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  • 1.
    Arvidsson Lindvall, Mialinn
    et al.
    Örebro University, School of Health Sciences. University Health Care Research Centre, Region Örebro County, Örebro, Sweden.
    Anderzen-Carlsson, Agneta
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Centre, Region Örebro County, Örebro, Sweden; Faculty of Health, Science, and Technology, Department of Health Sciences, Nursing, Karlstad University, Karlstad, Sweden.
    Appelros, Peter
    Faculty of Health, Science, and Technology, Department of Health Sciences, Nursing, Karlstad University, Karlstad, Sweden.
    Forsberg, Anette
    Örebro University, School of Health Sciences. Örebro University Hospital. Department of Physiotherapy.
    Validity and test-retest reliability of the six-spot step test in persons after stroke2020In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 36, no 1, p. 211-218Article in journal (Refereed)
    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.

  • 2.
    Hammer, Ann
    et al.
    Örebro University, Department of Clinical Medicine.
    Nilsagård, Ylva
    Örebro University Hospital, Örebro, Sweden.
    Forsberg, Anette
    Örebro County Council, Örebro, Sweden.
    Pepa, Helena
    Örebro University Hospital, Örebro, Sweden.
    Skargren, Elisabeth
    Linköping University, Linköping, Sweden.
    Öberg, Birgitta
    Linköping University, Linköping, Sweden.
    Evaluation of therapeutic riding (Sweden)/hippotherapy (United States): a single-subject experimental design study replicated in eleven patients with multiple sclerosis2005In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 21, no 1, p. 51-77Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate whether therapeutic riding (TR, Sweden) hippotherapy (HT, United States) may affect balance, gait, spasticity, functional strength, coordination, pain, self-rated level of muscle tension (SRLMT), activities of daily living (ADL), and health-related quality of life. Eleven patients with multiple sclerosis (MS) were studied in a single-subject experimental design iSSED) study, type A-B-A. The intervention comprised ten weekly TR/HT sessions of 30 minutes each. The subjects were measured a maximum of 13 times. Physical tests were: the Berg balance scale, talking a figure of eight, the timed up and go test, 10 m walking, the modified Ashworth scale, the Index of Muscle Function, the Birgitta Lindmark motor assessment, part B, and individual measurements. Self-rated measures were. the Visual Analog Scale for pain, a scale for SRLMT, the Patient-Specific Functional Scale for ADL, and the SF-36. Data were analyzed visually, semi-statistically and considering clinical significance. Results showed improvement for ten subjects in one or more of the variables, particularly balance, and some improvements were also seen in pain, muscle tension, and ADL. Changes in SF-36 were mostly positive, with an improvement in Role-Emotional seen in eight patients. Conclusively, balance and Role-Emotional were the variables most often improved, but TR/HT appeared to benefit the subjects differently.

  • 3.
    Holopainen, Riikka
    et al.
    Faculty of Sport and Health Sciences, University of Jyväskylä, Jyvaskyla, Finland.
    Piirainen, Arja
    Faculty of Sport and Health Sciences, University of Jyväskylä, Jyvaskyla, Finland.
    Karppinen, Jaro
    Medical Research Center Oulu, University of Oulu, Oulu University Hospital, Oulu, Finland; Finnish Institute of Occupational Health, Oulu, Finland.
    Linton, Steven J.
    Örebro University, School of Law, Psychology and Social Work.
    O'Sullivan, Peter
    School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia.
    An adventurous learning journey: Physiotherapists' conceptions of learning and integrating cognitive functional therapy into clinical practice2020In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040Article in journal (Refereed)
    Abstract [en]

    Background: Recent low back pain guidelines recommend a BPS approach to the management of disabling low back pain. However, the most effective way of teaching physiotherapists to implement these approaches remains unknown. The present qualitative study aimed to explore physiotherapists' conceptions of learning and integrating Cognitive Functional Therapy (CFT) into clinical practice in Finnish primary health care.

    Methods: We interviewed 22 physiotherapists, who participated in four to six days of CFT workshops. A phenomenographic approach was used to explore the variation in the physiotherapists' conceptions of this process.

    Results: Four themes emerged from the data: 1) membership of work community; 2) learning journey; 3) transition to new working methods; and 4) professional role as a physiotherapist. These themes varied in four categories of description: recognizing difference of the new approach, toward integrating the new approach, waking up to explore, commitment to new approach and expanding application of new approach. The critical aspects between the categories that enabled the integration of CFT into clinical practice were ability to overcome resistance and to change views, being shaken and ability to critically reflect on one's work, support from the work community and becoming convinced, creativity, multidisciplinary collaboration and continuous learning.

    Conclusion: The participants' responses to the training varied greatly, suggesting that for some, the training was insufficient to support adequate changes in their practice behavior; whereas for others, the training was a life changing experience.

  • 4.
    Nilsagård, Ylva
    et al.
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Carling, Anna
    Örebro University, School of Medical Sciences. Department of Physiotherapy, Faculty of Medicine and Health , Örebro University , Örebro , Sweden.
    Davidsson, Oskar
    NeuroRehab, Nyköping Hospital, Nyköping, Sweden.
    Franzén, Lisbeth
    NeuroRehab, Nyköping Hospital, Nyköping, Sweden.
    Forsberg, Anette
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Comparison of trunk impairment scale versions 1.0 and 2.0 in people with multiple sclerosis: A validation study2017In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 33, no 10, p. 772-779Article in journal (Refereed)
    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.

  • 5.
    Rådman, Lisa
    et al.
    Department of Physiotherapy, Örebro University Hospital, Örebro, Sweden; Centre for Health Care Sciences, Örebro County Council, Örebro, Sweden.
    Forsberg, Anette
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Family Medicine Research Centre, , Region Örebro County, Örebro, Sweden.
    Nilsagård, Ylva
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Centre for Health Care Sciences, Örebro University Hospital, Örebro, Sweden.
    Modified Rivermead Mobility Index: a reliable measure in people within 14 days post-stroke2015In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 31, no 2, p. 126-129Article in journal (Refereed)
    Abstract [en]

    Purpose: The reliability of the Modified Rivermead Mobility Index (MRMI) has not previously been investigated in the very early post-stroke phase. The aim of the study was to evaluate inter-rater and intra-rater reliability and internal consistency in patients, 1-14 d post-stroke.

    Method: A cohort study with repeated measures within 24 h, on 37 patients, 1-14 d post-stroke was conducted. Inter-rater (two raters) and intra-rater (one rater) reliability was analyzed using weighted kappa (kappa) statistics and internal consistency with Cronbach's alpha and intra-class correlation (ICC), 3.k.

    Results: Inter-rater and intra-rater reliability was excellent (ICC coefficient 0.97 and 0.99) for MRMI summary score. Intra-rater exact agreement for separate items was between 77% and 97%; kappa between 0.81 and 0.96. Inter-rater exact agreement for separate items was between 68% and 92%; kappa 0.59-0.87. The internal consistency was high (alpha 0.96; ICC 3.k 0.99). Conclusion: The MRMI is a reliable measure of physical mobility in the early post-stroke phase.

  • 6.
    Sahlander, Carina
    et al.
    Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden.
    Mattsson, Monica
    Department of Psychiatry, Umeå University, Umeå, Sweden.
    Bejerot, Susanne
    Department of Clinical Neuroscience, Section Psychiatry, St. Göran Karolinska Institute, Stockholm, Sweden.
    Motor function in adults with Asperger's disorder: a comparative study2008In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 24, no 2, p. 73-81Article in journal (Refereed)
    Abstract [en]

    In the original description of Asperger's disorder (AD), clumsiness was an associated feature. Several studies of children have shown deficits in motor control, whereas research regarding adults is scarce. The aim of the present study was to compare motor function in adults with AD, with a normal comparison group. Gross and fine motor skills were examined by a standardized, norm referenced test developed for children, but also used in young adults, the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP). In addition, a questionnaire regarding the participants' physical activity during leisure time was administered. We found that adults (age 21-35) with AD (N = 15) performed significantly worse than the normal comparison group (N = 29) in six of eight subtests in the BOTMP. Males with AD were less physically active than males in the comparison group. Among females, physical activity did not differ between the groups. There was a positive association between physical activity and gross motor function in the AD group. Participants with AD were encouraged by the assessments. Physical coaching may be an important future field for improving quality of life in adults with AD.

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