| 1. |
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- 2017
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Ingår i: Physical Review D. - 2470-0010 .- 2470-0029. ; 96:2
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Tidskriftsartikel (refereegranskat)
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| 2. |
- Abbott, Allan, 1978-, et al.
(författare)
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Understanding the role of diabetes in the osteoarthritis disease and treatment process: a study protocol for the Swedish Osteoarthritis and Diabetes (SOAD) cohort
- 2019
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Ingår i: Bmj Open. - : BMJ. - 2044-6055. ; 9:12
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Osteoarthritis (OA) is the most common form of arthritis and a leading cause of disability worldwide. Metabolic comorbidities such as type II diabetes occur with a higher rate in people with OA than in the general population. Several factors including obesity, hyperglycaemia toxicity and physical inactivity have been suggested as potential links between diabetes and OA, and have been shown to negatively impact patients' health and quality of life. However, little is known on the role of diabetes in determining the outcome of non-surgical and surgical management of OA, and at the same time, how different OA interventions may affect diabetes control. Thus, the overall aim of this project is to explore (1) the impact of diabetes on the outcome of non-surgical and surgical OA treatments and (2) the impact of non-surgical and surgical OA treatments on diabetes control. Methods and analysis The study cohort is based on prospectively ascertained register data on a national level in Sweden. Data from OA patients who received a first-line non-surgical intervention and are registered in the National Quality Register for Better Management of Patients with Osteoarthritis will be merged with data from the Swedish Knee and Hip Arthroplasty Registers and the National Diabetes Register. Additional variables regarding patients' use of prescribed drugs, comorbidities, socioeconomic status and cause of death will be obtained through other national health and population data registers. The linkage will be performed on an individual level using unique personal identity numbers. Ethics and dissemination This study received ethical approval (2019-02570) from the Swedish Ethical Review Authority. Results from this cohort will be submitted to peer-reviewed scientific journals and reported at the leading national and international meetings in the field.
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| 3. |
- Ahrens, Maryon, et al.
(författare)
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Multi-messenger Observations of a Binary Neutron Star Merger
- 2017
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Ingår i: Astrophysical Journal Letters. - : American Astronomical Society. - 2041-8205 .- 2041-8213. ; 848:2
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Tidskriftsartikel (refereegranskat)abstract
- On 2017 August 17 a binary neutron star coalescence candidate (later designated GW170817) with merger time 12:41:04 UTC was observed through gravitational waves by the Advanced LIGO and Advanced Virgo detectors. The Fermi Gamma-ray Burst Monitor independently detected a gamma-ray burst (GRB 170817A) with a time delay of similar to 1.7 s with respect to the merger time. From the gravitational-wave signal, the source was initially localized to a sky region of 31 deg(2) at a luminosity distance of 40(-8)(+8) Mpc and with component masses consistent with neutron stars. The component masses were later measured to be in the range 0.86 to 2.26 M-circle dot. An extensive observing campaign was launched across the electromagnetic spectrum leading to the discovery of a bright optical transient (SSS17a, now with the IAU identification of AT 2017gfo) in NGC 4993 (at similar to 40 Mpc) less than 11 hours after the merger by the One-Meter, Two Hemisphere (1M2H) team using the 1 m Swope Telescope. The optical transient was independently detected by multiple teams within an hour. Subsequent observations targeted the object and its environment. Early ultraviolet observations revealed a blue transient that faded within 48 hours. Optical and infrared observations showed a redward evolution over similar to 10 days. Following early non-detections, X-ray and radio emission were discovered at the transient's position similar to 9 and similar to 16 days, respectively, after the merger. Both the X-ray and radio emission likely arise from a physical process that is distinct from the one that generates the UV/optical/near-infrared emission. No ultra-high-energy gamma-rays and no neutrino candidates consistent with the source were found in follow-up searches. These observations support the hypothesis that GW170817 was produced by the merger of two neutron stars in NGC4993 followed by a short gamma-ray burst (GRB 170817A) and a kilonova/macronova powered by the radioactive decay of r-process nuclei synthesized in the ejecta.
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| 4. |
- Abbott, Allan, 1978-, et al.
(författare)
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Effectiveness of implementing a best practice primary healthcare model for low back pain (BetterBack) compared with current routine care in the Swedish context : an internal pilot study informed protocol for an effectiveness-implementation hybrid type 2 trial
- 2018
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 8:4
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Low back pain (LBP) is a major health problem commonly requiring healthcare. In Sweden, there is a call from healthcare practitioners (HCPs) for the development, implementation and evaluation of a best practice primary healthcare model for LBP.Aims (1) To improve and understand the mechanisms underlying changes in HCP confidence, attitudes and beliefs for providing best practice coherent primary healthcare for patients with LBP; (2) to improve and understand the mechanisms underlying illness beliefs, self-care enablement, pain, disability and quality of life in patients with LBP; and (3) to evaluate a multifaceted and sustained implementation strategy and the cost-effectiveness of the BetterBack☺ model of care (MOC) for LBP from the perspective of the Swedish primary healthcare context.Methods This study is an effectiveness-implementation hybrid type 2 trial testing the hypothesised superiority of the BetterBack☺ MOC compared with current routine care. The trial involves simultaneous testing of MOC effects at the HCP, patient and implementation process levels. This involves a prospective cohort study investigating implementation at the HCP level and a patient-blinded, pragmatic, cluster, randomised controlled trial with longitudinal follow-up at 3, 6 and 12 months post baseline for effectiveness at the patient level. A parallel process and economic analysis from a healthcare sector perspective will also be performed. Patients will be allocated to routine care (control group) or the BetterBack☺ MOC (intervention group) according to a stepped cluster dogleg structure with two assessments in routine care. Experimental conditions will be compared and causal mediation analysis investigated. Qualitative HCP and patient experiences of the BetterBack☺ MOC will also be investigated.Dissemination The findings will be published in peer-reviewed journals and presented at national and international conferences. Further national dissemination and implementation in Sweden and associated national quality register data collection are potential future developments of the project.
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| 5. |
- Abbott, Allan
(författare)
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Evidence base and future research directions in the management of low back pain
- 2016
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Ingår i: World Journal of Orthopedics. - Pleasanton, CA, USA : Baishideng Publishing Group Inc. - 2218-5836. ; 7:3, s. 156-161
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Tidskriftsartikel (refereegranskat)abstract
- Low back pain (LBP) is a prevalent and costly condition. Awareness of valid and reliable patient history taking, physical examination and clinical testing is important for diagnostic accuracy. Stratified care which targets treatment to patient subgroups based on key characteristics is reliant upon accurate diagnostics. Models of stratified care that can potentially improve treatment effects include prognostic risk profiling for persistent LBP, likely response to specific treatment based on clinical prediction models or suspected underlying causal mechanisms. The focus of this editorial is to highlight current research status and future directions for LBP diagnostics and stratified care.
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| 6. |
- Carter, Josh, et al.
(författare)
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Shoulder Pain and Dysfunction in Young Surf Lifesavers
- 2015
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Ingår i: Physical Therapy in Sport. - : Elsevier. - 1466-853X .- 1873-1600. ; 16:2, s. 162-168
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesTo determine the incidence and prevalence of significantly interrupting shoulder pain (SIP) in young surf lifesavers and to determine association with training dosage and the ‘combined elevation test’.Participants54 surf lifesavers aged 10 – 18 from the Gold Coast, Australia.Methods and Outcome MeasuresRetrospective survey of SIP and training dosage. Cross-sectional measures of the combined elevation test.DesignRetrospective.Results56.5% of female surf lifesavers reported a history of SIP compared to males with 48.5%. Females had a higher combined elevation score compared to males, 28.32±SD8.52cm and 26.09±SD6.64cm, respectively. Young surf lifesavers had an incidence rate of 2.1 SIP episodes per thousand hours of training, an incidence proportion of 51.9% and prevalence of 18.5%. Combined elevation had low level positive trends with training dosages and statistically significant negative correlation with board paddling sessions per week (r= -0.287, p=<0.05). Those with a history of SIP had a statistically significant higher number of sessions (p=0.008), duration (p=0.015) and distance (p=0.005) swimming per week.ConclusionYoung surf lifesavers with a history of SIP have greater swimming dosage not associated with decrease in combined elevation score. More board paddling sessions per week decreased the combined elevation score of young surf lifesavers.
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| 7. |
- Diarbakerli, Elias, et al.
(författare)
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Quality of life in males and females with idiopathic scoliosis
- 2019
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Ingår i: Spine. - : Lippincott Williams & Wilkins. - 0362-2436 .- 1528-1159. ; 44:6, s. 404-410
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Tidskriftsartikel (refereegranskat)abstract
- Study Design. Cross-sectional.Objective. To describe quality of life in males and females with idiopathic scoliosis.Summary of Background Data. Idiopathic scoliosis is a three-dimensional deformity affecting the growing spine. The prevalence of larger curves, requiring treatment, is higher in females.Methods. This cross-sectional study comprised 1519 individuals with idiopathic scoliosis (211 males) with a mean (SD) age of 35.3 (14.9) years. They all answered the Scoliosis Research Society 22 revised (SRS-22r) questionnaire and EuroQol 5-dimension-index (EQ-5D). Five hundred twenty eight were surgically treated (78 males), 535 were brace treated (50 males), and 456 were untreated (83 males). The SRS-22r subscore (excluding the satisfaction domain), the SRS-22r domains and the EQ-5D index score were calculated. Subgroup analyses based on treatment and age were performed. Statistical comparisons were performed using analysis of covariance with adjustments for age and treatment. A P-value less than 0.05 was considered as statistical significant.Results. The mean (SD) SRS-22r subscore was 4.19 (0.61) in males and 4.05 (0.61) in females (P = 0.010). The males had higher scores on the SRS-22r domains function (4.56 vs. 4.42), pain (4.20 vs. 4.00), and mental health (4.14 vs. 3.92) (all P < 0.05). The mean (SD) EQ-5D index score was 0.85 (0.22) for males and 0.81 (0.21) for females (P = 0.10). There were minor differences when comparing males and females in treatment and age groups, but both treated and untreated groups had reduced quality of life compared with the national norms.Conclusion. When compared with females, males with idiopathic scoliosis tend to have slightly higher scores in the scoliosis specific SRS-22r but not in the generic quality of life measurement EQ-5D. Quality of life is overall similar between males and females in treatment and age groups, but reduced in comparison with the general population.Level of Evidence: 3
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| 8. |
- Diarberkali, Elias, et al.
(författare)
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Adolescents with and without idiopathic scoliosis have similar self-reported level of physical activity : a cross-sectional study
- 2016
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Ingår i: Scoliosis and Spinal Disorders. - : BioMed Central. - 2397-1789. ; 11:17, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Little is known about physical activity levels in individuals with idiopathic scoliosis. The aim of this study was to describe the level of physical activity in adolescents with and without idiopathic scoliosis.METHODS:Two hundred thirty-nine adolescents, median (25th, 75th percentile) age 16.0 (14.4, 17.6) with idiopathic scoliosis and 58 randomly recruited population-based individuals without scoliosis aged 14.6 (12.8, 16.3) participated. The 239 idiopathic scoliosis patients consisted of 88 untreated, 43 previously braced, 36 with ongoing brace-treatment and 72 surgically treated individuals. Main outcome measure was the proportion achieving at least moderate activity level, as estimated by the International Physical Activity Questionnaire short form (IPAQ-SF). Other outcome measures were Metabolic Equivalent Task (MET) minutes/week, time spent sitting, spare time activity level and sporting activities. Statistical analyses were adjusted for age and sex.RESULTS:The proportion of individuals with scoliosis with moderate activity level was 180 out of 239 (75 %) and for individuals without scoliosis 49 out of 58 (85 %) (p = 0.14). Median MET-minutes/week (25th,75th percentile) was for individuals with scoliosis scoliosis 1977 (840,3777) and for individuals without scoliosis 2120 (887,4598) (p = 0.11). Sporting activities did not differ (p = 0.28). The ongoing brace-treatment group had a significantly higher proportion of individuals categorizing themselves at high spare time activity level compared to the surgically treated and previously braced individuals (p = 0.046). No difference was seen between the treatment groups regarding the proportion achieving moderate activity (p = 0.11) and sporting activities (p = 0.20). Median MET minutes/week was 2160 (794,3797) for the untreated group, 989 (661,2706) for the previously braced group, 2055 (1010, 4026) for the surgery group and 2106 (990,4480) for the ongoing brace-treatment group (p = 0.031).CONCLUSION:Adolescents with idiopathic scoliosis show similar levels of self-reported physical activity as individuals without idiopathic scoliosis. Bracing and surgery do not appear to inhibit physical activity.
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| 9. |
- Dufvenberg, Marlene, 1961-, et al.
(författare)
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Does postural stability differ between adolescents with idiopathic scoliosis and typically developed? : A systematic literature review and meta-analysis
- 2018
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Ingår i: Scoliosis and Spinal Disorders. - : BioMed Central (BMC). - 2397-1789. ; 13:1
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Forskningsöversikt (refereegranskat)abstract
- BackgroundPostural stability deficits have been proposed to influence the onset and progression of adolescent idiopathic scoliosis (AIS). This study aimed to systematically identify, critically evaluate and meta-analyse studies assessing postural stability during unperturbed stance with posturography in AIS compared to typically developed adolescents.MethodsStudies from four electronic databases (PubMed, Scopus, CINAHL, PEDro) were searched and case-control methodological quality assessed using a risk-of-bias assessment tool and a posturography methodological quality checklist. Pooled data regarding centre of pressure (COP) parameters such as sway area, Mediolateral (ML) and Anteroposterior (AP) position and range were compared for AIS and typically developed adolescents using Cohen’s d effect size (ES) and homogeneity estimates.ResultsEighteen studies for quality analysis and 9 of these for meta-analysis were identified from 971 records. Risk-of-bias assessment identified 6 high, 10 moderate and 2 low risk-of-bias studies. The posturography methodological quality checklist identified 4 low, 7 moderate and 7 high-quality studies. Meta-analysis was performed for sway area whereas ML and AP are presented in three different meta-analyses due to divergent measurement units used in the studies: ML position 1 (MLP1), ML position 2 (MLP2) and ML range (MLR); AP position 1 (APP1), AP position 2 (APP2) and AP range (APR). Cohen’s d showed a medium ES difference in sway area 0.65, 95% CI (0.49–0.63), whereas ML showed no (MLP1, MLP2) and large (MLR) ES differences; MLP1 0.15, 95% CI (0.08–0.22); MLP2 0.14, 95% CI (0.08–0.19); and MLR 0.94, 95% CI (0.83–1.04). Cohen’s d for AP showed small ES (APP1) and large ES difference (APP2 and APR); APP1 0.43, 95% CI (0.31–0.54); APP2 0.85, 95% CI (0.72–0.97); and APR 0.98, 95% CI (0.87–1.09). Cochran’s Q and Higgins I2 showed homogeneity between studies.ConclusionsThere is moderate quality evidence for decreased postural stability in AIS measured as COP parameters sway area, ML and AP range with a positional shift posteriorly in the sagittal plane. The findings support studying postural stability in early stage AIS and also prospectively identify cause and effect of the curvature as well as effectiveness of postural control interventions in the prevention of scoliosis progression.
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| 10. |
- Folmli, Brookes, et al.
(författare)
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Dose-response of somatosensory cortex repeated anodal transcranial direct current stimulation on vibrotactile detection : A randomized sham controlled trial
- 2018
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Ingår i: Journal of Neurophysiology. - Bethesda, United States : American Physiological Society. - 0022-3077 .- 1522-1598.
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Tidskriftsartikel (refereegranskat)abstract
- This randomized sham-controlled trial investigated anodal transcranial direct current stimulation (tDCS) over the somatosensory cortex contralateral to hand dominance for dose-response (1mA-20 minutes x 5 days) effects on vibrotactile detection thresholds (VDT). VDT was measured before and after tDCS on days 1,3&5 for low (30hz) and high (200hz) frequency vibrations on the dominant and non-dominant hands in 29 healthy adults (mean age = 22.86; 15 males, 14 females). Only the dominant hand 200Hz VDT displayed statistically significant medium effect size improvement for mixed model analysis of variance time x group interaction for active tDCS compared to sham. Post Hoc contrasts were statistically significant for dominant hand 200Hz VDT on day 5 after tDCS compared to day 1 before tDCS , day 1 after tDCS and day 3 before tDCS. There was a linear dose-response improvement with dominant hand 200Hz VDT mean difference decreasing from day 1 before tDCS peaking at -15.5% (SD=34.9%) on day 5 after tDCS. Both groups showed learning effect trends over time for all VDT test conditions but only the non-dominant hand 30Hz VDT was statistically significant (p=0.03) though Post Hoc contrasts were non-significant after Sidak adjustment. No adverse effects for tDCS were reported. In conclusion, anodal tDCS 1mA-20 minutes x 5 days on the dominant sensory cortex can modulate a linear improvement of dominant hand high frequency VDT but not for low frequency or non-dominant hand VDT.
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| 11. |
- Fors, Maria, 1987-, et al.
(författare)
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Effects of pre-surgery physiotherapy on walking ability and lower extremity strength in patients with degenerative lumbar spine disorder : Secondary outcomes of the PREPARE randomised controlled trial
- 2019
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Ingår i: BMC Musculoskeletal Disorders. - : BioMed Central. - 1471-2474. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundDegenerative lumbar spine disorders are common among musculoskeletal disorders. When disabling pain and radiculopathy persists after adequate course of rehabilitation and imaging confirms compressive pathology, surgical decompression is indicated. Prehabilitation aiming to augment functional capacity pre-surgery may improve physical function and activity levels pre and post-surgery. This study aims to evaluate the effect and dose-response of pre-surgery physiotherapy on quadriceps femoris strength and walking ability in patients with degenerative lumbar spine disorders compared to waiting-list controls and their association with postoperative physical activity level.MethodIn this single blinded, 2-arm randomised controlled trial, 197 patients were consecutively recruited. Inclusion criteria were: MRI confirmed diagnosis and scheduled for surgery due to disc herniation, lumbar spinal stenosis, degenerative disc disease or spondylolisthesis, ages 25-80 years. Patients were randomised to 9 weeks of pre-surgery physiotherapy or to waiting-list. Patient reported physical activity level, walking ability according to Oswestry Disability Index item 4, walking distance according to the SWESPINE national register and physical outcome measures including the timed ten-meter walk test, maximum voluntary isometric quadriceps femoris muscle strength, patient-rated were collected at baseline and follow-up. Parametric or non-parametric within and between group comparisons as well as multivariate regression was performed.ResultsPatients who received pre-surgery physiotherapy significantly improved in all variables from baseline to follow-up (p < 0.001 – p < 0.05) and in comparison to waiting-list controls (p < 0.001 – p < 0.028). Patients adhering to ≥12 treatment sessions significantly improved in all variables (p < 0.001 – p < 0.032) and those receiving 0-11 treatment session in only normal walking speed (p0.035) but there were no significant differences when comparing dosages. Physical outcome measures after pre-surgery physiotherapy together significantly explain 27.5% of the variation in physical activity level 1 year after surgery with pre-surgery physical activity level having a significant multivariate association.ConclusionPre-surgery physiotherapy increased walking ability and lower extremity strength in patients with degenerative lumbar spine disorders compared to waiting-list controls. A clear treatment dose-response response relationship was not found. These results implicate that pre-surgery physiotherapy can influence functional capacity before surgical treatment and has moderate associations with maintained postoperative physical activity levels mostly explained by physical activity level pre-surgery.Trial registrationNCT02454400. Trial registration date: August 31st 2015, retrospectively registered.
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| 12. |
- Furness, James, et al.
(författare)
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Acute Injuries in Recreational and Competitive Surfers : Incidence, Severity, Location, Type, and Mechanism
- 2015
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Ingår i: American Journal of Sports Medicine. - : Sage Publications. - 0363-5465 .- 1552-3365. ; 43:5, s. 1246-1254
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:There are an estimated 37 million surfers worldwide, with 2.5 million recreational surfers in Australia. The recreational activity and sport of surfing has grown dramatically since the 1960s, but scientific research has been poorly mirrored in comparison with most other mainstream sports.PURPOSE:To identify the incidence, severity, location, type, and mechanism of acute injuries in recreational and competitive surfers over a 12-month period.STUDY DESIGN:Descriptive epidemiology study.METHODS:An online survey using an open-source survey application was utilized. The survey consisted of 2 primary sections: Section 1 included demographic information and participation levels (age, height, weight, hours surfed, competitive level); section 2 incorporated injury type, mechanism, severity, and injury management.RESULTS:A total of 1348 participants (91.3% males; 43.1% competitive surfers) were included in data analysis. A total of 512 acute injuries were classified as major, providing an incidence proportion of 0.38 (CI, 0.35-0.41) acute injuries per year. The incidence rate was calculated to be 1.79 (CI, 1.67-1.92) major injuries per 1000 hours of surfing. The shoulder, ankle, and head/face regions had the highest frequencies of acute injury, representing 16.4%, 14.6%, and 13.3%, respectively. Injuries were predominantly of muscular, joint, and skin origin, representing 30.3%, 27.7%, and 18.9%, respectively. Skin injuries were primarily a result of direct trauma, while joint and muscular injuries were mainly a result of maneuvers performed and repetitive actions. Key risk factors that increased the incidence of sustaining an acute injury included competitive status, hours surfed (>6.5 hours/week), and the ability to perform aerial maneuvers. The incidence proportion for surfers completing aerial maneuvers was calculated to be 0.48 (CI, 0.39-0.58) major injuries per year, this being the highest incidence proportion irrespective of competitive status.CONCLUSION:This is the largest surfing-specific survey that included both recreational and competitive surfers conducted in Australia to date. The shoulder, ankle, head, and face were identified as the key regions where acute injuries occur in surfers. This research may aid in reducing the occurrence of injury through musculoskeletal screening in these key injury-prone regions and through the use of sport-specific strength training and conditioning.
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| 13. |
- Furness, James, et al.
(författare)
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Assessment of shoulder acitve range of motion in prone versus supine : a reliability and concurrent validity study
- 2015
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Ingår i: Physiotherapy Theory and Practice. - : Taylor & Francis Group. - 0959-3985 .- 1532-5040. ; 31:7, s. 489-495
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Tidskriftsartikel (refereegranskat)abstract
- Background: As swimming and surfing are prone dominant sports, it would be more sport specific to assess shoulder active range of motion in this position. Objectives: To determine the reliability of the inclinometer and HALO© for assessing shoulder active range of motion in supine and prone and the concurrent validity of the HALO©. Concurrent validity is based on the comparison of the HALO© and inclinometer. To determine if active range of motion (AROM) differences exists between prone and supine when assessing shoulder internal (IR) and external rotation (ER). Design: The design included clinical measurement, reliability and validity. Methods: Thirty shoulders (mean age = 26.8 years) without pathology were evaluated. Measurements were taken in supine and prone with both an inclinometer and HALO© device. Results: Active ER ROM in prone was significantly higher than in supine when using both devices. Intra-rater reliability (within and between session) intraclass correlation coefficient (ICC) values ranged between 0.82–0.99 for both devices in supine and prone. An ICC test revealed a significant (p < 0.01) correlation for both devices in IR and ER movements (ICC3,1 = 0.87 and ICC3,1 = 0.72), respectively. Conclusion: This study has shown prone assessment of active ER and IR ROM to be a reliable and appropriate method for prone dominant athletes (swimmers and surfers). In this study greater ER ROM was achieved in prone compared to supine. This finding highlights the importance of standardizing the test position for initial and follow up assessments. Furthermore the HALO© and inclinometer have been shown to be reliable tools that show good concurrent validity.
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| 14. |
- Furness, James, et al.
(författare)
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Clinical methods to quantify trunk mobility in an elite male surfing population
- 2016
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Ingår i: Physical Therapy in Sport. - : Elsevier. - 1466-853X .- 1873-1600. ; 19, s. 28-35
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundHigh numbers of acute shoulder and chronic lumbar injuries have been identified in a surfing population. A simple screening tool could be used to determine whether thoracic spine dysfunction is a possible contributor to shoulder or lumbar injuries. Importantly, thoracic mobility in the sagittal and horizontal planes are key requirements in the sport of surfing; however to date the normal values of these movements have not yet been quantified in a surfing population.ObjectivesTo develop a reliable method to quantify thoracic mobility in the sagittal plane; to assess the reliability of a thoracic rotation method, and quantify thoracic mobility in an elite male surfing population.DesignClinical Measurement, reliability (repeated measures) and comparative study. Methods: 27 subjects were used to determine the reliability of a new method to assess thoracic mobility in the sagittal plane and 30 subjects were used to confirm the reliability of an existing thoracic rotation method. A total of 15 elite surfers were used as part of a comparative analysis with age and gender matched controls. Results: Intra-rater reliability (within and between session) intraclass correlation coefficient (ICC) values ranged between 0.95 - 0.99 for both thoracic methods in the sagittal plane and between 0.95 – 0.98 for the rotation method. There was no significant difference in the amount of thoracic mobility in the sagittal plane between groups; however the elite surfing group had significantly (p ≤ 0.05) greater rotation than the comparative group (mean rotation 63.57° versus 40.80° respectively). Symmetry was also confirmed between left and right thoracic rotation in the elite surfing group (63.06 versus 64.01). Conclusion: This study has illustrated reliable methods to assess the thoracic spine in the sagittal and horizontal planes. It has also quantified ROM in a surfing cohort; identifying thoracic rotation as a key movement. This information may provide clinicians, coaches and athletic trainers with imperative information regarding the importance of maintaining adequate thoracic rotation and symmetry. From a screening perspective thoracic rotation should be assessed for performance purposes and to limit the potential for injury in the thoracic spine or in surrounding regions.
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| 15. |
- Green, Adeline, et al.
(författare)
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Physiotherapeutic rehabilitation following lumbar total disc replacement : A retrospective study
- 2016
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Ingår i: Physiotherapy Research International. - : John Wiley & Sons. - 1358-2267 .- 1471-2865. ; 21:3, s. 155-163
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE:This study sought to answer the following questions: What are the outcomes of physiotherapy post lumbar total disc replacement (LTDR) compared with patient self-mediated rehabilitation? Is a difference in outcomes related to the number of physiotherapy sessions?METHODS:This is a retrospective observational study of 600 patients post TDR. Patient outcomes for self-mediated rehabilitation (Group 1), 1-3 sessions of clinic-based physiotherapy (Group 2) and ≥4 sessions of clinic-based physiotherapy (Group 3) were analysed. Outcomes measures included the Oswestry Disability Index (ODI), Roland Morris Disability Questionnaire (RMQ), Short Form-36 Physical (SF-36 PCS) and Mental Subscale Components (SF-36 MCS), Visual Analogue Scale (VAS) for back and leg pain intensity. Patient's pre-operative baseline measures and post-operative follow-up measures at 3, 6, 12 and 24 months post-operatively were analysed.RESULTS:Oswestry Disability Index and RMQ had significantly lower scores in Group 3 compared with Group 1 at 3, 6, 12 and 24 months follow-up. Significantly lower scores for Group 2 compared with Group 1 were observed for the ODI at 3 months follow-up and for the RMQ at 3 and 6 months follow-up. Significantly lower scores were observed in Group 3 compared with Group 1 for VAS back pain at 3 months and VAS leg pain at 6 months follow-up. Significantly higher scores in Group 3 compared with Group 1 were also observed in the SF-36 PCS at 6, 12 and 24 months. Significantly higher scores in Group 2 compared with Group 1 were observed at 6 months follow up. These trends were also observed when investigating the percentage of patients with a greater 50% improvement in the outcome measure.CONCLUSIONS:Physiotherapy post-LTDR produces statistically significant and possibly clinically important improvements in functional disability, pain and quality of life outcomes compared with self-mediated rehabilitation. Copyright © 2015 John Wiley & Sons, Ltd.
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| 16. |
- Karlsson, Linda, et al.
(författare)
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Effekter av styrketräning för barn med cerebral pares
- 2015
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Ingår i: Fysioterapi. - Stockholm : Fysioterapeuterna. - 1653-5804. ; 9, s. 38-42
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Forskningsöversikt (övrigt vetenskapligt/konstnärligt)abstract
- I Sverige föds ungefär 200 barn med cerebral pares (CP) varje år. CP innebär en störning av rörelseförmågan orsakad av skada som drabbar den icke färdigutvecklade hjärnan. Personer med CP har rätt till habiliterande insatser, där fysioterapeut är en av professionerna. Vilka insatser som ges utgår från barnens behov och deras grovmotoriska förmåga. Gross Motor Function Classification System är ett sätt att klassificera grovmotorisk förmåga hos barn med cerebral pares. Klassificeringen är främst inriktad på funktionen att sitta och gå. Denna översiktsartikel fokuserar på den bästa tillgängliga kunskapen om effekterna av styrketräning för barn med CP med en funktionsnivå på GMFCS 1–3. Fokus läggs mot områdena muskelstyrka, förflyttningsförmåga och smärta. Dessutom redovisas i artikeln vilka rekommendationer kring upplägg av träning gällande frekvens, intensitet och duration som finns i den granskade litteraturen. Effekter av styrketräning på muskelstyrka hos barn med cerebral pares visar olika resultat i litteraturen, från ingen signifikant förbättring till ökning i knäextensorer, höftextensorer, höftabduktorer och knäflexorer. Vad gäller förflyttningsförmåga visar litteraturen ingen signifikant effekt av styrketräning. En studie har visat effekt på gånghastighet, samt ökad extension av höft och knä i ståfasen under gång. Det saknas litteratur som undersöker effekter på smärta. Studier som ger klarhet i hur träningen bör läggas upp gällande frekvens, intensitet och duration finns inte. Vidare forskning behövs inom dessa områden.
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| 17. |
- Kato, Norihiro, et al.
(författare)
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Trans-ancestry genome-wide association study identifies 12 genetic loci influencing blood pressure and implicates a role for DNA methylation
- 2015
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Ingår i: Nature Genetics. - : Nature Publishing Group. - 1061-4036 .- 1546-1718. ; 47:11, s. 1282-1293
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Tidskriftsartikel (refereegranskat)abstract
- We carried out a trans-ancestry genome-wide association and replication study of blood pressure phenotypes among up to 320,251 individuals of East Asian, European and South Asian ancestry. We find genetic variants at 12 new loci to be associated with blood pressure (P = 3.9 × 10−11 to 5.0 × 10−21). The sentinel blood pressure SNPs are enriched for association with DNA methylation at multiple nearby CpG sites, suggesting that, at some of the loci identified, DNA methylation may lie on the regulatory pathway linking sequence variation to blood pressure. The sentinel SNPs at the 12 new loci point to genes involved in vascular smooth muscle (IGFBP3, KCNK3, PDE3A and PRDM6) and renal (ARHGAP24, OSR1, SLC22A7 and TBX2) function. The new and known genetic variants predict increased left ventricular mass, circulating levels of NT-proBNP, and cardiovascular and all-cause mortality (P = 0.04 to 8.6 × 10−6). Our results provide new evidence for the role of DNA methylation in blood pressure regulation.
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| 18. |
- Kjaer, Per, et al.
(författare)
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GLA:D-(R) Back group-based patient education integrated with exercises to support self-management of back pain- development, theories and scientific evidence-
- 2018
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Ingår i: BMC Musculoskeletal Disorders. - : BMC. - 1471-2474. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundClinical guidelines recommend that people with back pain be given information and education about their back pain, advice to remain active and at work, and exercises to improve mobility and physical activity. Guidelines, however, rarely describe how this is best delivered. The aim of this paper is to present the development, theories, and underlying evidence for GLA:D Back - a group education and exercise program that translates guideline recommendations into a clinician-delivered program for the promotion of self-management in people with persistent/recurrent back pain.MethodsGLA:D Back, which included a rationale and objectives for the program, theory and evidence for the interventions, and program materials, was developed using an iterative process. The content of patient education and exercise programs tested in randomised trials was extracted and a multidisciplinary team of expert researchers and clinicians prioritised common elements hypothesised to improve back pain beliefs and management skills. The program was tested on eight people with persistent back pain in a university clinic and 152 patients from nine primary care physiotherapy and chiropractic clinics. Following feedback from the clinicians and patients involved, the working version of the program was created.ResultsEducational components included pain mechanisms, pain modulation, active coping strategies, imaging, physical activity, and exercise that emphasised a balance between the sum of demands and the individuals capacity. These were operationalised in PowerPoint presentations with supporting text to aid clinicians in delivering two one-hour patient education lectures.The exercise program included 16 supervised one-hour sessions over 8weeks, each comprising a warm-up section and eight types of exercises for general flexibility and strengthening of six different muscle groups at four levels of difficulty. The aims of the exercises were to improve overall back fitness and, at the same time, encourage patients to explore variations in movement by incorporating education content into the exercise sessions.ConclusionFrom current best evidence about prognostic factors in back pain and effective treatments for back pain, research and clinical experts developed a ready-to-use structured program - GLA:D (R) Back - to support self-management for people with persistent/recurrent back pain.
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| 19. |
- Limbäck Svensson, Gunilla, et al.
(författare)
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BOA - Better manangement of patients with arthritis - National quality registry annual report 2018
- 2019
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- This is the ninth annual report of the BOA register and the ninth year of BOA as a national quality registry. The BOA registry collects clinician reported process measures and patient-reported outcomes. This to monitor the quality of primary health care for knee, hip and hand osteoarthritis according to Swedish national guideline recommendations. The annual report for 2018 provides a summary of these health quality indicators on a national and regional level. The annual report is available on the website, boa.registercentrum.se. The website also provides open online aggregate statistics for health care quality indicator on a national, regional and clinic level.Thank you to everyone who has worked in the past year to collect data, support patients and contribute to the use of the BOA register as a tool in improving health care. Thanks also to the Steering Group and regional contact persons for your invaluable work in managing the register.
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| 20. |
- Limbäck-Svensson, Gunilla, et al.
(författare)
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BOA - Bättre omhändertagande av patienter med artros. Årsrapport 2018
- 2019
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Detta är den nionde årsrapporten för BOA-registret och det nionde året för BOA som nationellt kvalitetsregister. Vi har glädjen att meddela att BOA-registret har höjts från certifieringsnivå 3 till 2 av Ledningsfunktionen för Nationella Kvalitetsregister. Detta visar att BOA kontinuerligt förbättras och anses hålla god kvalitet.BOA-registret syftar främst till att patienter som har artros ska få optimal grundbehandling. Registret ska mäta vårdkvalitet, patientrapporterat utfall och serva verksamheter med relevant information som hjälper dem att uppfylla målet om optimal grundbehandling. Patienter med artros erbjuds grundbehandling av fysioterapeuter och arbetsterapeuter inom primärvård.Data från BOA-registret påvisar variationer i omhändertagande och resultat av behandling av patienter med artros i höft, knä eller hand. Registret utvecklas hela tiden för att bättre kunna användas som ett värdefullt verktyg för utvärdering och förbättring av det kliniska arbetet.Årsrapporten 2018 kommer att finnas tillgänglig på hemsidan, boa.registercentrum.se, men den kommer inte att tryckas och distribueras. Läsarundersökningar har visat att årsrapporten läses av få, medan vår statistikportal med realtidsdata på enhetsnivå är frekvent besökt med runt 1000 sidvisningar per månad. Vi fortsätter med att lägga resurser på att utveckla statistikportalen och underlätta administrationen kring registreringen.Årsrapporten vänder sig i första hand till vårdpersonal som möter personer med artros, men även till övriga intresserade som vill fördjupa sig i statistiken från registret.Tack till alla er som under det gångna året arbetat med att samla in data, utbildat patienter och bidragit till att BOA-registret kan användas som ett verktyg i vården. Tack även till styrgrupp och kontaktpersoner för ert ovärderliga arbete med att driva registret.
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| 21. |
- Lindbäck, Yvonne, 1967-, et al.
(författare)
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Altered somatosensory profile according to quantitative sensory testing in patients with degenerative lumbar spine disorders scheduled for surgery
- 2017
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Ingår i: BMC Musculoskeletal Disorders. - : BIOMED CENTRAL LTD. - 1471-2474. ; 18
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Tidskriftsartikel (refereegranskat)abstract
- Background: Somatosensory profiling in affected and non-affected body regions can strengthen our insight regarding the underlying pain mechanisms, which can be valuable in treatment decision making and to improve outcomes, in patients with degenerative lumbar spine disorders pre-surgery. The aim was to describe somatosensory profiles in patients with degenerative lumbar spine disorders, to identify the proportion with altered somatosensory profile, and to analyze demographic characteristics, self-reported function, pain, and health pre- and 3 months post-surgery. Methods: In this prospective cohort study in a Spine Clinic, 105 patients scheduled for surgery for spinal stenosis, disc herniation, degenerative disc disease, or spondylolisthesis were consecutively recruited. Exclusion criteria were; indication for acute surgery or previous surgery at the same spinal level or severe grade of pathology. Quantitative sensory testing (QST) and self-reported function, pain, and health was measured pre- and 3 months post-surgery. The somatosensory profile included cold detection threshold, warmth detection threshold, cold pain threshold, heat pain threshold and pressure pain threshold in affected and non-affected body regions. Results: On a group level, the patients somatosensory profiles were within the 95% confidence interval (CI) from normative reference data means. On an individual level, an altered somatosensory profile was defined as having two or more body regions (including a non-affected region) with QST values outside of normal ranges for reference data. The 23 patients (22%) with altered somatosensory profiles, with mostly loss of function, were older (P = 0.031), more often female (P = 0.005), had higher back and leg pain (P = 0.016, 0.020), lower mental health component summary score (SF 36 MCS) (P = 0.004) and larger pain distribution (P = 0.047), compared to others in the cohort. Post-surgery there was a tendency to worse pain, function and health in the group with altered somatosensory profile pre-surgery. Conclusions: On a group level, patients with degenerative lumbar spine disorders scheduled for surgery were within normal range for the QST measurements compared to reference values. On an individual level, an altered somatosensory profile outside of normal range in both affected and non-affected body regions occurred in 22% of patients, which may indicate disturbed somatosensory function. Those patients had mostly loss of sensory function and had worse self-reported outcome pre-surgery, compared to the rest of the cohort. Future prospective studies are needed to further examine whether these dimensions can be useful in predicting post-surgery outcome and guide need of additional treatments.
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| 22. |
- Lindbäck, Yvonne, 1967-, et al.
(författare)
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Association between pain sensitivity in the hand and outcomes after surgery in patients with lumbar disc herniation or spinal stenosis.
- 2017
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Ingår i: European spine journal. - : Springer. - 0940-6719 .- 1432-0932. ; 26:10, s. 2581-2588
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To investigate the association between pain sensitivity in the hand pre-surgery, and patient-reported outcomes (PROs) in function, pain and health pre- and post-surgery in patients with disc herniation or spinal stenosis.METHODS: This is a prospective cohort study with 82 patients. Associations between pressure-, cold- and heat pain threshold (PPT, CPT, HPT) in the hand pre-surgery and Oswestry, VAS pain, EQ-5D, HADS, and Self-Efficacy Scale, pre- and three months post-surgery; were investigated with linear regression.RESULTS: Patients with disc herniation more sensitive to pressure pain pre-surgery showed lower function and self-efficacy, and higher anxiety and depression pre-surgery, and lower function, and self-efficacy, and higher pain post-surgery. Results for cold pain were similar. In patients with spinal stenosis few associations with PROs were found and none for HPT and PROs.CONCLUSIONS: Altered pain response in pressure- and cold pain in the hand, as a sign of widespread pain pre-surgery had associations with higher pain, lower function and self-efficacy post-surgery in patients with disc herniation.
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| 23. |
- Lindbäck, Yvonne, et al.
(författare)
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PREPARE: Pre-surgery physiotherapy for patients with degenerative lumbar spine disorder: a randomized controlled trial protocol
- 2016
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Ingår i: BMC Musculoskeletal Disorders. - : BioMed Central. - 1471-2474. ; 17:270
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Tidskriftsartikel (refereegranskat)abstract
- Background: Current guidelines for the management of patients with specific low back pain pathology suggest non-surgical intervention as first-line treatment, but there is insufficient evidence to make recommendations of the content in the non-surgical intervention. Opinions regarding the dose of non-surgical intervention that should be trialled prior to decision making about surgery intervention vary. The aim of the present study is to investigate if physiotherapy administrated before surgery improves function, pain and health in patients with degenerative lumbar spine disorder scheduled for surgery. The patients are followed over two years. A secondary aim is to study what factors predict short and long term outcomes. Methods: This study is a single blinded, 2-arm, randomized controlled trial with follow-up after the completion of pre-surgery intervention as well as 3, 12 and 24 months post-surgery. The study will recruit men and women, 25 to 80 years of age, scheduled for surgery due to; disc herniation, spinal stenosis, spondylolisthesis or degenerative disc disease. A total of 202 patients will be randomly allocated to a pre-surgery physiotherapy intervention or a waiting list group for 9 weeks. The waiting-list group will receive standardized information about surgery, post-surgical rehabilitation and advice to stay active. The pre-surgery physiotherapy group will receive physiotherapy 2 times per week, consisting of a stratified classification treatment, based on assessment findings. One of the following treatments will be selected; a) Specific exercises and mobilization, b) Motor control exercises or c) Traction. The pre-surgery physiotherapy group will also be prescribed a tailor-made general supervised exercise program. The physiotherapist will use a behavioral approach aimed at reducing patient fear avoidance and increasing activity levels. They will also receive standardized information about surgery, post-surgical rehabilitation and advice to stay active. Primary outcome measure is Oswestry Disability Index. Secondary outcome measures are the visual analogue scale for back and leg pain, pain drawing, health related quality of life, Hospital anxiety and depression scale, Fear avoidance beliefs questionnaire, Self-efficacy scale and Work Ability Index. Discussion: The study findings will help improve the treatment of patients with degenerative lumbar spine disorder scheduled for surgery.
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| 24. |
- Lindbäck, Yvonne, 1967-, et al.
(författare)
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PREPARE: presurgery physiotherapy for patients with degenerative lumbar spine disorder : a randomized controlled trial
- 2018
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Ingår i: The spine journal. - : Elsevier. - 1529-9430 .- 1878-1632. ; 18:8, s. 1347-1355
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Tidskriftsartikel (refereegranskat)abstract
- Background ContextSurgery because of disc herniation or spinal stenosis results mostly in large improvement in the short-term, but mild to moderate improvements for pain and disability at long-term follow-up. Prehabilitation has been defined as augmenting functional capacity before surgery, which may have beneficial effect on outcome after surgery.PurposeThe aim was to study if presurgery physiotherapy improves function, pain, and health in patients with degenerative lumbar spine disorder scheduled for surgery.Study DesignA single-blinded, two-arm, randomized controlled trial (RCT).Patient SampleA total of 197 patients were consecutively included at a spine clinic. The inclusion criteria were patients scheduled for surgery because of disc herniation, spinal stenosis, spondylolisthesis, or degenerative disc disease (DDD), 25–80 years of age.Outcome MeasuresPrimary outcome was Oswestry Disability Index (ODI). Secondary outcomes were pain intensity, anxiety, depression, self-efficacy, fear avoidance, physical activity, and treatment effect.MethodsPatients were randomized to either presurgery physiotherapy or standardized information, with follow-up after the presurgery intervention as well as 3 and 12 months post surgery. The study was funded by regional research funds for US$77,342. No conflict of interest is declared.ResultsThe presurgery physiotherapy group had better ODI, visual analog scale (VAS) back pain, EuroQol-5D (EQ-5D), EQ-VAS, Fear Avoidance Belief Questionnaire-Physical Activity (FABQ-PA), Self-Efficacy Scale (SES), and Hospital Anxiety and Depression Scale (HADS) depression scores and activity level compared with the waiting-list group after the presurgery intervention. The improvements were small, but larger than the study-specific minimal clinical important change (MCIC) in VAS back and leg pain, EQ-5D, and FABQ-PA, and almost in line with MCIC in ODI and Physical Component Summary (PCS) in the physiotherapy group. Post surgery, the only difference between the groups was higher activity level in the physiotherapy group compared with the waiting-list group.ConclusionsPresurgery physiotherapy decreases pain, risk of avoidance behavior, and worsening of psychological well-being, and improves quality of life and physical activity levels before surgery compared with waiting-list controls. These results were maintained only for activity levelspost surgery. Still, presurgery selection, content, dosage of exercises, and importance of being active in a presurgery physiotherapy intervention is of interest to study further to improve long-term outcome.
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| 25. |
- Murnane, Andrew, et al.
(författare)
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The impact of an inpatient hospital admission on patients’ physical functioning and quality of life in the oncology setting
- 2015
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Ingår i: Journal of Nursing Education and Practice. - : Sciedu Press. - 1925-4040 .- 1925-4059. ; 5:7, s. 75-82
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Cancer can affect an individual’s level of physical function and health related quality of life (HRQoL). Those requiring hospital admission may be at risk of further decline during hospitalisation. The aim of this study was to investigate physical functioning and HRQoL of cancer patients on admission and over the course of their hospital admission.Methods: A prospective observational study was undertaken on the inpatient wards of a specialist oncology hospital. Assessment measures were taken bi-weekly until discharge from hospital or if they became too unwell to continue. Functional outcome measures included timed-up and go test (TUG), 30 second sit to stand test (30SST), 30 second arm curl test and isometric muscle strength (30ACT). HRQoL was assessed via the EORTC-C30 and SF-8 and distress was measured using the Distress Thermometer.Results: Fifty-five patients (28 males), mean age 64 years ± 10.8, with an average length of stay of 19 days participated in the study. Primary reasons for hospital admission included; symptom management (36%) or delivery of cancer treatment (35%). On hospital admission, the majority of patients scored worse than normative levels on the EORTC-C30 and SF-8. Similarly, 65%, 69% and 35% recorded below age norms for TUG, 30SST and 30ACT. Most measures showed a trend towards worsening during hospitalisation with up to 59% of patients experiencing ± 10% worsening over time. However, only role and social functioning (p < .05), as well as financial difficulty showed statistically significant worsening (p < .05) during hospitalisation.Conclusions: Participants demonstrated substantially reduced HRQoL and physical functioning at time of hospital admission which tended to worsen during hospitalisation. Despite this low level of function, very few received rehabilitation follow-up. Screening programs using HRQoL and functional assessment measures could be useful in identifying patients who are deconditioned or at risk of deconditioning and require specialised therapy to prevent declines in function and hospital re-admissions.
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| 26. |
- Prowse, Ashleigh, et al.
(författare)
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Reliability and concurrent validity of postural asymmetry measurement in adolescent idiopathic scoliosis.
- 2017
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Ingår i: World Journal of Orthopedics. - : Baishideng Publishing Group Co., Limited. - 2218-5836. ; 8:1, s. 68-76
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To investigate the reliability and concurrent validity of the Baseline(®) Body Level/Scoliosis meter for adolescent idiopathic scoliosis postural assessment in three anatomical planes.METHODS: This is an observational reliability and concurrent validity study of adolescent referrals to the Orthopaedic department for scoliosis screening at Karolinska University Hospital, Stockholm, Sweden between March-May 2012. A total of 31 adolescents with idiopathic scoliosis (13.6 ± 0.6 years old) of mild-moderate curvatures (25° ± 12°) were consecutively recruited. Measurement of cervical, thoracic and lumbar curvatures, pelvic and shoulder tilt, and axial thoracic rotation (ATR) were performed by two trained physiotherapists in one day. The intraclass correlation coefficient (ICC) was used to determine the inter-examiner reliability (ICC2,1) and the intra-rater reliability (ICC3,3) of the Baseline(®) Body Level/Scoliosis meter. Spearman's correlation analyses were used to estimate concurrent validity between the Baseline(®) Body Level/Scoliosis meter and Gold Standard Cobb angles from radiographs and the Orthopaedic Systems Inc. Scoliometer.RESULTS: There was excellent reliability between examiners for thoracic kyphosis (ICC2,1 = 0.94), ATR (ICC2,1 = 0.92) and lumbar lordosis (ICC2,1 = 0.79). There was adequate reliability between examiners for cervical lordosis (ICC2,1 = 0.51), however poor reliability for pelvic and shoulder tilt. Both devices were reproducible in the measurement of ATR when repeated by one examiner (ICC3,3 0.98-1.00). The device had a good correlation with the Scoliometer (rho = 0.78). When compared with Cobb angle from radiographs, there was a moderate correlation for ATR (rho = 0.627).CONCLUSION: The Baseline(®) Body Level/Scoliosis meter provides reliable transverse and sagittal cervical, thoracic and lumbar measurements and valid transverse plan measurements of mild-moderate scoliosis deformity.
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| 27. |
- Prowse, Ashleigh, et al.
(författare)
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Reliability and validity of inexpensive and easily administered anthropometric clinical evaluation methods of postural asymmetry measurement in adolescent idiopathic scoliosis : a systematic review
- 2016
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Ingår i: European spine journal. - : Springer Publishing Company. - 0940-6719 .- 1432-0932. ; 25:2, s. 450-466
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Forskningsöversikt (refereegranskat)abstract
- PURPOSE:As accurate and reproducible measurements of spinal curvature are crucial in the examination of patients with adolescent idiopathic scoliosis (AIS), this systematic review aims to report on the reliability and validity of a range of inexpensive and easily administered anthropometric methods of postural asymmetry measurement in an AIS population, to inform practice in a clinical setting.METHODS:A systematic search of health research databases located studies assessing reliability and validity of inexpensive and easily administered anthropometric measures.RESULTS:Fourteen studies satisfied eligibility criteria. The methodological quality of included studies ranged from low to high. Validity studies were of moderate to high quality. In total, nine clinically applicable, inexpensive and easily administered anthropometric methods were identified, for assessing AIS curvature. All methods demonstrated high to very high inter-observer and intra-observer reliability. Reported criterion validity of the scoliometer and 2D photographs, when compared to Cobb angle assessed from radiographs, ranged from low to very high. iPhone measurements correlated well with scoliometer measurements. 2D photography results had a moderate to high correlation with 3D topography results.CONCLUSIONS:Overall, strong levels of evidence exist for iPhone and scoliometer measurements, with a high to very high reliability and moderate to very high validity. Moderate levels of evidence exist for scoliometer with mathematical formula and clinical examination with moderate and low validity, respectively. Limited evidence exists for aesthetic tools TRACE and AI and 2D photography. These results indicate there are accurate and reproducible anthropometric measures that are inexpensive and applicable in therapy settings to assess postural asymmetry; however, these only exist for measurement in the transverse plane, despite 3D characteristics of AIS. Further research is required into an inexpensive and easily administered method that can assess postural asymmetry in all anatomical planes.
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| 28. |
- Theis, Jennifer C, et al.
(författare)
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An observational study on surgically treated adult idiopathic scoliosis patients' quality of life outcomes at 1- and 2-year follow-ups and comparison to controls.
- 2017
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Ingår i: Scoliosis and spinal disorders. - : BioMed Central (BMC). - 2397-1789. ; 12
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Prospective data on health-related quality of life in patients with idiopathic scoliosis treated surgically as adults is needed. We compared preoperative and 1- and 2-year follow-up data in surgically treated adults with idiopathic scoliosis with juvenile or adolescent onset. Results were compared to untreated adults with scoliosis and population normative data.METHODS: A comparison of preoperative and 1- and 2-year follow-up data of 75 adults surgically treated for idiopathic scoliosis at a mean age of 28 years (range 18 to 69) from a prospective national register study, as well as a comparison with age- and sex-matched data from 75 untreated adults with less severe scoliosis and 75 adults without scoliosis, was made. Outcome measures were EuroQol-5 dimensions (EQ-5D) and Scoliosis Research Society (SRS)-22r questionnaire.RESULTS: In the surgically treated, EQ-5D and SRS-22r scores had statistically significant improvements at both 1- and 2-year follow-ups (all p < 0.015). The effect size of surgery on EQ-5D at 1-year follow-up was large (r = -0.54) and small-medium (r = -0.20) at 2-year follow-up. The effect size of surgery on SRS-22r outcomes was medium-large at 1- and 2-year follow-ups (r = -0.43 and r = -0.42 respectively). At the 2-year follow-up, the EQ-5D score and the SRS-22r subscore were similar to the untreated scoliosis group (p = 0.56 and p = 0.91 respectively), but lower than those in the adults without scoliosis (p < 0.001 for both comparisons).CONCLUSIONS: Adults with idiopathic scoliosis experience an increase in health-related quality of life following surgery at 2-year follow-up, approaching the health-related quality of life of untreated individuals with less severe scoliosis, but remain lower than normative population data.
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| 29. |
- Theis, Jennifer, et al.
(författare)
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Quality of life outcomes in surgically treated adult scoliosis patients : A systematic review
- 2015
-
Ingår i: European spine journal. - : Springer. - 0940-6719 .- 1432-0932. ; 24:7, s. 1343-1355
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Forskningsöversikt (refereegranskat)abstract
- PURPOSE:The aim of this systematic review was to identify prospective studies reporting the impact of surgical intervention on health-related quality of life (HRQL) outcomes for adults with scoliosis at a minimum 2 year follow-up.METHOD:An electronic database search was conducted for January 2000-November 2013 in conjunction with a reference list search of two related systematic reviews for prospective studies of adults with scoliosis reporting HRQL outcome measure. Methodological quality of included articles was assessed using the Downs and Black checklist. Cohen's d effect size was calculated for Scoliosis Research Society Questionnaire (SRS) and Oswestry Disability Index (ODI) outcomes for included studies and pooled data.RESULTS:The database and reference list searches returned 349 potential articles; three articles met the inclusion criteria. Downs and Black scores ranged from 18/28 to 21/28 (fair-good quality evidence). Total number of 188 patients were treated surgically and had a mean age of 38 years or older. All studies showed significant improvement in reported HRQL outcomes for at least a 2 year follow-up. The Cohen's d effect size for SRS was d = 1.4 (n = 188, 95 % CI; 0.9, 1.8) and for ODI d = 0.9 (n = 120, 95 % CI; 0.4, 1.4).CONCLUSION:Findings from this review suggest surgery improves HRQL in patients with adult scoliosis at a minimum 2 year follow-up. However, these findings are based on limited data of fair to good quality which needs to be taken into consideration when interpreting the results and highlights the need for additional high quality prospective studies.
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