| 1. |
- Arvidsson Lindvall, Mialinn, 1977-, et al.
(författare)
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Basic Body Awareness Therapy for patients with stroke : Experiences among participating patients and physiotherapists
- 2016
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Ingår i: Journal of Bodywork & Movement Therapies. - : Elsevier. - 1360-8592 .- 1532-9283. ; 20:1, s. 83-89
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Tidskriftsartikel (refereegranskat)abstract
- Background: After a stroke many patients have muscle weakness, spasticity and compromised sensation leading to decreased postural stability. Basic Body Awareness Therapy includes slow movements that challenge postural control.Aim: The aim was to describe experiences of 8 weeks of Basic Body Awareness Therapy from the perspective of both patients with stroke and physiotherapists.Method: This study had a qualitative design. Twenty-one patients and four physiotherapists were interviewed. The interviews were analysed using manifest and latent content analysis.Results: One overall theme emerged "Simple yet challenging" which was based on six categories: "Facing one's limitations", "Individualized movements", "A feeling of harmony", "Improved balance", "Integrated knowledge" and "Frustration and doubt". The patients described improvement in balance and stability, as well as increased wellbeing.Conclusion: The patients and physiotherapists related that Basic Body Awareness Therapy challenges balance but also provides an opportunity to reflect on the body.
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| 2. |
- Arvidsson Lindvall, Mialinn, 1977-
(författare)
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Physiotherapeutic perspectives on balance control after stroke : exercises, experiences and measures
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to investigate physiotherapeutic perspectives on balance after stroke, in terms of exercises, experiences and measurements. Study I was a pilot randomized controlled trial with 46 persons who had had a stroke, 24 of whom were included in the intervention group and 22 who were included in the control group. The intervention consisted of 8 weeks of body awareness therapy (BAT). There were no significant differences over time between the groups in the outcome measures of balance, walking, self-reported balance confidence and quality of life. Study II had a qualitative design using content analysis. Participants in the intervention group from Study I and the four physiotherapists who had been in charge of the BAT were interviewed. One overall theme emerged: "Simple yet challenging", which was based on six categories. Study III investigated the validity and test-retest reliability of the Six-Spot Step test (SSST), an instrument used to assess the ability to take load on each leg. A cross-sectional design with 81 persons who had had stroke was performed. The convergent validity was strong to moderate, and the test-retest reliability was good. In Study IV a mixed method design including both qualitative and quantitative data collection was used. The participants’ experiences of balance and its influence in everyday life were presented in two themes: "Feeling dizzy and unstable is a continuous challenge" and "Feeling trust and confidence despite dizziness and unsteadiness". Taken together, the different data sets provided complementary and confirmatory information about balance. All participants experienced the balance limitations as a continuous challenge in everyday life, yet they also felt trust and confidence.In summary, BAT can be a complement in physiotherapeutic stroke rehabilitation and the SSST can be used as a measuring instrument of walking balance in persons with stroke. Living with balance limitations was experienced as a challenge but the participants were still able to manage their everyday life and activities.
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| 3. |
- Carling, Anna, 1985-, et al.
(författare)
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Balance exercise facilitates everyday life for people with multiple sclerosis : A qualitative study
- 2018
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Ingår i: Physiotherapy Research International. - : John Wiley & Sons. - 1358-2267 .- 1471-2865. ; 23:4
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aim of this qualitative study was to describe the experience and perceived effects on everyday life for people with multiple sclerosis after participating in a balance exercise programme focusing on core stability, dual tasking, and sensory strategies (the CoDuSe programme).METHODS: A qualitative approach was chosen, using face-to-face interviews analysed with content analysis. Twenty-seven people with multiple sclerosis (20 women, 7 men) who had participated in the CoDuSe programme were included. All could walk 20 m with or without walking aids but could not walk further than 200 m. The CoDuSe programme was given twice weekly during a 7-week period.RESULTS: The analysis revealed five categories. Learning to activate the core muscles described how the participants gained knowledge of using their core muscles and transferred this core muscle activation into everyday life activities. Improved bodily confidence covered narratives of being more certain of the ability to control their bodies. Easier and safer activities showed how they could now perform activities in everyday life more safely and easily. Increased independence and participation involved the participants' improved ability and self-confidence to execute activities by themselves, as well as their increased participation in activities in daily living. Experiences of the balance exercise programme revealed that they found the programme novel and challenging. The overall theme was balance exercise facilitates everyday life.CONCLUSION: Participating in the CoDuSe programme was perceived to facilitate everyday life for people with multiple sclerosis. Taking part in the balance exercise programme taught the participants how to activate and use the core muscles, which increased their bodily confidence. Having increased bodily confidence helped them to perform everyday life activities with more ease and safety, which increased their independence and participation. The participants described the CoDuSe programme as novel and challenging, yet feasible.
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| 4. |
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| 5. |
- Carling, Anna, 1985-, et al.
(författare)
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CoDuSe group exercise programme improves balance and reduces falls in people with multiple sclerosis : A multi-centre, randomized, controlled pilot study
- 2017
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Ingår i: Multiple Sclerosis Journal. - London, United Kingdom : Sage Publications. - 1352-4585 .- 1477-0970. ; 23:10, s. 1394-1404
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Tidskriftsartikel (refereegranskat)abstract
- Background: Imbalance leading to falls is common in people with multiple sclerosis (PwMS).Objective: To evaluate the effects of a balance group exercise programme (CoDuSe) on balance and walking in PwMS (Expanded Disability Status Scale, 4.0-7.5).Methods: A multi-centre, randomized, controlled single-blinded pilot study with random allocation to early or late start of exercise, with the latter group serving as control group for the physical function measures. In total, 14 supervised 60-minute exercise sessions were delivered over 7 weeks. Pretest-posttest analyses were conducted for self-reported near falls and falls in the group starting late. Primary outcome was Berg Balance Scale (BBS). A total of 51 participants were initially enrolled; three were lost to follow-up.Results: Post-intervention, the exercise group showed statistically significant improvement (p = 0.015) in BBS and borderline significant improvement in MS Walking Scale (p = 0.051), both with large effect sizes (3.66; -2.89). No other significant differences were found between groups. In the group starting late, numbers of falls and near falls were statistically significantly reduced after exercise compared to before (p < 0.001; p < 0.004).Conclusion: This pilot study suggests that the CoDuSe exercise improved balance and reduced perceived walking limitations, compared to no exercise. The intervention reduced falls and near falls frequency.
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| 6. |
- Carling, Anna, 1985-, et al.
(författare)
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Fall bland personer med multipel skleros
- 2017
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Ingår i: Best Practice. - Uppsala, Sweden : BestPractice. - 1329-1874. ; :20, s. 24-27
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 7. |
- Carling, Anna, 1985-, et al.
(författare)
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Falls in people with multiple sclerosis : experiences of 115 fall situations
- 2018
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Ingår i: Clinical Rehabilitation. - : Sage Publications. - 0269-2155 .- 1477-0873. ; 32:4, s. 526-535
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim was to describe falls and the perceived causes, experienced by people with multiple sclerosis shortly after falling.Design: A qualitative study using content analysis and quantitative data to illustrate where and why people report falls most commonly. Semi-structured telephone interviews were performed. Interviews were conducted shortly (0–10 days) after a fall.Subjects: In all, 67 informants who had reported at least one fall during the previous three-month period and who used a walking aid participated.Results: A total of 57 (85%) informants fell at least once during eight months resulting in 115 falls; 90 (78%) falls happened indoors, most commonly in the kitchen (n = 20; 17%) or bathroom (n = 16; 14%). Informants fell during everyday activities and walking aids had been used in more than a third of the reported falls. The falls were influenced of both intrinsic and extrinsic factors. Two categories emerged from the analysis: ‘activities when falling’ and ‘influencing factors’. The category contained three (basic activities of daily living, instrumental activities of daily living and leisure and work) and six (multiple sclerosis–related symptoms, fluctuating body symptoms, being distracted, losing body control, challenging surrounding and involvement of walking aid) subcategories, respectively.Conclusion: The majority of falls occurs indoors and in daily activities. Several factors interacted in fall situations and should be monitored and considered to reduce the gap between the person’s capacity and the environmental demands that cause fall risk. Fluctuation of bodily symptoms between and within a day is a variable not earlier targeted in multiple sclerosis fall risk research.
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| 8. |
- Carling, Anna, 1985-
(författare)
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Impaired balance and fall risk in people with multiple sclerosis
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The symptoms from the neurological disease multiple sclerosis vary from person to person and over time. Impaired balance is common in people with multiple sclerosis and can lead to falls. Fall frequency is high in people with multiple sclerosis, above 50%. Multiple sclerosis affects not only the person having the disease but also their next of kin. To be able to reduce fall risk it is important to know when, why and where people with multiple sclerosis fall, and how to improve balance and reduce falls with exercise. It is also important to know how the falls affect the residing next of kin to people with multiple sclerosis.The overall aim of this thesis was to gain enhanced knowledge by investigating when and why people with MS fall and how these falls possibly affect their next of kin, and also to evaluate the effects and perceptions of participating in a specific balance exercise.Data were gathered using four different data collections, and this thesis contains both qualitative and quantitative data.The major finding in this thesis is that people with multiple sclerosis fall in the course of everyday life activities, most often in their own homes due to various intrinsic and extrinsic factors. Balance can be improved and falls reduced and everyday life may be made easier and facilitated after participating in the CoDuSe balance exercise. This is important also for the next of kin, since they are adapting, adjusting and renouncing their activities due to the falls of the PwMS, in order to make it work for the whole family.
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| 9. |
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| 10. |
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| 11. |
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| 12. |
- Forsberg, Anette, 1965-, et al.
(författare)
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Balancing everyday life two years after falling ill with Guillain-Barre syndrome : a qualitative study
- 2015
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Ingår i: Clinical Rehabilitation. - London, United Kingdom : Sage Publications. - 0269-2155 .- 1477-0873. ; 29:6, s. 601-610
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim was to describe experiences of disability in everyday life and managing the recovery process two years after falling ill with Guillain-Barré syndrome.Design: Qualitative interview study.Methods: Interviews were conducted with 35 persons (22 male, mean age 50 years) two years after the onset of Guillain-Barré syndrome. The interviews were transcribed verbatim and analysed using content analysis.Results: The analysis revealed four categories and an overall theme: ‘Striving for balance in everyday life’. The participants described persistent lived body restrictions that affected their arms, legs, and face. Bodily symptoms and loss of energy limited or restricted many everyday activities. In connection with healthcare, both satisfaction and feeling vulnerable in a critical situation were described. Experiences of the recovery process varied. The participants described acceptance and reappraisal of a new life situation despite their limitations, and having gained the knowledge that life can change suddenly. However, they also expressed disappointment following an overly positive prognosis in the early stages, and over a continuous wait for recovery. For some participants life had returned to as before.Conclusion: The participants experienced limitations in everyday life and decreased functioning in several parts of the body. The recovery process may still be ongoing two years after onset. Rehabilitation intervention with an extended focus on supporting individualized coping processes could facilitate ways to live with persistent disability.
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| 13. |
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| 14. |
- Forsberg, Anette, 1965-, et al.
(författare)
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Effects on Balance and Walking with the CoDuSe Balance Exercise Program in People with Multiple Sclerosis : A Multicenter Randomized Controlled Trial
- 2016
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Ingår i: Multiple Sclerosis International. - New York, USA : Hindawi Publishing Corporation. - 2090-2654 .- 2090-2662.
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Tidskriftsartikel (refereegranskat)abstract
- Background: Balance and walking impairments are frequent in people with multiple sclerosis (MS).Objective: The aim was to investigate the effects of a group-based balance exercise program targeting core stability, dual tasking, and sensory strategies (CoDuSe) on balance, postural sway, walking, perceived walking limitations, and balance confidence.Design: A single-blinded randomized multicenter trial. No intervention was given to controls. Participants. People with MS able to walk 100 meters but unable to maintain tandem stance >= 30 seconds. Eighty-seven participants were randomized to intervention or control.Intervention: The 60-minute CoDuSe group program, twice weekly for seven weeks, supervised by physical therapists.Measurements: Primary outcome was dynamic balance (Berg Balance Scale (BBS)). Secondary outcomes were postural sway, walking (Timed-Up and Go test; Functional Gait Assessment (FGA)), MS Walking Scale, and Activities-specific Balance Confidence (ABC) Scale. Assessments were performed before and after (week 8) the intervention.Results: 73 participants fulfilled the study. There were significant differences between the intervention and the control groups in change in the BBS and in the secondary measures: postural sway with eyes open, FGA, MS Walking Scale, and ABC scale in favor of the intervention.Conclusions: The seven-week CoDuSe program improved dynamic balance more than no intervention.
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| 15. |
- Forsberg, Anette, 1965-, et al.
(författare)
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Measuring postural sway in people with multiple sclerosis
- 2015
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Ingår i: Multiple Sclerosis Journal. - : SAGE Publications. - 1352-4585 .- 1477-0970. ; 21:4, s. 531-531
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: Many people with multiple sclerosis (MS) have increased postural sway, which is associated with a higher risk of falls. Significantly increased sway has been found in people with slight or no balance impairment. Measuring postural sway is appropriate to perform in clinical settings; however, technical devices can be costly. The Swaymeter is a low-tech cheaper alter-native, considered reliable and valid in both younger and older populations (Sturnieks et al, 2011).Aims: To investigate the feasibility and validity of the Swaymeter in people with MS.Methods: Baseline values in a trial were used, with inclusion cri-teria unable to stand in tandem for 30 seconds; 87 persons with MS were tested in outpatient clinical settings, mean age 54 years (SD 11). Fifteen participants (17%) used an assistive walking device indoors and 52 (59%) outdoors. Assessments of sway were done in the bipedal stance for 30 seconds with no shoes, four con-ditions: floor eyes open (EO); floor eyes closed (EC); foam EO; and foam EC. The Swaymeter recorded displacements of the body in the horizontal plane at waist level. The displacement sway area was calculated in millimetres (anterioposterior × mediolateral). Construct validity was investigated through correlations with the Berg balance scale (BBS), the timed up and go (TUG) test, and the sit-to-stand test.Results: The postural sway displacements were large: floor EO (n=87) mean area 1393 mm (SD 1612); floor EC (n=82) mean area 3041 mm (SD 4447); foam EO (n=83) mean area 4007 mm (SD 3466); foam EC (n=62) mean area 9178 mm (SD 6514). For floor EO and foam EC, there was no significant correlation between the sway area and any of the balance tests. For floor with EC there was a low correlation (r=−0.266, P=0.016) between the sway area and the BBS, but not the other tests. For the condition foam with EO there were significant low–moderate correlation coefficients for the BBS (r=−0.45, P<0.001), the TUG test (r=0.26, P=0.016), and the sit-to-stand test (r=0.33, P=0.003).Conclusions: The Swaymeter was feasible in a clinical setting, but only 62 (71%) participants could stand on foam with EC for 30 seconds. Construct convergent validity with dynamic balance tests could not be established becausee most correlation coeffi-cients were low and non-significant. Further studies are needed to investigate the properties of the Swaymeter in MS.
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| 16. |
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| 17. |
- Nilsagård, Ylva, 1964-, et al.
(författare)
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Comparison of trunk impairment scale versions 1.0 and 2.0 in people with multiple sclerosis : A validation study
- 2017
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Ingår i: Physiotherapy Theory and Practice. - : Taylor & Francis. - 0959-3985 .- 1532-5040. ; 33:10, s. 772-779
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Tidskriftsartikel (refereegranskat)abstract
- Background: Trunk control impairment often accompanies multiple sclerosis (MS). Trunk stability is necessary for movements of extremities, as are selective trunk movements for normal gait. Measuring trunk function is thus of interest.Methods: We examined the relationships between the Trunk Impairment Scale (TIS1.0 and TIS2.0) and the Berg Balance Scale (BBS), 5 sit-to-stand test (5STS), Timed Up and Go test (TUG), 10-m timed walk test (10TW), 2-min walk test (2MWT), Falls Efficacy Scale - International, and 12-item MS Walking Scale (MSWS-12) in 47 outpatients. We determined construct validity by calculating the degree to which the TIS versions produced different scores between known groups: use or nonuse of walking aid, MS disability status, and whether participants experienced a fall or not during 14 weeks.Results: TIS correlated moderately with BBS and 5STS; moderately (TIS1.0) or weakly (TIS2.0) with TUG, 10TW, and 2MWT; and weakly to moderately with MSWS-12 in subgroups with Expanded Disability Status Scale (EDSS) > 6.0. No other clear correlation patterns were found. TIS did not discriminate between known groups.Conclusions: TIS1.0 is recommended for individuals with MS (EDSS score 4.0-7.5). Better trunk function correlates with better balance and walking ability. TIS has limited value in fall risk screening.
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| 18. |
- Nilsagård, Ylva, 1964-, et al.
(författare)
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Engagement in performing clinical physiotherapy research : Perspectives from leaders and physiotherapists
- 2019
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Ingår i: Physiotherapy Research International. - : John Wiley & Sons. - 1358-2267 .- 1471-2865. ; 24:2
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The recent increase in physiotherapy research has led to more physiotherapists being involved in research. Consequently, leaders must make a standpoint on whether the department should engage in research, whereas individual physiotherapists have to decide if they want to play an active role in carrying out a research project. The purpose of this study was to explore perceptions and experiences of both participating physiotherapists and their leaders regarding taking part in clinical physiotherapy research projects.METHODS: A qualitative study using face-to-face interviews was conducted. All (n = 8) leaders were interviewed individually. Physiotherapists (n = 18) were interviewed either individually (n = 5) or in small groups including two to three persons (n = 13). The interviews were analysed using inductive conventional content analysis.RESULTS: There was a consensus that engagement of the leaders was a prerequisite for entering research projects and that the research had to be in line with the department's regular assignment. For the physiotherapists, the key factors for success were having designated time and having support from their leader, especially when feelings of responsibility became overwhelming. The leaders stressed the importance of being well informed. Participating in clinical research created value such as personal and professional growth for the physiotherapists, who also inspired their colleagues and thus positively affected the organization. Engaging in research contributed to being an attractive employer and gave a boost to evidence-based practice.CONCLUSION: The study provides perspectives from leaders and physiotherapists on engaging in research. There was a consensus that participating in a research project was beneficial for the organization, the individual physiotherapist, and the patients. However, clinical applicability, support, sufficient time, and early involvement of leaders are significant prerequisites.
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| 19. |
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| 20. |
- Rådman, Lisa, 1983-, et al.
(författare)
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Modified Rivermead Mobility Index : a reliable measure in people within 14 days post-stroke
- 2015
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Ingår i: Physiotherapy Theory and Practice. - : Taylor & Francis. - 0959-3985 .- 1532-5040. ; 31:2, s. 126-129
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The reliability of the Modified Rivermead Mobility Index (MRMI) has not previously been investigated in the very early post-stroke phase. The aim of the study was to evaluate inter-rater and intra-rater reliability and internal consistency in patients, 1-14 d post-stroke.Method: A cohort study with repeated measures within 24 h, on 37 patients, 1-14 d post-stroke was conducted. Inter-rater (two raters) and intra-rater (one rater) reliability was analyzed using weighted kappa (kappa) statistics and internal consistency with Cronbach's alpha and intra-class correlation (ICC), 3.k.Results: Inter-rater and intra-rater reliability was excellent (ICC coefficient 0.97 and 0.99) for MRMI summary score. Intra-rater exact agreement for separate items was between 77% and 97%; kappa between 0.81 and 0.96. Inter-rater exact agreement for separate items was between 68% and 92%; kappa 0.59-0.87. The internal consistency was high (alpha 0.96; ICC 3.k 0.99). Conclusion: The MRMI is a reliable measure of physical mobility in the early post-stroke phase.
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| 21. |
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