| 1. |
- Aasa, Björn, et al.
(författare)
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A characterisation of pain, disability, kinesiophobia and physical capacity in patients with predominantly peripherally mediated mechanical low back pain
- 2011
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Ingår i: Physiotherapy. - 0031-9406 .- 1873-1465. ; 97:Suppl. 1, s. eS18-
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The specific objectives were to: 1) describe the level of pain intensity, disability, activity limitation, kinesiophobia and physical capacity in patients with predominantly peripherally mediated mechanical back pain, and 2) investigate whether differences between these patients in physical and psychosocial factors can be distinguished when the patients are further sub-grouped.Relevance: To improve assessment among patients with chronic low back pain (CLBP) it is important to investigate the prevalence of physical and psychosocial features in homogenous sub-groups.Participants: Seventy-one patients with CLBP, 20-60 years old, with peripherally mediated mechanical pain at the the moment for the study, were included and each patient was sub-classified into one of five sub-groups based on their pain behaviour and functional movement pattern (flexion n=20, flexion/lateral shift, n=11, active extension n=23 , passive extension n=8, and multidirectional pattern n=9).Methods: Data on pain intensity (Visual Analogue Scale), disability (the Roland and Morris Questionnaire), activity limitation (the Patient Specific Functional Scale), kinesiophobia (the Tampa Scale of Kinesiophobia) and physical capacity (lifting capacity and trunk extensor endurance) was collected.Analysis: Mean and standard deviation for parametric and median and interquartile range for non-parametric data were used for descriptive statistics. One-way ANOVA for normally distributed data and Kruskal-Wallis for non-normally distributed data were used for analyses of differences between the sub-groups. The subjects were also divided into two age-groups (20-40 and 41-60 years) and measures of physical capacity were compared to women and men at the ages of 34 and 50, respectively, in the general Swedish population using one sample T-test.Results: The patients reported low to moderate pain intensity (3.1/10±2.4), disability (RMDQ (7.27/24 ±4.2) and kinesiophobia (33.4/68 ±7) and these levels were lower than reported levels in other studies including more heterogenous groups of patients with CLBP. The patiens reported activity limitations (PSFS 13/30±23). Lifting capacity and trunk extensor endurance were significantly lower than in the general population in the youngest age-group. No significant differences in pain intensity, disability, kinesiophobia or physical capacity were found between the sub-groups.Conclusions: This research highlights that patients with predominantly peripherally mediated mechanical back pain may differ from other sub-groups of patients with CLBP (e.g., patients with central sensitization as dominating pain mechanism) regarding physical and psychosocial factors. The individual variation in pain intensity, disability, kinesiophbia and physical capacity among the patients indicates the importance to assess these factors in every patient. Due to the fact that there were few patients in the sub-groups, further research is necessary to explore whether there are differences, that we were not able to disingjish, between patients with different movement patterns.
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| 3. |
- Abbott, Allan, et al.
(författare)
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The influence of psychological factors on pre-operative levels of pain intensity, disability and HRQOL in lumbar spinal fusion surgery patients
- 2010
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Ingår i: Physiotherapy. - : Elsevier. - 0031-9406 .- 1873-1465. ; 96:3, s. 213-221
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES:To assess the extent to which perceived pain and psychological factors explain levels of disability and health-related quality of life (HRQOL) in patients scheduled for lumbar fusion surgery, and to test the hypothesis that relationships between pain intensity, mental health, fear of movement/(re)injury, disability and HRQOL are mediated by cognitive beliefs and appraisals.DESIGN:Cross-sectional, correlation study.SETTING:Orthopaedic outpatient setting in a tertiary hospital.PARTICIPANTS:One hundred and seven chronic back pain patients scheduled for lumbar fusion surgery.MEASURES:Visual analogue scale for pain intensity, Short Form 36 mental health subscale, Tampa Scale for Kinesiophobia, Back Beliefs Questionnaire, Self-efficacy Scale, Coping Strategy Questionnaire, Oswestry Disability Index and European Quality of Life Questionnaire.RESULTS:The group effect of multiple mediators significantly influenced the relationships between pain intensity and mental health, fear of movement/(re)injury, functional disability and HRQOL. Pain catastrophising significantly mediated the relationship between pain intensity and mental health, control over pain significantly mediated the relationship between mental health and functional disability, self-efficacy and pain outcome expectancy significantly mediated the relationship between mental health and HRQOL, and self-efficacy also significantly mediated the relationship between pain intensity, fear of movement/(re)jury and functional disability. The model explained 28, 30, 52 and 42% of the variation in mental health, fear of movement/(re)injury, functional disability and HRQOL, respectively.CONCLUSIONS:This study highlights the strong influence and mediation roles of psychological factors on pain, mental health, fear of movement/(re)injury, disability and HRQOL in patients scheduled for lumber fusion. Future research should focus on screening as well as pre- and post-operative interventions based on these psychological factors for the potential improvement of lumber fusion surgery outcomes.Copyright 2010 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.
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| 4. |
- Berglund, Lars, et al.
(författare)
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Which patients with persistent mechanical low back pain will respond to high load motor control training?
- 2011
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Ingår i: Physiotherapy. - 0031-9406 .- 1873-1465. ; 97:Suppl. 1, s. eS124-eS125
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of this study was to explore variables influencing success or failure of eight weeks of high load motor control training with the conventional deadlift exercise.Relevance: Researching viable exercises for rehabilitation of specific sub-groups of persistent low back pain is relevant for physical therapists in order to develop tailored treatment regimes for patients with persistent low back pain. This study contributes to this research by exploring which variables characterize the ideal patient for the conventional deadlift exercise.Participants: Thirty-five patients with persistent mechanical low back pain were recruited consecutively from two occupational health care services in Umeå, Sweden . Inclusion and exclusion criteria were designed to include patients with persistent mechanical low back pain.Methods: The study design was a prospective cohort study. The intervention consisted of eight weeks of training with the conventional deadlift exercise. To discriminate between patients with a successful or failed outcome of treatment, change in the patient-specific functional scale was used and a cut-off at 50 % improvement was set. Possible predictive variables collected at baseline included physical activity level, pain intensity (Visual Analogue Scale), activity limitation (the Roland and Morris Disability Questionnaire and the Patient-Specific Functional Scale), kinesiophobia (Tampa Scale of Kinesiophobia), specific anamnestic questions regarding patients' history and symptoms of low back pain, test of active movement control of the low back, trunk muscle endurance(Prone bridge test, Side-bridge test, Biering-Sörensen test) and lift strength (static two-hand lift test), two-point discrimination of the low back and ultrasound imaging of the mm. multifidi.Analysis: Student´s T-test for normally distributed continuous data, Mann Whitney for non-normally distributed continuous data and chi-square tests or Fisher´s Exact tests for categorical variables were used for analyses of differences between the success and the failure group.Results: No significant differences between groups were found in background, anamnestic or physical performance variables. After eight weeks of training, 15 patients (43 %) were categorized as treatment success and 20 patients (57 %) were categorized as treatment failure according to the cut-off set for the PSFS. The patients reported difficulty in performing a wide variation of activities, ranging from not being able to sit for longer than 15 minutes, to stand upright and watch their children play football games, and to not being able to run long distances, play football or perform different lifting tasks.Conclusions: We conclude that the conventional deadlift exercise may be considered a possible exercise to improve patients' activity limitations, if administered by a therapist experienced in resistance training and analyzing movement patterns. However, further research is needed to explore which variables can define patients in the successful and in the failure group, respectively.Implications: The results of this study imply that the conventional deadlift exercise can be used in treatment of patients with mechanical low back pain in order to increase activity limitation. However, it is still unclear on what grounds treatment with the conventional deadlift exercise is indicated to achieve these results.
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| 5. |
- Blomqvist, Sven, et al.
(författare)
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Test-retest reliability, smallest real difference and concurrent validity of six different balance tests on young people with mild to moderate intellectual disability
- 2012
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Ingår i: Physiotherapy. - : Elsevier BV. - 0031-9406 .- 1873-1465. ; 98:4, s. 313-319
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Tidskriftsartikel (refereegranskat)abstract
- Objectives Some studies have reported that people with intellectual disability may have reduced balance ability compared with the population in general. However, none of these studies involved adolescents, and the reliability and validity of balance tests in this population are not known. The purpose of this study was to examine the reliability of six different balance tests and to investigate their concurrent validity.Design Test-retest reliability assessment.Settings All subjects were recruited from a special school for people with intellectual disability in Bollnas, Sweden.Participants Eighty-nine adolescents (35 females and 54 males) with mild to moderate intellectual disability with a mean age of 18 years (range 16 to 20 years).Interventions All subjects followed the same test protocol on two occasions within an 11-day period.Main outcomes Balance test performances.Results Intraclass correlation coefficients greater than 0.80 were achieved for four of the balance tests: Extended Timed Up and Go Test, Modified Functional Reach Test, One-leg Stance Test and Force Platform Test. The smallest real differences ranged from 12% to 40%; less than 20% is considered to be low. Concurrent validity among these balance tests varied between no and low correlation.Conclusion The results indicate that these tests could be used to evaluate changes in balance ability over time in people with mild to moderate intellectual disability. The low concurrent validity illustrates the importance of knowing more about the influence of various sensory subsystems that are significant for balance among adolescents with intellectual disability.(C) 2011 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.
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| 7. |
- Janaudis-Ferreira, Tania, 1976-, et al.
(författare)
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Comparison of the 6-minute walk distance test performed on a non-motorised treadmill and in a corridor in healthy elderly subjects
- 2010
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Ingår i: Physiotherapy. - : Elsevier BV. - 0031-9406 .- 1873-1465. ; 96:3, s. 234-239
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To compare the 6-minute walk distance (6MWD) test performed on a non-motorised treadmill (6MWD-T) with the 6MWD test performed in a corridor (6MWD-C) in healthy elderly subjects. PARTICIPANTS: Sixteen healthy elderly individuals. DESIGN: Participants performed three 6MWD-T tests and three 6MWD-C tests on two different days. OUTCOME MEASURES: Distance walked was recorded in metres. Perceived exertion and leg fatigue were rated on the modified Borg scale before and after each test. RESULTS: Using the Bland and Altman limits of agreement analysis method, the mean difference between the two methods was 153.3m (limits of agreement: 28 to 278). The mean difference between days 1 and 2 for the 6MWD-C test was -7.2m (limits of agreement: -45.4 to 30.8), and the mean difference between days 1 and 2 for the 6MWD-T test was -1.6m (limits of agreement: -64.0 to 60.7). The mean difference between the first and second repetitions of the 6MWD-C test was -5m (limits of agreement: -41 to 31), and the mean difference between the first and second repetitions of the 6MWD-T test was -17m (limits of agreement: -85 to 51). CONCLUSIONS: The 6MWD-C and 6MWD-T tests are not interchangeable. However, the results showed good test-retest reliability between days and between test repetitions for both tests. Therefore, the 6MWD-T test may offer an alternative option to the 6MWD-C test when a 30-m corridor is not available. These findings may have implications for execution of the 6MWT-T test within cardiac and pulmonary rehabilitation.
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| 8. |
- Johnsson, Anna, et al.
(författare)
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Physical activity during and after adjuvant chemotherapy in patients with breast cancer.
- 2013
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Ingår i: Physiotherapy. - : Elsevier BV. - 1873-1465 .- 0031-9406. ; 99:3, s. 221-227
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To describe changes in physical activity levels related to health-enhancing physical activity guidelines during and after adjuvant chemotherapy in a cohort of Swedish patients with breast cancer. DESIGN: Exploratory clinical prospective longitudinal study with 6 and 12 months of follow-up. PARTICIPANTS: Forty women treated for breast cancer with adjuvant chemotherapy were included, and 33 women completed the study. MAIN OUTCOME MEASURES: The primary outcome was the proportion of participants meeting the health-enhancing physical activity guidelines, both in relative terms (perceived exertion using Borg's rate of perceived exertion scale) and absolute terms (metabolic equivalent). RESULTS: The proportion of participants meeting the guidelines when leisure-time physical activity was measured in terms of absolute intensity was 81 (25/31) to 94% (31/33) during chemotherapy, 93% (29/31) at 6-month follow-up and 87% (26/30) at 12-month follow-up. Women who had been physically active before their cancer diagnosis and women who had received information about physical activity were more physically active during chemotherapy. CONCLUSIONS: Swedish patients with breast cancer are generally more physically active during adjuvant chemotherapy than has been reported previously in international studies. Physical activity habits prior to cancer diagnosis and information about the benefits of physical activity appear to be important factors for higher levels of physical activity during and after chemotherapy.
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| 9. |
- Landén Ludvigsson, Maria, et al.
(författare)
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Evaluation of physiotherapists as primary assessors of patients with musculoskeletal disorders seeking primary health care
- 2012
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Ingår i: Physiotherapy. - : Elsevier. - 0031-9406 .- 1873-1465. ; 98:2, s. 131-137
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To evaluate primary physiotherapist assessment and management of patients with musculoskeletal disorders in primary care, and to compare patient satisfaction with primary assessment by a physiotherapist or a general practitioner (GP). less thanbrgreater than less thanbrgreater thanDesign An observational, retrospective cohort study reviewing medical records, and a separate consecutive non-randomised study of patient satisfaction. less thanbrgreater than less thanbrgreater thanSetting Primary healthcare centre. less thanbrgreater than less thanbrgreater thanParticipants Four hundred and thirty-two patients with musculoskeletal disorders, primarily assessed by a physiotherapist. Fifty-one of these patients primarily assessed by a physiotherapist and 42 patients assessed by a GP answered a patient satisfaction questionnaire. less thanbrgreater than less thanbrgreater thanInterventions Primary assessment and management of patients with musculoskeletal disorders. less thanbrgreater than less thanbrgreater thanMain outcome measures Data from medical records within 3-month after the visit, and patient satisfaction questionnaire. less thanbrgreater than less thanbrgreater thanResults Eighty-five percent (367/432) of patients did not need to see a GP. Serious pathologies were found among the 6% (26/432) of patients who were referred to a GP by a physiotherapist, but no serious pathologies were found among the 9% (39/432) of patients who subsequently returned for a GP appointment for the same disorder. Patients assessed by a physiotherapist were more satisfied with the information received about their disorder and self-care than patients assessed by a GP. Patients also had higher confidence in the ability of physiotherapists to assess their disorder (P andlt; 0.002). less thanbrgreater than less thanbrgreater thanConclusion Physiotherapists can be considered primary assessors of patients with musculoskeletal disorders in primary care as few patients needed additional assessment by a GP, patients with confirmed serious pathologies were identified by the physiotherapists, and patients were satisfied with assessment by a physiotherapist.
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| 10. |
- Mikaelsson, Katarina, et al.
(författare)
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Inactivity in adolescents, what are the effects on physical capacity?
- 2011
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Ingår i: Physiotherapy. - 0031-9406 .- 1873-1465. ; 97:Suppl. 1, s. eS808-
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of the study was to investigate the effect of physical activity on physical capacity among graduates from upper secondary school.Relevance: Physical activity and physical fitness are important health related parameters, which both have declined the last decades. Adolescents who are about to leave compulsory school and physical education are supposed to peak regarding physical capacity. Therefore it is interesting to investigate the effect physical inactivity (according to WHO-recommendation) have on physical performance.Participants: The participants where third grade students (38 female and 61 male) from upper secondary school (18 - 20 years).Methods: International Physical Activity Questionnaire (IPAQ) was used to estimate the level of physical activity. The participants were divided, in accordance with World Health Organizations recommendations for physical activity, to A) physically inactive or B) physically active. Physical fitness was tested using the Åstrand bicycle test and functional tests of muscular strength and balance.Analysis: By Student's independent t-test, separate for females and males, differences in aerobic capacity, push-ups, grip strength, vertical jump height, sit-ups and balance, between physically inactive and active were tested.Results: Maximum oxygen uptake differed significantly between physically inactive and active males (mean ± SD: 3.0 ± 0.6 l/kg, vs. 3.6 ± 0.7 p = 0.002) and females (2.5± 0.3 l/kg, vs. 3.0 ± 0.6 p = 0.016). There was a difference among physically inactive and active males regarding push-ups (28.5 ± 7.0 vs. 37.1 ± 9.0, p < 0.001) and sit-ups (39.6 ± 19.4 vs. 59.2 ± 30.2, p = 0.010). No significant differences were found regarding vertical jump or grip strength among males, any of the muscle strength measurements among females, and balance (in any sex).Conclusions: The level of physical activity was related to aerobic capacity in both sexes, but did not seem to have the same impact on muscular fitness and balance, especially concerning the females. Since aerobic capacity is an important parameter in preventing future health problems, it is crucial to engage all adolescents in physical activity.Implications: According to this study physical activity have positive effects on aerobic capacity, without similar trend in muscle strength. Addressing strength training, as complement to aerobic training should be recommended regardless of level of physical activity performed. Therefore we see a future need for promoting and designing detailed guidelines regarding strength training for children and adolescents.
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| 11. |
- Mikaelsson, Katarina, et al.
(författare)
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Is self-rated physical activity a good indicator of physical capacity and is time spent sitting negative for physical capacity?
- 2011
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Ingår i: Physiotherapy. - 0031-9406 .- 1873-1465. ; 97:Suppl. 1, s. eS805-
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of this study was to relate levels of physical activity to physical capacity and to study whether time sitting influences physical capacity among students in upper secondary school.Relevance: Physical activity and physical fitness are important health related parameters. Modern living habits with increased time spent on sedentary behaviors like watching TV and computer gaming have a potential for a negative influence. This calls for reliable and cost-effective measures of physical activities as indicators of physical capacity as tools for identifying people with an inactive lifestyle.Participants: Research participants where 99 third grade students (38 female, 61 male) from upper secondary school in Sweden (18-20 years).Methods: Levels of physical activity was established using the International Physical Activity Questionnaire (IPAQ) and determined for both 1) Level of activity (Total, Vigorous, Moderate, Walking), 2) IPAQ-classification Amount of activity (High, Medium, Low) and 3) Time sitting. Physical fitness was measured using the Åstrand bicycle test and functional tests of muscular strength.Analysis: The relation between 1) Level of activity, 2) IPAQ- amount of activity and 3) Time sitting and physical capacity was investigated by separate linear regression analyses.Results: There were a relation between Total level of activity and A) aerobic capacity (l/min2) (R2 = 0.1, p = 0.001), B) push-ups (R2 = 0.05, p = 0.011), and C) sit-ups (R2 = 0.046, p = 0.016), while other measure of physical capacity was non significant. An identical pattern was reveled for activity performed on Vigorous level with A) aerobic capacity (l/min2) (R2 = 0.2, p < 0.000), B) push-ups (R2 = 0.16, p < 0.000) and C) sit-ups (R2 = 0.082, p = 0.023). For activity on Moderate level the only significant relation was with aerobic capacity (R2 = 0.033, p = 0.033). For Walking no relation was significant. Regarding the IPAQ-classification of High-, Medium, and Low physical activity, no relation with any measures of physical capacity was found. Further, surprisingly, no relation was found between Time sitting and any measures of physical capacity.Conclusions: The results imply that the intensity of physical activity is of importance for achieving high aerobic capacity, while the amount of activity is not. Further, our results indicate that time sitting is not related to physical capacity.Implications: The self-rated questionnaire IPAQ can be questioned for use as a direct indicator of health parameters as physical capacity. Further, it seems that the intensity of activity is of importance for physical performance.
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