) 12.5 (CI 11.8-13.3), 11.8 (CI 11.0-12.8) for the intervention group, and 13.3 (CI 12.6-14.0), 12.8 (CI 12.0-13.7) for the control group. Self-reported adherence for exercise frequency at six weeks was significantly better for the intervention group, 93.2 (CI 86.9-99.5) compared to the controls 82.9 (CI 76.9-88.8) (P = 0.02). There were no differences in range of motion, self-efficacy or satisfaction. Conclusion: The smartphone application used in this study did not improve adherence, self-efficacy or range of motion compared to standard rehabilitation for flexor tendon injuries. Further research regarding smartphone applications is needed.
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| 11. |
- Tuvemo Johnson, Susanna, et al.
(författare)
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Self-management of falls in people with multiple sclerosis : A scoping review
- 2023
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Ingår i: Clinical Rehabilitation. - : SAGE Publications. - 0269-2155 .- 1477-0873. ; 37:2, s. 162-176
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Tidskriftsartikel (refereegranskat)abstract
- Objective Falls are common in people with multiple sclerosis. There is rising interest in how the multifactorial and chronic nature of fall risk among people with multiple sclerosis can be addressed through self-management. Thus, the aims were to investigate the extent and the scope of publications on self-management of falls in people with multiple sclerosis, and to identify how the concept of self-management was defined and used. Data sources A systematic literature search in Medline, Cochrane, Web of Science and PsycInfo was conducted to identify publications until July 2022. Review methods Published methodological guidance was followed. Articles targeting: (1) people with multiple sclerosis, (2) falls, and (3) self-management were selected. Of 1656 records, 203 publications were assessed for eligibility, of which 173 did not meet the inclusion criteria, and 16 publications did not contain empirical data. The type of publication, study focus, and study design was extracted. If applicable, key findings, self-management tasks and skills, and the definition of self-management were extracted. Results Fourteen original articles met all inclusion criteria. Ten articles represented six different fall prevention interventions. Three publications were randomized controlled trials. Self-management content was variable and not comprehensive in nature. None of the 14 publications included a self-management definition. Conclusion The limited number of original articles and the even fewer intervention studies show that the research on self-management of falls in people with multiple sclerosis is in its infancy. To progress in the research area of self-management of falls, a more robust, consensus-based description of self-management frameworks and activities is needed.
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| 12. |
- Vahlberg, Birgit, 1964-, et al.
(författare)
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Effects on walking performance and lower body strength by short message service guided training after stroke or transient ischemic attack (The STROKEWALK Study) : a randomized controlled trial
- 2021
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Ingår i: Clinical Rehabilitation. - : Sage Publications. - 0269-2155 .- 1477-0873. ; 35:2, s. 276-287
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate whetherdaily mobile-phone delivered messages with training instructions during three months increase physical activity and overall mobility in patients soon after stroke or transient ischemic attack.DESIGN: Randomised controlled trial with intention-to-treat analyses.SETTING: University hospital. Data collection from November 2016 until December2018.SUBJECTS: Seventy-nine patients (mean (SD) age 63.9 (10.4) years, 29 were women) were allocated to either intervention (n = 40) or control group (n = 39). Participants had to be independent (modified Ranking Scale ⩽2) and able to perform the six-minute walking test at discharge from the hospital.INTERVENTIONS: The intervention group received standard care and daily mobile phone instructional text messages to perform regular outdoor walking and functional leg exercises. The control group received standard care; that is, primary care follow-up.MAIN MEASURES: Walking performance by six-minute walking test (m), lower body strength by five times chair-stand test (s), the short physical performance battery (0-12 points) and 10-metres walk test (m/s) were assessed at baseline and after three months.RESULTS: The estimated median difference in the six-minute walking test was in favour of the intervention group by 30 metres (95% CI, 55 to 1; effect size 0.64; P = 0.037) and in the chair-stand test by 0.88 seconds (95% CI, 0.02 to 1.72; effect size 0.64; P = 0.034). There were no differences between groups on the short physical performance battery or in 10-metres walking time.CONCLUSIONS: Three months of daily mobile phone text messages with guided training instructions improved composite mobility measures; that is, walking performanceand lower body strength.CLINICAL TRIAL REGISTRY: The study is registered with ClinicalTrials.gov, number NCT02902367.
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| 13. |
- Verheijden Klompstra, Leonie, 1982-, et al.
(författare)
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Physical activity enjoyment, exercise motivation, and physical activity in patients with heart failure : A mediation analysis
- 2022
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Ingår i: Clinical Rehabilitation. - : Sage Publications Ltd. - 0269-2155 .- 1477-0873. ; 36:10, s. 1324-1331
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Tidskriftsartikel (refereegranskat)abstract
- Objective To determine whether physical activity enjoyment mediated the association between motivation and physical activity in patients with heart failure. Design and setting A cross-sectional study at the cardiology clinic in the university hospital in Valencia, Spain Subjects A total of 134 patients with heart failure. Main measurements Physical activity was assessed with the International Physical Activity Questionnaire, motivation was assessed with the Exercise Motivation Index and Physical Activity Enjoyment was assessed with the Physical Activity Enjoyment Scale. Analysis Mediation analysis using Hayes PROCESS macro (Model 4) for SPSS. Results The mean age of the sample was 70 +/- 14 years, 47 patients were female (35%), and 87 patients were in New York Heart Association I/II (67%). A positive relationship was found between exercise motivation and physical activity (t = 4.57, p < .01) and physical activity enjoyment (t = 11.52, p < .01). Physical activity enjoyment was found to positively affect physical activity (t = 3.50, p < .01). After controlling for physical activity enjoyment, the effect of exercise motivation on physical activity changed from a significant to non-significant (t = 1.33, p = .89), indicating that enjoyment completely mediated the relationship between motivation and physical activity. Overall, 25% of the variation in physical activity was explained by the mediation model. Conclusions Physical activity enjoyment mediates the relationship between exercise motivation and physical activity in patients with heart failure. This means that even highly motivated heart failure patients may not be physically active if they do not enjoy the physical activity.
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| 14. |
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