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| 2. |
- Antonson, Maria, et al.
(author)
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Andningsvårdande behandling vid buk- och thoraxkirurgi
- 2010
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In: Fysioterapi. - 1653-5804. ; :2, s. 36-40
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Journal article (peer-reviewed)abstract
- Sedan snart hundra år arbetar sjukgymnaster för att minska risken för postoperativa lungkomplikationer hos patienter som skall opereras i bröstkorg och buk. Klinisk erfarenhet visar att sjukgymnastisk andningsvård är viktig men vad vet vi idag om effekten av olika insatser? Vilka insatser bör man i första hand välja? Författarna till denna artikel har utarbetat Riktlinjer för andningsvårdande behandling inom sjukgymnastik för patienter som genomgår buk- och thoraxkirurgi. Målet med riktlinjearbetet har varit att utvärdera och sammanställa befintlig evidens för andningsvårdande behandlingsmetoder inom sjukgymnastik som används i samband med buk- och thoraxkirurgiska ingrepp. Den samlade evidensen i kombination med expertgruppens kommentarer har resulterat i kliniska behandlingsrekommendationer. Dessa riktar sig till kliniskt verksamma sjukgymnaster som arbetar med buk- och thoraxkirurgiska patienter. Förhoppningen är att den aktuella och systematiskt sammanställda kunskapen ska bidra till diskussioner på enskilda arbetsplatser och att behandlingsrekommendationerna kan anpassa till lokala förhållanden. Denna artikel är en sammanfattning av riktlinjerna som finns att hämta på Sjukgymnastförbundets hemsida under Profession. I riktlinjedokumentet återfinns också en fullständig referenslista
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| 4. |
- Biörserud, Christina, et al.
(author)
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Objective measurements of excess skin in post bariatric patients - inter-rater reliability.
- 2016
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In: Journal of plastic surgery and hand surgery. - 2000-6764. ; 50:2, s. 68-73
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Journal article (peer-reviewed)abstract
- An ability to reliably assess excess skin after massive weight loss using well-described and transferrable methods is important. The aim of this trial was to evaluate inter-rater reliability of ptosis and circumference measurements in patients with excess skin after bariatric surgery.
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| 5. |
- Engström, My, 1977, et al.
(author)
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The meaning of awaiting bariatric surgery due to morbid obesity.
- 2011
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In: The open nursing journal. - : Bentham Science Publishers Ltd.. - 1874-4346. ; 5, s. 1-8
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Journal article (peer-reviewed)abstract
- The understanding of the association between the objective conditions of health and the subjective perceptions of morbidly obese patients appears to be poor. The use of objective indicators alone produces results totally unrelated to the feelings and experiences of the bariatric patients studied. No study has approached the bariatric patient from both an inside and a preoperative perspective.
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- Fagevik Olsén, Monika, 1964, et al.
(author)
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Long-term effects of physical activity prescription after bariatric surgery: A randomized controlled trial
- 2022
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In: Physiotherapy Theory and Practice. - : Informa UK Limited. - 0959-3985 .- 1532-5040. ; 38:11
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Journal article (peer-reviewed)abstract
- Purpose This study examined the effects of physical activity prescription (PAP) in patients after gastric bypass surgery. Patients' physical activity (PA) levels and outcomes were followed over their first postoperative year. Methods Patients slated for bariatric surgery were randomized to a control group (n = 64) (basic information about postoperative PA) or an intervention group (n = 57) (also received physical therapist-prescribed PAP). Outcome measures were self-reported PA/exercise and sedentary time; and weight, waist circumference, blood pressure, and blood lipids; recorded pre-operatively and at 2, 6, and 12 months postoperatively. Follow-ups were conducted by nurses/dieticians. Trial registration: "Research and Development in Sweden" number 107371. Results There were no differences between the groups except for higher level of PA (579 vs. 182 minutes/week) six months after surgery (p = .046) and a larger decrease in cholesterol (-24 vs. -8%) after a year (p = .017) in the intervention group. Patients in both groups lost considerable weight, had reduced waist circumference, and increased PA (p < .001). Conclusion Although marked differences between groups were not observed over one year, the intervention group increased its PA 6-months postoperatively, but not at other time points. Whether long-term outcomes of PAP use are more robust with physical therapist participation across follow-ups warrants study.
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| 9. |
- Samulowitz, Anke, 1965, et al.
(author)
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“Sense of control": Patients experiences of multimodel pain rehabilitation and its impact in their everyday lives
- 2019
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In: Journal of Rehabilitation Medicine Clinical Communications. - : Medical Journals Sweden AB. - 2003-0711. ; 2
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Journal article (peer-reviewed)abstract
- Objective: Long-lasting pain is a challenge for patients’ everyday lives. The aim of this study was to examine how women and men who have participated in multimodal pain rehabilitation experience its impact in their everyday lives. Patients and methods: Individual semi-structured interviews with 5 women and 3 men who had participated in multimodal pain rehabilitation at a clinic in Sweden, analysed using qualitative content analysis. Results: Participants perceived that their “sense of control” increased, which had a positive impact in their everyday life. Sense of control consisted of 3 categories: importance of the patient–provider relationship, knowledge gained (especially on body functions and medication), and pain in a social context. Three results were discussed in particular: (i) a trustful patient–provider relationship based on confidence in the provider’s expertise was a prerequisite for pain acceptance; (ii) patients were aware of gender norms in healthcare; (iii) social support was not stressed as important to cope with pain. Conclusion: The importance of patients’ confidence in the provider’s expertise and patients’ awareness about gender norms need consideration in terms of the patient–provider encounter. The value of social support for pain rehabilitation was found to be less important compared with previous research; this should be explored further.
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| 10. |
- Tullberg, Helene Stenmark, et al.
(author)
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"Stepping with ease towards a new way of living" - experiences of physical activity 5 years after bariatric surgery
- 2017
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In: European Journal of Physiotherapy. - : Informa UK Limited. - 2167-9169 .- 2167-9177. ; 19:3, s. 154-159
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Journal article (peer-reviewed)abstract
- Aim: Obesity has many negative health consequences. The only evidence-based treatment with long-term effects on weight reduction is bariatric surgery. There is limited knowledge on how patients experience physical activity several years after such surgery. The aim of the study was, therefore, to describe how patients who have undergone bariatric surgery experience physical activity more than 5 years after the operation. Methods: In this qualitative interview study, 12 patients (10 women/2 men) were included. They had all undergone laparoscopic bariatric surgery >5 years previously because of super obesity (BMI > 50 kg/m(2)). The patients were interviewed about their experiences of physical activity and the interviews were recorded and transcribed verbatim. The analysis was made with qualitative content analysis using an inductive approach as described by Graneheim and Lundman. The local research ethics committee approved the study. Results: Five themes appeared focusing on different aspects of activity in life: daily life, family, occupation, physical exercise and emotions. Opportunities and obstacles emerged as categories. Conclusion: The study indicates that several years after the obesity surgery most of the patients still experience many obstacles that interfere with the experience of physical activity as a natural part of daily life. These data suggest that assessment of barriers to physical activity remain an important step in physical activity counselling several years after bariatric surgery.
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| 11. |
- Wiklund, Malin, 1972, et al.
(author)
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Accuracy of a pedometer and an accelerometer in women with obesity.
- 2012
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In: Open obesity journal. - : Bentham Science Publishers Ltd.. - 1876-8237. ; 4, s. 11-17
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Journal article (peer-reviewed)abstract
- Aim: The main purpose of this study was to examine the accuracy of a specific pedometer (Silva model Pedometer Plus 56013-3) and accelerometer (Silva model Ex3 plus 56026) in women suffering from obesity. The second aim was to study the impact of BMI, waist and hip circumference and waist-hip ratio on different pedometer and accelerometer positions on the body. Methods: Forty women with a BMI > 30 kg/m 2 wore two pedometers and two accelerometers during a standardized 6 minute walk test. Accelerometer 1 (A1) was placed around the neck. Accelerometer 2 (A2) was attached to the waistband of the woman's trousers in line with left hip, Pedometer 1 (P1) in line with right hip and pedometer 2 (P2) behind back in line with the spine. During the test an assistant manually counted number of steps, using a hand counter as reference for step accuracy. Results: Steps registered with the pedometer were significantly different from actual steps counted. The intra class correlations for the actual steps counted compared with the steps registered were P1 = 0.13, P2 = 0.20, A1= 0.99 and A2 = 0.41. All correlations between the tested pedometer and accelerometer at the different locations and BMI, waist circumference, hip circumference and hip-to waist ratio were little (if any) or low. Conclusions: The accelerometer is more accurate than the pedometer in measuring steps in women suffering from obesity. The location, which gave the most accurate results, was found to be around the neck. © Wiklund et al.
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| 12. |
- Wiklund, Malin, 1972, et al.
(author)
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Experiences of Physical Activity One Year after Bariatric Surgery
- 2014
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In: The Open Obesity Journal. - : Bentham Science Publishers Ltd.. - 1876-8237. ; 6:1, s. 25-30
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Journal article (peer-reviewed)abstract
- Abstract: Background and purpose: Obesity is a major global health problem today and the only evidence-based method leading to a long-lasting weight reduction is bariatric surgery. Physical activity improves health, decreases the incidence of several diseases and may influence weight loss outcome after bariatric surgery. Knowledge regarding how patients experience physical activity after bariatric surgery could provide us with better tools to enhance physically active. Methods: The aim of the present study was to describe how patients experience physical activity one year after bariatric surgery. An inductive qualitative content analysis was used to analyse semi-structured interviews with twenty-four patients one year after bariatric surgery. Results: The main findings emerged in four overarching themes: “Hindrances of physical activity”, “Physical activity with a less obese body implies achievement”, “Coming to an understanding of the benefits of physical activity” and “Need of support”. Conclusion: According to our findings patients experience both achievements and hinders with regard to physical activity one year after surgery. Patients had an increased understanding of the benefits of physical activities, but support appears necessary to obtain and maintain a suitable level.
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| 13. |
- Wiklund, Malin, 1972, et al.
(author)
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Physical activity as viewed by adults with severe obesity, awaiting gastric bypass surgery.
- 2011
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In: Physiotherapy research international. - : Wiley. - 1471-2865 .- 1358-2267. ; 16:3, s. 179-186
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Journal article (peer-reviewed)abstract
- Background and Purpose.Today, it is known that adults suffering from obesity benefit from physical activity. There is however lack of research with regard to how patients with severe obesity experience physical activity. It is important to explore this topic in order to be able to improve communication with and to tailor information and exercise programmes for patients suffering with obesity. The aim of the present qualitative study was to describe how adults with severe obesity, awaiting gastric bypass surgery experience physical activity.Methods.A qualitative method inspired by a phenomenographic approach was used to analyze the data. Data collection was performed by in-depth semi-structured interviews with 18 patients. All patients were aged between 18 and 65 years, suffered from severe obesity and were scheduled for laparoscopic Roux-en Y gastric bypass surgery at Sahlgrenska University Hospital in Sweden.Results.The analysis resulted in nine qualitatively different categories that were then divided into four aspects: 'the obese body', 'the mind', 'knowledge' and 'the environment'. Many patients experienced well-being after physical activity, but most patients were uncomfortable with appearing in public wearing exercise clothing. The excess weight itself was considered an obstacle, and weight loss was assumed to facilitate physical activity. Exercising together with someone at the same level of fitness increased motivation. A white lie about training was sometimes used to satisfy the need to be seen as capable.Conclusion.Physical activity is experienced positively among adults with severe obesity, but many obstacles exist that influence their capacity and their will. Support is necessary in different ways, not only to initiate physical activity, but also to maintain it.
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| 14. |
- Wiklund, Malin, 1972, et al.
(author)
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Physical Activity in the Immediate Postoperative Phase in Patients Undergoing Roux-en-Y Gastric Bypass—a Randomized Controlled Trial
- 2015
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In: Obesity Surgery. - : Springer Science and Business Media LLC. - 0960-8923 .- 1708-0428. ; 25:12, s. 2245-2250
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Journal article (peer-reviewed)abstract
- Background The purpose of this study is to register the number of steps taken during the first postoperative week by patients who underwent laparoscopic Roux-en-Y gastric bypass surgery (LRYGB) and evaluate whether goals for steps taken per day could affect the patients’ physical activity level, time to first flatus and stool, days at hospital, and recovery. Methods Fifty-five patients undergoing LRYGB surgery carried a step counter on the first postoperative week and recorded the number of steps taken. They also registered hours spent sitting, lying down and sleeping, assessed their level of recovery, and noted the first day of flatus and defecation. The intervention group was informed to try to reach a daily goal regarding the number of steps to be taken. Results The patients took 2000–3000 steps/day on the first postoperative days. There were significant differences between the groups in numbers of steps taken in favor of the intervention group on four of the postoperative days. The patients in the intervention group found that the goals were set at the right level, except for the second day, where they thought 1300 steps were too few. There were no significant differences between the groups in the mean time spent sitting or lying. Neither were there any differences in time for first flatus, stool, days at hospital, nor degree of recovery. Conclusions Goals set for steps taken per day increase the amount of steps walked in patients undergoing gastric bypass surgery. Step counters and predefined goals can be used to facilitate mobilization after obesity surgery.
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| 15. |
- Wiklund, Malin, 1972, et al.
(author)
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Physical Fitness and Physical Activity in Swedish Women before and onePhysical Fitness and Physical Activity in Swedish Women before and one Year after Roux-en-Y Gastric Bypass Surgery
- 2014
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In: The Open Obesity Journal. - : Bentham Science Publishers Ltd.. - 1876-8237. ; 6, s. 38-43
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Journal article (peer-reviewed)abstract
- Aim: To investigate physical fitness, physical activity level and time spent sitting in Swedish women before and one year after laparoscopic Roux-en-Y Gastric Bypass surgery (LRYGB). Method: Thirty-seven women (age: 41.2±9.6 years and Body Mass Index (BMI): 42±6.5 kg/m2) were tested before and one year after LRYGB. (BMI: 30.5±5.8 kg/m2). Physical fitness was assessed using the six minute walk test (6MWT), and three muscular endurance and one handgrip test. Physical activity level and sitting time were assessed using the short form of the International Physical Activity Questionnaire (IPAQ). Results: One year after surgery the mean distance walked during 6MWT increased from 532 m to 599 m (p=<0.001) and the muscular endurance was significantly improved (p0.016), while no statistical significant difference was found in grip force compared to pre-operatively. After surgery, the women walked significantly more minutes/week (p=0.018) and increased their level of moderate (p=0.039) and vigorous (p=0.033) physical activity, but there were no significant differences in sitting time (p=0.206) compared to preoperatively. Conclusions: The physical activity level as well as physical fitness increased while grip strength remained same in Swedish women one year after LRYGB, compared to before surgery. The improved physical fitness and the considerable weight loss are important factors in reducing the risk of developing lifestyle associated diseases and risk of premature death in this group of women. But even if both physical activity and physical fitness increased at group level one year after LRYGB, some individuals still needed to be more physically active and to enhance the physical fitness level. These patients might benefit from physiotherapy to be able to be more physically active.
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| 16. |
- Wiklund, Malin, 1972, et al.
(author)
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Physical Function and Health Related Quality of Life Before and 18 Months after Bariatric Surgery
- 2015
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In: The Open Obesity Journal. - : Bentham Science Publishers Ltd.. - 1876-8237. ; 7, s. 12-16
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Journal article (peer-reviewed)abstract
- Introduction: The mobility disability experienced by people with obesity is well known and has been found to be associated with reduced health related quality of life (HRQoL) compared to people without obesity. Research is lacking related to the patients experiences that how their capacity to perform various daily physical activities and HRQoL are affected by weight loss following bariatric surgery. Aim: To evaluate patients’ experiences of their HRQoL and physical function before and 18 months after laparoscopic Roux-en-Y Gastric Bypass surgery (LRYGB). Method: A series of 70 patients filled in one HRQoL questionnaire, the EQ-5D (including EQ VAS and EQ-5D descriptive system) and two self-assessment questionnaires that evaluate disability by assessing activity and participation limitations, the Disability Rating Index (DRI) and a questionnaire with five disease-specific questions. Results: All activities, in both DRI as well as the five disease-specific questions were experienced as significantly less difficult to perform postoperatively than preoperatively (p<0.05). In this study, the median (min, max) EQ VAS score was 60 (20, 100) mm preoperatively and 80 (20, 100) mm postoperatively (100 = best imaginable health; 0 = worst imaginable health). The difference between pre- and postoperative EQ VAS was significant (p<0.001). Conclusion: Both the HRQoL and the self experienced ability to perform various daily physical activities increased significantly 18 months after LRYGB compared to preoperatively.
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