| 1. |
- Kammerlind, Ann-Sofi, et al.
(författare)
-
Test–retest reliability of the Swedish version of the life-space assessment questionnaire among community-dwelling older adults
- 2014
-
Ingår i: Clinical Rehabilitation. - : SAGE Publications. - 0269-2155 .- 1477-0873. ; 28:8, s. 817-823
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To examine the test–retest reliability of the Swedish version of the Life-Space Assessment Questionnaire.Design: Test–retest reliability study.Subjects: A total of 298 community-dwelling subjects between 75 and 90 years of age.Methods: The Life-Space Assessment Questionnaire was translated into Swedish. By personal interviews during home visits and two weeks later by telephone interviews the subjects were asked about their life-space mobility during the past four weeks, and how often and whether they were independent or needed assistance from another person or equipment to reach different life-space levels.Results: None of the four scoring methods showed significant difference between test sessions. The mean (SD) total scores were 65 (22) and 65 (23) out of the maximum possible score of 120 at the two sessions. High levels were found for independent, assisted, and maximal life-space at both sessions. Intraclass correlation coefficients and weighted Kappa-values between 0.84–0.94 were found for the total score, the independent, and the assisted life-space levels, indicating good to excellent reliability. A lower Kappa-value was observed for the maximal life-space level, mainly owing to skewed distributions. The method error values showed that a change of 10 in the total score and a change of one level in any of the three life-space levels can be considered to indicate a real change in clinical practice.Conclusion: The Swedish version of the Life-Space Assessment Questionnaire can be reliably used among community-dwelling older adults.
|
|
| 2. |
- Areskoug Josefsson, Kristina, et al.
(författare)
-
Evidence-based practice in a multiprofessional context
- 2012
-
Ingår i: International Journal of Evidence-Based Healthcare. - : Ovid Technologies (Wolters Kluwer Health). - 1744-1595 .- 1744-1609. ; 10:2, s. 117-125
-
Tidskriftsartikel (refereegranskat)abstract
- Background Healthcare today is a complex system with increasing needs of specific knowledge of evaluation of research and implementation into clinical practice. A critical issue is that we all apply evidence-based practice (EBP) with standardised methods and continuing and systematic improvements. EBP includes both scientific and critical assessed experience-based knowledge. For the individual, this means applying evidence-based knowledge to a specific situation, and for the organisation, it means catering for a systematic critical review and evaluation and compiling research into guidelines and programmes. In 2009, the County Council of Jönköping had approximately 335 000 inhabitants and the healthcare organisation had more than 10 000 employees. As the County Council actively promotes clinical improvement, it is interesting to explore how healthcare employees think about and act upon EBP. The aim of this survey was therefore to describe factors that facilitate or hinder the application of EBP in the clinical context.Method A quantitative study was performed with a questionnaire to healthcare staff employed in the County Council of Jönköping in 2009. The questionnaire consisted of questions concerning which factors are experienced to affect the development of evidence-based healthcare. There were 59 open and closed questions, divided into the following areas:• Sources of knowledge used in practice• Barriers to finding and evaluating research reports and guidelines• Barriers to changing practice on the basis of best evidence• Facilitating factors for changing practice on the basis of best evidence• Experience in finding, evaluating and using different sources of evidenceThe participants were selected using the county council's staff database and included medical, caring and rehabilitative staff within hospitals, primary care, dentistry and laboratory medicine. The inclusion criteria were permanent employment and clinical work. Invitations were sent to 5787 persons to participate in the study and 1445 persons answered the questionnaire.Results Knowledge used in daily clinical practice was mainly based on information about the patient, personal experience and local guidelines. Twenty per cent answered that they worked ‘in the way they always had’, and 11% responded that they used evidence from research as a basis for change. The participants experienced that EBP was not used enough in clinical healthcare and explained this with practical and structural barriers, which they thought should be better monitored by the organisation and directors.Conclusion Overall, the results indicate that the scientific evidence for healthcare is not used sufficiently as a base for decisions in daily practice as well as for changing practice. This is more prominent among assistant staff. As a consequence, this might affect the care of the patients in a negative way. Increased awareness of EBP and a stronger evidence-based approach are keys in the ongoing improvement work in the county. Local guidelines seem to be a way to implement knowledge. But, as the arena of activities is complex and the employees have diverse education levels, different strategies to facilitate and promote EBP are necessary.
|
|
| 3. |
- Hermansen, Anna, et al.
(författare)
-
Evaluation of Physical Function in Individuals 11 to 14 Years after AnteriorCervical Decompression and Fusion Surgery : A Comparison betweenPatients and Healthy Reference Samples and Between 2 Surgical Techniques
- 2014
-
Ingår i: Journal of Manipulative and Physiological Therapeutics. - : Elsevier. - 0161-4754 .- 1532-6586. ; 37:2, s. 87-96
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: The purpose of this study was to evaluate neck-related physical function in individuals 11 to 14 years after anterior cervical decompression and fusion (ACDF) surgery for degenerative cervical disk disease and to compare the long-term outcome of 2 surgical techniques, including the Cloward procedure and cervical intervertebral fusion cage. Methods: In this cross-sectional study, 51 individuals, 11 years or more after ACDF, underwent testing of cervical active range of motion, hand-grip strength, static and dynamic balance, neck muscle endurance, and completed pain ratings. The participants values were compared with values of age-and sex-matched healthy individuals to evaluate impairments. Correlations between different test scores and pain were performed. Group differences were analyzed between the 2 surgical techniques. Results: Sixty-five percent and 82% exhibited impairment in ventral and dorsal neck muscle endurance, respectively. Impairment rates of 18% to 39% for cervical active range of motion, 27% to 43% for hand-grip strength, 37% for standing balance, and 35% for dynamic balance were recorded. Twenty-nine percent of the participants had impairment (greater than30 mm visual analog scale) in pain. There were no significant differences in physical function between the 2 surgical treatment groups (Cloward procedure or cervical intervertebral fusion cage) (P = .10-.92). Conclusions: In those studied, a large percentage of patients who had anterior cervical decompression and fusion surgery have impairments in neck-related physical function when compared 11 to 14 years after surgery with age-and sex-matched healthy reference individuals. Neck-specific function, but not balance, was statistically correlated to pain. Neck muscle endurance was most affected, and balance impairments were also present in one-third of the individuals. There were no differences in long-term physical function between the 2 surgical techniques.
|
|
| 4. |
- Kammerlind, Ann-Sofi C., et al.
(författare)
-
Recovery after acute unilateral vestibular loss and predictors for remaining symptoms
- 2011
-
Ingår i: American Journal of Otolaryngology. - : WB Saunders. - 0196-0709 .- 1532-818X. ; 32:5, s. 366-375
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aims of this study were to follow recovery during the first 6 months after acute unilateral vestibular loss (AUVL) and to determine predictors for self-rated remaining symptoms. Materials and methods: Forty-two subjects were included less than 10 days after AUVL. Static and dynamic clinical balance tests, visual analogue scales, University of California Los Angeles Dizziness Questionnaire, Dizziness Beliefs Scale, European Quality of Life questionnaire, Dizziness Handicap Inventory, and Hospital Anxiety and Depression Scale were performed at inclusion and at 7 follow-ups over 6 months. Subjects rated their symptoms on visual analogue scales daily at home. Videonystagmography was performed in the acute stage and after 10 weeks. Results: Decrease of symptoms and improvement of balance function were larger during the first compared with the latter part of the follow-up period. Visual analogue scale ratings for balance problems were higher than those for dizziness. A prediction model was created based on the results of 4 tests in the acute stage: standing on foam with eyes closed, standing on 1 leg with eyes open, visual analogue scale rating of vertigo at rest, and European Quality of Life questionnaire rating of health-related quality of life. The prediction model identified subjects at risk of having remaining symptoms after 6 months with a sensitivity of 86% and a specificity of 79%. Conclusions: Recovery mainly takes place during the first weeks after AUVL. Subjects rate more balance problems than dizziness. Self-rated remaining symptoms after 6 months may be predicted by clinical balance tests and subjective ratings in the acute stage.
|
|
| 5. |
- Ledin, Torbjörn, et al.
(författare)
-
Dizziness and disequlibrium
- 2010
-
Ingår i: Physical activity in the prevention and treatment of disease. - Stockholm : Swedish National Institute of Public Health. - 9789172577152 ; , s. 356-366
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Svimmelhet er en vanlig forekommende tilstand, og forekomsten øker med stigendealder. Nedsatt, mistet eller forstyrret funksjon i en eller flere av delene ibalansesystemet kan forårsakes av aldring samt av mange forskjellige sykdommerog skader og kan føre til forstyrret balansefunksjon og bevegelsesillusjoner(svimmelhet). Diagnostikken består blant annet av nøyaktig anamnese, tester avvestibulær funksjon, posisjonstester og vurdering av postural kontroll. Denneframstillingen behandler noen svimmelhetstilstander der bevegelsestrening erviktig for å oppnå størst mulig grad av tilheling.Akutt perifert vestibulært tap av balansenervens funksjon på den ene siden girrask og kraftig svimmelhet og balanseforstyrrelser. Tilheling kan påskyndes ved åstimulere sentral kompensasjon med øyebevegelser, hodebevegelser og balanseøvelserav gradvis økende intensitet. Ved godartet posisjonssvimmelhet, det vil sibenign paroksysmal posisjonell vertigo (BPPV), har noen otolitter løsnet og flyttetseg fra hinnesekk til buegang i det indre øret, noe som gir svimmelhet ved hodebevegelserog endringer i kroppsstilling. Ved BPPV brukes to forskjellige behandlingsprinsipper,habitueringstrening og manøverbehandling. Skader i sentralnervesystemetog aldersrelatere forandringer av balansesystemets funksjon kan også føretil svimmelhet og balanseforstyrrelser. Svimmelhet og balansevanskeligheter hoseldre er en stor risikofaktor for fall og påfølgende fraktur. Ved skade på sentralnervesystemetog ved aldersrelatert svimmelhet skal treningen forbedre balanse,koordinasjon og styrke, redusere bevegelsesfrykten og øke aktivitetsgraden.
|
|
| 6. |
- Peolsson, Anneli, et al.
(författare)
-
Effects of neck-specific exercise with or without a behavioural approach in addition to prescribed physical activity for individuals with chronic whiplash-associated disorders: a prospective randomised study
- 2013
-
Ingår i: BMC Musculoskeletal Disorders. - : BioMed Central. - 1471-2474. ; 14:311
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Up to 50% of chronic whiplash associated disorders (WAD) patients experience considerable pain and disability and remain on sick-leave. No evidence supports the use of physiotherapy treatment of chronic WAD, although exercise is recommended. Previous randomised controlled studies did not evaluate the value of adding a behavioural therapy intervention to neck-specific exercises, nor did they compare these treatments to prescription of general physical activity. Few exercise studies focus on patients with chronic WAD, and few have looked at patients ability to return to work and the cost-effectiveness of treatments. Thus, there is a great need to develop successful evidence-based rehabilitation models. The study aim is to investigate whether neck-specific exercise with or without a behavioural approach (facilitated by a single caregiver per patient) improves functioning compared to prescription of general physical activity for individuals with chronic WAD. less thanbrgreater than less thanbrgreater thanMethods/Design: The study is a prospective, randomised, controlled, multi-centre study with a 2-year follow-up that includes 216 patients with chronic WAD (andgt;6 months and andlt;3 years). The patients (aged 18 to 63) must be classified as WAD grade 2 or 3. Eligibility will be determined with a questionnaire, telephone interview and clinical examination. The participants will be randomised into one of three treatments: (A) neck-specific exercise followed by prescription of physical activity; (B) neck-specific exercise with a behavioural approach followed by prescription of physical activity; or (C) prescription of physical activity alone without neck-specific exercises. Treatments will be performed for 3 months. We will examine physical and psychological function, pain intensity, health care consumption, the ability to resume work and economic health benefits. An independent, blinded investigator will perform the measurements at baseline and 3, 6, 12 and 24 months after inclusion. The main study outcome will be improvement in neck-specific disability as measured with the Neck Disability Index. All treatments will be recorded in treatment diaries and medical records. less thanbrgreater than less thanbrgreater thanDiscussion: The study findings will help improve the treatment of patients with chronic WAD.
|
|
| 7. |
- Peolsson, Anneli, et al.
(författare)
-
Outcome of physiotherapy after surgery for cervical disc disease: a prospective randomised multi-centre trial
- 2014
-
Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 15
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Many patients with cervical disc disease require leave from work, due to long-lasting, complex symptoms, including chronic pain and reduced levels of physical and psychological function. Surgery on a few segmental levels might be expected to resolve disc-specific pain and reduce neurological deficits, but not the non-specific neck pain and the frequent illness. No study has investigated whether post-surgery physiotherapy might improve the outcome of surgery. The main purpose of this study was to evaluate whether a well-structured rehabilitation programme might add benefit to the customary post-surgical treatment for cervical disc disease, with respect to function, disability, work capability, and cost effectiveness. Methods/Design: This study was designed as a prospective, randomised, controlled, multi-centre study. An independent, blinded investigator will compare two alternatives of rehabilitation. We will include 200 patients of working age, with cervical disc disease confirmed by clinical findings and symptoms of cervical nerve root compression. After providing informed consent, study participants will be randomised to one of two alternative physiotherapy regimes; (A) customary treatment (information and advice on a specialist clinic); or (B) customary treatment plus active physiotherapy. Physiotherapy will follow a standardised, structured programme of neck-specific exercises combined with a behavioural approach. All patients will be evaluated both clinically and subjectively (with questionnaires) before surgery and at 6 weeks, 3 months, 6 months, 12 months, and 24 months after surgery. The main outcome variable will be neck-specific disability. Cost-effectiveness will also be calculated. Discussion: We anticipate that the results of this study will provide evidence to support physiotherapeutic rehabilitation applied after surgery for cervical radiculopathy due to cervical disc disease.
|
|
| 8. |
|
|
