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Nilsagård, Y., Westerdahl, E. & Forsberg, A. (2019). Engagement in performing clinical physiotherapy research: Perspectives from leaders and physiotherapists. Physiotherapy Research International, 24(2), Article ID e1767.
Open this publication in new window or tab >>Engagement in performing clinical physiotherapy research: Perspectives from leaders and physiotherapists
2019 (English)In: Physiotherapy Research International, ISSN 1358-2267, E-ISSN 1471-2865, Vol. 24, no 2, article id e1767Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: The recent increase in physiotherapy research has led to more physiotherapists being involved in research. Consequently, leaders must make a standpoint on whether the department should engage in research, whereas individual physiotherapists have to decide if they want to play an active role in carrying out a research project. The purpose of this study was to explore perceptions and experiences of both participating physiotherapists and their leaders regarding taking part in clinical physiotherapy research projects.

METHODS: A qualitative study using face-to-face interviews was conducted. All (n = 8) leaders were interviewed individually. Physiotherapists (n = 18) were interviewed either individually (n = 5) or in small groups including two to three persons (n = 13). The interviews were analysed using inductive conventional content analysis.

RESULTS: There was a consensus that engagement of the leaders was a prerequisite for entering research projects and that the research had to be in line with the department's regular assignment. For the physiotherapists, the key factors for success were having designated time and having support from their leader, especially when feelings of responsibility became overwhelming. The leaders stressed the importance of being well informed. Participating in clinical research created value such as personal and professional growth for the physiotherapists, who also inspired their colleagues and thus positively affected the organization. Engaging in research contributed to being an attractive employer and gave a boost to evidence-based practice.

CONCLUSION: The study provides perspectives from leaders and physiotherapists on engaging in research. There was a consensus that participating in a research project was beneficial for the organization, the individual physiotherapist, and the patients. However, clinical applicability, support, sufficient time, and early involvement of leaders are significant prerequisites.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
Evidence-based practice, physical therapy, professional development, qualitative research
National Category
Nursing
Identifiers
urn:nbn:se:oru:diva-71652 (URN)10.1002/pri.1767 (DOI)000463029100007 ()30657235 (PubMedID)
Note

Funding Agency:

Örebro Research Committee, Sweden

Available from: 2019-01-22 Created: 2019-01-22 Last updated: 2019-06-19Bibliographically approved
Zakrisson, A.-B., Anerös, T., Eliason, G. & Forsberg, A. (2019). Projekt Region Örebro län: Att använda en mobil app med larm för att motivera till fysisk aktivitet hos patienter med KOL – en mixed method pilot-studie. Lung och Allergi Forum, 32-39
Open this publication in new window or tab >>Projekt Region Örebro län: Att använda en mobil app med larm för att motivera till fysisk aktivitet hos patienter med KOL – en mixed method pilot-studie
2019 (Swedish)In: Lung och Allergi Forum, ISSN 2000-5237, p. 32-39Article in journal (Other academic) Published
Place, publisher, year, edition, pages
Mediahuset i Göteborg AB, 2019
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:oru:diva-73737 (URN)
Available from: 2019-04-15 Created: 2019-04-15 Last updated: 2019-04-24Bibliographically approved
Carling, A., Nilsagård, Y. & Forsberg, A. (2018). Balance exercise facilitates everyday life for people with multiple sclerosis: A qualitative study. Physiotherapy Research International, 23(4), Article ID e1728.
Open this publication in new window or tab >>Balance exercise facilitates everyday life for people with multiple sclerosis: A qualitative study
2018 (English)In: Physiotherapy Research International, ISSN 1358-2267, E-ISSN 1471-2865, Vol. 23, no 4, article id e1728Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: The aim of this qualitative study was to describe the experience and perceived effects on everyday life for people with multiple sclerosis after participating in a balance exercise programme focusing on core stability, dual tasking, and sensory strategies (the CoDuSe programme).

METHODS: A qualitative approach was chosen, using face-to-face interviews analysed with content analysis. Twenty-seven people with multiple sclerosis (20 women, 7 men) who had participated in the CoDuSe programme were included. All could walk 20 m with or without walking aids but could not walk further than 200 m. The CoDuSe programme was given twice weekly during a 7-week period.

RESULTS: The analysis revealed five categories. Learning to activate the core muscles described how the participants gained knowledge of using their core muscles and transferred this core muscle activation into everyday life activities. Improved bodily confidence covered narratives of being more certain of the ability to control their bodies. Easier and safer activities showed how they could now perform activities in everyday life more safely and easily. Increased independence and participation involved the participants' improved ability and self-confidence to execute activities by themselves, as well as their increased participation in activities in daily living. Experiences of the balance exercise programme revealed that they found the programme novel and challenging. The overall theme was balance exercise facilitates everyday life.

CONCLUSION: Participating in the CoDuSe programme was perceived to facilitate everyday life for people with multiple sclerosis. Taking part in the balance exercise programme taught the participants how to activate and use the core muscles, which increased their bodily confidence. Having increased bodily confidence helped them to perform everyday life activities with more ease and safety, which increased their independence and participation. The participants described the CoDuSe programme as novel and challenging, yet feasible.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
Exercise, multiple sclerosis, postural balance, qualitative research
National Category
Occupational Therapy Other Health Sciences
Research subject
Disability Science
Identifiers
urn:nbn:se:oru:diva-68373 (URN)10.1002/pri.1728 (DOI)000447159800008 ()29962013 (PubMedID)2-s2.0-85050613048 (Scopus ID)
Funder
Swedish Research Council
Note

Funding Agencies:

Norrbacka-Eugenia Foundation

Uppsala-Örebro Regional Research Committee

Available from: 2018-08-07 Created: 2018-08-07 Last updated: 2018-11-19Bibliographically approved
Carling, A., Forsberg, A. & Nilsagård, Y. (2018). Falls in people with multiple sclerosis: experiences of 115 fall situations. Clinical Rehabilitation, 32(4), 526-535
Open this publication in new window or tab >>Falls in people with multiple sclerosis: experiences of 115 fall situations
2018 (English)In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 32, no 4, p. 526-535Article in journal (Refereed) Published
Abstract [en]

Objectives: The aim was to describe falls and the perceived causes, experienced by people with multiple sclerosis shortly after falling.

Design: A qualitative study using content analysis and quantitative data to illustrate where and why people report falls most commonly. Semi-structured telephone interviews were performed. Interviews were conducted shortly (0–10 days) after a fall.

Subjects: In all, 67 informants who had reported at least one fall during the previous three-month period and who used a walking aid participated.

Results: A total of 57 (85%) informants fell at least once during eight months resulting in 115 falls; 90 (78%) falls happened indoors, most commonly in the kitchen (n = 20; 17%) or bathroom (n = 16; 14%). Informants fell during everyday activities and walking aids had been used in more than a third of the reported falls. The falls were influenced of both intrinsic and extrinsic factors. Two categories emerged from the analysis: ‘activities when falling’ and ‘influencing factors’. The category contained three (basic activities of daily living, instrumental activities of daily living and leisure and work) and six (multiple sclerosis–related symptoms, fluctuating body symptoms, being distracted, losing body control, challenging surrounding and involvement of walking aid) subcategories, respectively.

Conclusion: The majority of falls occurs indoors and in daily activities. Several factors interacted in fall situations and should be monitored and considered to reduce the gap between the person’s capacity and the environmental demands that cause fall risk. Fluctuation of bodily symptoms between and within a day is a variable not earlier targeted in multiple sclerosis fall risk research.

Place, publisher, year, edition, pages
Sage Publications, 2018
Keywords
Accidental falls, multiple sclerosis, walking aid, content analysis
National Category
Neurology Physiotherapy
Identifiers
urn:nbn:se:oru:diva-65948 (URN)10.1177/0269215517730597 (DOI)000429777600011 ()28901164 (PubMedID)2-s2.0-85042230415 (Scopus ID)
Available from: 2018-03-22 Created: 2018-03-22 Last updated: 2018-11-19Bibliographically approved
Carling, A., Nilsagård, Y. & Forsberg, A. (2018). Making it work: experience of living with a person who falls due to multiple sclerosis. Disability and Rehabilitation, 1-8
Open this publication in new window or tab >>Making it work: experience of living with a person who falls due to multiple sclerosis
2018 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, p. 1-8Article in journal (Refereed) Epub ahead of print
Abstract [en]

PURPOSE: The purpose of this study was to describe how everyday life is experienced by next of kin sharing residence with a person who falls due to multiple sclerosis (MS).

METHODS: Twenty face-to-face interviews were analysed using a qualitative content analysis.

RESULTS: The overall theme "Making it work" represents the next of kin's struggle to make life work. It comprises three themes: "Taking responsibility", "Making adjustments", and "Standing aside for someone else". The two first themes reflect what relatives do to make the situation work, and the last theme represents what they give up.

CONCLUSION: Next of kin who share residence and everyday life with a person with MS are affected by that person's occasional falls. They often take on the responsibility of preventing such falls and adapt their lives practically and emotionally. However, adaptation is neither always enough or always possible. In these cases, relatives often deprioritize their own needs and free time to make everyday life in the home work. Implications for rehabilitation By highlighting that next of kin also are affected by the falls of their cohabiting person with multiple sclerosis enhances the importance of fall prevention activities that should include the next of kin. Next of kin to people who occasionally fall due to multiple sclerosis can be in need of both practical and emotional support from the health care system. Enhanced information from the health care system can empower and help them to take care of themselves while managing to live with, care for, and protect the person with multiple sclerosis from falls.

Place, publisher, year, edition, pages
Informa Healthcare, 2018
Keywords
Accidental falls, family, multiple sclerosis, qualitative research
National Category
Nursing Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:oru:diva-69584 (URN)10.1080/09638288.2018.1514078 (DOI)30299167 (PubMedID)
Available from: 2018-10-16 Created: 2018-10-16 Last updated: 2018-11-19Bibliographically approved
Arvidsson Lindvall, M., Anderzen-Carlsson, A., Appelros, P. & Forsberg, A. (2018). Validity and test-retest reliability of the six-spot step test in persons after stroke. Physiotherapy Theory and Practice
Open this publication in new window or tab >>Validity and test-retest reliability of the six-spot step test in persons after stroke
2018 (English)In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND AND PURPOSE: After stroke, asymmetric weight distribution is common with decreased balance control in standing and walking. The six-spot step test (SSST) includes a 5-m walk during which one leg shoves wooden blocks out of circles marked on the floor, thus assessing the ability to take load on each leg. The aim of the present study was to investigate the convergent and discriminant validity and test-retest reliability of the SSST in persons with stroke.

METHODS: Eighty-one participants were included. A cross-sectional study was performed, in which the SSST was conducted twice, 3-7 days apart. Validity was investigated using measures of dynamic balance and walking. Reliability was assessed using intraclass correlation coefficient, standard error of the measurement (SEM), and smallest real difference (SRD).

RESULTS: The convergent validity was strong to moderate, and the test-retest reliability was good. The SEM% was 14.7%, and the SRD% was 40.8% based on the mean of four walks shoving twice with the paretic and twice with the non-paretic leg.

CONCLUSION: Values on random measurement error were high affecting the use of the SSST for follow-up evaluations but the SSST can be a complementary measure of gait and balance.

Place, publisher, year, edition, pages
Taylor & Francis, 2018
Keywords
Balance, reliability, stroke, validity
National Category
Physiology
Identifiers
urn:nbn:se:oru:diva-67220 (URN)10.1080/09593985.2018.1482511 (DOI)29873590 (PubMedID)
Available from: 2018-06-11 Created: 2018-06-11 Last updated: 2018-09-14Bibliographically approved
Carling, A., Forsberg, A., Gunnarsson, M. & Nilsagård, Y. (2017). CoDuSe group exercise programme improves balance and reduces falls in people with multiple sclerosis: A multi-centre, randomized, controlled pilot study. Multiple Sclerosis, 23(10), 1394-1404
Open this publication in new window or tab >>CoDuSe group exercise programme improves balance and reduces falls in people with multiple sclerosis: A multi-centre, randomized, controlled pilot study
2017 (English)In: Multiple Sclerosis, ISSN 1352-4585, E-ISSN 1477-0970, Vol. 23, no 10, p. 1394-1404Article in journal (Refereed) Published
Abstract [en]

Background: Imbalance leading to falls is common in people with multiple sclerosis (PwMS).

Objective: To evaluate the effects of a balance group exercise programme (CoDuSe) on balance and walking in PwMS (Expanded Disability Status Scale, 4.0-7.5).

Methods: A multi-centre, randomized, controlled single-blinded pilot study with random allocation to early or late start of exercise, with the latter group serving as control group for the physical function measures. In total, 14 supervised 60-minute exercise sessions were delivered over 7 weeks. Pretest-posttest analyses were conducted for self-reported near falls and falls in the group starting late. Primary outcome was Berg Balance Scale (BBS). A total of 51 participants were initially enrolled; three were lost to follow-up.

Results: Post-intervention, the exercise group showed statistically significant improvement (p = 0.015) in BBS and borderline significant improvement in MS Walking Scale (p = 0.051), both with large effect sizes (3.66; -2.89). No other significant differences were found between groups. In the group starting late, numbers of falls and near falls were statistically significantly reduced after exercise compared to before (p < 0.001; p < 0.004).

Conclusion: This pilot study suggests that the CoDuSe exercise improved balance and reduced perceived walking limitations, compared to no exercise. The intervention reduced falls and near falls frequency.

Place, publisher, year, edition, pages
London, United Kingdom: Sage Publications, 2017
Keywords
Accidental falls, exercise, multiple sclerosis, postural balance, core stability
National Category
Neurology
Identifiers
urn:nbn:se:oru:diva-53488 (URN)10.1177/1352458516677591 (DOI)000407918800014 ()27834736 (PubMedID)2-s2.0-85027895184 (Scopus ID)
Note

Funding Agencies:

Uppsala-Örebro Regional Research Committe  

Research committee of Örebro County Council  

Norrbacka-Eugenia Foundation 

Available from: 2016-11-14 Created: 2016-11-14 Last updated: 2018-11-19Bibliographically approved
Nilsagård, Y., Carling, A., Davidsson, O., Franzén, L. & Forsberg, A. (2017). Comparison of trunk impairment scale versions 1.0 and 2.0 in people with multiple sclerosis: A validation study. Physiotherapy Theory and Practice, 33(10), 772-779
Open this publication in new window or tab >>Comparison of trunk impairment scale versions 1.0 and 2.0 in people with multiple sclerosis: A validation study
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2017 (English)In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 33, no 10, p. 772-779Article in journal (Refereed) Published
Abstract [en]

Background: Trunk control impairment often accompanies multiple sclerosis (MS). Trunk stability is necessary for movements of extremities, as are selective trunk movements for normal gait. Measuring trunk function is thus of interest.

Methods: We examined the relationships between the Trunk Impairment Scale (TIS1.0 and TIS2.0) and the Berg Balance Scale (BBS), 5 sit-to-stand test (5STS), Timed Up and Go test (TUG), 10-m timed walk test (10TW), 2-min walk test (2MWT), Falls Efficacy Scale - International, and 12-item MS Walking Scale (MSWS-12) in 47 outpatients. We determined construct validity by calculating the degree to which the TIS versions produced different scores between known groups: use or nonuse of walking aid, MS disability status, and whether participants experienced a fall or not during 14 weeks.

Results: TIS correlated moderately with BBS and 5STS; moderately (TIS1.0) or weakly (TIS2.0) with TUG, 10TW, and 2MWT; and weakly to moderately with MSWS-12 in subgroups with Expanded Disability Status Scale (EDSS) > 6.0. No other clear correlation patterns were found. TIS did not discriminate between known groups.

Conclusions: TIS1.0 is recommended for individuals with MS (EDSS score 4.0-7.5). Better trunk function correlates with better balance and walking ability. TIS has limited value in fall risk screening.

Place, publisher, year, edition, pages
Taylor & Francis, 2017
Keywords
Multiple sclerosis, postural balance, torso, validity
National Category
Occupational Therapy
Identifiers
urn:nbn:se:oru:diva-60733 (URN)10.1080/09593985.2017.1346025 (DOI)000407975000004 ()28715271 (PubMedID)2-s2.0-85024405409 (Scopus ID)
Note

Funding Agencies:

Uppsala-Örebro Regional Research Council  467731 

Örebro County Research Committee  456981 

Norrbacka-Eugenia Foundation  812/14 

Neuro Sweden 

Available from: 2017-09-11 Created: 2017-09-11 Last updated: 2018-10-23Bibliographically approved
Forsberg, A., Carling, A. & Nilsagård, Y. (2017). Effects on balance and walking with a CoreStability Exercise Program in people with multiple sclerosis. In: : . Paper presented at World Confederation of Physical Therapy Congress, Cape Town, South Africa, 2-4 July, 2017.
Open this publication in new window or tab >>Effects on balance and walking with a CoreStability Exercise Program in people with multiple sclerosis
2017 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Physiotherapy Neurology
Identifiers
urn:nbn:se:oru:diva-65951 (URN)
Conference
World Confederation of Physical Therapy Congress, Cape Town, South Africa, 2-4 July, 2017
Available from: 2018-03-22 Created: 2018-03-22 Last updated: 2018-10-23Bibliographically approved
Carling, A., Forsberg, A. & Nilsagård, Y. (2017). Fall bland personer med multipel skleros. Best Practice (20), 24-27
Open this publication in new window or tab >>Fall bland personer med multipel skleros
2017 (Swedish)In: Best Practice, ISSN 1329-1874, no 20, p. 24-27Article in journal (Other academic) Published
Place, publisher, year, edition, pages
Uppsala, Sweden: BestPractice, 2017
National Category
Physiotherapy Neurology
Identifiers
urn:nbn:se:oru:diva-65954 (URN)
Available from: 2018-03-22 Created: 2018-03-22 Last updated: 2018-10-23Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-6768-5740

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