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  • 1.
    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.

  • 2.
    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.

  • 3.
    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.

  • 4.
    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.

  • 5.
    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.

  • 6.
    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.

  • 7.
    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.

  • 8.
    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.

  • 9.
    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.

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