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  • 1.
    Archer, T.
    et al.
    Department of Psychology, University of Gothenburg, Gothenburg, Sweden.
    Svensson, K
    School of Education, Psychology and Sport Science, Linnaeus University, Kalmar, Sweden.
    Alricsson, Marie
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Physical exercise ameliorates deficits induced by traumatic brain injury2012In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 125, no 5, p. 293-302Article, review/survey (Refereed)
    Abstract [en]

    The extent and depth of traumatic brain injury (TBI) remains a major determining factor together with the type of structural insult and its location, whether mild, moderate or severe, as well as the distribution and magnitude of inflammation and loss of cerebrovascular integrity, and the eventual efficacy of intervention. The influence of exercise intervention in TBI is multiple, ranging from anti-apoptotic effects to the augmentation of neuroplasticity. Physical exercise diminishes cerebral inflammation by elevating factors and agents involved in immunomodulatory function, and buttresses glial cell, cerebrovascular, and blood-brain barrier intactness. It provides unique non-pharmacologic intervention that incorporate different physical activity regimes, whether dynamic or static, endurance or resistance. Physical training regimes ought necessarily to be adapted to the specific demands of diagnosis, type and degree of injury and prognosis for individuals who have suffered TBI. © 2012 John Wiley & Sons A/S.

  • 2.
    Clifford Lind, Maria
    et al.
    FoU JÄMT; Östersund.
    Björkman Randström, Kerstin
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Ledvård vid kontrakturer2016Report (Other academic)
    Abstract [sv]

    Bakgrund

    Kontrakturer är vanligt förekommande bland den äldre befolkningen samt hos personer som lider av olika sjukdomar. Det finns många förödande konsekvenser i dagligt liv för en person med kontraktur. Fastän behandlingar görs för att förhindra uppkomsten av kontrakturer samt behandla redan uppkomna kontrakturer så finns ännu ingen konsensus när det gäller vilken behandlingsmetod som är mest effektiv

    Syftet med denna litteraturöversikt var att undersöka det vetenskapliga stödet för behandlingsmetoder som används för att förebygga eller behandla kontrakturer.

    Metod

    Litteratursökningar gjordes genom att använda databaserna Cinahl, Amed, Medline och PEDro. De artiklar som inkluderades rankades genom att använda PEDro kvalitetspoäng. Artiklarna sorterades utifrån vilken behandlingsmetod som undersöktes och resultaten från originalstudien extraherades och koncentrerades.

    Resultat

    Tjugosex artiklar uppfyllde inklusionskriterierna och togs med i litteraturöversikten. I resultatet framkom sju behandlingsmetoder. Flertalet av behandlingsmetoderna visade inte på tillräckligt vetenskapligt stöd varken för att förkasta eller rekommendera metoden. När det gäller stretching, för personer som inte viljemässigt kan utnyttja det vunna rörelseomfånget, fanns det dock anledning att tvivla på värdet av behandlingen. De metoder som indikerade positiva resultat är de som använder aktiva rörelser samt försiktig positionering, men fler väldesignade studier behövs.

  • 3.
    Fernandez-Gonzalo, Rodrigo
    et al.
    Karolinska Inst, Dept Physiol & Pharmacol, S-17177 Stockholm, Sweden.
    Nissemark, Catarina
    Östersund Rehabctr Remonthagen, Östersund, Sweden.
    Aslund, Birgitta
    Östersund Rehabctr Remonthagen, Östersund, Sweden.
    Tesch, Per A.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Sojka, Peter
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Östersund Rehabctr Remonthagen, Östersund, Sweden.
    Chronic stroke patients show early and robust improvements in muscle and functional performance in response to eccentric-overload flywheel resistance training: a pilot study2014In: Journal of NeuroEngineering and Rehabilitation, ISSN 1743-0003, E-ISSN 1743-0003, Vol. 11, p. Art. no. 150-Article in journal (Refereed)
    Abstract [en]

    Background: Resistance exercise comprising eccentric (ECC) muscle actions enhances muscle strength and function to aid stroke patients in conducting daily tasks. The purpose of this study was to assess the efficacy of a novel ECC-overload flywheel resistance exercise paradigm to induce muscle and functional performance adaptations in chronic stroke patients. Methods: Twelve patients (similar to 8 years after stroke onset) performed 4 sets of 7 coupled concentric (CON) and ECC actions using the affected limb on a flywheel leg press (LP) device twice weekly for 8 weeks. Maximal CON and ECC isokinetic torque at 30, 60 and 90 degrees/s, isometric knee extension and LP force, and CON and ECC peak power in LP were measured before and after training. Balance (Berg Balance Scale, BBS), gait (6-Min Walk test, 6MWT; Timed-Up-and-Go, TUG), functional performance (30-s Chair-Stand Test, 30CST), spasticity (Modified Ashworth Scale) and perceived participation (Stroke Impact Scale, SIS) were also determined. Results: CON and ECC peak power increased in both the trained affected (34 and 44%; P < 0.01), and the untrained, non-affected leg (25 and 34%; P < 0.02). Power gains were greater (P = 0.008) for ECC than CON actions. ECC isokinetic torque at 60 and 90 degrees/s increased in the affected leg (P < 0.04). The increase in isometric LP force for the trained, affected leg across tests ranged 10-20% (P < 0.05). BBS (P = 0.004), TUG (P = 0.018), 30CST (P = 0.024) and SIS (P = 0.058) scores improved after training. 6MWT and spasticity remained unchanged. Conclusions: This novel, short-term ECC-overload flywheel RE training regime emerges as a valid, safe and viable method to improve muscle function, balance, gait and functional performance in men and women suffering from chronic stroke.

  • 4.
    Hedlund, M.
    et al.
    Department of Community Medicine and Rehabilitation - Physiotherapy, Umeå University, SE-901 87 Umeå, Sweden.
    Sojka, Peter
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Lundström, R
    Department of Public Health and Clinical Medicine, Umeå University, Sweden.
    Lindström, B
    siotherapy, Umeå University, SE-901 87 Umeå, Sweden.
    Insufficient loading in stroke subjects during conventional resistance training2012In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 14, no 1, p. 18-28Article in journal (Refereed)
    Abstract [en]

    Our objective was to assess the loading during a resistance-training task at a given training intensity in subjects with stroke and in healthy subjects. Subjects with stroke (n = 11) and two control groups (n = 11 in each) underwent strength measurements and a resistance-training task for elbow flexors. Torque and muscular activity obtained during the resistance-training task was related to values obtained during strength measurements. Even if relative loading throughout the concentric phase of the resistance-training task, expressed as percent of concentric isokinetic torque, was found to be similar among groups, we found indications of insufficient loading for the stroke group. Relative loading during the eccentric contraction phase, expressed as percent of eccentric isokinetic torque, was significantly lower for the stroke group. Also, when related to isometric maximum voluntary contraction, the loading was significantly lower for the stroke group, compared with the control groups, during the concentric and eccentric contraction phases. Furthermore, muscle activation during, as well as muscular fatigue after, the resistance-training task was somewhat lower for the stroke group. Hence, for subjects with stroke, the relative loading during resistance training, performed at a training intensity considered adequate for able-bodied, appears to be too low compared with the healthy controls. © 2012 Informa Healthcare.

  • 5.
    Hébert-Losier, Kim
    Univeristy of Otago.
    An Investigation of the Influence of Knee Flexion Angle on the Activity of the Triceps Surae Muscles during the Heel-Raise Test2011Doctoral thesis, monograph (Other academic)
    Abstract [en]

    Background: The heel-raise test (HRT) is used in clinical practice and research to assess the triceps suare (TS) muscles. The test involves repetitive unilateral heel-raises in upright stance. The test is administered with the knee straight for gastrocnemius medialis (GM) and lateralis (GL), and with the knee bent for soleus (SOL). The maximum number of heel-raises which can be performed is utilised as a clinical outcome measure and informs clinical decisions. The use of knee flexion (KF) to direct HRT assessment towards SOL or GAST currently relies on fundamental principles and has a limited evidence-base.

    Aims: The primary aim of this research was to investigate the influence of KF angle on SOL, GM, and GL activity and fatigue during the HRT. Secondary aims were to explore the total number of heel-raises completed, and the influence of age group on TS muscle activity and fatigue.

    Methods: Specific literature reviews were undertaken to contextualise the HRT within a comprehensive anatomical and biomechanical framework, and the experimental research involved a sequence of biomechanical studies. Seventeen subjects participated in a preliminary study that involved heel-raise testing to fatigue in two KF positions and generalised estimation equations were used to determine whether select KF angles were maintained. Forty-eight subjects, stratified by age and gender, participated in the main experimental study. Surface electromyography (EMG) activity of SOL, GM, and GL during maximum voluntary isometric contractions (MVIC) was collected in 0°KF, 45°KF, and 90°KF to inform EMG normalisation. Subjects then completed 10 unilateral heel-raises in 0°KF and 45°KF to investigate EMG amplitudes (% of MVIC) and heel-raises to fatigue for power spectrum analysis (median frequency and normalised slope). Mixed-effects models and stepwise regressions were used for the main analysis.

    Results: The preliminary study identified that select KF angles were reasonably well maintained during testing and subjects completed an average of 40 heel-raises in the two KF positions. The investigation of (EMG) muscle activity during MVIC developed a normalisation protocol specific to capturing SOL, GM, and GL peak activity. Data collected from heel-raises demonstrated higher SOL (p=.005) and lower GM (p<.001) and GL (p<.001) amplitudes in 45°KF rather than 0°KF; however, KF did not influence fatigue of the individual TS muscles. GM and GL fatigued at the same rate (p=.088), to the same extent (p=.385), and faster than SOL (p<.001) in both angles. GM (p=.008), but not GL (p=.118), fatigued more than SOL. Similar maximum numbers of heel-raises were performed in 0°KF (n=45) and 45°KF (n=48). Age did not influence any of the variables analysed.

    Conclusion: The research results question the common utilisation of KF to direct the HRT towards SOL or GAST assessment. Although influences of KF on EMG amplitudes were statistically significant, they may not be clinically meaningful. KF did not influence TS fatigue or the total number of heel-raises. While these findings do not imply the absence of clinical or rehabilitative benefits from HRT procedures in select KF positions, the evidence challenges the common perceptions and definitions that the test assesses SOL with the knee bent and GAST with the knee straight.

  • 6.
    Hébert-Losier, Kim
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Holmberg, Hans-Christer
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Exercise prescription to prevent injuries during recreational skiing and snowboarding2015In: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 101, no Suppl. 1, p. e552-Article in journal (Refereed)
  • 7.
    Hébert-Losier, Kim
    et al.
    Univeristy of Otago.
    Newsham-West, Richard J.
    Schneiders, Anthony G.
    Univeristy of Otago.
    Sullivan, S. John
    Univeristy of Otago.
    Raising the standards of the calf-raise test: a systematic review.2009In: Journal of science and medicine in sport / Sports Medicine Australia, ISSN 1878-1861, Vol. 12, no 6, p. 594-602Article in journal (Refereed)
    Abstract [en]

    The calf-raise test is used by clinicians and researchers in sports medicine to assess properties of the calf muscle-tendon unit. The test generally involves repetitive concentric-eccentric muscle action of the plantar-flexors in unipedal stance and is quantified by the number of raises performed. Although the calf-raise test appears to have acceptable reliability and face validity, and is commonly used for medical assessment and rehabilitation of injuries, no universally acceptable test parameters have been published to date. A systematic review of the existing literature was conducted to investigate the consistency as well as universal acceptance of the evaluation purposes, test parameters, outcome measurements and psychometric properties of the calf-raise test. Nine electronic databases were searched during the period May 30th to September 21st 2008. Forty-nine articles met the inclusion criteria and were quality assessed. Information on study characteristics and calf-raise test parameters, as well as quantitative data, were extracted; tabulated; and statistically analysed. The average quality score of the reviewed articles was 70.4+/-12.2% (range 44-90%). Articles provided various test parameters; however, a consensus was not ascertained. Key testing parameters varied, were often unstated, and few studies reported reliability or validity values, including sensitivity and specificity. No definitive normative values could be established and the utility of the test in subjects with pathologies remained unclear. Although adapted for use in several disciplines and traditionally recommended for clinical assessment, there is no uniform description of the calf-raise test in the literature. Further investigation is recommended to ensure consistent use and interpretation of the test by researchers and clinicians.

  • 8.
    Hébert-Losier, Kim
    et al.
    Univeristy of Otago.
    Schneiders, Anthony G
    Univeristy of Otago.
    García, José A.
    University of Otago.
    Sullivan, S. John
    Univeristy of Otago.
    Simoneau, Guy G.
    Marquette University.
    Peak triceps surae muscle activity is not specific to knee flexion angles during MVIC.2011In: Journal of Electromyography & Kinesiology, ISSN 1050-6411, E-ISSN 1873-5711, Vol. 21, no 5, p. 819-26Article in journal (Refereed)
    Abstract [en]

    There is limited research on peak activity of the separate triceps surae muscles in select knee flexion (KF) positions during a maximum voluntary isometric contraction (MVIC) used to normalize EMG signals. The aim of this study was to determine how frequent peak activity occurred during an MVIC for soleus (SOL), gastrocnemius medialis (GM), and gastrocnemius lateralis (GL) in select KF positions, and if these peaks were recorded in similar KF positions. Forty-eight healthy individuals performed unilateral plantar-flexion MVIC in standing with 0°KF and 45°KF, and in sitting with 90°KF. Surface EMG of SOL, GM, and GL were collected and processed in 250 ms epochs to determine peak root-mean-square amplitude. Peak activity was most frequently captured in standing and rarely in sitting, with no position selective to SOL, GM or GL activity. Peak GM and GL activity was more frequent in 0°KF than 45°KF, and more often in similar KF positions than not. Peak SOL activity was just as likely in 45°KF as 0°KF, and more in positions similar to GM, but not GL. The EMG amplitudes were at least 20% greater in positions that captured peak activity over those that did not. The overall findings support performing an MVIC in more than one KF position to normalize triceps surae EMG. It is emphasized that no KF position is selective to SOL, GM, or GL alone.

  • 9.
    Hébert-Losier, Kim
    et al.
    Univeristy of Otago.
    Schneiders, Anthony G.
    Univeristy of Otago.
    Newsham-West, Richard J
    Sullivan, S. John
    Univeristy of Otago.
    Scientific bases and clinical utilisation of the calf-raise test.2009In: Physical Therapy in Sport, ISSN 1466-853X, E-ISSN 1873-1600, Vol. 10, no 4, p. 142-9Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Athletes commonly sustain injuries to the triceps surae muscle-tendon unit. The calf-raise test (CRT) is frequently employed in sports medicine for the detection and monitoring of such injuries. However, despite being widely-used, a recent systematic review found no universal consensus relating to the test's purpose, parameters, and standard protocols.

    OBJECTIVES: The purpose of this paper is to provide a clinical perspective on the anatomo-physiological bases underpinning the CRT and to discuss the utilisation of the test in relation to the structure and function of the triceps surae muscle-tendon unit.

    DESIGN: Structured narrative review.

    METHODS: Nine electronic databases were searched using keywords and MESH headings related to the CRT and the triceps surae muscle-tendon unit anatomy and physiology. A hand-search of reference lists and relevant journals and textbooks complemented the electronic search.

    SUMMARY: There is evidence supporting the clinical use of the CRT to assess soleus and gastrocnemius, their shared aponeurosis, the Achilles tendon, and the combined triceps surae muscle-tendon unit. However, employing the same clinical test to assess all these structures and their associated functions remains challenging.

    CONCLUSIONS: Further refinement of the CRT for the triceps surae muscle-tendon unit is needed. This is vital to support best practice utilisation, standardisation, and interpretation of the CRT in sports medicine.

  • 10.
    Hébert-Losier, Kim
    et al.
    Univeristy of Otago.
    Schneiders, Anthony G.
    Univeristy of Otago.
    Sullivan, S. John
    Univeristy of Otago.
    December 2011 Letters to the Editor-in-Chief.2011In: Journal of Orthopaedic and Sports Physical Therapy, ISSN 0190-6011, E-ISSN 1938-1344, Vol. 41, no 12, p. 983-7Article in journal (Refereed)
    Abstract [en]

    Letters to the Editor-in-Chief of JOSPT as follows:"Early Prognostic Factors in Patients With Whiplash" and Author's Response "Staying Current in the Use of Ultrasound Imaging" and Author's Response"Differentiating the Soleus From the Gastrocnemius With the Heel Raise Test" and Author's ResponseJ Orthop Sports Phys Ther 2011;41(12):983-987. doi:10.2519/jospt.2011.0202.

  • 11.
    Hébert-Losier, Kim
    et al.
    Univeristy of Otago.
    Schneiders, Anthony G.
    Univeristy of Otago.
    Sullivan, S. John
    Univeristy of Otago.
    Newsham-West, Richard J
    García, José A.
    Univeristy of Otago.
    Simoneau, Guy G.
    Marquette University.
    Analysis of knee flexion angles during 2 clinical versions of the heel raise test to assess soleus and gastrocnemius function.2011In: Journal of Orthopaedic and Sports Physical Therapy, ISSN 0190-6011, E-ISSN 1938-1344, Vol. 41, no 7, p. 505-13Article in journal (Refereed)
    Abstract [en]

    STUDY DESIGN: Controlled laboratory study, using a repeated-measures, counterbalanced design.

    OBJECTIVES: To provide estimates on the average knee angle maintained, absolute knee angle error, and total repetitions performed during 2 versions of the heel raise test.

    BACKGROUND: The heel raise test is performed in knee extension (EHRT) to assess gastrocnemius and knee flexion (FHRT) for soleus. However, it has not yet been determined whether select knee angles are maintained or whether total repetitions differ between the clinical versions of the heel raise test.

    METHODS: Seventeen healthy males and females performed maximal heel raise repetitions in 0° (EHRT) and 30° (FHRT) of desired knee flexion. The average angle maintained and absolute error at the knee during the 2 versions, and total heel raise repetitions, were measured using motion analysis. Participants' kinematic measures were fitted into a generalized estimation equation model to provide estimates on EHRT and FHRT performance applicable to the general population.

    RESULTS: The model estimates that average angles of 2.2° and 30.7° will be maintained at the knee by the general population during the EHRT and the FHRT, with an absolute angle error of 3.4° and 2.5°, respectively. In both versions, 40 repetitions should be completed. However, the average angles maintained by participants ranged from -6.3° to 21.6° during the EHRT and from 22.0° to 43.0° during the FHRT, with the highest absolute errors in knee position being 25.9° and 33.5°, respectively.

    CONCLUSION: On average, select knee angles will be maintained by the general population during the select heel raise test versions, but individualized performance is variable and total repetitions do not distinguish between versions. Clinicians should, therefore, interpret select heel raise test outcomes with caution when used to respectively assess and rehabilitate soleus and gastrocnemius function.

  • 12.
    Sjöström, Rita
    et al.
    Strömsund Health Centre, Jämtland County Council, Strömsund, Sweden .
    Asplund, Ragnar
    Research and Development Unit, Jämtland County Council, Östersund, Sweden.
    Alricsson, Marie
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Evaluation of a multidisciplinary rehabilitation program with emphasis on musculoskeletal disorders: A 5-year follow-up2013In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 45, no 2, p. 175-182Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aim of this study was to perform a 5-year follow-up of a 7-week multidisciplinary rehabilitation program focusing on pain, physical disability, anxiety and depression as well as stress and sick leave and to compare the results from the baseline, a 2-year follow-up and this 5-year follow-up. PARTICIPANTS: Out of 60 participants of the original rehabilitation program 54 were followed-up after 5 years. METHODS: The rehabilitation program was individually adapted and consisted of physical activity in several forms as well as theoretical and practical education. At baseline (start of study) and 2 and 5 years after completion of the rehabilitation program all participants were evaluated in terms of sick leave, pain rating (Visual Analogue Scale), the Disability Rating Index, Hospital Anxiety and Depression Scale, and Stress Test. RESULTS: Between the start of the program and the 5-year follow-up pain rating (P < 0.017) and the rate of full-time sick leave (P < 0.0005) decreased. Physical disability, anxiety, depression and stress were maintained from the 2-year follow-up until the 5-year follow-up. CONCLUSIONS: The rehabilitation program seemed to have had an effect on the participant's ability to manage with symptoms long after the end of the rehabilitation program. Most participants had returned to work, and reported less pain. The improvements made in physical disability and mental health prior to the 2-year follow-up were maintained at the 5-year follow-up occasion.

  • 13.
    Styrke, J.
    et al.
    Division of Surgery, Department of Surgical and Perioperative Sciences, Umeå University, 901 85 Umeå, Sweden.
    Stålnacke, B. -M
    Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, Umeå, Sweden.
    Bylund, P. -O
    Emergency and Disaster Medical Center, Umeå University Hospital, Umeå, Sweden.
    Sojka, Peter
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Björnstig, U.
    Division of Surgery, Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden.
    A 10-year incidence of acute whiplash injuries after road traffic crashes in a defined population in Northern Sweden2012In: PM&R, ISSN 1934-1482, E-ISSN 1934-1563, Vol. 4, no 10, p. 739-747Article in journal (Refereed)
    Abstract [en]

    Objective: To examine the annual incidence of acute whiplash injuries after road traffic crashes in a geographic catchment area in Northern Sweden during the period 2000-2009. Design: Descriptive epidemiology determined by prospectively collected data from a defined population. Setting: The study was conducted at a public hospital in Sweden. Participants: The population of the hospital's catchment area (136,600 inhabitants in 1999 and 144,500 in 2009). Methods: At the emergency department, all injured persons (approximately 11,000 per year) were asked to answer a questionnaire about the injury incident. Data from the medical records also were analyzed. From 2000-2009, 15,506 persons were injured in vehicle crashes. Persons who were subject to an acute neck injury within whiplash-associated disorder grades 1-3 were included. The overall and annual incidences were calculated as incidence. Age, gender, type of injury event, and direction of impact were described. The incidences were compared with national statistics on insurance claims from 2003, 2007, and 2008 to detect changes in the proportions of claims. Main Outcome Measures: The annual incidence of acute whiplash injuries. Secondary outcome measures were types of injury events, age and gender distribution, changes in the proportion of rear-end crashes during 2000-2009, and changes in the proportion of insurance claims during 2003-2008. Results: During 2000-2009, 3297 cases of acute whiplash injury were encountered. The overall incidence was 235/100,000/year. The average yearly increase in incidence was 1.0%. Women comprised 51.9% and men 48.1% of the injured. Car occupants (86.4%) and bicycle riders (6.1%) were most frequently injured. The proportion of rear-end crashes decreased from 55% to 45% from 2000-2009. The proportion of insurance claims significantly decreased between 2003 and 2008 (P &lt; .0001, χ 2 test). Conclusion: The incidence of emergency department visits attributable to acute whiplash injuries after road traffic crashes have been relatively stable during the past decade in our area, except in 2007 and 2008, when a peak occurred. © 2012 American Academy of Physical Medicine and Rehabilitation.

  • 14.
    Svensson, G. L.
    et al.
    Department of Orthopaedics, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden .
    Wendt, G. K.
    Department of Orthopaedics, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden .
    Thomeé, R.
    Department of Orthopaedics, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden .
    Danielson, Ella
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Patients' experience of health three years after structured physiotherapy or surgery for lumbar disc herniation2013In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 45, no 3, p. 293-299Article in journal (Refereed)
    Abstract [en]

    Objective: To describe the experience of health among patients 3 years after treatment with a structured physiotherapy model or surgery for lumbar disc herniation. Design: A qualitative research study. Subjects/patients: Patients were referred to the orthopaedic clinic at Sahlgrenska University Hospital with sciatica due to lumbar disc herniation. Twenty patients who were eligible for surgery were treated either with a structured physiotherapy model or with surgery. Methods: Open-ended interviews were conducted and analysed using content analysis. Results: Findings were grouped into two themes: feeling of well-being and feeling of ill-being. In the group treated with structured physiotherapy there were a high number of codes in the feeling of well-being theme. In the group treated with surgery there were a high number of codes in the feeling of ill-being theme. Conclusion: Patients treated with structured physiotherapy or surgery experienced feelings of well-being and ill-being 3 years after treatment. Patients treated with physiotherapy and surgery described varying experiences of health 3 years after treatment for lumbar disc herniation. It can be speculated that the experience of well-being may be explained by the ability of structured physiotherapy treatments to empower patients.

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