| 1. |
- Nooijen, Carla F., et al.
(author)
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Validation of an activity monitor for children who are partly or completely wheelchair-dependent
- 2015
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In: Journal of NeuroEngineering and Rehabilitation. - : Springer Science and Business Media LLC. - 1743-0003. ; 12, s. 11-
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Journal article (peer-reviewed)abstract
- BACKGROUND: Children who are wheelchair-dependent are at risk for developing unfavorable physical behavior; therefore, assessment, monitoring and efforts to improve physical behavior should start early in life. VitaMove is an accelerometer-based activity monitor and can be used to detect and distinguish different categories of physical behavior, including activities performed in a wheelchair and activities using the legs. The purpose of this study was to assess the validity of the VitaMove activity monitor to quantify physical behavior in children who are partly or completely wheelchair-dependent. METHODS: Twelve children with spina bifida (SB) or cerebral palsy (CP) (mean age, 14 +/- 4 years) performed a series of wheelchair activities (wheelchair protocol) and, if possible, activities using their legs (n = 5, leg protocol). Activities were performed at their own home or school. In children who were completely wheelchair-dependent, VitaMove monitoring consisted of one accelerometer-based recorder attached to the sternum and one to each wrist. For children who were partly ambulatory, an additional recorder was attached to each thigh. Using video-recordings as a reference, primary the total duration of active behavior, including wheeled activity and leg activity, and secondary agreement, sensitivity and specificity scores were determined. RESULTS: Detection of active behaviour with the VitaMove activity monitor showed absolute percentage errors of 6% for the wheelchair protocol and 10% for the leg protocol. For the wheelchair protocol, the mean agreement was 84%, sensitivity was 80% and specificity was 85%. For the leg protocol, the mean agreement was 83%, sensitivity was 78% and specificity was 90%. Validity scores were lower in severely affected children with CP. CONCLUSIONS: The VitaMove activity monitor is a valid device to quantify physical behavior in children who are partly or completely wheelchair-dependent, except for severely affected children and for bicycling.
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| 2. |
- Blom, Victoria, et al.
(author)
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The effects on self-efficacy, motivation and perceived barriers of an intervention targeting physical activity and sedentary behaviours in office workers : a cluster randomized control trial.
- 2021
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In: BMC Public Health. - : BioMed Central (BMC). - 1471-2458. ; 21:1
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Journal article (peer-reviewed)abstract
- BACKGROUND: The importance of physical activity on health is clear, but changing behaviour is difficult. Successful interventions aiming to improve physical activity and reduce sedentary behaviour is therefore of importance. The aim of this study was to evaluate effects on motivation, self-efficacy and barriers to change behaviour from two different behavioural intervention focusing either on reducing sedentary behaviour or on increasing physical activity as compared to a waiting list control group.METHODS: The study was designed as a cluster randomized control trial (RCT) within two private companies. Self-efficacy, motivation and perceived barriers were together with demographic variables assessed before and after a 6-month intervention. Participant cluster teams were randomly allocated to either the physical activity intervention (iPA), the sedentary behaviour intervention (iSED), or control group. The intervention was multi componential and included motivational counselling based on Cognitive behaviour therapy and Motivational interviewing, group activities and management involvement. Group differences were determined using Bayesian multilevel modelling (parameter estimate; credible interval (CI)), analysing complete cases and those who adhered to the protocol by adhering to at least 3 out of 5 intervention sessions.RESULTS: After the intervention, the complete cases analysis showed that the iPA group had significantly higher autonomous motivation (0.33, CI: 0.05-0.61) and controlled motivation (0.27, CI: 0.04-0.51) for physical activity compared with the control group. The iSED group scored less autonomous and controlled motivation compared to the iPA group (0.38, CI: - 0.69- -0.087 respectively - 0.32, CI: - 0.57-0.07) but no significant differences compared with the control group. Among individuals that adhered to the protocol, the results showed higher scores on Exercise (3.03, CI: 0.28-6.02) and Sedentary self-efficacy (3.59, CI: 0.35-7.15) for individuals in the iPA group and on Sedentary self-efficacy (4.77, CI: 0.59-9.44) for the iSED group compared to the control group.CONCLUSION: These findings indicate that the interventions were successful in increasing self-efficacy in each intervention group and autonomous motivation for exercise in the iPA group, in particular when actively participating in the motivational counselling sessions.
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| 3. |
- Borg, David N, et al.
(author)
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Bicycling and tricycling road race performance in international para-cycling events between 2011 and 2019.
- 2022
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In: American Journal of Physical Medicine & Rehabilitation. - : Lippincott Williams & Wilkins. - 0894-9115 .- 1537-7385. ; 101:4, s. 384-388
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Journal article (peer-reviewed)abstract
- ABSTRACT: This study described bicycling (C-classes) and tricycling (T-classes) performance in International Cycling Federation road race events between 2011 and 2019. A total of 3,243 race results from 33 events were analyzed. Race velocity was calculated for each result. Bicycling and tricycling data were separately modelled using a linear mixed-effects model. Bicycling velocity was statistically different between all adjacent men's classes (Cohen's d = 0.14 to 0.73), and between the women's C1 and C2 (d = 1.15), and C3 and C4 (d = 0.48) classes. The absence of statistical differences between some women's bicycling classes may be due to a limited number of observations in these classifications. As expected, velocity was statistically different between men's (d = 1.64) and women's (d = 1.38) T1 and T2 classes. Road race performance was hierarchical within the disciplines of bicycling and tricycling, although not all adjacent women's bicycling classes were statistically different. The existence of a performance hierarchy does not necessarily validate the classification system. The integration of information regarding athlete impairment type and severity, with performance data, would provide greater insight into the validity of the classification system, and should be prioritized as an area of future research.
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| 4. |
- Ekblom, Maria, 1974-, et al.
(author)
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Fysisk aktivitet och hjärnhälsa
- 2018
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In: Fysioterapi. - 1653-5804. ; :5, s. 32-35
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Journal article (pop. science, debate, etc.)abstract
- Psykisk ohälsa är den vanligaste orsaken till sjukskrivning. Fysisk aktivitet kan förebygga många former av ohälsa, men vilka fysiska aktivitetsmönster som gynnar psykisk hälsa och kognitiva förmågor är fortfarande okänt. Denna typ av forskning är komplex och kräver samarbete med många olika aktörer i samhället.
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| 5. |
- Kouwijzer, Ingrid, et al.
(author)
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EFFECTS OF PUSH-OFF ABILITY AND HANDCYCLE TYPE ON HANDCYCLING PERFORMANCE IN ABLE-BODIED PARTICIPANTS
- 2018
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In: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 50:6, s. 563-568
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Journal article (peer-reviewed)abstract
- Objective: To assess the effects on handcycling performance and physiological responses, of: (i) making a closed chain by comparing handcycling in a recumbent bike with 2-feet footrest (closed chain) with handcycling with 1 footrest (partial closed chain) and without a footrest (no closed chain); (ii) equipment by comparing handcycling in a recumbent bike with a kneeling bike. Methods: Ten able-bodied participants performed submaximal exercise and sprint tests, once in a kneeling bike and 3 times on a recumbent: 2-feet support, 1-foot support and without foot support. Physical strain (submaximal oxygen uptake and heart rate), peak (POpeak) and mean power output (POmean) were measured. Results: Significantly higher POpeak, and POmean were found with 2-feet support (mean 415 W (standard deviation (SD) 163) and mean 281 W (SD 96)) and higher POmean with 1-foot support (mean 279 W (SD 104)) compared with no foot support (mean 332 W (SD 127) and mean 254 W (SD 101)), p<0.05. No differences were found for physical strain. In the kneeling bike, POpeak and POmean were significantly higher (mean 628 W (SD 231) and 391 W (SD 121)) than in the recumbent (mean 415 W (SD 163) and 281 W (SD 96)), p=0.001. Conclusion: The ability to make a closed chain has a significant positive effect on handcycling sprint performance; therefore, this ability may be a discriminating factor. Sprint performance was significantly higher in kneeling compared with recumbent handcycling.
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| 6. |
- LaBerge, Nicole B, et al.
(author)
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Comorbidities and medical complexities of mobility device users : a retrospective study.
- 2023
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In: Disability and Rehabilitation. - : Taylor & Francis. - 1748-3107 .- 1748-3115. ; 18:7, s. 1035-1042
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To determine the medical complexities and comorbidities of individuals who utilise wheeled mobility devices. As well as, to examine costly events including the number of urinary tract infections (UTIs), hospitalizations, urgent care(UC)/emergency department (ED) visits that are commonly seen in this population over a period of time one year prior to and one year post receiving their wheeled mobility equipment.DESIGN/SETTING: A retrospective data review of 857 individual medical charts at a Level 1 Trauma Hospital and Clinic System.PARTICIPANTS: 330 male and female (24-92 years old) mobility device users with a wide range of diagnoses, of which: 56 used manual wheelchairs (MWC),138 scooters (POV), 123 power wheelchairs without integrated standing (PWC), and 13 power wheelchairs with integrated standing (iS-PWC).RESULTS: Overall, 92% (n = 304) had at least three medical comorbidities and medical complexities. The most common comorbidity was pain (91%). A change was noted in a lower incidence of UTIs in those using an iS-PWC, respectively 23% with at least 1 UTI in the year prior to and 8% in the year after the mobility device evaluation.CONCLUSIONS: The large number of comorbidities and medical complexities amongst all mobility device users is concerning. The burden and the accompanying healthcare costs of this population is high. The potential that iS-PWC and other interventions could have on reducing these issues should be explored further.Implications of rehabilitationRegardless of a person's primary diagnosis or the wheeled mobility device they use, 100% have at least one and 92% have at least three comorbidities and medical complexities if they spend the majority of their day sittingThe high healthcare cost situations such as Emergency Department visits, Urgent Care visits, hospitalizations, and Urinary Tract Infections are present across those that use all mobility device types and the means to potentially reduce these incidences should be further exploredThe introduction of integrated standing within a power wheelchair, as a means to minimize the frequency of comorbidities and medical complications, should also be investigated further.
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| 7. |
- Larisch, Lisa-Marie, et al.
(author)
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Effects of two randomized and controlled multi-component interventions focusing on 24-hour movement behavior among office workers: A compositional data analysis
- 2021
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In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18
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Journal article (peer-reviewed)abstract
- Intervention studies aiming at changing movement behavior have usually not accounted for the compositional nature of time-use data. Compositional data analysis (CoDA) has been sug-gested as a useful strategy for analyzing such data. The aim of this study was to examine the effects of two multi-component interventions on 24-h movement behavior (using CoDA) and on cardi-orespiratory fitness among office workers; one focusing on reducing sedentariness and the other on increasing physical activity. Office workers (n = 263) were cluster randomized into one of two 6-month intervention groups, or a control group. Time spent in sedentary behavior, light-intensity, moderate and vigorous physical activity, and time in bed were assessed using accelerometers and diaries, both for 24 h in total, and for work and leisure time separately. Cardiorespiratory fitness was estimated using a sub-maximal cycle ergometer test. Intervention effects were analyzed using linear mixed models. No intervention effects were found, either for 24-h behaviors in total, or for work and leisure time behaviors separately. Cardiorespiratory fitness did not change significantly. Despite a thorough analysis of 24-h behaviors using CoDA, no intervention effects were found, nei-ther for behaviors in total, nor for work and leisure time behaviors separately. Cardiorespiratory fitness did not change significantly. Although the design of the multi-component interventions was based on theoretical frameworks, and included cognitive behavioral therapy counselling, which has been proven effective in other populations, issues related to implementation of and compliance with some intervention components may have led to the observed lack of intervention effect.
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| 8. |
- Liljedahl, Johanna B, et al.
(author)
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Para-cycling race performance in different sport classes.
- 2021
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In: Disability and Rehabilitation. - : Taylor & Francis. - 0963-8288 .- 1464-5165. ; 43:24, s. 3440-3444
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Journal article (peer-reviewed)abstract
- Purpose: The para-cycling classification system, consisting of five classes (C1-C5) for bicycling (C5 athletes having least impairments), is mostly based on expert-opinion rather than scientific evidence. The aim of this study was to determine the differences in race performance between para-cycling classes. Methods: From official results of the men's 1 km time trials for classes C1-C5 of seven Union Cycliste Internationale World Championships and Paralympics, median race speed of the five fastest athletes in each class was calculated (n = 175). Para-cycling results were expressed as a percentage of able-bodied performance using race results from the same years (n = 35). To assess differences between consecutive classes, Kruskal-Wallis tests with Mann-Whitney U post hoc tests were performed, correcting for multiple testing (p < 0.013). Results: Para-cyclists in C1 reached 75% (median ± interquartile range = 44.8 ± 4.2 km/h) and in C5 90% (53.5 ± 2.9 km/h) of able-bodied race speed (59.4 ± 0.9 km/h). Median race speed between consecutive classes was significantly different (χ2 = 142.6, p < 0.01), except for C4 (52.1 ± 2.8 km/h) and C5 (U = 447.0, p = 0.05). Conclusion: Current para-cycling classification does not clearly differentiate between classes with least impairments.IMPLICATIONS FOR REHABILITATIONThe current classification system is not evidence-based and does not clearly differentiate between relevant groups of para-cyclists.An evidence-based para-cycling classification system is essential for a fair and equitable competition.Fair competition will make it more interesting and increase participation.Para-cycling can inspire everyone with and even those without disabilities to be physically active.
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| 9. |
- Liljedahl, Johanna, et al.
(author)
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Isometric, dynamic, and manual muscle strength measures and their association with cycling performance in elite para-cyclists.
- 2023
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In: American Journal of Physical Medicine & Rehabilitation. - : Wolters Kluwer. - 0894-9115 .- 1537-7385. ; 102:5, s. 461-467
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Journal article (peer-reviewed)abstract
- OBJECTIVE: Para-cycling classification aims to generate fair competition by discriminating between levels of activity limitation. This study investigated the relationship between lower limb Manual Muscle Tests (MMT) with ratio-scaled measures of isometric and dynamic strength, and of the ratio-scaled measures with cycling performance.DESIGN: Fifty-six para-cyclists (44 males, 12 females) with leg impairments performed isometric and dynamic strength tests: leg push and pull, and an all-out 20 s sprint. MMT results were obtained from the classification database (n = 21) and race speeds from time trials (n = 54).RESULTS: Regression analyses showed significant associations of MMT with isometric push (R2 = .49), dynamic push (R2 = .35), and dynamic pull (R2 = .28). Isometric strength was significantly correlated with dynamic push (ρ = .63) and pull (ρ = .54). The isometric and dynamic tests were significantly associated with sprint power and race speed (R2 = .16-.50).CONCLUSION: The modified MMT and ratio-scaled measures were significantly associated. The significant relation of isometric and dynamic strength with sprint power and race speed maps the impact of lower limb impairments on para-cycling performance. MMT and the isometric and dynamic measures show potential for use in para-cycling classification.
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| 10. |
- Liljedahl, Johanna
(author)
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Towards evidence-based classification in para-cycling
- 2022
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Doctoral thesis (other academic/artistic)abstract
- The aim of classification in Paralympic sport is to minimize the impact of impairment on the outcome of competition. The aim of this thesis was to investigate the impact of different types of impairments on para-cycling performance to develop an evidence-based classification system in the para-cycling C (bicycling) and T (tricycling) divisions.This thesis is based on four articles. The first article examined differences in race performance between para-cycling classes by comparing track race results. The second article evaluated leg strength measures in para-cyclists with musculoskeletal impairments. The third article investigated leg coordination and leg strength and the association with para-cycling performance in para-cyclists with hypertonia, ataxia, or athetosis. The fourth article aimed to gather consensus on para-cycling classification issues and to identify research priorities within para-cycling, by consulting a panel with expertise within para-cycling and para-sport.This thesis has identified performance characteristics in para-cyclists with musculoskeletal and coordination impairments, and suggested tests with potential to be used in para-cycling classification to assess muscle strength and coordination. The results indicate that the classes for athletes with the least impairments, as well as the classes for athletes with impaired coordination, need to be further investigated.
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