| 1. |
- Backåberg, Sofia, 1979-, et al.
(författare)
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Sustainable human movements - a threshold concept with potential to open up new perspectives in physiotherapy
- 2024
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Ingår i: European Journal of Physiotherapy. - : Taylor & Francis Group. - 2167-9169 .- 2167-9177.
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Tidskriftsartikel (refereegranskat)abstract
- There is a call to action for physiotherapists worldwide to contribute to the transition towards 'sustainable health'. In this paper, we build upon the current definition of 'sustainable health' and also on 'sustainable physical activity' to introduce and theoretically substantiate the concept of sustainable human movements, and suggest a definition thereof. Sustainable human movements will be described as a threshold concept with three aligned critical concepts; (i) movement control, including forces as causes of emerging movements, (ii) movement quality, referring to how movements are performed in terms of optimisation, and (iii) physical literacy, including motivation, confidence and physical competence. A deep understanding of these concepts, combined with a collaboration and learning approach applied together with the patient, is proposed to enable a sustainable human movement approach to permeate physiotherapy theory and practice. To facilitate this, a generic and easily accessible tool has recently been developed. It combines support for structured observational movement analysis and pedagogical support for creating a mutual and extended understanding of a patient's lived experience. This encourages the patient to become actively involved and take responsibility for promoting his/her 'sustainable health'. The aims of this paper are to a) suggest a theoretical framework for and definition of the concept sustainable human movements, and b) introduce a clinical tool that ultimately aims at promoting sustainable movements and health.
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| 2. |
- Beyaert, Christian, et al.
(författare)
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Gait post-stroke : Pathophysiology and rehabilitation strategies
- 2015
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Ingår i: Neurophysiologie clinique. - : Elsevier BV. - 0987-7053 .- 1769-7131. ; 45:4-5, s. 335-355
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Forskningsöversikt (refereegranskat)abstract
- We reviewed neural control and biomechanical description of gait in both non-disabled and post-stroke subjects. In addition, we reviewed most of the gait rehabilitation strategies currently in use or in development and observed their principles in relation to recent pathophysiology of post-stroke gait. In both non-disabled and post-stroke subjects, motor control is organized on a task-oriented basis using a common set of a few muscle modules to simultaneously achieve body support, balance control, and forward progression during gait. Hemiparesis following stroke is due to disruption of descending neural pathways, usually with no direct lesion of the brainstem and cerebellar structures involved in motor automatic processes. Post-stroke, improvements of motor activities including standing and locomotion are variable but are typically characterized by a common postural behaviour which involves the unaffected side more for body support and balance control, likely in response to initial muscle weakness of the affected side. Various rehabilitation strategies are regularly used or in development, targeting muscle activity, postural and gait tasks, using more or less high-technology equipment. Reduced walking speed often improves with time and with various rehabilitation strategies, but asymmetric postural behaviour during standing and walking is often reinforced, maintained, or only transitorily decreased. This asymmetric compensatory postural behaviour appears to be robust, driven by support and balance tasks maintaining the predominant use of the unaffected side over the initially impaired affected side. Based on these elements, stroke rehabilitation including affected muscle strengthening and often stretching would first need to correct the postural asymmetric pattern by exploiting postural automatic processes in various particular motor tasks secondarily beneficial to gait.
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| 3. |
- Frykberg E, Gunilla, 1957-, et al.
(författare)
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Movement analysis of sit-to-stand : research informing clinical practice
- 2015
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Ingår i: Physical Therapy Reviews. - : Maney Publishing. - 1083-3196 .- 1743-288X. ; 20:3, s. 156-167
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Tidskriftsartikel (refereegranskat)abstract
- Background: Sit-to-stand (STS) is a crucial transfer influencing a person's independence in daily activities, as well as safety and quality of life, and is thus vital to evaluate in research and in practice. Clinical STS tests provide single values in seconds or numbers of STS. There is, however, increasing numbers of research papers reporting spatial and temporal kinematic and kinetic process STS data.Objectives: To provide an overview of research findings from laboratory-based movement analyses regarding phases and determinants of typical STS, characteristics of successful versus failed STS transfers, and finally STS performance in some neurological conditions.Major Findings: The STS transfer, previously regarded as mainly requiring lower limb muscle strength, is increasingly recognized as a complex transfer skill. Muscle strength, balance, foot position, chair height and the movement strategy are major determinants influencing STS performance. Scaling and timing of momentum generation throughout STS seems critical for success or failure. Sit-to-stand in stroke and Parkinson's disease (PD) is characterized by asymmetry in force generation and difficulties in switching movement direction, respectively. In-depth, knowledge regarding mechanisms of momentum control during STS sub-phases, STS failures, as well as exploration of variability in normal and atypical STS is still lacking.Conclusions: Recent research based on instrumented movement analyses has generated better understanding of movement control during STS, but the specifics are not yet reflected in clinical assessments. There seems to be a call for clinical tools capturing determinants and process characteristics of the STS transfer for a more comprehensive evaluation in rehabilitation.
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| 4. |
- Frykberg E, Gunilla, 1957-, et al.
(författare)
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The Arm Posture Score for assessing arm swing during gait : An evaluation of adding rotational components and the effect of different gait speeds
- 2014
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Ingår i: Gait & Posture. - : Elsevier BV. - 0966-6362 .- 1879-2219. ; 40:1, s. 64-69
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Tidskriftsartikel (refereegranskat)abstract
- In 3D gait analysis, quantification of leg movements is well established, whereas ameasure of armswing has been lacking. Recently, the Arm Posture Score (APS) was introduced to characterize arm movements in children with cerebral palsy, including information from four variables (APS(4)) in the sagittal and frontal planes. A potential limitation of the APS is that it does not include rotational movements and has not yet been evaluated with regard to gait speed. The aims of this study were (i) to investigate the effect on APS of adding two components of arm rotation (APS(6)) and (ii) to determine the influence of gait speed on the APS measures, when applied to non-disabled adults. Forty-two subjects walked 10 m at a selfselected speed (1.34 m/s), and in addition a subgroup of 28 subjects walked at a slowspeed (0.66 m/s) set by a metronome. Data were collected from markers in a whole-body set up and by eight optoelectronic cameras. The results demonstrated significantly higher APS(6) than APS(4) values for both arms, irrespective of gait speed. Speed condition, whether self-selected or slow, had a significant effect on both APS measures. The two additional arm components are suggested to provide relevant information about arm swing during walking. However, APS(6) needs to be implemented in gait analysis of individuals with gait arm pathologies in order to further examine its utility. Werecommend that gait speed should to be taken into account when using APS measures to quantify arm swing during gait. (C) 2014 Elsevier B. V. All rights reserved.
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| 5. |
- Frykberg, Gunilla E., 1957-, et al.
(författare)
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Neuroplasticity in action post-stroke : challenges for physiotherapists
- 2015
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Ingår i: European Journal of Physiotherapy. - : Informa UK Limited. - 2167-9169 .- 2167-9177. ; 17:2, s. 56-65
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Forskningsöversikt (refereegranskat)abstract
- Knowledge regarding neuroplasticity post-stroke is increasingly expanding. In spite of this, only a few physiotherapy interventions have been able to demonstrate effectiveness in achieving recovery of lost sensorimotor control. The aims of this review article are to highlight and discuss challenges for physiotherapists working with patients post-stroke, to question some current assessment methods and treatment approaches, and to pose critical questions indicating a possible new direction for physiotherapists in stroke rehabilitation. Differentiation between recovery and compensation post-stroke is increasingly being emphasized. Implementation of this goal in the clinic is insufficient, with a lack of assessment tools with potential to discriminate between the concepts. Large-scale reviews are performed without considering whether functional gains are achieved through “more effective” compensatory strategies or through recovery. Cortical plasticity in neurorehabilitation research and voluntary control in contemporary treatment methods are in focus. Challenges for physiotherapists in stroke rehabilitation consist of rethinking, including looking upon the body under the influence of gravity, focusing on implicit factors that impact movement control and developing new assessment tools. The introduction of a new assessment and treatment concept aiming at expanding the boundaries of center of mass movements towards the paretic side is proposed. In conclusion, we need to assume our responsibilities and step forward as the experts in movement science that we have the potential to be.
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| 6. |
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| 7. |
- Johansson, Gudrun M., et al.
(författare)
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Assessment of arm movements during gait in stroke : the Arm Posture Score
- 2014
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Ingår i: Gait & Posture. - : Elsevier BV. - 0966-6362 .- 1879-2219. ; 40:4, s. 549-555
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of the study was to apply the Arm Posture Score (APS) to a stroke population, since comprehensive measures to quantify arm swing in the affected and non-affected arms during gait are lacking. A further aim was to investigate how gait speed and upper limb function estimated by clinical measures are related to the APS in the stroke group. The APS is the summarized root mean square deviation (RMSD) from normal, based on kinematics. Four arm movements (sagittal and frontal planes) as well as six arm movements (incorporating transversal plane) were included in the calculation of APS, referred to as APS4 and APS6, respectively. The study population consisted of 25 persons with stroke and 25 age- and gender-matched controls. The APS measures were significantly different between the affected and non-affected arms, as well as between the affected arm and the non-dominant arm of the controls (p≤0.001). Spasticity significantly influenced both APS measures, while speed only had a significant effect on the APS4. The APS measures correlated significantly to clinical measures of upper limb function. Both APS measures seem to be useful indices to quantify and discriminate between impaired and normal arm swing during gait after stroke. The variability of rotational arm movements needs to be studied further before considering the additional value of the APS6 over the APS4. When interpreting the APS, complementary kinematics should be taken into account, as the single value of the APS gives no information about the direction of the deviation.
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| 8. |
- Zetterberg, Hedvig, et al.
(författare)
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Neural and nonneural contributions to wrist rigidity in Parkinson's disease: an explorative study using the NeuroFlexor
- 2015
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Ingår i: BioMed research international. - : Hindawi Limited. - 2314-6141 .- 2314-6133. ; 2015, s. 276182-
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Tidskriftsartikel (refereegranskat)abstract
- Objective. The NeuroFlexor is a novel method incorporating a biomechanical model for the measurement of neural and nonneural contributions to resistance induced by passive stretch. In this study, we used the NeuroFlexor method to explore components of passive movement resistance in the wrist and finger muscles in subjects with Parkinson’s disease (PD).Methods. A cross-sectional comparison was performed in twenty-five subjects with PD with clinically identified rigidity and 14 controls. Neural (NC), elastic (EC), and viscous (VC) components of the resistance to passive extension of the wrist were calculated using the NeuroFlexor. Measurements were repeated during a contralateral activation maneuver.Results. PD subjects showed greater total resistance(P<0.001)and NC(P=0.002)compared to controls. EC and VC did not differ significantly between groups. Contralateral activation maneuver resulted in increased NC in the PD group but this increase was due to increased resting tension. Total resistance and NC correlated with clinical ratings of rigidity and with bradykinesia.Conclusions. The findings suggest that stretch induced reflex activity, but not nonneural resistance, is the major contributor to rigidity in wrist muscles in PD. The NeuroFlexor is a potentially valuable clinical and research tool for quantification of rigidity.
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