| 1. |
- Borg, Sabina, et al.
(författare)
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The Added Value of a Behavioral Medicine Intervention in Physiotherapy on Adherence and Physical Fitness in Exercise-Based Cardiac Rehabilitation (ECRA): A Randomised, Controlled Trial
- 2020
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Ingår i: Patient Preference and Adherence. - : DOVE MEDICAL PRESS LTD. - 1177-889X. ; 14, s. 2517-2529
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Despite beneficial effects, adherence to exercise-based cardiac rehabilitation (exCR) is low in patients with coronary artery disease (CAD). The aim of this study was to investigate adherence to and the effects of a behavioral medicine intervention in physiotherapy (BMW) added to routine exCR care on the primary outcome of physical fitness compared with routine exCR care. Patients and Methods: In a randomized, controlled trial, 170 patients with CAD (136 men), mean age 62.3 (7.9) years, were included at a Swedish university hospital. Patients were randomized 1:1 to routine exCR care (RC) or to a BMIP added to routine exCR care for four months, with a long-term follow-up at 12 months. The outcome assessment included submaximal aerobic exercise capacity, muscle endurance and self-reported physical activity and physical capacity. Results: The four-month follow-up showed improvements in all outcomes for both groups, but changes did not differ significantly between the groups. Patients in the BMIP group were more adherent to exCR recommendations compared with the RC group (31% vs 19%) and a non-significant tendency towards the maintenance of submaximal aerobic exercise capacity over time was seen in the BMIP group, whereas patients in the RC group appeared to deteriorate. Conclusion: Both groups improved significantly at the four-month follow-up, while the 12-month follow-up showed a non-significant tendency towards better long-term effects on submaximal aerobic exercise capacity and exercise adherence for a BMIP compared with RC. In spite of this, a better understanding of the role of a BMIP in enhancing adherence is needed.
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| 2. |
- Agervi, Pia, et al.
(författare)
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Foveal function in children treated for amblyopia.
- 2010
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Ingår i: Acta ophthalmologica. - : Wiley. - 1755-3768 .- 1755-375X. ; 88:2, s. 222-226
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: This study aimed to evaluate foveal function, using three different methods, in children treated for monocular amblyopia. METHODS: A sample of 24 otherwise healthy children with treated amblyopia and an age-matched control group of 25 healthy children were examined for best corrected visual acuity (BCVA) using a standard decimal (KM) chart and the computerized TriVA method at 50% and 10% contrasts. Foveal function was also measured with the rarebit fovea test (RFT), which is included in the rarebit perimetry program package. This test uses very small and bright dots against a dark background. The result is expressed as mean hit rate (MHR). RESULTS: Amblyopic eyes showed significantly lower BCVA when evaluated with the KM chart and with the TriVA test at different contrast levels, compared with both fellow eyes and control eyes. No statistically significant difference between amblyopic and fellow eyes was found when foveal function was evaluated with the RFT (median MHRs 91.5% and 94.5%, respectively), although results for both amblyopic and fellow eyes were statistically lower than those of the control group (median MHR 97%) (p = 0.001 and p = 0.046, respectively). This might indicate that the RFT provides different information about foveal function than conventional VA tests. CONCLUSIONS: The findings in the current study accord with those of other studies reporting abnormalities in the fellow eyes of previously treated amblyopic patients. These findings may reflect a general disturbance in the visual system rather than a monocular adaptation to refractive error or ocular motor disturbance.
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| 3. |
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| 4. |
- Borg, Sabina, et al.
(författare)
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Effectiveness of a behavioral medicine intervention in physical therapy on secondary psychological outcomes and health-related quality of life in exercise-based cardiac rehabilitation : a randomized, controlled trial
- 2023
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Ingår i: BMC Sports Science, Medicine and Rehabilitation. - : BioMed Central Ltd. - 2052-1847. ; 15:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Interventions promoting adherence to exercise-based cardiac rehabilitation (exCR) are important to achieve positive physical and psychological outcomes, but knowledge of the added value of behavioral medicine interventions for these measures is limited. The aim of the study was to investigate the added value of a behavioral medicine intervention in physical therapy (BMIP) in routine exCR on psychological outcomes and health-related quality of life (HRQoL) versus routine exCR alone (RC). Methods: A total of 170 patients with coronary artery disease (136 men), mean age 62.3 ± 7.9 years, were randomized at a Swedish university hospital to a BMIP plus routine exCR or to RC for four months. The outcome assessments included HRQoL (SF-36, EQ-5D), anxiety and depression (HADS), patient enablement and self-efficacy and was performed at baseline, four and 12 months. Between-group differences were tested with an independent samples t-test and, for comparisons within groups, a paired t-test was used. An intention-to-treat and a per-protocol analysis were performed. Results: No significant differences in outcomes between the groups were shown between baseline and four months or between four and 12 months. Both groups improved in most SF-36 domains, EQ-VAS and HADS anxiety at the four-month follow-up and sufficient enablement remained at the 12-months follow-up. Conclusion: A BMIP added to routine exCR care had no significant effect on psychological outcomes and HRQoL compared with RC, but significant improvements in several measures were shown in both groups at the four-month follow-up. Since recruited participants showed a better psychological profile than the general coronary artery disease population, further studies on BMIP in exCR, tailored to meet individual needs in broader patient groups, are needed. Trial registration number NCT02895451, 09/09/2016, retrospectively registered.
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| 5. |
- Borg, Sabina, et al.
(författare)
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The role of a behavioural medicine intervention in physiotherapy for the effects of rehabilitation outcomes in exercise-based cardiac rehabilitation (ECRA) - the study protocol of a randomised, controlled trial
- 2017
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Ingår i: BMC Cardiovascular Disorders. - : BIOMED CENTRAL LTD. - 1471-2261 .- 1471-2261. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Background: To help patients with coronary artery disease (CAD) benefit from the positive health effects attained by exercise-based cardiac rehabilitation (CR), adherence to these programmes according to international guidelines is important. Strategies to increase adherence to exercise-based CR are mainly an unexplored area. The objective of this study is to investigate the effects of a behavioural medicine intervention in physiotherapy, containing goal-setting, self-monitoring and feedback, with the aim of improving rehabilitation outcomes for exercise-based CR, compared with usual care. Methods: This is a randomised, controlled trial. A total of 160 patients with CAD will be included consecutively at the Coronary Care Unit at a university hospital in Sweden. Patients are randomised 1:1 using sealed envelopes to usual care or a behavioural medicine intervention in physiotherapy, in addition to usual care for 4 months. Outcome assessment at baseline, 4 and 12 months includes submaximal aerobic capacity (primary outcome), exercise adherence, muscle endurance, level of physical activity, biomarkers, anxiety and depression, health-related quality of life, patient enablement and self-efficacy (secondary outcomes). Discussion: This is the first study to evaluate the role of an integrated behavioural medicine intervention in exercise-based CR in the effects of rehabilitation outcomes. The results of this study will provide valuable information about the effect of these interventions in exercise-based CR and it has the potential to inform and assist in further treatment in secondary prevention for patients with CAD.
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| 6. |
- Elvén, Maria, 1973-
(författare)
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Clinical reasoning focused on clients’ behaviour change in physiotherapy : Development and evaluation of the Reasoning 4 Change instrument
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- With the recognition of the impact of lifestyle behaviours on health and the evidence of incorporating behavioural considerations in physiotherapy, there is a need to advance the clinical reasoning of physiotherapists. Clinical reasoning encompasses the thinking and decision-making processes guiding client management and is a core competency of physiotherapists. Enabling clinical reasoning advancements requires investigations in practice and education, which in turn require robust assessments. The overall aim of this thesis was to develop and evaluate an instrument to study physiotherapy students’ clinical reasoning focused on clients’ activity-related behaviour and behaviour change.In study I, a conceptual model was developed based on exploration of existing research, theory and views of physiotherapists and students. The data resulted in the clinical reasoning model focused on clients’ behaviour change with reference to physiotherapists (CRBC-PT). Studies II and III included instrument development and evaluation in four phases. Phase 1 included determination of the instrument structure and item generation based on the CRBC-PT model, evidence in clinical reasoning assessment and existing measures. Phase 2 included cognitive interviews with students to assess item understanding and resulted in revisions of item problems and approval of feasibility. Phase 3 included a Delphi study with physiotherapists with expertise in behavioural medicine to evaluate item relevance. The findings demonstrated a high level of consensus regarding content relevance. The final version of the Reasoning 4 Change (R4C) instrument included four domains, namely, Physiotherapist, Input from client, Functional behavioural analysis, and Strategies for behaviour change. In phase 4, the reliability and validity of the instrument were evaluated. Physiotherapists with expertise in behavioural medicine and students responded to the web-based R4C instrument and the Pain Attitudes and Beliefs Scale for Physiotherapists. The analyses showed excellent inter-rater reliability, satisfactory construct validity, internal consistency and test-retest reliability. In study IV, final-semester students (n=151) from all physiotherapy programmes in Sweden completed the R4C instrument. Hierarchical multiple regression analyses were conducted with three dependent variables, namely, input from client, functional behavioural analysis, and strategies for behaviour change. All included independent variables explained 37% of the variance in input from client. Cognitive and metacognitive skills explained 22%, attitudes 15% and curriculum with behavioural medicine competencies 3%. Only the variable curriculum with behavioural medicine competencies explained the variance in functional behavioural analysis (4%) and strategies for behaviour change (5%).In conclusion, the in-depth description of clinical reasoning focused on clients’ behaviour change may contribute to expanded understanding of the complexity and multidimensionality in reasoning processes that incorporate factors related to human behaviours, analyses of what factors motivate or hinder behaviours, and interventions to support behaviour change. Such knowledge is valuable for the teaching of and learning clinical reasoning. The R4C instrument helps fill the need for well-tested instruments and can support investigations and evaluations in physiotherapy education and research. To develop students’ clinical reasoning competence, cognitive and metacognitive skills, positive attitudes and the incorporation of behavioural medicine competencies into physiotherapy curricula should be targeted. Further attention to complex reasoning, including analysis and intervention, is warranted.
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| 7. |
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| 8. |
- Lindberg, Daniel, 1976-, et al.
(författare)
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How Have Physical Activity and Sedentary Behavior, Changed during the COVID-19 Pandemic? A Swedish Repeated Cross-Sectional Design Study
- 2023
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 20:4, s. 3642-3642
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Tidskriftsartikel (refereegranskat)abstract
- Physical activity (PA) and sedentary behavior (SB) affect people’s physical and mental health. The aim was to examine changes in PA and SB in a Swedish population: at three time points: 2019, 2020, and 2022, i.e., before and during the COVID-19 pandemic. Pre-pandemic PA and SB, i.e., 2019, were assessed retrospectively in 2020. Associations between PA and SB with sex, age, occupation, COVID-19 history, weight change, health, and life satisfaction were also examined. The design was repeated cross-sectionally. The main findings demonstrate the PA levels decreased between 2019 and 2020, and between 2019 and 2022, but not between 2020 and 2022. The SB increase was most evident between 2019 and 2020. Between 2020 and 2022, results showed a decrease in SB, but SB did not reach pre-pandemic levels. Both sexes decreased their PA over time. Although men reported more PA sex, they did not have any association with PA changes. Two age groups, 19–29 years and 65–79 years, decreased their PA over time. Both PA and SB were associated with COVID-19, occupation, age, life satisfaction, health, and weight change. This study underlines the importance of monitoring changes in PA and SB as they have relevance for health and well-being. There is a risk that the levels of PA and SB do not return to pre-pandemic levels in the population.
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| 9. |
- Lönnblad, Jens, et al.
(författare)
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Artefacts in continuous ECG recordings : provoking and preventing manoeuvres
- 2005
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Ingår i: Scandinavian Cardiovascular Journal. - : Informa UK Limited. - 1401-7431 .- 1651-2006. ; 39:3, s. 167-171
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. A systematic estimation of the effects of some clinically important artefact provoking and artefact-preventing manoeuvres.Design. A test protocol for the evaluation of technical modifications of continuous ECG recordings was tested in 17 patients. The programme comprised ECG recordings during five artefact-provoking manoeuvres (slight shaking of the ECG cables, rotating shoulders, slight electrode touching, washing, teeth-brushing) and two simple artefact-preventing manoeuvres (taping ECG cables and covering electrodes with paper cups). Results. The artefact-provoking manoeuvres induced a substantial increase in artefactual ECG. The artefact-preventing manoeuvres only incompletely prevented this increase. Conclusion. There is a great need of technical improvements to reduce the distortion of ECG by artefacts. The test protocol developed by us exposes a broad spectrum of different categories of ECG qualities and is therefore suitable for evaluating technical improvements concerning artefactual ECG.
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| 10. |
- Martin, Lene, 1953-, et al.
(författare)
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Test-retest variation in macular thickness measurements with the Heidelberg Retina Tomograph
- 2012
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Ingår i: Clinical and experimental optometry. - : Informa UK Limited. - 0816-4622 .- 1444-0938. ; 95:5, s. 515-521
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim was to evaluate the test-retest variation of macular thickness measurements using the Heidelberg Retina Tomograph (HRT3) Retina Module and compare it with the Stratus optical coherence tomography (OCT). As no normative data has been published for the HRT Retina Module, a secondary purpose was to obtain reference values for this technique. Methods: Thirty healthy subjects and nine patients with macular oedema were examined. The healthy subjects underwent five examinations by two experienced examiners at two different occasions. The patients with maculopathy were examined twice by one examiner on one occasion. All measurements were made with both the HRT3 and the Stratus OCT and the macular thickness measurements were used for calculations of thetest-retest variation. Results: In healthy subjects the coefficient of variation (CV) ranged from 4.5 to 8.8 per cent with the HRT3 and from 0.6 to 1.5 per cent with the Stratus OCT. In the nine patients withmacular oedema, the HRT CV ranged from 7.9 to16.6 per cent and for OCT from 1.1 to 2.5 per cent. The intra-class correlation in the central area for intra-observer/intra-visit in healthy subjects was 0.78 with the HRT3 and 0.93 with the Stratus OCT. Corresponding values for the patients with macular oedema were 0.64 with the HRT3 and 1.0 with the Stratus OCT. Mean macular thickness was significantly larger in all areas measured with the HRT3 compared with the Stratus OCT. No significant correlations were found between the thickness values from the different instruments. Conclusion: In this study, macular thickness was measured with two different techniques. The HRT3 showed lower repeatability and reproducibility as well as a higher CV compared with the Stratus OCT in both healthy subjects and patients with macular oedema. This difference might be of clinical relevance, even though the nine patients with maculopathy in the current study showed abnormal results with both methods.
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