| 1. |
- Alfredson, Håkan
(författare)
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Clinical commentary of the evolution of the treatment for chronic painful mid-portion Achilles tendinopathy
- 2015
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Ingår i: Revista Brasileira de Fisioterapia. - : FapUNIFESP (SciELO). - 1413-3555 .- 1809-9246. ; 19:5, s. 429-432
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The chronic painful Achilles tendon mid-portion was for many years, and still is in many countries, treated with intratendinous revision surgery. However, by coincidence, painful eccentric calf muscle training was tried, and it showed very good clinical results. This finding was unexpected and led to research into the pain mechanisms involved in this condition. Today we know that there are very few nerves inside, but multiple nerves outside, the ventral side of the chronic painful Achilles tendon mid-portion. These research findings have resulted in new treatment methods targeting the regions with nerves outside the tendon, methods that allow for a rapid rehabilitation and fast return to sports.
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| 2. |
- Bilterys, T., et al.
(författare)
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Predictors for physical activity and its change after active physical therapy in people with spinal pain and insomnia: Secondary analysis of a randomized controlled trial
- 2022
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Ingår i: Brazilian Journal of Physical Therapy. - : Elsevier BV. - 1413-3555. ; 26:6
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Tidskriftsartikel (refereegranskat)abstract
- Background: In healthy people and people with nonspecific chronic spinal pain (nCSP) and/or insomnia, participation in physical activity on a regular basis has several physical and psychological health benefits. However, people with chronic conditions often tend to reduce physical activity participation which can lead to deconditioning over time. Currently, there are no known predictors for an (in)active lifestyle (before and after physical therapy treatment) in people with chronic spinal pain and comorbid insomnia. Objective: To examine predictors of pre-treatment moderate-to-vigorous physical activity (MVPA) and to examine determinants for a change in MVPA in response to 14-weeks of active physical therapy treatment in people with nonspecific chronic spinal pain (nCSP) and comorbid insomnia. Methods: Baseline data and post-treatment data were analyzed for 66 participants. A linear multiple regression analysis was conducted to examine which factors predict MVPA at baseline. Linear mixed-effects modeling was used to identify determinants for change in MVPA in response to an active physical therapy treatment. Results: Physical fatigue (b = -0.9; 95%CI: -1.59, -0.15), less limitations in functioning as a result of emotional problems (b = 0.1; 95%CI: 0.03, 0.10), mental fatigue (b = -1.0; 95%CI: -1.67, -0.43), lower general sleep quality (b= 0.7; 95%CI: 0.22, 1.17), and body mass index (b = -0.5; 95%CI: -0.93, -0.16) were significant predictors of baseline MVPA. The regression model explained 33.3% of the total variance in baseline MVPA. The change of MVPA in response to the treatment ranged from a decrease of 17.5 to an increase of 16.6 hours per week. No determinants for change in MVPA after treatment could be identified. Conclusion: People with nCSP and comorbid insomnia are more likely to engage in MVPA if they report, at baseline, lower sleep quality, fewer limitations in functioning resulting from emotional problems, lower body mass index, as well as less physical and mental fatigue.
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| 3. |
- Fältström, Anne, et al.
(författare)
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Self-reported knee function and activity level are reduced after primary or additional anterior cruciate ligament injury in female football players: a five-year follow-up study
- 2023
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Ingår i: Revista Brasileira de Fisioterapia. - : ASSOCIACAO BRASILEIRA PESQUISA POS-GRADUACAO FISIOTERAPIA-ABRAPG-FT. - 1413-3555 .- 1809-9246. ; 27:6
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Tidskriftsartikel (refereegranskat)abstract
- Background: Playing football involves a high risk of anterior cruciate ligament (ACL) injuries and these may affect knee function and activity level. Objectives: To measure changes in self-reported knee function, activity level, and satisfaction with knee function and activity level in female football players with or without an ACL-recon-structed knee. Methods: Female football players, age 19.9 (SD 2.6) years, with either a primary ACL-recon-struction 1.6 (SD 0.7) years after ACL-reconstruction (n = 186) or no ACL injury (n = 113) were fol-lowed prospectively for five years. Self-reported data collected at baseline and follow-up included knee function (International Knee Documentation Committee Subjective Knee Form [IKDC-SKF]), activity level (Tegner Activity Scale), and satisfaction with knee function (Likert scale 1=happy; 7=unhappy) and activity level (1-10 scale). Information on any new ACL injury during the follow-up period was collected. Results: Players with ACL-reconstruction at baseline who either did (n = 56) or did not (n = 130) sustain an additional ACL injury, and players with no injury at baseline who remained injury free (n = 101) had a lower Tegner score at follow-up. Players with additional ACL injury had lower IKDC-SKF score (mean difference:-11.4, 95% CI:-16.0,-6.7), and satisfaction with activity level (mean difference:-1.5, 95% CI:-2.3,-0.7) at follow-up. Players with no additional ACL injury had higher satisfaction with knee function (mean difference: 0.6, 95% CI: 0.3, 0.9) at fol-low-up. Players with no ACL injury had lower satisfaction with activity level (mean difference:-0.7, 95% CI:-1.1,-0.3) at follow-up. Players with additional ACL injury had larger decreases in all variables measured compared to the two other groups. Conclusion: Primary, and even more so additional, ACL injuries decreased self-reported knee function, activity level, and satisfaction with knee function and activity level in female football players. (c) 2023 The Author(s). Published by Elsevier Espana, S.L.U. on behalf of Associacao Brasileira de Pesquisa e Pos-Graduacao em Fisioterapia. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
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| 4. |
- Hernández, Edgar D, et al.
(författare)
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Intra- and interrater reliability of Fugl-Meyer Assessment of Lower Extremity early after stroke.
- 2021
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Ingår i: Brazilian journal of physical therapy. - : Elsevier BV. - 1809-9246 .- 1413-3555. ; 25:6, s. 709-718
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Tidskriftsartikel (refereegranskat)abstract
- The Fugl-Meyer Assessment of Lower Extremity (FMA-LE) is a widely used and recommended scale for evaluation of post-stroke motor impairment. However, the reliability of the scale has only been established by using parametric statistical methods, which ignores the ordinal properties of the scale.To determined intra- and inter-rater reliability of the FMA-LE at item and summed score level early after stroke.Sixty patients (mean age 65.9 years, median FMA-LE 29 points) admitted to the hospital due to stroke were included. The FMA-LE was simultaneously, but independently, scored by three experienced and trained physical therapists randomly assigned into pairs, on two consecutive days, between 4 to 9 days post stroke. A rank-based statistical method for paired ordinal data was used to assess the level of agreement and systematic and random disagreements.The item-level reliability was high (percentage of agreement [PA] ≥75%). Two items (ankle dorsiflexion during flexor synergy and normal reflex activity) showed some systematic disagreement in intrarater analysis. A satisfactory intrarater reliability (PA ≥70%) was reached for all summed scores when a 1- or 2-point difference was accepted between ratings.The FMA-LE is a reliable tool for assessment of motor impairment both within and between raters early after stroke. The scale can be recommended not only for use in Spanish speaking countries, but also internationally. A unified international use of FMA-LE would allow comparison of stroke recovery outcomes worldwide and thereby potentially improve the quality of stroke rehabilitation.
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| 5. |
- Johannesson, E., et al.
(författare)
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Women's experiences of obstetric anal sphincter injury and physical therapy interventions - A qualitative study: Experiences after anal sphincter injury
- 2022
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Ingår i: Brazilian Journal of Physical Therapy. - : Elsevier BV. - 1413-3555. ; 26:2
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Tidskriftsartikel (refereegranskat)abstract
- Background: During childbirth, women may suffer perineal injuries that can lead to persistent disorders. No interview study has investigated women's experience of obstetric anal sphincter injuries (OASIS) and physical therapy rehabilitation process after the injury. Objective: To describe women's experiences of OASIS and the physical therapy rehabilitation process. Methods: A qualitative study with an inductive approach based on semi-structured interviews was performed with 14 primi- and multi-parous women affected by OASIS. They had been sutured within 24 h and were recruited from a university hospital in Sweden. The interviews lasted between 35 and 66 min. Data were processed and analyzed using qualitative content analysis. Results: Three main categories emerged from the analysis: The categories described experiences of a difficult time after the injury and physical therapy rehabilitation but also experiences of a safe follow-up. Moreover, experiences of that it wasn´t that bad after all when looking back. Conclusion: Regardless of the extent of the injury, some women experienced a long and troublesome recovery with intense physical therapy rehabilitation, while other women felt that they fortunately got away lightly. Factors that can influence a woman's confidence in safely beginning pelvic floor muscle training at an early stage include individualizing when and how information about OASIS is provided. Meeting each woman's needs and wishes is emphasized by this study. © 2022 The Author(s)
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| 6. |
- Leemans, L., et al.
(författare)
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Do psychological factors relate to movement-evoked pain in people with musculoskeletal pain? A systematic review and meta-analysis
- 2022
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Ingår i: Brazilian Journal of Physical Therapy. - : Elsevier BV. - 1413-3555. ; 26:6
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Tidskriftsartikel (refereegranskat)abstract
- Background: A growing body of evidence has demonstrated the importance of implementing movement-evoked pain in conventional pain assessments, with a significant role for psychologi-cal factors being suggested. Whether or not to include these factors in the assessment of move-ment-evoked pain has not yet been determined.Objectives: The aim of this systematic review is to explore the association between psychologi-cal factors and movement-evoked pain scores in people with musculoskeletal pain.Methods: For this systematic review with meta-analysis, four electronic databases (PubMed, Medline, WOS, and Scopus) were searched. Cross-sectional studies, longitudinal cohort studies, and randomized controlled trials investigating the association between movement-evoked pain and psychological factors in adults with musculoskeletal pain were considered. Meta-analysis was conducted for outcomes with homogeneous data from at least 2 studies. Fischer-Z transfor-mations were used as the measure of effect. Quality of evidence was assessed using the National Institutes of Health's Quality assessment tool for observational cohort and cross-sectional studies and Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Results: Meta-analyses and grading the quality of evidence revealed moderate evidence for a relation between movement-evoked pain and depressive symptoms (Fisher-z=0.27; 95%CI: 0.17, 0.36; 5 studies (n=440)), pain-related fear (Fisher-z=0.35; 95%CI: 0.26, 0.44; 6 studies (n=492)), and pain catastrophizing (Fisher-z=0.47; 95%CI: 0.36, 0.58; 4 studies (n=312)) in people with musculoskeletal pain.Conclusions: Movement-evoked pain is weakly to moderately associated to depressive symp-toms, pain-related fear, and pain catastrophizing in people with musculoskeletal pain.(c) 2022 Associa4ao Brasileira de Pesquisa e Pos-Gradua4ao em Fisioterapia. Published by Elsevier Espana, S.L.U. All rights reserved.
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| 7. |
- Munneke, Wouter, et al.
(författare)
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Comparing physical therapy students' attitudes and beliefs regarding chronic low back pain and knee osteoarthritis: an international multi-institutional comparison between 2013 and 2020 academic years
- 2024
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Ingår i: BRAZILIAN JOURNAL OF PHYSICAL THERAPY. - 1413-3555 .- 1809-9246. ; 28:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: In 2013, physical therapy students demonstrated low guideline -adherent recommendations regarding chronic low back pain (CLBP) for spinal pathology, activity, and work. Objectives: To assess the differences in physical therapy students' attitudes, beliefs, and adherence to guideline recommendations regarding CLBP and knee osteoarthritis between 2013 and 2020. Methods: In 2013 and 2020, second and fourth -year physical therapy students were recruited from 6 Belgian and 2 Dutch institutions. Attitudes and beliefs regarding CLBP and knee OA were evaluated using the Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT), the Health Care Providers' Pain and Impairment Relationship Scale (HC -PAIRS), and a questionnaire regarding therapeutic exercise and knee osteoarthritis. A clinical vignette was used to measure guideline -adherent recommendations regarding spinal pathology, activity, and work. Results: In 2013, 927 second -year and 695 fourth -year students; in 2020, 695 second -year and 489 fourth -year students; were recruited to participate in the study. Compared to 2013, students had less biomedical and stronger biopsychosocial attitudes and beliefs regarding CLBP, more guideline -adherent recommendations for activity, and more biopsychosocial beliefs regarding the benefits of exercise for patients with knee osteoarthritis in both the second and fourth year. Only fourth -year students in 2020 scored significantly better on HC -PAIRS and guideline -adherent recommendation relating to spinal pathology. No differences were found regarding work recommendations. Conclusions: Between 2013 and 2020, physical therapy students made a positive shift towards a more biopsychosocial approach to CLBP and knee osteoarthritis management. Guideline -adherent recommendations for CLBP concerning activity improved, however, concerning work and spinal pathology, it remained low.
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| 8. |
- Reis, F. J. J., et al.
(författare)
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Culture and musculoskeletal pain: strategies, challenges, and future directions to develop culturally sensitive physical therapy care
- 2022
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Ingår i: Brazilian Journal of Physical Therapy. - : Elsevier BV. - 1413-3555. ; 26:5
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Tidskriftsartikel (refereegranskat)abstract
- Background: Pain experience has a multidimensional nature. Assessment and treatment recom-mendations for pain conditions suggest clinicians use biopsychosocial approaches to treat pain and disability. The current pain research is overwhelmingly skewed towards the study of biologi-cal and psychological factors including interventions, whereas, cultural factors are often ignored.Objective: The aims of this Masterclass is threefold: (1) to discuss cultural influences on pain, (2) to provide strategies for delivering appropriate pain education and exercises in culturally diverse people with chronic pain, and (3) to present challenges and future directions to clinicians and researchers.Discussion: Cultural factors have a relevant influence on the way individuals experience and manage health and illness. Thus, people with different cultural experience perceive, respond, communicate and manage their pain in different ways. In this aspect, the contents of pain education should be presented using different culturally appropriate examples, metaphors, images, and delivery methods that may enhance the impact of the message. Efforts should be made to produce and spread culturally adapted evidence-based materials and resources. In addi-tion, a culturally sensitive approach may help to introduce patients to graded activities, so that they can apply these strategies in culturally acceptable and meaningful ways. Future studies should investigate the effectiveness of culturally-adapted interventions in pain-related out-comes in different pain conditions in patients with different cultural backgrounds.(c) 2022 Associacao Brasileira de Pesquisa e Pos-Graduacao em Fisioterapia. Published by Elsevier Espana, S.L.U. All rights reserved.
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| 9. |
- Smitheman, H. P., et al.
(författare)
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Putting the fear-avoidance model into practice - what can patients with chronic low back pain learn from patients with Achilles tendinopathy and vice versa?
- 2023
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Ingår i: Brazilian Journal of Physical Therapy. - 1413-3555 .- 1809-9246. ; 27:5
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Tidskriftsartikel (refereegranskat)abstract
- Background: Fear-avoidance variables are present in patients with musculoskeletal pain conditions, such as chronic low back pain (CLBP) and Achilles tendinopathy (AT) and can lead to reduced function and recovery. It is unknown how these variables relate in populations with different etiologies but similar pain provocation mechanisms. Objective: To compare kinesiophobia, pain catastrophizing, and disability between these two groups. Methods: Patients with CLBP and those with AT were included. Tampa Scale of Kinesiophobia (TSK-17) and Pain Catastrophizing Scale (PCS-13) were evaluated in both groups. The CLBP group completed the Oswestry Disability Index (ODI) and the AT group completed the PROMIS-29 questionnaire. Gait speed was calculated for each group. Disability outcomes were normalized between groups. Results: 119 patients in the CLBP group (64 female, 46 +/- 8 years) and 83 patients in the AT group (42 female, 48 +/- 12 years) were included. Both groups (CLBP, AT) presented with high prevalence of kinesiophobia (67%, 55%) but the CLBP group presented with higher prevalence of pain cata-strophizing (22%, 2%). The CLBP group demonstrated higher levels of disability via normalized ODI (MD= 12.4, 95% CI: 9.2, 15.5) but the AT group demonstrated slower gait speed (MD= 0.1 m/ s, 95% CI: 0.0, 0.2). Conclusion: Similarly high prevalence of kinesiophobia was found in patients with CLBP and patients with AT. While the CLBP group reported greater prevalence of catastrophizing thoughts and greater disability, the AT group had slower gait speed. Overall, these findings demonstrate that CLBP and AT have similarities that may allow clinicians to learn from one to inform treatment of the other. Clinical Trial Registration Numbers: NCT03523325, ISRCTN17115599. (c) 2023 Associacao Brasileira de Pesquisa e Pos-Graduacao em Fisioterapia. Published by Elsevier Espana, S.L.U. All rights reserved.
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| 10. |
- Svahn Ekdahl, Annika, 1969, et al.
(författare)
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Expertise and individually tailored interventions are expected by pregnant women with pelvic girdle pain who seek physical therapy: a qualitative study.
- 2023
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Ingår i: Brazilian journal of physical therapy. - : Elsevier BV. - 1413-3555 .- 1809-9246. ; 27:2
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Tidskriftsartikel (refereegranskat)abstract
- Pelvic girdle pain (PGP) in pregnancy may result in activity limitations and thus a negative impact on the individual woman's everyday life. Women's expectations when they seek physical therapy because of PGP are not yet known.To explore pregnant women's lived experience of PGP and what needs and expectations they express prior to a physical therapy consultation.A qualitative study using a descriptive phenomenological method. Interviews conducted with 15 pregnant women seeking physical therapy because of PGP, recruited through purposive sampling at one primary care rehabilitation clinic.PGP was described by four themes; An experience with larger impact on life than expected, A time for adjustments and acceptance, A feeling of insecurity and concern, A desire to move forward. PGP had a large impact on the pregnant women´s life. Thoughts of PGP as something to be endured was expressed, the women therefore accepted the situation. Finding strategies to manage everyday life was hard and when it failed, the women described despair and a need for help. They expected the physical therapist to be an expert who would see them as individuals and provide advice that could make their everyday life easier.Our results reveal that pregnant women with PGP delay seeking physical therapy until their situation becomes unmanageable and they run out of strategies for self-care. The women express, in light of their individual experiences, needs and expectations for professional management and advice tailored to their individually unique situation.
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