| 1. |
- Abbott, Allan, et al.
(författare)
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CONTRAIS: CONservative TReatment for Adolescent Idiopathic Scoliosis : a randomised controlled trial protocol
- 2013
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Ingår i: BMC Musculoskeletal Disorders. - : BioMed Central. - 1471-2474. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Background:Idiopathic scoliosis is a three-dimensional structural deformity of the spine that occurs in children and adolescents. Recent reviews on bracing and exercise treatment have provided some evidence for effect of these interventions. The purpose of this study is to improve the evidence base regarding the effectiveness of conservative treatments for preventing curve progression in idiopathic scoliosis.Methods/design:Patients: Previously untreated girls and boys with idiopathic scoliosis, 9 to 17 years of age with at least one year of remaining growth and a curve Cobb angle of 25–40 degrees will be included. A total of 135 participants will be randomly allocated in groups of 45 patients each to receive one of the three interventions.Interventions: All three groups will receive a physical activity prescription according to the World Health Organisation recommendations. One group will additionally wear a hyper-corrective night-time brace. One group will additionally perform postural scoliosis-specific exercises.Outcome: Participation in the study will last until the curve has progressed, or until cessation of skeletal growth. Outcome variables will be measured every 6 months. The primary outcome variable, failure of treatment, is defined as progression of the Cobb angle more than 6 degrees, compared to the primary x-ray, seen on two consecutive spinal standing x-rays taken with 6 months interval. Secondary outcome measures include the SRS-22r and EQ5D-Y quality of life questionnaires, the International Physical Activity Questionnaire (IPAQ) short form, and Cobb angle atend of the study.Discussion:This trial will evaluate which of the tested conservative treatment approaches that is the most effective for patients with adolescent idiopathic scoliosis.Trial registration: NCT01761305
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| 2. |
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| 3. |
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| 4. |
- Abbott, Allan, et al.
(författare)
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Early rehabilitation targeting cognition, behaviour and motor function after lumbar fusion: A randomised controlled trial
- 2010
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Ingår i: Abstracts. ; , s. 186-186
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Study Design: Open label randomised controlled trial with 3, 6, 12 month and 2-3 year follow-up.Objective. To investigate the effectiveness of a psychomotor therapy focusing on cognition, behaviour and motor relearning compared to exercise therapy applied during the first 3 months after lumbar fusion.Methods: The study recruited 107 patients, aged 18 to 65 years, selected for lumbar fusion due to 12 months of symptomatic spinal stenosis, degenerative/isthmic spondylolisthesis or degenerative disc disease. The exercise therapy group received a home program focusing on pain contingent training of back, abdominal and leg muscle functional strength and endurance, stretching and cardiovascular fitness. The psychomotor therapy group received a home program and 3 outpatient sessions focusing on modifying maladaptive pain cognitions, behaviours and motor control. Patient-rated questionnaires investigating functional disability, pain, health related quality of life, functional self-efficacy, outcome expectancy, fear of movement/(re)injury and copingwere assessed at baseline, 3, 6, 12 months and 2-3 years after surgery.Results: Follow-up rates were 93% at 12 months and 81% at 2-3 years after surgery. Psychomotor therapy improved functional disability, self-efficacy, outcome expectancy and fear of movement/(re)injury significantly more than exercise therapy at respective follow-up occasions. Similar results occurred for pain coping but group differences were non-significant at 2-3 year follow-up.Conclusions: The study shows that post-operative rehabilitation can be effectively implemented during the first 3 months after lumbar fusion and should include measures to modify psychological aswell as motor functions.
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| 5. |
- Abbott, Allan, et al.
(författare)
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Is there a need for cervical collar usage post anterior cervical decompression and fusion? : A randomized control pilot trial
- 2013
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Ingår i: Physiotherapy Theory and Practice. - : Taylor & Francis. - 0959-3985 .- 1532-5040. ; 29:4, s. 290-300
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Tidskriftsartikel (refereegranskat)abstract
- Anterior cervical discectomy and fusion (ACDF) is a common surgical intervention for radiculopathy resulting from degenerative cervical spine conditions. Post-surgical cervical collar use is believed to reduce post-operative pain, provide the patient with a sense of security during activities of daily living and even reduce rates of non-fusion. This prospective randomized controlled pilot trial investigates trial design feasibility in relation to prospective physical, functional, and quality of life-related outcomes of patients undergoing ACDF with interbody cage, with (n = 17) and without (n = 16) post-operative cervical collar usage. Results show that the sample provides sufficient statistical power to show that the use of a rigid cervical collar during 6 post-operative weeks is associated with significantly lower levels of neck disability index after 6 weeks and significantly lower levels of prospective neck pain. To investigate causal quality of life or fusion rate outcomes, sample size needs to be increased at least fourfold and optimally sixfold when accounting for data loss in prospective follow-up. The study suggests that post-surgical cervical collar usage may help certain patients cope with initial post-operative pain and disability.
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| 6. |
- Abbott, Allan, et al.
(författare)
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Leg pain and psychological variables predict outcome 2-3 years after lumber fusion surgery
- 2011
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Ingår i: European spine journal. - : Springer. - 0940-6719 .- 1432-0932. ; 20:10, s. 1626-1634
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Tidskriftsartikel (refereegranskat)abstract
- Prediction studies testing a thorough range of psychological variables in addition to demographic, work-related and clinical variables are lacking in lumbar fusion surgery research. This prospective cohort study aimed at examining predictions of functional disability, back pain and health-related quality of life (HRQOL) 2-3 years after lumbar fusion by regressing nonlinear relations in a multivariate predictive model of pre-surgical variables. Before and 2-3 years after lumbar fusion surgery, patients completed measures investigating demographics, work-related variables, clinical variables, functional self-efficacy, outcome expectancy, fear of movement/(re)injury, mental health and pain coping. Categorical regression with optimal scaling transformation, elastic net regularization and bootstrapping were used to investigate predictor variables and address predictive model validity. The most parsimonious and stable subset of pre-surgical predictor variables explained 41.6, 36.0 and 25.6% of the variance in functional disability, back pain intensity and HRQOL 2-3 years after lumbar fusion. Pre-surgical control over pain significantly predicted functional disability and HRQOL. Pre-surgical catastrophizing and leg pain intensity significantly predicted functional disability and back pain while the pre-surgical straight leg raise significantly predicted back pain. Post-operative psychomotor therapy also significantly predicted functional disability while pre-surgical outcome expectations significantly predicted HRQOL. For the median dichotomised classification of functional disability, back pain intensity and HRQOL levels 2-3 years post-surgery, the discriminative ability of the prediction models was of good quality. The results demonstrate the importance of pre-surgical psychological factors, leg pain intensity, straight leg raise and post-operative psychomotor therapy in the predictions of functional disability, back pain and HRQOL-related outcomes.
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| 7. |
- Abbott, Allan, et al.
(författare)
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Multidimensional assessment of pain related disability after surgery for cervical disc disease
- 2013
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Ingår i: APA Conference 2013. - : Australian Physiotherapy Association. ; , s. 2-2
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Questions: Given only 25% of patients, 10 year post-surgery for cervical disc disease report clinically meaningful improvements in functional disability, what are the biopsychosocial factors associated with continued long-term disability? What are the implications for physiotherapy practice?Design: Cross-sectional observational study.Participants: Ninety patients who had undergone anterior discectomy and fusion (ACDF) surgery 10-13 years prior.Outcome Measures: The Neck Disability Index (NDI), ACDF surgery type, surgical fusion status, patient age and Part 1 of the West Haven-Yale multidimensional pain inventory Swedish version (MPI-S) were entered into a statistical model. Part 1 of the MPI-S contains 5 subscales: pain severity, interference, life control, affective distress and support.Results: Seventy-three patients answered the questionnaires. Non-linear categorical regression modeling (CATREG) of the selected predictive variables explained 76.1% of the variance in NDI outcomes 10-13 years post ACDF. Of these predictors, MPI-S affective distress subscale (β = 0.635, p = <0.001) and pain severity subscale (β = 0.354, p = <0.001) were significant individual predictors of NDI ratings.Conclusion: This is the first study to investigate potential factors associated with prolonged functional disability greater than 10 years post-surgery for cervical disc disease. The results suggest the importance of not only pain severity but also screening affective distress as a potential barrier to physical functioning in patients previously operated for cervical disc disease. Future research on the utility of affect-focused body awareness therapy and pain coping strategies for post-surgical patients with continuing pain and physical disability is indicated.Key Practice Points:• The screening of pain severity and affective distress is of importance for patients presenting with continuing physical disability after previous surgery for cervical disc disorders• Affect-focused body awareness therapies and pain coping strategies may be a potential treatment alternative for patients with continuing pain and physical disability.
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| 8. |
- Abbott, Allan, et al.
(författare)
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Patient’s experience post-lumbar fusion regarding back problems, recovery and expectations in terms of the international classification of functioning, disability and health.
- 2011
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Ingår i: Disability and Rehabilitation. - : Taylor & Francis. - 0963-8288 .- 1464-5165. ; 33:15-16, s. 1399-1408
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE:To describe within the context of the International Classification of Functioning, Disability and Health (ICF), patient's experiences post-lumber fusion regarding back problems, recovery and expectations of rehabilitation and to contrast with the content of outcome measures and the ICF low back pain (LBP) core sets.METHODS:The study has a cross-sectional and retrospective design and involves 20 lumbar fusion patients. Using the ICF, qualitative content analysis of semi-structured interviews 3-6 months post-surgery was performed. This was compared with the ICF related content of the Oswestry Disability Index (ODI), Medical Outcome Study Short Form 36 (SF-36), European Quality of Life Questionnaire (EQ5D) and the ICF LBP core sets.RESULTS:Patient's experiences were most frequently linked to psychological, sensory, neuromusculoskeletal and movement related body function chapters of the ICF. The most frequently linked categories of activity and participation were mobility, domestic activities, family relationships, work, recreation and leisure. Environmental factors frequently linked were the use of analgesics, walking aids, family support, social security systems, health care systems and labour market employment services.CONCLUSIONS:This study highlights important ICF related aspects of patient's experiences post-lumber fusion. The use of the comprehensive ICF core sets is recommended in conjunction with ODI, SF-36 and the EQ5D for a broader analysis of patient outcomes post-lumbar fusion.
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| 9. |
- Abbott, Allan, 1978-
(författare)
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Physiotherapeutic rehabilitation and lumbar fusion surgery
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Over the last two decades, the economic costs and rates of lumbar fusion surgery for chronic low back pain has risen dramatically in western industrialized countries. Data from the Swedish National Spine Register suggest that 25% of patients experience unimproved pain and up to 40% are not satisfied with the outcome of lumbar fusion surgery. Thus, there is a definite need to optimize the selection and management of patients to improve lumbar fusion outcomes. Aim: To investigate the role of biopsychosocial factors in explaining disability and health related quality of life in chronic low back pain patients before and after lumbar fusion surgery and to evaluate the effectiveness of post-operative rehabilitation regimes. Methods: At total of 107 patients were recruited, aged 18 to 65 years, selected for lumbar fusion due to 12 months of symptomatic back and/or leg pain due to spinal stenosis, degenerative/isthmic spondylolisthesis or degenerative disc disease. Measures of disability, health related quality of life, pain, mental health, fear of movement/(re)injury, self-efficacy, outcome expectancy, pain coping styles, work status, health care use, analgesic use and sickness leave were collected with self-rated questionnaires at baseline (Studies I-IV), 3, 6, 12 months (Study II) and 2-3 years after surgery (Studies II-III). In Studies II-IV, patients were randomised to psychomotor therapy (N=53) or exercise therapy (N=54) implemented during the first 3 post-operative months. Semi-structured interviews were conducted 3-6 months after surgery on 20 patients including 10 from each rehabilitation group to investigate experiences of back problems before and after surgery, post-operative recovery and expectations of rehabilitation analysed in terms of the International Classification of Functioning, Disability and Health (Study IV). Results: Approximately 50% of the variability in baseline disability and 40% of the variability in baseline health related quality of life could be explained by psychological variables. In particular, catastrophizing, control over pain, self-efficacy and outcome expectancy had significant mediation roles (Study I). For the short and long term outcome of lumbar fusion surgery, post-operative psychomotor therapy is significantly more effective than exercise therapy with approximately 10-20% better outcome in measures of disability, fear of movement/(re)injury, pain catastrophizing, self-efficacy, outcome expectancy sickness leave, health care utilization and return to work (Study II). A model with good outcome predictive performance which significantly predicts disability, back pain and health related quality of life outcomes 2-3 year after lumbar fusion surgery, was shown to involve pre-operative screening of disability, leg pain intensity, mental health, fear of movement/(re)injury, outcome expectations, catastrophizing, control over pain and the implementation of post-operative psychomotor therapy (Study III). Lumbar fusion patient s experiences of back problems before and after the operation as well as experiences of recovery and outcome expectations correspond well with the content of outcomes measures used in the study suggesting good content validity (Study IV). Conclusion: Psychological factors strongly influence levels of disability and health related quality of life in lumbar fusion candidates as well as predicts post-operative outcomes. Early post-operative rehabilitation focusing on cognition, behaviour and motor control is recommended for improved lumbar fusion outcomes.
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| 10. |
- Abbott, Allan
(författare)
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The Coping Strategy Questionnaire
- 2010
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Ingår i: Journal of Physiotherapy. - : Elsevier. - 1836-9553 .- 1836-9561. ; 56:1, s. 63-63
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 11. |
- Abbott, Allan, et al.
(författare)
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The effectiveness of physiotherapeutic rehabilitation and issues of outcome prediction after lumber fusion surgery.
- 2011
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Ingår i: Proceedings of the WCPT Congress, Amsterdam Netherlands.. - : World Confederation of Physical Therapy. ; , s. 20-
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Purpose: The primary purpose was to analyse the short and long term effectiveness of physiotherapeutic rehabilitation programs performed during the first 3 month after lumbar fusion surgery. A secondary purpose was to analyse factors predicting long-term disability, back pain and health related quality of life (HRQOL) outcomes after lumbar fusion.Relevance: The study provides evidence for the effectiveness of early physiotherapy after lumbar fusion. Furthermore improved knowledge of predictive factors can help physiotherapist in the screening of lumbar fusion candidates and the individualised implementation of pre-surgical and post-surgical interventions.Participants: A total of 107 patients were recruited from the Karolinska University Hospital's Orthopaedic Clinic, Stockholm, Sweden. The inclusion criteria were: men and women aged between 18 and 65 years with a >12 month history of back pain and/or sciatica; a primary diagnosis of spinal stenosis, degenerative or isthmic spondylolisthesis or degenerative disc disease; selected for lumbar fusion with or without decompression; competence in the Swedish language. The criteria for exclusion were: previous lumbar fusion, rheumatoid arthritis and ankylosing spondylitis.Methods: An open book randomised controlled trial with pre-surgical and post-surgical measures at 3, 6, 12 and 24-36 months was performed to investigate the effectiveness of a psychomotor therapy focusing on cognition, behaviour and motor relearning compared to exercise therapy focusing on strength and conditioning, applied during the first 3 months after lumbar fusion. Randomisation allocated 53 patients to psychomotor therapy and 54 patients to exercise therapy. The Oswestry disability index (ODI) was the primary outcome measure. Secondary measures included the Visual analogue scale for back pain (VAS), European quality of life questionnaire (EQ5D), as well as other clinical, psychological and work related variables.Analysis: A total of 78 patients were needed assuming a power = 80%. Patient compliance was analysed and an intention to treat principle applied to data analysis. For statistical comparison between the 2 independent groups, analysis of covariance was used. Categorical regression with optimal scaling transformation, elastic net regularization and bootstrapping were used to investigate pre-surgical predictor variables and address predictive model validity.Results: Follow-up rates were 93% at 12 months and 81% at 24-36 months after surgery. Psychomotor therapy improved functional disability, self-efficacy, outcome expectancy and fear of movement/(re)injury significantly more than exercise therapy at respective follow-up occasions. Pre-surgical control over pain significantly predicted functional disability and HRQOL. Pre-surgical catastrophizing and leg pain intensity significantly predicted functional disability and back pain while the pre-surgical lasegue test significantly predicted back pain. The implementation of post-operative psychomotor therapy also significantly predicted functional disability while pre-surgical outcome expectations significantly predicted HRQOL.Conclusions: The study shows that post-operative rehabilitation can be safely implemented during the first 3 months after lumbar fusion and should include measures to modify psychological as well as motor functions. The study also demonstrates the importance of pre-surgical psychological factors, leg pain intensity, the lasegue test and post-operative psychomotor therapy in the predictions of functional disability, back pain and HRQOL related outcomes.Implications: Physiotherapist should screen patients pain, psychological factors and neuromusculoskeletal system pre-surgically and rehabilitate patients with early psychomotor therapy after lumbar fusion.
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| 12. |
- 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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| 13. |
- Abbott, Allan, et al.
(författare)
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The validity of using an electrocutaneous device for pain assessment in patients with cervical radiculopathy
- 2014
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Ingår i: Physiotherapy Theory and Practice. - : Taylor & Francis. - 0959-3985 .- 1532-5040. ; 30:7, s. 500-506
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to evaluate the validity and preference for assessing pain magnitude with electrocutaneous testing (ECT) compared to the visual analogue scale (VAS) and Borg CR10 scale in men and women with cervical radiculopathy of varying sensory phenotypes. An additional purpose was to investigate ECT sensory and pain thresholds in men and women with cervical radiculopathy of varying sensory phenotypes. This is a cross-sectional study of 34 patients with cervical radiculopathy. Scatterplots and linear regression were used to investigate bivariate relationships between ECT, VAS and Borg CR10 methods of pain magnitude measurement as well as ECT sensory and pain thresholds. The use of the ECT pain magnitude matching paradigm for patients with cervical radiculopathy with normal sensory phenotype shows good linear association with arm pain VAS (R(2) = 0.39), neck pain VAS (R(2) = 0.38), arm pain Borg CR10 scale (R(2) = 0.50) and neck pain Borg CR10 scale (R(2) = 0.49) suggesting acceptable validity of the procedure. For patients with hypoesthesia and hyperesthesia sensory phenotypes, the ECT pain magnitude matching paradigm does not show adequate linear association with rating scale methods rendering the validity of the procedure as doubtful. ECT for sensory and pain threshold investigation, however, provides a method to objectively assess global sensory function in conjunction with sensory receptor specific bedside examination measures.
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| 14. |
- Furness, James, et al.
(författare)
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Retrospective analysis of chronic injuries in recreational and competitive surfers : injury, location, type and mechanism
- 2014
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Ingår i: International Journal of Aquatic Research and Education. - : Human Kinetics. - 1932-9997 .- 1932-9253. ; 8:3, s. 277-287
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Tidskriftsartikel (refereegranskat)abstract
- Only two studies have reported on chronic musculoskeletal surfing injuries. They found over half of the injuries were non-musculoskeletal, but did not consider mechanisms of injury. This study identified the location, type, and mechanisms of chronic injury in Australian recreational and competitive surfers using a cross-sectional retrospective observational design. A total of 1,348 participants (91.3% males, 43.1% competitive surfers) reported 1,068 chronic injuries, 883 of which were classified as major. Lower back (23.2%), shoulder (22.4%), and knee (12.1%) regions had the most chronic injuries. Competitive surfers had significantly (p < .05) more lower back, ankle/foot, and head/face injuries than recreational surfers. Injuries were mostly musculoskeletal with only 7.8% being of non-musculoskeletal origin. Prolonged paddling was the highest frequency (21.1%) for mechanism of injury followed by turning maneuvers (14.8%). The study results contribute to the limited research on chronic surfing injuries.
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| 15. |
- Green, A, et al.
(författare)
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The effect of physiotherapeutic rehabilitation following lumbar total disc replacement
- 2013
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Ingår i: APA Conference 2013. - : Australian Physiotherapy Association. ; , s. 2-2
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Question: What is the effect of physiotherapeutic rehabilitation post total disc replacement?Design: Retrospective cohort study.Participants: Six hundred patients who received lumbar disc replacement (TDR) or hybrid surgery (TDR + fusion) between 1997 and 2008.Intervention: Group 1 received no post-surgical physiotherapy. Group 2 received one to three physiotherapy sessions. Group 3 received four or more physiotherapy sessions.Outcome Measures: Oswestry Disability Index (ODI), Roland Morris Disability Questionnaire (RMQ), Short Form-36 Physical (SF-36 PCS). Preoperative measures taken at baseline, and again at follow-up at 3, 6, 12 and 24 months postoperatively were audited.Results: RMQ demonstrated a significant better improvement in Group 3 compared to Group 1 after 3, 6, 12 and 24 months (p = 0.001, <0.001, 0.001 and 0.04, respectively), and for Group 2 compared to Group 1 after 3 and 6 months (p = 0.01 and 0.01, respectively). A significant better change in Group 3 compared to Group 1 was seen in the ODI after 3, 6 and 12 months (p = 0.007, p = 0.006 and 0.003, respectively). A significant better change in Group 2 compared to Group 1 was observed in the SF-36 PCS after 6 months (p = 0.01). A significant better change in Group 3 compared to Group 1 for SF-36 PCS at 6, 12 and 24 months (p = <0.001, 0.012 and 0.004, respectively) was observed.Conclusion: Four or more sessions of post-operative physiotherapy demonstrated consistent statistically significant improvements in functional disability outcomes. However, these results were not considered clinically significant.Key Practice Points:• Four or more sessions of post-operative physiotherapy may improve functional disability outcomes in patients post TDR surgery.• Prospective randomised controlled trials evaluating the effectiveness of specific physiotherapy interventions post-TDR surgery are indicated.
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| 16. |
- Halvorsen, Marie, et al.
(författare)
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Endurance and fatigue characteristics in the neck muscles during sub-maximal isometric test in patients with cervical radiculopathy
- 2014
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Ingår i: European spine journal. - : Springer Berlin/Heidelberg. - 0940-6719 .- 1432-0932. ; 23:3, s. 590-598
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Tidskriftsartikel (refereegranskat)abstract
- PurposeThe aim of the study was to compare myoelectric manifestation in neck muscle endurance and fatigue characteristics during sub-maximal isometric endurance test in patients with cervical radiculopathy and asymptomatic subjects. An additional aim was to explore associations between primary neck muscle endurance, myoelectric fatigability, and self-rated levels of fatigue, pain and subjective health measurements in patients with cervical radiculopathy.MethodsMuscle fatigue in the ventral and dorsal neck muscles was assessed in patients with cervical radiculopathy and in an asymptomatic group during an isometric neck muscle endurance test in prone and supine. 46 patients and 34 asymptomatic subjects participated. Surface electromyography signals were recorded from the sternocleidomastoid, cervical paraspinal muscles and upper and middle trapezius bilaterally during the endurance test. Subjective health measurements were assessed with questionnaires.ResultsThe results showed altered neck muscle endurance in several of the muscles investigated with greater negative median frequency slope, greater variability, side imbalance, lower endurance time and higher experience of fatigue among the cervical radiculopathy patients compared with healthy subjects. Endurance times were significantly lower in both prone and in supine positions between the patients compared to asymptomatic subjects. During the neck muscle endurance test, fatigues in the upper trapezius muscles during the prone test and in the sternocleidomastoid muscles during the supine test were of more importance than self-perceived pain, fatigue, disability and kinesiophobia in predicting neck muscle endurance (NME).ConclusionNME testing in the primary neck muscles seems to be an important factor to take into consideration in rehabilitation.
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| 17. |
- Halvorsen, Marie, et al.
(författare)
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Endurance and fatigue characteristics of static test of the neck muscles in patients with cervical radiculopathy
- 2012
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Ingår i: Proceedings of the XIXth Congress of the International Society of Electrophysiology and Kinesiology. - : The International Society of Electrophysiology and Kinesiology (ISEK). - 9780646582283 ; , s. 55-55
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- INTRODUCTION: Neck muscle function is important for support and control of the cervical spine. With the application of frequency analysis of the electromyography (EMG) signal, the fatigue rate of muscles can be monitored. In several EMG studies, the neck muscles have been shown to fatigue faster in subjects with neck pain. This can be seen when the median frequency (MF) decreases when a contraction is sustained.AIM: In this experimental study the purpose was to evaluate patients with cervical radiculopathy compared to healthy subjects regarding changes in neckZmuscle fatigue during static endurance test in prone and supine.METHODS: A total of 33 patients (19 women and 14 men) with cervical radiculopathy and 28 healthy subjects (17 women and 11 men) were included in the study. Neck muscle fatigue was studied using EMG with surface electrodes bilaterally on cervical paraspinal and sternocleidomastoid muscle groups with electrode placement according to SENIAM. Measurements of neck muscle fatigue were performed in supine and prone positions until patient perceived time till exhaustion. Subjective neck muscle fatigue was rated on a Borg CRZ10 scale while subjective neck pain was measured on 0Z10 Visual analogue scale (VAS). Patients with cervical radiculopathy even completed the Neck Disability Index (NDI).RESULTS: The mean endurance time during static extension between groups was significantly different (p<0.001) with cervical radiculopathy patients recording 190 seconds (Sd=119) and the healthy subjects 509 seconds (Sd=213). Differences in mean endurance time during static flexion between groups were nonZsignificant with cervical radiculopathy patients recording 64 seconds (Sd=40) and the healthy subjects 96 seconds (Sd=69). Cervical radiculopathy patients MF EMG slope (Z0.039) for the right cervical paraspinal muscles significantly decreased (p=0.009) more the healthy subjects (Z0.017) during the extension test. NDI significantly correlated with MF EMG slope for both left (r=Z0.631 p= 0.001) and right side (r=Z0Z496 p=0.014) cervical paraspinal muscles during extension for the patient group.CONCLUSION: Patients with cervical radiculopathy perform similar to healthy subjects with regards to static supine flexion endurance time and cervical muscle fatigue. Patients with cervical radiculopathy however have significantly lower endurance times and fatigue faster in the right side cervical paraspinal muscles during static prone extension.ACKNOWLEDGEMENT: The authors declare no conflicts of interest. The present study was supported by funds from Karolinska Institute.
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| 18. |
- Imbesi, S, et al.
(författare)
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Functional decline and quality of life in the inpatient oncology setting.
- 2013
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Ingår i: APA Conference 2013. - : Australian Physiotherapy Association. ; , s. 3-3
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Question: What effect does inpatient oncology treatment have on patient quality of life and physical functioning? Does recent weight loss associated with inferior physical functioning in patients admitted for inpatient oncology treatment? What are the implications for physiotherapy practice?Design: Prospective observational cohort studyParticipants: Thirty-two patients receiving inpatient oncology treatment.Outcome Measures: EORTC-30, SF8, isometric muscle strength, 30 second arm curl, sit to stand and timed up and go.Results: The EORTC-30 and SF-8 physical functioning and fatigue scales as well as timed up and go and sit to stand functional measures showed a trend of weekly decline in performance during inpatient oncology treatment but changes were not statistically different from baseline. Emotional and cognitive functioning and the 30 second arm curl however improved compared to baseline (p = <0.05). Social functioning showed a decline at two weeks compared to baseline (p = <0.05). Bivariate correlation analysis of baseline data showed sit to stand (r = -0.52), isometric knee extension (r = -0.39) and foot dorsiflexion (r = -0.42) strength to be significantly negatively associated with weight loss (p = <0.05).Conclusion: Despite non-significant decline in physical functioning during inpatient oncology treatment, comparison to healthy aged matched normative values showed obvious inferiority in quality of life and physical functioning at time of admission to hospital.Key Practice Points:• Physiotherapy management of patients in the inpatient oncology setting should focus on preventing decline in physical and social functioning.• Patients with greater reported weight loss may be more prone to larger declines in physical functioning in the inpatient oncology setting.
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| 19. |
- Kyhlbäck, Maria, et al.
(författare)
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Postoperativ rehabilitering vid ländryggsdiskbråck
- 2011
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Ingår i: Fysioterapi. - : Fysioterapeuterna,Swedish Association of Registered Physiotherapists. - 1653-5804. ; :1, s. 32-37
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Tidskriftsartikel (refereegranskat)abstract
- Sedan några årtionden tillbaka är diskbråcksoperation en standardoperation som utförs på liknande sätt vid Sveriges ortopedkliniker. Det postoperativa omhändertagandet och rehabiliteringen av opererade patienter kan dock se olika ut, beroende på var operationen skett. Under 2008/09 har en grupp sjukgymnaster från olika delar av landet tagit fram nationella riktlinjer, baserat på vetenskaplig evidens och klinisk erfarenhet, vilket tidigare saknats för dessa patienter. Konklusionen är att sjukgymnastiken efter diskbråcksoperation bör vara inriktad på tidig, aktiv träning för att förbättra patienternas ryggfunktion och höja aktivitetsgraden efter operation, även om de positiva effekterna av den postoperativa träningen måste betraktas som kortsiktiga. En tidig återgång till aktiviteter som inkluderar ett aktivt förhållningssätt ger, förutom de kortsiktiga förbättringarna, troligen en positiv påverkan på patienternas inställning till smärta och aktivitet. Förhoppningen är att den aktuella, systematiskt sammanställda kunskapen ska bidra till diskussioner på enskilda arbetsplatser och att behandlingsrekommendationerna kan anpassas till lokala förhållanden.
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| 20. |
- Kyhlbäck, Maria, et al.
(författare)
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Postoperativ rehabilitering vid ländryggsdiskbråck
- 2011
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Ingår i: Fysioterapi. - Stockholm. - 1653-5804. ; :1, s. 32-37
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund och syfte:Under 2008 har en grupp sjukgymnaster tagit fram nationella behandlingsriktlinjer för patienter som genomgått diskbråcksoperation. Syftet var att dessa skulle baseras på vetenskaplig evidens och klinisk erfarenhet.Metoder:Litteratursökning gjordes i sju olika databaser, sökningen omfattade randomiserade, kontrollerade studier under tidsperioden 1990-2008. Inkluderade studier granskades utifrån ett modifierat kvalitetsindex enligt SBU (Statens Beredning för medicinsk Utvärdering). För bevisvärdering av studieresultat användes SBU:s gradering högt, medelhögt och lågt bevisvärde. Evidensgrad för olika sjukgymnastiska metoder som förekom i de inkluderade studierna kategoriserades i enlighet med SBU:s nivåer för vetenskaplig evidens; starkt vetenskapligt underlag, måttligt starkt vetenskapligt underlag, begränsat vetenskapligt underlag och otillräckligt vetenskapligt underlag. Resultat:Sexton artiklar som uppfyllde kriterierna för granskning inkluderades i granskningen.Baserat på dessa studier finns måttligt stark evidens för att aktiv träning som inkluderar ett mer aktivt förhållningssätt är mer effektiv på kort sikt än mer försiktig/passiv träning och förhållningssätt (< 6 månader efter operation). Det finns ett starkt vetenskapligt stöd för att den aktiva träningen inte påverkar smärta och funktion på lång sikt (ett år efter operation), liksom att tidig, aktiv träning inte ökar komplikationsrisken efter operation. Det vetenskapliga stödet är begränsat vad gäller de positiva effekterna av enbart råd om fysisk aktivitet, motsägande beträffande effekten av övervakad träning jämfört med hemträning och otillräckligt beträffande effekten av beteendemedicinskt inriktad träning.Konklusion:Sjukgymnastiken efter diskbråcksoperation bör ha ett aktivt förhållningssätt inkluderande tidig, aktiv träning för att förbättra patienternas ryggfunktion och höja aktivitetsgraden efter operation.
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| 21. |
- Murnane, Andrew, et al.
(författare)
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The impact of an inpatient hospital admission on patient’s physical functioning and quality of life rate in the oncology setting
- 2014
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Ingår i: COSA’s 41st Annual Scientific Meeting. - : Clinical Oncology Society of Australia. ; , s. 204-204
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Prolonged bed rest is often associated with acute inpatient hospital admissions, has been shown to significantly decrease patient’s physical function and health related quality of life (HRQoL). The aim of this study was to investigate the effects of hospitalisation and to describe the pattern and prevalence of functional decline in oncology patients over the course of their inpatient admission.Methods: This was a prospective observational study of 55 consenting inpatients recruited over a 10 week period. Assessment measures were undertaken bi-weekly until discharge from hospital or they became too unwell to continue. Functional status and HRQoL data were collected using the, timed up and go test (TUG), 30-second chair sit to stand (STS), 30-second arm curl, isometric muscle strength testing, EORTC-C30 and SF-8.Results: 55 patients (28 male), median age 64 years (± SD 10.8) with an average length of stay of 18 days participated in the study. Reason for hospital admission included; symptom management (36%) or delivery of cancer treatment (35%). A number of subscales on the EORTC-C30 including physical functioning and functional assessments (TUG, STS and knee extension) showed a trend of weekly decline in performance but were not statistically significant. Compared to the general population 87% and 82% of the cohort scored below the norm in physical functioning and mental health respectively; 43% recorded TUG indicative of falls risks; 76% were below age matched norms for STS and 20% were below in upper limb strength.Conclusion: Despite non-significant declines in physical functioning and HRQoL during their hospital admission, participants demonstrated substantially reduced HRQoL and physical functioning at time of hospital admission and at discharge compared to healthy age-matched normative data. Despite this low level of function very few received rehabilitation follow-up. Screening programs using simple functional assessment measures (STS, TUG) could be useful in identifying patients at risk of deconditioning and those who require specialised input on discharge to prevent further declines in function and hospital re-admissions.
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| 22. |
- Palak, A, et al.
(författare)
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Motor assessment score. Is it fit for the future?
- 2014
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Ingår i: Special Issue: SMART STROKES 2014 Conference, 28-29 August 2014, Sheraton on the Park, Sydney, NSW, Australia. - : John Wiley & Sons. ; , s. 10-10
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: The Motor Assessment Scale (MAS) is commonly used to assess functional change in stroke patients. Anecdotal evidence suggests that the scale does not accurately reflect patient outcomes potentially impacting on physiotherapists’ use of the scale.Aims: This study aims to investigate physiotherapists use and perceived utility of the MAS to measure functional performance of stroke survivors undergoing rehabilitation.Method: A purpose-designed 29-item online survey was distributed to Queensland Rehabilitation Physiotherapy Network members. Open and closed questions were asked regarding demographics, MAS implementation, perception of item subtest hierarchy and levels of difficulty and adherence to scoring guidelines.Results: Thirty-one surveys were received; 63% were from physiotherapists in metropolitan centers, 84% from public hospitals and 61% insubacute settings. Approximately half (45%) had been practicing in neurological rehabilitation for 5–10 years. More than 70% of respondents routinely used the MAS. The majority (80%) reported using the recommended guidelines when scoring the MAS, though 55% did not score all subsets of Item 8. Most were dissatisfied with hierarchy and levels of difficulty of item subtests, with no item scoring 100% satisfaction by respondents. Thirty percent of respondents did not use the MAS. Common reasons included: too time consuming (56%), not sensitive to change (22%), lack of confidence in administration (33%), items not relevant for patient function (45%) and ceiling effect (44%).Conclusion: MAS use varies across rehabilitation units in Queensland. Difficulties were identified with all items, including use of recommended scoring guidelines. Further research is required to address these issues.
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| 23. |
- Saraste, Helena, et al.
(författare)
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3D analysis of spine and chest wall form and mobility. Application of a new method to evaluate treatment outcome in pediatric spine deformities
- 2012
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- SummaryA new optical scanning method is applyed for a static and dynamic analysis of thorax and spine deformities in brace and surgically treated scoliosis patients to capture intervention dependent changes over time. The costs and additional information captured by the method is analysed.IntroductionTo evaluate the intervention dependent changes in spine and chest wall deformities, such as mobility of thorax, volume, symmetry of growth, and possible growth distorting factors are poorly known and should be studied. In patients with neuropathic spine deformities, the seat loading is of importance to enhance balanced sitting and preventing pressure problems. Quantitative methods to be used for over time comparisons need to be further developed.In adolescents the decision to treat a spine deformity is mainly based on radiographic findings, whereas many patients are more interested in how their body configuration deviates from the normality. There is a need to implement and evaluate a method for this purpose. In brace treated children and adolescents, a non-radiation producing examination is to prefer for repeated follow-up controls.MethodsA consequtive series of children with spine deformity, who are enrolled in the treatment protocol, are invited to take part in the tests. In surgery group, tests are performed before and 3 months after surgery aimed to correct the spine and/or thorax deformity. In brace treatment and follow-up groups tests are made at the same time points as x-rays. The static and dynamic recordings are performed by and optic scanenr Artec 3D (Artec Group, San Diego, CA), and the sitting load distribution measurements with a sensor mat (Clin-seat Type 5315 by Tekscan, Boston, Massachusetts, USA). 60 children/year in brace treatment, 40 in surgery, and 50 in the follow-up group are estimated to be included. These methods´ costs and benefits as well as their added value for the clinical decision making will be evaluated after 2-3 years.ResultsA feasibility test shows that clinically small enough differences can be recorded and numerically expressed and analysed. An application on a consecutive, clinical patient group will be carried on.ConclusionThe optical scanning method by Artec, allows a static and dynamic capturing of respiratoryassociated thorax movements and the changes of a spine deformity over time. The new method will be applied in a consecutive series of patients.
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| 24. |
- Straker, Leon, et al.
(författare)
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Sit-stand desks and sedentary behavior in Swedish call centre workers
- 2012
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Ingår i: Be active 2012. - : Elsevier BV. ; , s. S94-
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Konferensbidrag (refereegranskat)abstract
- Introduction: Adults spend approximately 8 to 9 hours of the day in sedentary behavior and much of this is gathered at work. The rising level of occupational sedentary behavior is both a public health and occupational health concern due to the emerging evidence regarding the deleterious effect that sedentary behavior has on health, independent of physical activity. In the occupational setting, sit-stand desks have been purported to offer a means of reducing sedentariness. This study aimed to investigate whether or not use of sit-stand desks and awareness of the importance of postural variation and breaks are associated with the pattern of sedentary behavior in call centre workers.Method: The data came from a cross-sectional observation study of fifteen Swedish call centres, carried out in 2002–2003. Ten operators were randomly selected from each of the call centres and invited to participate. Inclinometers recorded ‘seated’ or ‘standing/walking’ episodes of the operators over a full work shift. Differences in sedentary behavior based on desk type (categorized as ‘sit-stand’ or ‘sit’) and awareness of the importance of posture variation and breaking up seated computer work within those using a sit-stand desk were assessed by non-parametric analyses.Results: Four operators declined to participate and 15 operators had inclinometer recordings that were not of sufficient quality. Of the remaining 131 operators, 90 (68.7%) worked at a sit-stand desk. Working at a sit-stand desk, as opposed to a sit desk, was associated with a modest reduction in the time seated (78.5 vs 83.8%, p = 0.010), and less time taken to accumulate 5 minutes of standing/walking (36.2 vs 46.3 minutes, p = 0.022), but no significant difference to sitting episode length or the number of switches between sitting and standing/walking per hour. Ergonomics awareness had no significant association with any sedentary behavior pattern variable among those using a sit-stand desk.Conclusion: Use of sit-stand desks was associated with better sedentary behavior in call centre workers, however ergonomics awareness did not enhance the effect. The growing number of people in occupations dominated by sedentary work and the clear evidence of the importance of sedentary behavior as a key lifestyle risk factor support the need to develop effective interventions. Sit-stand desks may be an important remedy in this endeavor, particularly in office settings, while ergonomics awareness may be able to contribute to further changes in sedentary behavior if improved and supported by the work organization.
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| 25. |
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| 26. |
- Straker, Leon, et al.
(författare)
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Sit-stand desks in call centres : associations of use and ergonomics awareness with sedentary behavior
- 2013
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Ingår i: Applied Ergonomics. - : Elsevier BV. - 0003-6870 .- 1872-9126. ; 44:4, s. 517-522
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Tidskriftsartikel (refereegranskat)abstract
- Objective. Sedentary behavior is an independent risk factor for obesity, diabetes, and all cause mortality. With adults in occupational settings spending two thirds or more of their time in sedentary behavior, novel strategies are required to intervene with occupational sitting. To investigate whether or not use of sit-stand desks and awareness of the importance of postural variation and breaks are associated with the pattern of sedentary behavior in office workers.Method. The data came from a cross-sectional observation study of Swedish call centre workers. Inclinometers recorded ‘seated’ or ‘standing/walking’ episodes of 131 operators over a full work shift. Differences in sedentary behavior based on desk type and awareness of the importance of posture variation and breaks were assessed by non-parametric analyses.Results. 90 (68.7%) operators worked at a sit-stand desk. Working at a sit-stand desk, as opposed to a sit desk, was associated with less time seated (78.5 vs 83.8%, p=0.010), and less time taken to accumulate 5 minutes of standing/walking (36.2 vs 46.3 minutes, p=0.022), but no significant difference to sitting episode length or the number of switches between sitting and standing/walking per hour. Ergonomics awareness was not associated with any sedentary pattern variable among those using a sit-stand desk.Conclusion. Use of sit-stand desks was associated with better sedentary behavior in call centre workers, however ergonomics awareness did not enhance the effect. Further investigation into how best to intervene with occupational sitting is required.
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