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  • 1.
    Andersson, Caroline
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Bondesson, Maria
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    En kvalitativ intervjustudie om implementeringsprocessen av ett projekt för att stärka stöd och rehabilitering efter förvärvad hjärnskada.2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Knowledge about implementation is important for new methods to be integrated with regular working methods and reach those who can benefit from them. In order to improve the long-term support for people with acquired brain injury, a collaboration project has been carried out in Stockholm for three years.

    Objective: With focus on Normalization Process Theory (NPT) describe managers’ and employees’ experiences of an implementation process in the project Hjärna Tillsammans.

    Method: A descriptive study with qualitative approach where interviews were used for data collection, and various workplaces in the project were represented. The analysis was done with a qualitative content analysis with a deductive approach where NPT constituted the theoretical framework.

    Result: The analysis resulted in twelve subcategories under the four main categories on which NPT is structured. The respondents described the project in different ways, but the majority described the project and the collaboration between different workplaces as valuable for the target group to get a better support in their illness. One difficulty in implementing the work was to reach the target group. For example, to involve employees, the project has been distributed at various meetings, but it was rarely done with a plan for the work.

    Conclusion: When implementing complex interventions, a coherence of those who are to implement the project is required. It may also be of value to have a plan for implementation and use methods that promote the implementation process.

  • 2.
    Axelsson, Johanna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Tellström, Linda
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Mobil hälsa (m-hälsa) genom användning av mobiltelefon som intervention för barn med övervikt eller fetma.: En systematisk litteraturstudie.2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    The presence of overweight and obesity among children is increasing in

    large parts of the world. Lack of physical activity is one of the causes of overweight and

    obesity. For children with obesity, small amounts of physical activity may have major

    positive health effects. There is a need to develop new effective strategies to increase the

    amount of physical activity among children with overweight or obesity. Mobile health

    (mHealth) is used as an umbrella term for health services transmitted by mobile devices

    and is defined as "medical or public health practice supported by mobile devices such as

    mobile phones, patient monitoring devices, personal digital assistants and other wireless

    devices." A potential strategy for influencing the amount of physical activity in children

    with overweight or obesity is mHealth through the use of mobile phones.

    Objective:

    To examine and describe what interventions with mHealth component

    through the use of mobile phones that evaluated physical activity or Body Mass Index

    (BMI) in children with overweight or obesity.

    Methods:

    A systematic literature study in which studies describing interventions with

    mHealth components for the target group of children 0-18 years of overweight or obesity

    were included. Search was conducted in three scientific databases.

    Results:

    The searches resulted in 649 studies, of which 16 met set inclusion criteria. In

    most studies, the mHealth component included the use of text messaging and in some

    studies the use of app. The function of the mHealth component was studied and divided

    into self-registration, communication, encouragement, education and reminder. The

    included studies reported different forms of BMI where two studies showed significant

    differences between the intervention and control group with the greatest reduction for

    the intervention group. Few studies reported objectively measured time in physical

    activity of moderate to high intensity.

    Conclusion:

    The most common intervention with mHealth component through the use

    of mobile phones among children with overweight or obesity was text messaging. In

    order to understand and compare how mHealth can be used, a framework for the

    description of these interventions would facilitate.

  • 3.
    Bergling, Hanna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Landin, Terese
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Upplevelsen av gångträning med Hybrid Assistive Limb (HAL) hos personer med stroke: En intervjustudie2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: One of the most common goals people post stroke express is to improve gait. Gait training with the Hybrid Assistive Limb (HAL) enables intense and repetitive training and has been proved safe to use during rehabilitation post stroke. Qualitative research is needed to describe how people post stroke experience gait training with HAL.

    Aim: To describe how people post stroke experience gait training with HAL.

    Method: An interview study was carried out with people post stroke (n = 18) who participated in a gait study with HAL and had good communicative ability. A semi-structured interview guide was used, and the interviews were analysed with an inductive approach, using qualitative content analysis.

    Results: Gait training with HAL was perceived as challenging physically and mentally which was described as a positive thing. However, some participants experienced that gait training with HAL took all their energy and affected the ability to participate in other activities. Most of the participants experienced improvements in strength, fitness and balance. Several experienced improved gait and a positive impact on their self-confidence. Wearing HAL was described as heavy and clumsy. Gait training with HAL was experienced as amusing and meaningful.

    Conclusion: The participants described that gait training with HAL was challenging and improved their gait and various body functions. Benefits from gait training with HAL were that participants perceived it as amusing and meaningful. More qualitative studies are needed to explore the experience of gait training with HAL.

  • 4.
    Berterud Andersson, Catarina
    et al.
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Dennis, Katarina
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Lumbal spinal stenos och fotbäddar: Kan av formgjutna fotbäddar minska kvarstående ländrygg- och bensmärta hos patienter som opererats för lumbal spinal stenos? En kvasi-experimentell jämförande studie.2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Lumbar spinal stenosis (LSS) is a common pathological condition in the lower back. The aim of most interventions when treating LSS is to reduce pain in the lower back and leg. The current knowledge regarding orthotics and low back pain is insufficient. Objectives: The aim with this study was to investigate weather custom-made orthotics would reduce self-reported pain in the lower back and leg, in patients who had had surgery for LSS. A second aim was to compare the self-reported pain in the lower back and leg, as well as low back function of the intervention group, with the one/year follow-up of a control group, who had undergone the same surgery two years earlier. Method: Eleven persons who had undergone surgery for LSS at the Spine surgery clinic of Strängnäs got to use custom-made orthotics for six weeks. Primary outcome measure was pain intensity in the lower back and leg, evaluated with the Numeric Rating Scale (NRS). To describe the baseline characteristics of the participants, low back function was measured with the Oswestry Low Back Pain Disability Index (ODI). To detect a change of the median value for pain intensity of the participants, before compared to after the intervention, Wilcoxon signed rank sum test was conducted (CI 95%). The post-intervention measurement was compared to a control condition; i.e. data was collected from the quality register from Swespine. Results: There was no difference in self-reported pain intensity in the lower back, compared to before the intervention (p=0,76). There was no difference in self-reported pain intensity in the leg, compared to before the intervention (p=0,40). There was no difference between the self-reported pain intensity for lower back (p=0,078) or leg (p=0,85) between the follow-up of the intervention group and the result from the one-year follow-up of the control group. Conclusion: This study could not detect any differences in pain in either the lower back or the leg after six weeks of using custom-made orthotics, compared with before the intervention. No difference could be found in self-reported pain intensity between the intervention group and the control for lower back or leg.

  • 5.
    Ekdahl, Victor
    et al.
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Lindblom, Johan
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Behandling av iliotibialbandssyndrom hos löpare: En strukturerad litteraturstudie2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Running is a popular form of exercise around the world. Iliotibial band syndrome (ITBS) is one of the most common overuse injuries in runners. Several different conservative treatment methods have been studied, but evidence is limited and not sufficient enough to support a specific treatment method. Objective: To describe through a structured literature review the conservative treatment methods studied on runners with ITBS and the effect these treatment methods have on pain. Method: A search to identify relevant articles was carried out in the PubMed, Cinahl, Scoupus and Web of Science databases. The search terms used were iliotibial band syndrome, iliotibial band friction syndrome and iliotibial band strain. A screening of titles and abstracts was made. Potentially relevant articles were obtained in full text, and then a relevance assessment was performed. The methodological quality of the included articles was examined. An ethical review was conducted on all included articles. Results: Four randomized controlled trials and two cohort studies were included. The interventions studied in the articles were correction of the supposed aetiological factors for running related injuries, anti-inflammatory / analgesic drugs, deep transverse friction massage, hip strengthening rehabilitation program, corticosteroid injection and shockwave treatment compared to manual therapy. Many of the interventions reduced pain, however, to varying degrees. In two of the studies there was no significant difference in decrease of pain between intervention and control group. The articles had varied methodological quality. Conclusion: Although ITBS is common in runners, relatively few studies have investigated it’s conservative treatment methods. Several of the studies indicated positive results in the form of pain reduction but there are difficulties in drawing conclusions about effect from the treatment methods due to methodological weaknesses.

  • 6.
    Flynner, Kristina
    et al.
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Hagström Backe, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Innehållsvalidering av den svenska preliminära San Salvadourskalan: En modifierad Delphistudie2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Pain is more common among adults with severe cognitive and physical impairments than in the overall population. These persons are often nonverbal and therefore dependent upon people in the vicinity to detect and continuously chart the presence of their pain. Validated and reliable pain observation scales for the group is scanty.

    Aim: The aim of this study was to assess the content validity of the Swedish preliminary version of the San Salvadourscale for adults with severe cognitive and physical impairments.

    Method: A modified Delphi in two rounds examined content validity of the Swedish preliminary version of the San Salvadourscale. A survey was distributed over email in 2 rounds. 13 clinically experienced experts estimated the relevance in the baseline-chart, the pain questionnaire and the different degrees in it. Item content validity Index (I-CVI) was calculated for the questions, Scale content validity index universal agreement (S-CVI UA) and Scale content validity index average (S-CVI Ave) was calculated for the scale.

    Result: The I-CVI for the questions in the baseline-chart, the pain questionnaire and the text for the different degrees was above 0.78 in most cases. S-CVI UA was below 0.80 in every domain. S-CVI Ave was greater than and or equal to 0.90 in five out of six domains. And below 0.90 for the different degrees in the pain questionnaire in the second round.

    Conclusion: Based on the experts ratings of the questions I-CVI showed mostly excellent result. Further studies on the content validity of the Swedish preliminary version of the San Salvadourscale is needed to investigate whether the content validity is sufficient to measure behaviors that can indicate pain in adults with severe cognitive and physical impairments.

  • 7.
    Gunnesson, Linnea
    et al.
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Zetterlund, Anna
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Fysisk aktivitetsnivå, smärtintensitet och funktionsnedsättning hos personer med ländryggssmärta: - En enkätstudie2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background

    Lower back pain is very common in the western world. It results in a great

    suffering for the person and large economic costs for the society. Today lower

    back pain is treated with information to stay active and medication for pain relief.

    There is a lack of knowledge with regards to what effect physical training has as

    prevention and treatment for acute and subacute lower back pain.

    Aim

    The aim of this study was to, among patients with acute and subacute non-specific

    lower back pain, describe their level of physical activity and evaluate differences

    between groups with different levels of activity. The aim was also to explore the

    association between pain intensity, disability and level of physical activity.

    Method

    The study was conducted as a survey. The participants was 15 patients, 6 men and

    9 women with the mean age of 49,2 years old, who had sought care for acute and

    subacute lower back pain in 6 different primary care clinics. The level of physical

    activity were estimated using the indicator questions for physical activity by

    Socialstyrelsen, the pain intensity was measured with the Numeric Rating Scale

    and the Roland Morris Disability Questionnaire was answered. Data was analyzed

    with descriptive statistics, differences were tested with Mann-Whitney U-test and

    correlations analyzed with Spearman correlations coefficient.

    Results

    Eight out of 15 participants reached the WHO recommendations of physical

    activity (> 150 min/week). Those who participated in physical training minimum

    90 mins/week had a median value of NRS 5,5 and RMDQ 8. For those who trained

    less the median values were for NRS 7,5 (p=0,153) and RMDQ 11,5 (p=0,175). A

    week correlation between NRS (r=-0,136) and level of physical activity was noted

    while such correlation between RMDQ was negligible (r=-0,158).

    Conclusion

    There were no statically significant difference between the groups who trained at

    least 90 minutes per week and those who trained less neither in regards to pain

    intensity or disability. A weak but not statistically significant correlation was

    observed between physical activity and pain intensity.

  • 8.
    Hildingsson, Victoria
    et al.
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Clarström, Anders
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Kartläggning av fysioterapeutiska interventioner i multimodal smärtrehabilitering inom primärvården.: En enkätstudie.2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Chronic pain is a major public health problem which involves high costs for

    society and, of course, also great suffering for the individual. Multimodal rehabilitation

    (MMR) means that different occupational categories work together around these patients.

    Research shows moderately to strong scientific evidence for MMR in complex pain

    problems. There are a lack of evidence about which type of physiotherapeutic interventions

    that are used in multimodal pain rehabilitation.

    Aim:

    The aim was to study which physiotherapy interventions that are used in multimodal

    primary healthcare rehabilitation in Sweden.

    Method:

    Cross-sectional survey with quantitative approach based on a self-designed web

    questionnaire. The population consisted of physiotherapists working in clinics reporting to

    the Swedish Quality Registry for Pain Rehabilitation (SQRP) in primary care and the result is

    based on the 23 physiotherapists who responded to the web questionnaire.

    Results:

    The results are based on 71% of the NRS-affiliated clinics. Counseling/teaching and

    various forms of physical training formed the basis of the physiotherapist's work in MMR

    teams in primary care. Almost all patients meet physiotherapists during the treatment period.

    Group treatment or a combination of group and individual treatment were most common. The

    treatment periods were mostly between four to eleven weeks where the patient met a

    physiotherapist most often weekly or several times a week. In the primary care MMR-team,

    the physiotherapist, occupational therapist, KBT therapist, physician and rehab coordinator

    were the most common occupational categories.

    Conclusion:

    Physiotherapists have a central role in the MMR-teams in primary care, they

    primarily use evidence-based, active interventions.

  • 9.
    Hultén, Petra
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Upplevelser av behandlingskonceptet Lee Silverman Voice Treatment BIG bland personer med Parkinsons sjukdom: -­ En kvalitativ intervjustudie2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Research today mainly focus on the measurable effects of physiotherapy interventions in Parkinson’s disease and, to a lesser extent, on the treatment experiences. Research describing people’s experiences of Lee Silverman Voice Treatment BIG (LSVT BIG) is lacking.

    Purpose: To examine and describe how people with Parkinson’s disease experience individual supervised treatment based on the LSVT BIG treatment concept.

    Method: Qualitative approach including three focus groups of a total of 19 persons with Parkinson's disease who started the treatment concept LSVT BIG. Interview questions were focused on the experiences of the treatment intervention. The interviews were transcribed before a qualitative content analysis was made.

    Result: Two main themes emerged from the analysis;; Prerequisites for treatment effects included the categories of A big effort, The importance of the role of the instructor, Self-­responsibility and Support from the environment. The second theme was Treatment Effects of LSVT BIG which included the categories Physical, Psychological and Social Effects as well as Behavioral Change.

    Conclusion: For good results of LSVT BIG, a big effort is required of the individual, their relatives and the healthcare provider. The big effort requires adjustments to the treatment intervention based on the conditions of above-­mentioned parties. The role of the instructor, family support, self-­discipline and a sense of situation-­influence were defined in the results as motivational factors that provide the conditions for good treatment effects. The treatment effects were multifaceted and reflected all aspects of the biopsychosocial model. In particular, improvements of the physical functions were found, which could be transferable to activities in daily living.

  • 10.
    Lamers, Petrus
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Sagnérius, Linda
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Prognostiska faktorer för att inte fullfölja multimodal smärtrehabilitering2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Prolonged pain is common and causes great suffering. Multimodal rehabilitation (MMR) is a treatment method that is offered to patients with complex rehabilitation needs. Treatment adherence is defined how well the patient's behavior is consistent with the recommendations the patient has agreed with his / her health care provider and is of importance for the treatment outcome. Little is known today about prognostic factors for treatment adherence at MMR. Identification of obstacles that can explain why patients do not complete treatment is therefore important in order to be able to optimize the treatment effects.

    Purpose: To investigate which factors were important for the prognosis to not completing MMR 2 treatment in patients with complex long-term pain.

    Method: The project was a prospective cohort study. Study population were patients aged 18–67 years with long-term pain who started an MMR 2 program between 2009–2016, registered in the National Register for Pain Rehabilitation (NRS). Thirty-six variables were available, the outcome measure was to complete or not complete MMR. To identify variables with the greatest importance for treatment adherence, regression models were created with logistic regression. The model's discriminatory ability was tested, and goodness of fit was assessed

    Results: The three most important factors that increased odds of not completing MMR were high MPI-PI, patients in the younger age category and low motivation. The model's discriminatory ability was substandard, goodness of fit was not significant.

    Conclusion: The model cannot predict outcomes on individual level but provides information on which factors historically have been important. In the long term, identification of factors that impair adherence can contribute to adapting MMR programs and thereby create better conditions so that several patients complete the rehabilitation.

  • 11.
    Larsson, Catarina
    et al.
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Lovén, Jessica
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Multimodal smärtrehabilitering i specialistvård: En kartläggning av fysioterapeutiska interventioner2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Chronic pain is a common cause for patients seeking care. The consequences of chronic pain can be seen at both individual and social level. Research has shown moderate to strong scientific support for multimodal rehabilitation (MMR) in complex pain problems. What the physiotherapist uses for interventions within MMR and how the collaboration with other occupational categories works is poorly described.

    Aim: To study what interventions physiotherapist’s use in multimodal pain rehabilitation in specialist care settings (MMR2) in Sweden.

    Methods: Web survey study where data was collected from 71 physiotherapists working at units connected to the Swedish Quality Registry for Pain Rehabilitation (SQRP).

    Results: The most common interventions were teaching/counseling and various forms of exercise. Strategies for behavioral change, mindfulness/body awareness and homework exercises are other commonly used interventions. Acceptance and Commitment Therapy (ACT) and Cognitive Behavioral Therapy (CBT) were used in several stages of rehabilitation on many units. Rehabilitation in group were the most common form of work and the interventions are primarily patient active as physical activity. The rehabilitation period were usually 8-11 weeks, where the patient saw a physiotherapist several times a week. The teams worked closely with regular team meetings, follow-ups and sometimes joint actions such as patient education and group training.

    Conclusion: The physiotherapist's work in MMR2 is based on a biopsychosocial perspective where the focus lies in restoring and/or improving body function. Physiotherapists have broad competence and long experience, enabling their knowledge about the body and the movement system to be integrated with behavioral change technics. Together with other occupational categories, the physiotherapist's work covers all domains in the Functional Classification, Disability and Health Classification (ICF). For increased understanding of the choice of physiotherapeutic interventions within MMR2, and how these interverventions works in the clinical setting, further research is needed.

  • 12.
    Löfbom, Linda
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Vidare i livet – inte tillbaka: Upplevelser av hur funktionsnedsättning och behandling påverkar livstillfredsställelsen hos vuxna personer med mjukdelssarkom.: En kvalitativ studie2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Soft tissue sarcoma is a rare form of cancer treated with surgery, radiotherapy and cytostatic. These treatments can cause impairment that affects the life satisfaction for those affected. Life satisfaction is the subjective experience of quality of life. Purpose: Describe how life satisfaction has been affected by the diagnosis, treatment and disability of soft tissue sarcoma. Method: Qualitative approach included eight semi structured interviews. The interviews were transcribed before analysis with qualitative content analysis Result: Through the analysis, an overall theme emerged Further in life. The theme covers the categories Reaction in diagnosis, Experience of treatment, Life after illness and Feel good Conclusion: Discomfort occurs in everyday life, but individuals are not restricted by them, they experience no disability. Life satisfaction was affected during treatment. After termination of treatment, ie at the time of the interviews, the researchers felt that their life satisfaction was not affected.

  • 13.
    Malmberg, Kim
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Sigfusson Nordgren, Jeanette
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Neuromuskulär elektrisk stimulering (NMES) som komplement under stabilitetsträning efter axelluxation: En interventionsstudie2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Shoulder dislocation is the most frequent shoulder injury in Sweden, where an individual can develop shoulder instability as a consequence of recurrent dislocation. The commonly used conservative management is stabilizing exercises for the rotator cuff and scapular control. Prior studies have examined the effect of Neuromuscular Electric Stimulation (NMES) as a complement during exercise for the elbow and knee joint, but to our knowledge no previous study has examined the effect of NMES on shoulder instability.

    Aim: Through a pilotstudie, evaluate the effect of NMES as complement during stabilizing exercise regarding self-assessed shoulder related quality of life in adults with recurrent shoulder dislocation. Furthermore, the aim was to examine the feasibility of the study design.

    Method: Eleven individuals were recruited. Six of them were matched to the intervention group and the other five to the control group. The exercise intervention progressed for six weeks and included twelve exercise sessions. The intervention group used NMES as complement during conventional stabilizing exercise while the control group performed the same exercise without NMES. The participant´s self-assessed shoulder related quality of life was measured before and after the exercise intervention with the validated measure Western Ontario Shoulder Instability Index (WOSI). After the exercise intervention differences between and within groups were analyzed with Mann-Whitney U-test and Wilcoxon signedrank test.

    Results: There were no difference in total WOSI-score between groups before (p = 0,47) or after (p = 0,36) the exercise intervention. An improvement over time, meaning after the intervention compared to before the intervention, was found in total WOSI-score within the intervention group (p = 0,028) while no improvement was found in the control group (p = 0,89).

    Conclusion: The improvement in the intervention group indicates that NMES during conventional shoulder stabilizing exercise can be an effective alternative for individuals with shoulder instability, but further studies is required to verify the positive effects of NMESexercise.

  • 14.
    Ärlebäck, Anna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Maineborn, Carina
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Sambandet mellan vidden på rektusdiastas och ländryggs- och bäckensmärta samt rörelserädsla: En kvantitativ tvärsnittsstudie2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The abdominal muscles play an important part in posture, inner unit stability, breathing, upper body movement, to generate power of the abdominal muscles and in supporting inner organs. Diastasis of the rectus abdominis muscles is common during and after pregnancy and might affect these important functions and thereby increase the vulnerability of the lower back and pelvic areas.

    Aim: To determine the correlation between the width of the diastasis recti abdominis and low back- and pelvic pain and the width of diastasis recti abdominis and fear of movement, in women after pregnancy.

    Method: Quantitative cross-sectional study. The amount of participants was 141. The population was women, 20-50 years old, who had given birth, the youngest child between the ages of 1-8 years old and were able to understand Swedish both verbally and in writing. The research participants had a diastasis recti abdominis more than 2 finger-widths, measured 4 cm above the umbilicus. The data collection was made with ultrasound and the questionnaires used were Numeric Rating Scale (NRS) and the swedish version of Tampa Scale of Kinesiophobia (TSK-SV). Correlation was analyzed with Spearman’s correlation coefficient. The participants were also divided into two groups based on a cut-off value of the diastasis of 2,4 cm and differences between groups were analyzed with Mann-Whitney U-test.

    Results: No statistical significance in correlation over p = 0,05 was found between the width of the diastasis recti abdominis and any of the pain ratings. However, there was a statistical significant weak positive correlation between the width of the diastasis recti abdominis and fear of movement. Furthermore there was no statistical significance between the groups ≤ 2,4 cm or > 2,4 cm of diastasis recti abdominis and the pain ratings, but a significant difference between the groups and the estimation on fear of movement.

    Conclusion: The study showed that the width of diastasis recti abdominis as alone factor doesn’t have any correlation with low back- and pelvic pain in women after pregnancy. Women with remaining diastasis recti abdominis > 2,4 cm, tended to estimate higher in this study in TSK-SV than those who had ≤ 2,4 cm. Regarding the ratings of the pain, no statistically significant difference between the groups were shown. When meeting these women physiotherapists should not only focus on the pain but also consider factors such as fear of movement and focus their efforts on guiding the women so that the risk of developing fear of movement is reduced.

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