1. |
- Bunketorp, Lina, 1975, et al.
(author)
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Evaluating the reliability of multi-item scales: a non-parametric approach to the ordered categorical structure of data collected with the Swedish version of the Tampa Scale for Kinesiophobia and the Self-Efficacy Scale.
- 2005
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In: Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977. ; 37:5, s. 330-4
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To compare the ability of a rank-invariant non-parametric method with that of kappa statistics to evaluate the reliability of the Swedish version of the Tampa Scale for Kinesiophobia and the Self-Efficacy Scale by identifying systematic and random disagreement. The aim was, further, to compare 2 different statistical approaches to obtain a global value from multi-item scales. DESIGN: A test-retest study. SUBJECTS: A total of 46 patients with whiplash-associated disorders were enrolled and 39 (85%) completed the test-retest assessment. METHODS: Data from the multi-item scales were summarized using both sum and median scores. Paired data were evaluated with a rank-invariant statistical method to identify systematic and random disagreement. Data were also evaluated with kappa statistics. RESULTS: The non-parametric approach demonstrated that the Swedish version of the Tampa Scale for Kinesiophobia and the Self-Efficacy Scale are reliable for patients with whiplash-associated disorders. In contrast to the rank-invariant method, kappa statistics provided no information on disagreement between the 2 test occasions. Median scoring improved reliability due to lack of disagreement while the sum scores method was characterized by random individual disagreement. CONCLUSION: This study has increased understanding of the advantages and limitations of 2 non-parametric statistical methods and, it is hoped, will contribute to the development of reliable measurements.
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2. |
- Bunketorp, Lina, 1975, et al.
(author)
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Neck pain and disability following motor vehicle accidents--a cohort study.
- 2005
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In: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. - : Springer Science and Business Media LLC. - 0940-6719. ; 14:1, s. 84-9
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Journal article (peer-reviewed)abstract
- The primary aim of the study was to compare the prevalence of neck pain and disability in a group exposed to motor vehicle accidents (MVAs) with those in the general population. The secondary aim was to assess the prevalence of a past history of exposure to an MVA with sequelae of neck pain in the general population. The exposed group consisted of 121 patients with neck complaints following an MVA in 1983. The control group, consisting of 1,491 subjects, was randomly selected, with attention to the distribution of age and gender in the exposed group. A neck-pain questionnaire was mailed to the subjects. In the control group, it included enquiry about a history of exposure to an MVA with sequelae of neck pain. The Neck Disability Index (NDI) was used to assess neck-related disability. In the exposed group 108 subjects (89%) responded, and in the control group 931 (62%) did. Seventeen years after the MVA, 59 subjects (55%) reported neck pain in the exposed group, with no gender differences. In the control group 270 (29%) reported neck pain with a higher frequency among women (34%) than men (19%) (p<0.01). There was a significant difference between the exposed group and the control group regarding the occurrence of neck pain (p<0.001). In the control group 34% recalled a history of an MVA, among whom one-third reported neck pain in connection with the accident and 28% had persistent neck pain referable to the accident. The exposed group scored significantly higher on the NDI (p<0.001) and reported significantly higher neck pain intensity than did the control group (p<0.001). In conclusion, a past history of exposure to an MVA with sequelae of neck pain appears to have a substantial impact on future persistent neck pain and associated disability.
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3. |
- Bunketorp, Lina, 1975, et al.
(author)
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The effectiveness of a supervised physical training model tailored to the individual needs of patients with whiplash-associated disorders--a randomized controlled trial.
- 2006
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In: Clinical rehabilitation. - : SAGE Publications. - 0269-2155 .- 1477-0873. ; 20:3, s. 201-17
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To evaluate the effects of a physical training programme which is supervised and tailored to meet the needs of patients with subacute whiplash-associated disorders. DESIGN: A randomized controlled trial with follow-up at three and nine months after randomization. SETTING: An interdisciplinary rehabilitation centre. SUBJECTS: Forty-seven patients with subacute disorders following a whiplash trauma. INTERVENTIONS: Patients were randomized to a supervised training group or a self-administered home training group. MAIN MEASURES: Primary outcome measures were the Self-Efficacy Scale, the Tampa Scale for Kinesiophobia and the Pain Disability Index. Secondary outcome measures were neck pain intensity, sensory and affective dimensions of pain, pain location and duration, muscle tenderness, grip strength, cervical mobility, sick leave and analgesic consumption. RESULTS: Forty patients (85%) completed the intervention period, and the drop-outs were followed up by intention-to-treat. The results showed that supervised training was significantly more favourable than home training, with a more rapid improvement in self-efficacy (P = 0.03), fear of movement/(re)injury (P = 0.03) and pain disability (P = 0.03) at three months. Further, supervised training significantly reduced the frequency of analgesic consumption (P = 0.03). The improvements were partly maintained at nine months, even though there was no amelioration in pain and physical disorders. Despite the favourable outcome, supervised intervention did not reduce sick leave. CONCLUSIONS: The findings indicate a treatment approach that is feasible in the rehabilitation of patients with subacute whiplash-associated disorders in the short term, but additional research is needed to extend these findings and elucidate treatment strategies that also are cost effective.
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4. |
- Bunketorp, Lina, 1975, et al.
(author)
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The perception of pain and pain-related cognitions in subacute whiplash-associated disorders: its influence on prolonged disability.
- 2006
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In: Disability and rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 28:5, s. 271-9
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Journal article (peer-reviewed)abstract
- PURPOSE: To clarify the relations between the sensory, affective and cognitive dimensions of pain and to analyse what influence these components have on persistent disability in patients with subacute whiplash-associated disorders (WAD). METHOD: The data was obtained from an on-going randomised controlled trial (RCT) on 47 patients. The sensory dimension of pain was evaluated with a visual analogue scale (VAS) diary and a Painometer. The affective dimension was assessed using the Painometer. The Tampa Scale for Kinesiophobia (TSK) and the Self-Efficacy Scale (SES) were used as measures of pain-related cognitions. The Pain Disability Index (PDI) was used as the outcome measure. RESULTS: Forty patients (85%) completed the trial. The correlations between the sensory and affective dimensions of pain were non-significant, which indicates that they are two independent constructs that describe various dimensions of whiplash-related pain. High pain intensity and pain affect, more widespread pain, and high fear of movement/(re)injury corresponded to low self-efficacy. Multiple regression analyses showed that self-efficacy was the most important predictor of persistent disability contributing to 42% of the variation in the PDI score. CONCLUSION: The treatment approach for patients with subacute WAD should incorporate the multidimensional nature of pain and to prevent disability special effort should be made to enhance the patient's self-efficacy beliefs.
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5. |
- Carlsson, Jane, 1946, et al.
(author)
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Fysioterapi vid huvudvärk hos barn och ungdomar
- 2009
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In: Migrän och spänningshuvudvärk hos barn och tonåringar, Bo Larsson (red). - Lund : Studentlitteratur. - 9789144048277 ; , s. 113-123
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Book chapter (other academic/artistic)abstract
- Återkommande huvudvärk är ett av de vanligaste hälsoproblemen bland barn och tonåringar. Tecken finns också som tyder på att ofta förekommande huvudvärk under senare år har ökat i förekomst i dessa åldersgrupper. Den är också kopplad till ökad förekomst av andra kroppsliga besvär och psykiska problem, nedsatt funktion i vardagen och sämre livskvalitet. Prognosen på såväl kort som lång sikt är också osäker för dessa individer. De vanligaste formerna av återkommande huvudvärk bland barn och ungdom, som inte beror på annan bakomliggande kroppslig eller psykisk sjukdom, är migrän och spänningshuvudvärk. Under senare år har kunskapen om förekomst, prognos, orsaker till sådan huvudvärk och psykosociala faktorer avsevärt ökat liksom om vilken behandling med läkemedel, psykologiska eller fysioterapeutiska metoder som kan minska besvären. Föreliggande bok är en starkt omarbetad upplaga av den första som utgavs till smärtåret 1998. Avsikten har varit att uppdatera innehållet i ljuset av senare års forskning och starka kunskapsutveckling. Då återkommande huvudvärk hos barn och ungdom är ett negligerat och starkt underbehandlat hälsoproblem är det en förhoppning att boken kan bidra till att fler får effektiv hjälp av det som finns att erbjuda i hälsovården. Förhoppningsvis ger boken också ett bättre underlag i valet av lämpliga bedömings- och behandlingsmetoder för dem som möter barn och ungdom med återkommande huvudvärk. Boken riktar sig främst till personal inom hälso- och sjukvård, men vänder sig också till tonåringar med återkommande huvudvärk, föräldrar, lärare och andra som vill öka sin kunskap och förståelse om detta angelägna hälsoproblem.
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6. |
- Dahlöf, Carl, 1947, et al.
(author)
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Huvudvärk - teori och klinik
- 2006
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Book (other academic/artistic)abstract
- Under senare år har större uppmärksamhet riktats mot neurologiska sjukdomars betydelse för folkhälsan eftersom det står klart att många stora hälsoproblem är orsakade av sjukdomar i hjärnan och dess nervsystem. Huvudvärk påverkar nästan alla någon gång och utgör ett problem för cirka 40 procent av befolkningen. Huvudvärk är en av de mest vanliga orsakerna till läkarbesök såväl inom primärvården som på neurologisk mottagning och representerar en stor socioekonomisk börda för såväl individ som samhälle. Huvudvärk är ett framträdande folkhälsoproblem i alla länder och dränerar produktiviteten, sjukvårdssystemet, samhället, individen och familjen på resurser. De socioekonomiska kostnaderna för huvudvärk är mycket höga, de uppskattades härom året till 10 miljarder ECU per år. Migrän och andra huvudvärksformer rankas på tredje plats efter slaganfall och demens och står för en tredjedel av den totala kostnaden för alla neurologiska sjukdomar i Europa. Författarnas ambition med föreliggande bok har varit att ge en balanserad och skäligt omfattande beskrivning av huvudvärk, nervsmärtor i hjärnan och ansiktssmärtor hos barn och vuxna med avseende på patofysiologi, diagnostik och behandling. Vi hoppas att denna lärobok ska vara till nytta för alla de inom sjukvården som behandlar huvudvärkspatienter och vill öka sina kunskaper inom denna högst intressanta del inom neurologin.
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7. |
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8. |
- Danielsson, Louise, 1979, et al.
(author)
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Exercise in the treatment of major depression: A systematic review grading the quality of evidence
- 2013
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In: Physiotherapy Theory and Practice. - : Informa UK Limited. - 0959-3985 .- 1532-5040. ; 29:8, s. 573-585
-
Journal article (peer-reviewed)abstract
- Objective: To examine the quality of evidence for exercise in the treatment of major depression, comparing specific study types; aerobic exercise vs. antidepressants, aerobic exercise vs. any physical activity, and aerobic exercise as augmentation therapy to treatment as usual vs. treatment as usual. Methods: Electronic searches for randomized controlled studies, reporting on treatment outcome in adults with major depression confirmed by a clinical interview. Quality of evidence was assessed using the Grading and Recommendations Assessment, Development and Evaluation and an additional risk of bias-protocol. Results: Fourteen eligible studies were retrieved, of which nine had low risk of bias. We found moderate quality of evidence that aerobic exercise has no significant effect compared to antidepressants. We found moderate quality of evidence that aerobic exercise at a moderate to high intensity has no significant effect compared to other forms of physical activity. We found low quality of evidence that exercise as augmentation to treatment as usual has a small effect - depression scores were on average 0.44 of a standard deviation lower - compared to treatment as usual. Conclusion: In general, exercise appears to be beneficial in the treatment of depression when used in combination with medication. A significant issue that is not well addressed in previous studies is the risks associated with exercise. Further, this review indicates that aerobic exercise is not more effective than other types of physical activity, pointing to a need to further investigate active components.
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9. |
- Danielsson, Louise, 1979, et al.
(author)
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Exercise or basic body awareness therapy as add-on treatment for major depression: A controlled study
- 2014
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In: Journal of Affective Disorders. - : Elsevier BV. - 0165-0327. ; 168, s. 98-106
-
Journal article (peer-reviewed)abstract
- Background: While physical exercise as adjunctive treatment for major depression has received considerable attention in recent years, the evidence is conflicting. This study evaluates the effects of two different add-on treatments: exercise and basic body awareness therapy. Methods: Randomized controlled trial with two intervention groups and one control, including 62 adults on antidepressant medication, who fulfilled criteria for current major depression as determined by the Mini International Neuropsychiatric Interview. Interventions (10 weeks) were aerobic exercise or basic body awareness therapy (BBAT), compared to a single consultation with advice on physical activity. Primary outcome was depression severity, rated by a blinded assessor using the Montgomery Asberg Rating Scale (MADRS). Secondary outcomes were global function, cardiovascular fitness, self-rated depression, anxiety and body awareness. Results: Improvements in MADRS score (mean change= -10.3, 95% CI (-13.5 to -7.1), p=0.038) and cardiovascular fitness (mean change=2.4 ml oxygen/kg/min, 95% Cl (1.5 to 3.3), p=0.017) were observed in the exercise group. Per-protocol analysis confirmed the effects of exercise, and indicated that BBAT has an effect on self-rated depression. Limitations: The small sample size and the challenge of missing data. Participants' positive expectations regarding the exercise intervention need to be considered. Conclusions: Exercise in a physical therapy setting seems to have effect on depression severity and fitness, in major depression. Our findings suggest that physical therapy can be a viable clinical strategy to inspire and guide persons with major depression to exercise. More research is needed to clarify the effects of basic body awareness therapy.
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10. |
- Ekman, Inger, 1952, et al.
(author)
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Person-centered care -ready for prime time.
- 2011
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In: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 10:4, s. 248-251
-
Journal article (peer-reviewed)abstract
- Long-term diseases are today the leading cause of mortality worldwide and are estimated to be the leading cause of disability by 2020. Person-centered care (PCC) has been shown to advance concordance between care provider and patient on treatment plans, improve health outcomes and increase patient satisfaction. Yet, despite these and other documented benefits, there are a variety of significant challenges to putting PCC into clinical practice. Although care providers today broadly acknowledge PCC to be an important part of care, in our experience we must establish routines that initiate, integrate, and safeguard PCC in daily clinical practice to ensure that PCC is systematically and consistently practiced, i.e. not just when we feel we have time for it. In this paper, we propose a few simple routines to facilitate and safeguard the transition to PCC. We believe that if conscientiously and systematically applied, they will help to make PCC the focus and mainstay of care in long-term illness.
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11. |
- Fichtel, Åsa, et al.
(author)
-
Psykologisk behandling
- 2009
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In: Migrän och spänningshuvudvärk hos barn och tonåringar, Bo Larsson (red). - Lund : Studentlitteratur. - 9789144048277 ; , s. 89-111
-
Book chapter (other academic/artistic)abstract
- Återkommande huvudvärk är ett av de vanligaste hälsoproblemen bland barn och tonåringar. Tecken finns också som tyder på att ofta förekommande huvudvärk under senare år har ökat i förekomst i dessa åldersgrupper. Den är också kopplad till ökad förekomst av andra kroppsliga besvär och psykiska problem, nedsatt funktion i vardagen och sämre livskvalitet. Prognosen på såväl kort som lång sikt är också osäker för dessa individer. De vanligaste formerna av återkommande huvudvärk bland barn och ungdom, som inte beror på annan bakomliggande kroppslig eller psykisk sjukdom, är migrän och spänningshuvudvärk. Under senare år har kunskapen om förekomst, prognos, orsaker till sådan huvudvärk och psykosociala faktorer avsevärt ökat liksom om vilken behandling med läkemedel, psykologiska eller fysioterapeutiska metoder som kan minska besvären. Föreliggande bok är en starkt omarbetad upplaga av den första som utgavs till smärtåret 1998. Avsikten har varit att uppdatera innehållet i ljuset av senare års forskning och starka kunskapsutveckling. Då återkommande huvudvärk hos barn och ungdom är ett negligerat och starkt underbehandlat hälsoproblem är det en förhoppning att boken kan bidra till att fler får effektiv hjälp av det som finns att erbjuda i hälsovården. Förhoppningsvis ger boken också ett bättre underlag i valet av lämpliga bedömings- och behandlingsmetoder för dem som möter barn och ungdom med återkommande huvudvärk. Boken riktar sig främst till personal inom hälso- och sjukvård, men vänder sig också till tonåringar med återkommande huvudvärk, föräldrar, lärare och andra som vill öka sin kunskap och förståelse om detta angelägna hälsoproblem.
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12. |
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13. |
- Jedel, Elizabeth, 1962, et al.
(author)
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Health-related quality of life in child patients with temporomandibular disorder pain.
- 2007
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In: European journal of pain (London, England). - : Wiley. - 1090-3801. ; 11:5, s. 557-63
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Journal article (peer-reviewed)abstract
- Temporomandibular disorders (TMDs) occurs frequently in children and measuring health-related quality of life (HRQL) can complement efficacy measures, offering a complete picture of the impact of disease and treatment on overall well-being. AIM: To compare HRQL, pain threshold (PT) and range of motion (ROM) in child patients with temporomandibular disorder (TMD) pain and an age and gender matched control group. METHODS: The study design was a controlled cross-sectional study. Forty-two children participated in the study. Twenty-one child patients referred to a dental pediatric clinic for specialist treatment because of TMD pain and an age and gender matched control group completed the Child health questionnaire-child form 87 (CHQ-CF87). PT was measured with Pain matcher and ROM in terms of maximum unassisted mandibular opening was measured with a ruler. RESULTS: The child patients with pain more than once a week had a pain duration ranging from 3 months to almost 6 years. The median for pain intensity measured with visual analogue scale (VAS) was 47 ranging from 5 to 80 and the median for behavioral rating scale (BRS) was 3 ranging from 1 to 4. Child patients with TMD pain more than once a week reported significantly lower scores in CHQ-CF87 when compared with a control group. The results for PT and ROM were non-significant. CONCLUSION: CHQ-CF87 could be used for measuring health and to evaluate the efficacy of treatment in child patients with TMD pain.
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14. |
- Lansinger, Birgitta, 1948, et al.
(author)
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Health-related quality of life in persons with long-term neck pain after treatment with qigong and exercise therapy respectively
- 2013
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In: European Journal of Physiotherapy. - : Informa UK Limited. - 2167-9169 .- 2167-9177. ; 15:3, s. 111-117
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Journal article (peer-reviewed)abstract
- The aims of this study were to evaluate health-related quality of life (HRQoL) in individuals with long-term, non-specific neck pain before and after treatment with qigong versus exercise therapy and to compare their HRQoL with an age and sex-matched reference population. A total of 122 persons were randomly assigned to either qigong or exercise therapy. HRQoL was measured with the 36-item Short Form Health Survey (SF-36) and pain intensity was assessed with a visual analogue scale (VAS) before and immediately after treatment, and at 12-month follow-up. Both treatment groups improved on all subscales; however, no differences were observed between the treatment groups either before or after treatment. Those who experienced pain relief (at least 10 mm change on VAS; 53%) also significantly improved from baseline on all SF-36 subscales. Persons with chronic neck pain had significantly lower scores on all SF-36 subscales than normative reference values both before and after treatment. The results of this study indicate no differences between qigong and exercise therapy in HRQoL outcome; however, broad HRQoL improvements seem to be contingent on significant pain reduction. As pain reduction was achieved in roughly half of the study group, more work is needed to refine these therapies, to identify neck pain persons most likely to benefit from them and to develop other physiotherapy treatment strategies suitable to non-responders.
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15. |
- Lansinger, Birgitta, 1948, et al.
(author)
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Qigong and exercise therapy in patients with long-term neck pain: a prospective randomized trial.
- 2007
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In: Spine. - 1528-1159. ; 32:22, s. 2415-22
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Journal article (peer-reviewed)abstract
- STUDY DESIGN: A randomized, controlled, multicenter trial: 1-year follow-up. OBJECTIVE: To compare the effectiveness of qigong and exercise therapy in subjects with long-term nonspecific neck pain. SUMMARY OF BACKGROUND DATA: The evidence for the benefit of treatment programs focusing on persons with long-term, nonspecific neck pain is conflicting. Several studies have shown support for exercise therapy, but the efficacy of qigong has not been scientifically evaluated. METHODS: A total of 122 patients were randomly assigned to receive either qigong (n = 60) or exercise therapy (n = 62). Most of them were women (70%), and the mean age was 44 years. A maximum of 12 treatments were given over a period of 3 months. Neck pain frequency and intensity, neck disability (NDI), grip strength, and cervical range of motion were recorded before and immediately after, at 6 months, and at 12 months after the treatment period. Changes in outcome variables were analyzed and dichotomized as improved or unchanged/deteriorated. RESULTS: Clinical and demographic characteristics were similar among groups at baseline. No differences were found between the 2 interventions: qigong and exercise therapy. Both groups significantly improved immediately after treatment and this was maintained at the 6- and 12-month follow-ups in 5 of 8 outcome variables: average neck pain in the most recent week, current neck pain (with exception for immediately after treatment period), neck pain diary, NDI, and cervical range of motion in rotation. CONCLUSION: These results indicate that treatments including supervised qigong or exercise therapy resulting in reduced pain and disability can be recommended for persons with long-term nonspecific neck pain.
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16. |
- Larsson, Bo, 1943, et al.
(author)
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Relaxation treatment of adolescent headache sufferers: results from a school-based replication series.
- 2005
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In: Headache. - : Wiley. - 0017-8748. ; 45:6, s. 692-704
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Journal article (peer-reviewed)abstract
- BACKGROUND: In recent reviews of psychological and drug treatment, relaxation training approaches have been found to be efficacious for children and adolescents suffering from recurrent tension-type headache (TTH), while biofeedback procedures provide effective help for migraine headache sufferers, primarily treated in tertiary clinics. OBJECTIVE: In a school-based replication series, the effectiveness and efficiency of relaxation training provided within school settings were examined, in addition to the effects on various headache features and the maintenance of treatment gains at a 6 to 10-month follow-up. METHODS: Over a 20-year period, 288 adolescents aged 10 to 18 years participated in seven randomized, controlled trials conducted within regular school health service settings. Subjects were included if they had suffered from frequent migraine or TTHs, or from both headache types for at least 1 year. Various formats of standardized relaxation training procedures were contrasted to different attention-control (ATCO) approaches or self-monitoring (SM) of headaches in prospective diary recordings. RESULTS: The results showed that a therapist-administered relaxation approach was superior to self-help or school-nurse administered relaxation training approaches, ATCO conditions or SM of headaches. Students with TTHs responded positively to any form of relaxation training, whereas those with frequent migraine responded well only to therapist-administered relaxation. However, school-nurse administered procedures were found to be the most efficient form of relaxation treatment, in particular for adolescents suffering from TTHs. Total headache activity, the number of headache days and peak headache intensity were significantly reduced after relaxation treatment, in addition to medication usage. Treatment gains were well maintained at the 6 to 10-month follow-up. CONCLUSION: Therapist-assisted relaxation training is an effective treatment for adolescents suffering from frequent TTHs or migraine. However, such treatment administered by school-nurses administered within school health care settings is an efficient treatment approach for adolescents suffering from the most common form of primary headache, ie, TTHs.
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17. |
- Lindberg, Jeanette, 1987, et al.
(author)
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The effects of whole-body vibration training on gait and walking ability - A systematic review
- 2012
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In: Physiotherapy Theory and Practice. - 0959-3985. ; 28:7, s. 485-498
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Journal article (peer-reviewed)abstract
- Background: Whole-body vibration (WBV) training has been introduced in the last decade and become a popular training method and may increase muscle performance. Objectives: To evaluate the evidence degree of the effect of WBV training on gait and walking ability by a critical examination of scientific studies. In addition, a minor objective was to compare two quality indexes. Method: Literature search in Scopus; quality assessments with The Risk of Bias and The PEDro Scale; and evidence appraisal according to GRADE. Result: Ten studies with varying populations using gait-related measurements after at least 1-month WBV intervention were included. Only two studies report significant positive effects. This is defined as low-quality evidence. Eighty percent and 90% of the studies were rated as high quality according to The PEDro Scale and The Risk of Bias, respectively. Discussion: The low-quality evidence indicates a need for further research. A standardized training protocol would make comparisons and conclusions of WBV training more reliable and feasible. Conclusion: There is low-quality evidence for WBV training having effects on gait and walking ability. Further research is needed. The evidence did not alter between the quality indexes.
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18. |
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19. |
- Linde, Mattias, 1966, et al.
(author)
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Role of the needling per se in acupuncture as prophylaxis for menstrually related migraine: a randomized placebo-controlled study.
- 2005
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In: Cephalalgia : an international journal of headache. - : SAGE Publications. - 0333-1024. ; 25:1, s. 41-7
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Journal article (peer-reviewed)abstract
- The objectives were to introduce a new method for controlled trials of acupuncture in the field of headache research and to examine the role of needling per se. Women with menstrually related migraine were randomized to three months of treatment with verum or placebo needles. Three standard size casts were moulded to secure the placebo needles in the head. No significant differences were found between the verum group (n=15) and the placebo group (n=13) during treatment or follow up three and six months later, either in the attack frequency or in the number of days per month with migraine, headache intensity or drug-use. The casts held the needles exactly in place despite movements of the head, and are validated as practical, hygienic and extremely durable. This method is satisfactory for controlled studies of acupuncture in headache. It is possible that the positive results in earlier clinical trials on acupuncture in migraine are attributable to other mechanisms than needling of subcutaneous tissue.
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20. |
- Mannerkorpi, Kaisa, 1955, et al.
(author)
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Tests of functional limitations in fibromyalgia syndrome: a reliability study.
- 1999
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In: Arthritis Care Res. ; 12, s. 193-199
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To evaluate the reliability and discriminative ability of a test battery consisting of 7 tests designed for the assessment of functional limitations in patients with fibromyalgia syndrome (FMS). METHODS: The intrarater reliability of the test battery was evaluated for 15 women with FMS. Interrater reliability was calculated on 4 tests separately. Fifteen healthy women constituted a reference group. RESULTS: The intrarater coefficient of variation was < 8% for the shoulder range of motion tests, chair test, and 6-minute walk test, and < 21% for the shoulder endurance test, with correlation coefficients above 0.80 for all tests. Kappa was 0.70-0.80 for the hand-to-scapula tests. The interrater coefficient of variation was < 5% for shoulder range of motion. The performances of the FMS patients were significantly decreased in comparison with healthy subjects in all the tests except for the hand-to-scapula movement. CONCLUSIONS: All but 1 of the selected 7 tests were considered to possess acceptable intrarater reliability for use in FMS in clinical physical therapy practice.
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21. |
- Norrby, Ulla, 1937, et al.
(author)
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Self-assessment of well-being in a group of children with epilepsy.
- 1999
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In: Seizure : the journal of the British Epilepsy Association. - : Elsevier BV. - 1059-1311. ; 8:4, s. 228-34
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Journal article (peer-reviewed)abstract
- Epilepsy is common in childhood, the prevalence being about five per 1000 children. The purpose of this study was to assess well-being in children with controlled epilepsy (but did not include those with obvious neurodeficits such as mental retardation or cerebral palsy) and compare them with age-matched healthy children. The patient group comprised of 31 children, 12 boys and 19 girls, whereas the control population group consisted of 342 children, 176 boys and 166 girls who were all in good health. All children involved in the study were aged between 9-13 years. A questionnaire was distributed to the children to complete. It consisted of 39 bipolar adjectives and a visual analogue scale was employed. The results show that the group of children with controlled epilepsy did not differ significantly from the age-matched control group. There was no significant difference between the sexes except for the dimension of vitality, where the boys scored better than the girls. Thus the well-being of children with controlled epilepsy seems to be similar to that of children from a control population. The psychometric properties of the instrument were also assessed. An assessment of well-being in children with intractable epilepsy, using a similar approach, is in progress.
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22. |
- Persson, Liselott, et al.
(author)
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Expectations of Qigong and Exercise Therapy in Patients With Long-term Neck Pain: An Analysis of a Prospective Randomized Study
- 2017
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In: Journal of Manipulative and Physiological Therapeutics. - : Elsevier BV. - 0161-4754. ; 40:9, s. 676-684
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Journal article (peer-reviewed)abstract
- Objective: The aim of the present study was to study differences in treatment expectations after participating in qigong and exercise therapy among participants with long-term neck pain, the impact of total group expectations on treatment outcomes, and the relationship between these treatment expectations and pain and disability. Method: Reliable questionnaires were used. Differences between qigong and exercise was studied in a randomized, controlled, multicenter trial (n = 122). The impact of total group expectations on treatment outcomes and the association between these treatment expectations and pain and disability were studied with nonparametric statistical analysis and Spearman's correlation coefficient. Results: The exercise group had higher expectations than the qigong group before the intervention on how logical treatment seemed to be and after the intervention on treatment credibility (ie, that the treatment would reduce/eliminate neck pain). The exercise group was also more confident that the treatment could reduce neck pain and significantly increased their expectations of reduced neck pain over the 3-month intervention period. Both treatment groups had high expectations of the assigned treatment. Those with high expectations had better treatment outcomes in pain and disability. The relationship between treatment expectations and credibility, pain, and disability was weak. Conclusions: The current findings support the role of assessment of expectation/credibility for positive treatment results. An understanding of each patient's treatment expectations may be helpful in guiding patients with respect to appropriate interventions and as an indication of risk of poor outcome.
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23. |
- Persson, Liselott, et al.
(author)
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Headache in patients with cervical radiculopathy: a prospective study with selective nerve root blocks in 275 patients.
- 2007
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In: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. - : Springer Science and Business Media LLC. - 0940-6719 .- 1432-0932. ; 16:7, s. 953-9
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Journal article (peer-reviewed)abstract
- Since many years we routinely use diagnostic selective nerve root blocks (SNRB) at our department when evaluating patients with cervical radiculopathy. Frequently patients who also presented with headache reported that the headache disappeared when the nerve root responsible for the radicular pain was blocked with local anaesthetics. Headache has been described as a companioning symptom related to cervical radiculopathy but has never before been evaluated with SNRB performed in the lower cervical spine. For this reason we added to our routine an evaluation of the response from the SNRB on headache in patients with cervical radiculopathy. The aim was to describe the frequency of headache in patients with cervical radiculopathy and its response to a selective nerve root block of the nerve root/roots responsible for the radiculopathy. Can nerve root compression in the lower cervical spine produce headache? In this consecutive series of 275 patients with cervical radiculopathy, 161 patients reported that they also suffered from daily or recurrent headache located most often unilaterally on the same side as the radiculopathy. All patients underwent a careful clinical examination by a neurosurgeon and a MRI of the cervical spine. The significantly compressed root/roots, according to the MRI, underwent SNRB with a local anaesthetic. The effect of the nerve root block on the radiculopathy and the headache was carefully noted and evaluated by a physiotherapist using visual analogue scales (VAS) before and after the SNRB. All patients with headache had tender points in the neck/shoulder region on the affected side. Patients with headache graded significantly more limitations in daily activities and higher pain intensity in the neck/shoulder/arm than patients without headache. After selective nerve root block, 59% of the patients with headache reported 50% or more reduction of headache and of these 69% reported total relief. A significant correlation was seen between reduced headache intensity and reduced pain in the neck, shoulder and arm. The result indicates that cervical root compression from degenerative disease in the lower cervical spine producing radiculopathy might also induce headache.
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24. |
- Rosenfeld, Mark, 1949, et al.
(author)
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Active intervention in patients with whiplash-associated disorders improves long-term prognosis: a randomized controlled clinical trial.
- 2003
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In: Spine. - 1528-1159. ; 28:22, s. 2491-8
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Journal article (peer-reviewed)abstract
- STUDY DESIGN: Three-year follow-up of a prospective randomized trial in 97 patients exposed to whiplash trauma in motor vehicle collisions. OBJECTIVES: To compare the long-term efficacy of active intervention with that of standard intervention and the effect of early versus delayed initiation of intervention. SUMMARY OF BACKGROUND DATA: There is no strong evidence for many treatments for whiplash-associated disorders. Some studies provide weak evidence supporting active intervention. METHOD: Patients were randomized to an intervention using frequent active cervical rotation complemented by assessment and treatment according to McKenzie's principles or to a standard intervention of initial rest, recommended soft collar, and gradual self-mobilization. To test the time factor, interventions were either made within 96 hours or delayed 14 days from collision. The effects of the two interventions and the time factor on pain intensity, cervical range of motion, and sick leave were analyzed at 6 months and 3 years. Cervical range of motion at 3 years was also compared with that in matched, unexposed individuals. RESULTS: Pain intensity and sick leave were significantly (P < 0.05) reduced if patients received active intervention compared with standard intervention. Delaying intervention 2 weeks did not affect outcome variables. However, at 3 years, only patients receiving early active intervention had a total cervical range of motion similar to that of matched unexposed individuals. CONCLUSION: In patients with whiplash-associated disorders, active intervention is more effective in reducing pain intensity and sick leave, and in retaining/regaining total range of motion than a standard intervention. Active intervention can be carried out as home exercises initiated and supported by appropriately trained health professionals.
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25. |
- Söderberg, Elisabeth, et al.
(author)
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Chronic tension-type headache treated with acupuncture, physical training and relaxation training. Between-group differences.
- 2006
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In: Cephalalgia : an international journal of headache. - : SAGE Publications. - 0333-1024. ; 26:11, s. 1320-9
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Journal article (peer-reviewed)abstract
- The aim of this study was to compare acupuncture, relaxation training and physical training in the treatment of chronic tension-type headache (CTTH). The study comprised 90 consecutive patients with CTTH who were randomly allocated to acupuncture, relaxation training or physical training. Headache intensity, headache-free days and headache-free periods were registered using a visual analogue scale and a headache diary. The measurements were made 4 weeks before, immediately after, and 3 and 6 months after the treatment period. Immediately after the last treatment, the number of headache-free periods and of headache-free days was higher in the relaxation group compared with the acupuncture group. There were no other significant differences between the groups at any time point. The clinical implications of our findings are that relaxation training induced the most pronounced effects directly after the treatment period, compared with acupuncture and physical training.
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