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  • 1.
    Appelros, Peter
    et al.
    University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Arvidsson Lindvall, Mialinn
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Center.
    Matérne, Marie
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Center.
    Stroke prevalence in a medium-sized Swedish municipality2021In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 143, no 2, p. 210-216Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Many patients who have had stroke survive with functional disability for years. Stroke prevalence is a fundamental measure of the impact of stroke in society. Stroke prevalence has never been evaluated in Sweden.

    MATERIALS & METHODS: 2019 with respect to stroke survivors (ICD-10 I60-I69) living in Kumla (population 21,738), a municipality well representative of Sweden.

    RESULTS: 330 individuals with stroke were found, of which 42% were women. The mean age was 74.1 years in men and 75.1 years in women. 11.5% of the patients had more than one stroke. The mean duration since the first stroke was 8.3 years. The crude prevalence per 100,000 was 1754 in men, 1281 in women and 1518 in both sexes. Adjusted to the European population, the ratio was 1570 per 100,000, and to the World population 936 per 100,000.

    CONCLUSIONS: In spite of a declining stroke incidence in Sweden, the stroke prevalence in Kumla, Sweden, is relatively high. Comparisons with other studies indicate that a decline in prevalence may have occurred since the early 2000s. Modern registers can support data collection, but the index stroke may have occurred almost forty years back in time.

  • 2. Appelros, Peter
    et al.
    Matérne, Marie
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Jarl, Gustav
    Örebro University Hospital. Örebro University, School of Health Sciences.
    Arvidsson Lindvall, Mialinn
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Center .
    Comorbidity in Stroke Survivors in a Medium-Sized Swedish Municipality2023Conference paper (Other academic)
  • 3.
    Appelros, Peter
    et al.
    University Health Care Research Center,Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Matérne, Marie
    Örebro University, School of Health Sciences. University Health Care Research Center.
    Jarl, Gustav
    Örebro University Hospital. Örebro University, School of Health Sciences. University Health Care Research Center; Department of Prosthetics and Orthotics.
    Arvidsson Lindvall, Mialinn
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Center.
    Comorbidity in stroke survivors in a medium-sized Swedish municipality2023In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 37, no Suppl. 1, p. 135-136Article in journal (Other academic)
    Abstract [en]

    Objectives: The purpose of this study was to evaluate the prevalence and impact of stroke-related comorbidity in a community-based sample of stroke survivors. With respect to the patients’ functional outcomes and general health, we wanted to find out which types of comorbidity were most important.

    Materials and Methods: All stroke survivors (n = 330) living in a medium-sized Swedish municipality were included. To determine the presence of comorbidities patient records were reviewed. A selection of patient reported outcomes were used to assess subjective symptoms, functional outcomes, and general health. All patients were asked to answer a questionnaire, the Swedish Stroke Register (Riksstroke). Three questions from the questionnaire were used as additional measures of comorbidity. “Do you feel tired?,” “Do you have pain?” and “Do you feel depressed?” As outcome measures the patient reported measures from the Riksstroke questionnaire were used: * Do you still have problems after your stroke? * Have you been able to return to the life and activities you had before the stroke? * How is your mobility now? * Do you get help from someone when visiting the toilet? * Do you get help with dressing and undressing? * How do you assess your general health? Logistic regression models were used to investigate the association between comorbidities, residual symptoms, and subjective symptoms on the one hand, and functional outcomes and general health on the other hand.

    Results: Hypertension (80%) was the most common cardiovascular risk factor. Ischemic heart disease was found in 18% and congestive heart failure in 10%. Of non-cardiovascular disorders, orthopedic diseases were commonest (30%). Psychiatric disorders and cognitive impairment were present in 11% and 12% respectively. Logistic regression analyses found that hemiparesis was associated with both poorer functional outcomes and lower general health. Additionally, orthopedic disorders, vertigo, cognitive impairment, nicotine use, chronic pulmonary disorders, and older age, were also associated with poorer functional outcomes. Psychiatric, orthopedic and neurological disorders were associated with poorer general health. The patient-reported outcome measure “feeling of tiredness” was a predictor of both outcomes, while “feeling depressed” and “having pain” were associated with poorer general health.

    Conclusions: Many medical conditions, several of which have received little attention so far, are associated with poorer functional outcome and lower general health among stroke survivors. Future research into comorbidities relevant to function and general health in stroke patients could further focus on these disorders that hitherto have received little attention.

  • 4.
    Appelros, Peter
    et al.
    University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Matérne, Marie
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Center.
    Jarl, Gustav
    Örebro University Hospital. Örebro University, School of Health Sciences. University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Department of Prosthetics and Orthotics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Arvidsson Lindvall, Mialinn
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Center.
    Comorbidity in Stroke-Survivors: Prevalence and Associations with Functional Outcomes and Health2021In: Journal of Stroke & Cerebrovascular Diseases, ISSN 1052-3057, E-ISSN 1532-8511, Vol. 30, no 10, article id 106000Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The purpose of this study was to evaluate the prevalence and impact of stroke-related comorbidity in a community-based sample of stroke survivors. We sought to find out which types of comorbidity that were most important with respect to the patients' functional outcomes and general health.

    MATERIALS AND METHODS: All stroke survivors (n = 330) living in a medium-sized Swedish municipality were included. Patient records were reviewed to determine the presence of comorbidities. A selection of patient reported outcomes were used to assess subjective symptoms, functional outcomes, and general health. Logistic regression models were used to investigate the association between comorbidities, residual symptoms, and subjective symptoms on the one hand, and functional outcomes and general health on the other hand.

    RESULTS: Hypertension (80%) was the most common cardiovascular risk factor. Ischemic heart disease was found in 18% and congestive heart failure in 10%. Of non-cardiovascular disorders, orthopaedic diseases were commonest (30%). Psychiatric disorders and cognitive impairment were present in 11% and 12% respectively. Hemiparesis is associated with both functional outcomes and general health. Additionally, orthopedic disorders, vertigo, cognitive impairment, nicotine use, chronic pulmonary disorders, and age, are associated with different functional outcomes. Psychiatric, orthopedic and neurological disorders are related to general health. The patient-reported outcome measure "feeling of tiredness" is important for many of the outcomes, while "feeling depressed" and "having pain" are associated with general health.

    CONCLUSIONS: Many medical conditions, several of which have received little attention so far, are associated with functional outcome and general health in stroke survivors. If the intention is to describe comorbidity relevant to function and general health in stroke patients, disorders that hitherto have received little attention, must be considered.

  • 5.
    Arvidsson Lindvall, Mialinn
    Örebro University, School of Health Sciences.
    Physiotherapeutic perspectives on balance control after stroke: exercises, experiences and measures2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of this thesis was to investigate physiotherapeutic perspectives on balance after stroke, in terms of exercises, experiences and measurements. Study I was a pilot randomized controlled trial with 46 persons who had had a stroke, 24 of whom were included in the intervention group and 22 who were included in the control group. The intervention consisted of 8 weeks of body awareness therapy (BAT). There were no significant differences over time between the groups in the outcome measures of balance, walking, self-reported balance confidence and quality of life. Study II had a qualitative design using content analysis. Participants in the intervention group from Study I and the four physiotherapists who had been in charge of the BAT were interviewed. One overall theme emerged: "Simple yet challenging", which was based on six categories. Study III investigated the validity and test-retest reliability of the Six-Spot Step test (SSST), an instrument used to assess the ability to take load on each leg. A cross-sectional design with 81 persons who had had stroke was performed. The convergent validity was strong to moderate, and the test-retest reliability was good. In Study IV a mixed method design including both qualitative and quantitative data collection was used. The participants’ experiences of balance and its influence in everyday life were presented in two themes: "Feeling dizzy and unstable is a continuous challenge" and "Feeling trust and confidence despite dizziness and unsteadiness". Taken together, the different data sets provided complementary and confirmatory information about balance. All participants experienced the balance limitations as a continuous challenge in everyday life, yet they also felt trust and confidence.

    In summary, BAT can be a complement in physiotherapeutic stroke rehabilitation and the SSST can be used as a measuring instrument of walking balance in persons with stroke. Living with balance limitations was experienced as a challenge but the participants were still able to manage their everyday life and activities.

    List of papers
    1. Body awareness therapy in persons with stroke: a pilot randomised controlled trial
    Open this publication in new window or tab >>Body awareness therapy in persons with stroke: a pilot randomised controlled trial
    2014 (English)In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 28, no 12, p. 1180-1188Article in journal (Refereed) Published
    Abstract [en]

    Objective: To investigate the effects of body awareness therapy on balance, mobility, balance confidence, and subjective health status in persons with stroke.

    Design: A pilot randomized controlled study with follow-up at one and 4–6 weeks after the intervention period.

    Setting: Four primary healthcare centres in Örebro County Council.

    Subjects: Persons more than six months post stroke, with walking ability of 100 metres.

    Intervention: The experimental intervention was body awareness therapy in groups once a week for eight weeks. The controls were instructed to continue their usual daily activities.

    Main measures: Berg Balance Scale, Timed Up and Go Test, Timed Up and Go Test with a cognitive component, 6-minute walk test, and Timed-Stands Test. Self-rated balance confidence was assessed using the Activities-specific Balance Confidence Scale, and subjective health status using the Short Form 36 (SF-36) questionnaire.

    Results: A total of 46 participants were included (mean age 64 years); 24 in the experimental intervention group and 22 in the control group. No significant differences in changed scores over time were found between the groups. Within the experimental intervention group, significant improvements over time was found for the tests Berg Balance Scale, Timed Up and Go cognitive, and 6-minute walk test. Within the control group, significant improvements over time were found for the Timed Up and Go Cognitive, and the Timed-Stands Test.

    Conclusion: In comparison to no intervention, no effects were seen on balance, mobility, balance confidence, and subjective health status after eight weeks of body awareness therapy.

    Place, publisher, year, edition, pages
    Sage Publications, 2014
    Keywords
    Body awareness therapy, postural control, physiotherapy, stroke
    National Category
    Health Sciences Nursing
    Research subject
    Health and Medical Care Research; Rehabilitation Medicine
    Identifiers
    urn:nbn:se:oru:diva-35843 (URN)10.1177/0269215514527994 (DOI)000347118700004 ()24668360 (PubMedID)2-s2.0-84921668455 (Scopus ID)
    Note

    Funding Agencies:

    Swedish Stroke Association

    Norrbacka Eugenia Foundation 803-11

    Research Committee Orebro County Council OLL-227701

    Available from: 2014-08-04 Created: 2014-08-04 Last updated: 2022-11-02Bibliographically approved
    2. Basic Body Awareness Therapy for patients with stroke: Experiences among participating patients and physiotherapists
    Open this publication in new window or tab >>Basic Body Awareness Therapy for patients with stroke: Experiences among participating patients and physiotherapists
    2016 (English)In: Journal of Bodywork & Movement Therapies, ISSN 1360-8592, E-ISSN 1532-9283, Vol. 20, no 1, p. 83-89Article in journal (Refereed) Published
    Abstract [en]

    Background: After a stroke many patients have muscle weakness, spasticity and compromised sensation leading to decreased postural stability. Basic Body Awareness Therapy includes slow movements that challenge postural control.

    Aim: The aim was to describe experiences of 8 weeks of Basic Body Awareness Therapy from the perspective of both patients with stroke and physiotherapists.

    Method: This study had a qualitative design. Twenty-one patients and four physiotherapists were interviewed. The interviews were analysed using manifest and latent content analysis.

    Results: One overall theme emerged "Simple yet challenging" which was based on six categories: "Facing one's limitations", "Individualized movements", "A feeling of harmony", "Improved balance", "Integrated knowledge" and "Frustration and doubt". The patients described improvement in balance and stability, as well as increased wellbeing.

    Conclusion: The patients and physiotherapists related that Basic Body Awareness Therapy challenges balance but also provides an opportunity to reflect on the body.

    Place, publisher, year, edition, pages
    Elsevier, 2016
    Keywords
    Basic Body Awareness Therapy, Physiotherapy, Qualitative study, Stroke
    National Category
    Nursing
    Research subject
    Rehabilitation Medicine
    Identifiers
    urn:nbn:se:oru:diva-52163 (URN)10.1016/j.jbmt.2015.06.004 (DOI)000381689000012 ()26891641 (PubMedID)2-s2.0-84958039596 (Scopus ID)
    Available from: 2016-09-14 Created: 2016-09-14 Last updated: 2022-11-02Bibliographically approved
    3. Validity and test-retest reliability of the Six-Spot Step Test in persons after stroke
    Open this publication in new window or tab >>Validity and test-retest reliability of the Six-Spot Step Test in persons after stroke
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:oru:diva-66907 (URN)
    Available from: 2018-05-09 Created: 2018-05-09 Last updated: 2022-11-02Bibliographically approved
    4. "I can still manage": a mixed-method study of balance after stroke
    Open this publication in new window or tab >>"I can still manage": a mixed-method study of balance after stroke
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:oru:diva-66909 (URN)
    Available from: 2018-05-09 Created: 2018-05-09 Last updated: 2022-11-02Bibliographically approved
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  • 6.
    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.

  • 7.
    Arvidsson Lindvall, Mialinn
    et al.
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Center.
    Anderzen-Carlsson, Agneta
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Center.
    Forsberg, Anette
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Center.
    Basic Body Awareness Therapy for patients with stroke: Experiences among participating patients and physiotherapists2016In: Journal of Bodywork & Movement Therapies, ISSN 1360-8592, E-ISSN 1532-9283, Vol. 20, no 1, p. 83-89Article in journal (Refereed)
    Abstract [en]

    Background: After a stroke many patients have muscle weakness, spasticity and compromised sensation leading to decreased postural stability. Basic Body Awareness Therapy includes slow movements that challenge postural control.

    Aim: The aim was to describe experiences of 8 weeks of Basic Body Awareness Therapy from the perspective of both patients with stroke and physiotherapists.

    Method: This study had a qualitative design. Twenty-one patients and four physiotherapists were interviewed. The interviews were analysed using manifest and latent content analysis.

    Results: One overall theme emerged "Simple yet challenging" which was based on six categories: "Facing one's limitations", "Individualized movements", "A feeling of harmony", "Improved balance", "Integrated knowledge" and "Frustration and doubt". The patients described improvement in balance and stability, as well as increased wellbeing.

    Conclusion: The patients and physiotherapists related that Basic Body Awareness Therapy challenges balance but also provides an opportunity to reflect on the body.

  • 8.
    Arvidsson Lindvall, Mialinn
    et al.
    Örebro University, School of Health Sciences.
    Anderzén-Carlsson, Agneta
    Örebro University, School of Health Sciences. Örebro University Hospital. Karlstad University, Karlstad, Sweden.
    Appelros, Peter
    Department of University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Forsberg, Anette
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Validity and test-retest reliability of the Six-Spot Step Test in persons after strokeManuscript (preprint) (Other academic)
  • 9.
    Arvidsson Lindvall, Mialinn
    et al.
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Appelros, Peter
    Örebro University, Faculty of Medicine and Health, Örebro, Sweden.
    Forsberg, Anette
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Anderzen-Carlsson, Agneta
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Experiences of living with balance limitations after first-ever stroke2023Conference paper (Refereed)
    Abstract [en]

    Background:  

    Stroke is the leading cause of serious, long-term disability among adults. Balance control after stroke may be affected due to motor impairment such as muscle weakness, spasticity and impaired sensory function and also cognitive deficits may affect balance control. The balance limitations affect walking and independence in activities of daily living. Having good balance has been described as an important factor in outdoor walking and for participation in exercises. Studies in which persons with stroke describe their experience of balance in everyday life are scarce.

    Purpose:  

    The aim of the present presentation is to describe experiences of living with balance limitations in everyday life after first-ever stroke.

    Methods:  

    Twenty persons initially agreed to participate; however, one person later declined further participation, thus giving a sample size of 19 participants (10 females and 9 men), aged between 42-92 years. The inclusion criteria were: having had a first-ever stroke and having self-reported impaired balance, unaffected speech, independence in toileting and dressing, and walking ability indoors and outdoors with or without a walking aid. A qualitative data collection through individual interviews was conducted. Data was analysed by means of an inductive content analysis covering both the manifest and the latent content of the transcribed interviews.

    Results:  

    The participants' experiences of balance and its influence in everyday life, are presented in two themes. The first theme “Feeling dizzy and unstable is a continuous challenge”, revolves around participants' descriptions of balance as a constant feeling of dizziness and unsteadiness. The second theme “Feeling trust and confidence despite dizziness and unsteadiness” is about perceived abilities and feelings of confidence about still being able to do things oneself, despite the dizziness and unsteadiness.

    Conclusion(s):  

    All participants experienced the balance limitations as a continuous challenge in everyday life, yet they also felt trust and confidence and experienced that they still managed their everyday life. In future research it would be of interest to establish which strategies can make persons with stroke feel in balance in relation to fear of falling.

    Implications:

    In physical therapy practice, the experiences of balance limitations after stroke from the person with stroke add valuable information to various assessments. By asking the person about their abilities and challenges in daily living, rehabilitation interventions can be more individualized and based on the person's actual condition and their wishes and needs.

  • 10.
    Arvidsson Lindvall, Mialinn
    et al.
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Appelros, Peter
    University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Forsberg, Anette
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Anderzen-Carlsson, Agneta
    Örebro University, School of Health Sciences. Örebro University Hospital.
    LIVING WITH BALANCE LIMITATIONS AFTER FIRST-EVER STROKE2020In: International Journal of Stroke, ISSN 1747-4930, E-ISSN 1747-4949, Vol. 15, no Suppl. 1, p. 257-257Article in journal (Other academic)
    Abstract [en]

    Background: Stroke is the leading cause of serious, long-term disability among adults. Balance can be limited after stroke and the limitations affect walking and independence in activities of daily living. Having good balance has been described as an important factor in outdoor walking and for participation in exercises. Studies in which persons with stroke describe their experience of balance in everyday life are scarce.

    Aim: To describe experiences of living with balance limitations after first-ever stroke.

    Methods: A qualitative design, comprising interviews with 19 persons with first-ever stroke, ten women and nine men, aged between 42–92 years. Inclusion criteria were: having had a first-ever stroke and self-reported impaired balance, unaffected speech, independence in toileting and dressing, and walking ability indoors and outdoors with or without a walking aid. Data was analysed by means of an inductive content analysis covering both the manifest and the latent content of the transcribed interviews.

    Results: The results are presented in two themes illustrating the latent content of the data. “Feeling dizzy and unstable is a continuous challenge” revolves around participants’ descriptions of balance as a constant feeling of dizziness and unsteadiness. “Feeling trust and confidence despite dizziness and unsteadiness” is about perceived abilities and feelings of confidence about still being able to do things oneself, despite the dizziness and unsteadiness.

    Conclusion: All participants experienced the balance limitations as a continuous challenge in everyday life, yet they also felt trust and confidence and experienced that they still managed their everyday life.

  • 11.
    Arvidsson Lindvall, Mialinn
    et al.
    Örebro University, School of Health Sciences. Örebro University Hospital. Department of University Health Care Research Center.
    Forsberg, Anette
    Örebro University, School of Health Sciences. Örebro University Hospital. Department of Physiotherapy.
    Appelros, Peter
    Department of University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Anderzen-Carlsson, Agneta
    Örebro University, School of Health Sciences. Örebro University Hospital. Department of University Health Care Research Center.
    "I can manage the challenge": a qualitative study describing experiences of living with balance limitations after first-ever stroke2021In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 16, no 1, article id 1857044Article in journal (Refereed)
    Abstract [en]

    Purpose: To describe experiences of living with balance limitations after first-ever stroke.

    Materials and methods: This study has a qualitative design, comprising interviews with 19 persons with first-ever stroke, ten women and nine men. Their mean age was 77 years and the mean time since stroke was 15 months. Stroke survivors who were able to walk outdoors with or without a walking aid and who were independent in toileting and dressing were invited to participate. Semi-structured individual interviews were performed. An inductive qualitative content analysis of the manifest and latent content was conducted.

    Results: The results are presented in two themes illustrating the latent content of the data, "Feeling dizzy and unstable is a continuous challenge" and "Feeling confidence despite dizziness and unsteadiness", and seven categories illustrating the manifest content: Limitations in daily life; Being emotionally affected; The need for physical support; Everything takes time; I can still manage; Feelings of acceptance; and Finding individual solutions.

    Conclusions: All participants experienced the balance limitations as a continuous challenge in their everyday life, yet they also felt confidence. They had to some degree adapted their activities and were able to manage their daily life. 

  • 12.
    Arvidsson Lindvall, Mialinn
    et al.
    Örebro University, School of Health Sciences.
    Forsberg, Anette
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Appelros, Peter
    Department of University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Anderzén-Carlsson, Agneta
    Örebro University, School of Health Sciences. Örebro University Hospital.
    "I can still manage": a mixed-method study of balance after strokeManuscript (preprint) (Other academic)
  • 13.
    Arvidsson Lindvall, Mialinn
    et al.
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Centre.
    Lidström-Holmqvist, Kajsa
    Örebro University, School of Health Sciences. University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Department of Neurology and Rehabilitation Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Axelsson Svedell, Lena
    Örebro University, School of Health Sciences. Department of Psychiatry, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Philipson, Anna
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Centre.
    Cao, Yang
    Örebro University, School of Medical Sciences. Clinical Epidemiology and Biostatistics, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Msghina, Mussie
    Örebro University, School of Medical Sciences. Department of Psychiatry, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
    START - physical exercise and person-centred cognitive skills training as treatment for adult ADHD: protocol for a randomized controlled trial2023In: BMC Psychiatry, E-ISSN 1471-244X, Vol. 23, no 1, article id 697Article in journal (Refereed)
    Abstract [en]

    Background: Core symptoms in attention deficit hyperactivity disorder (ADHD) are inattention, impulsivity and hyperactivity. Many individuals with this disorder also have a sedentary lifestyle, co-morbid mental illness such as depressive and anxiety disorders, and reduced quality of life. People with ADHD often have impaired executive function, which among other things may include difficulty in time management and structuring of everyday life. Pharmacological treatment is often the first-line option, but non-pharmacological treatment is also available and is used in clinical settings. In children and adolescents with ADHD, physical exercise is used as a non-pharmacological treatment. However, the evidence for the effectiveness of exercise in adults is sparse.

    Objective: To implement the START intervention (START = Stöd i Aktivitet, Rörelse och Träning [Support in activity, movement and exercise]) consisting of a 12-week, structured mixed exercise programme with or without a cognitive intervention, in adults with ADHD, and study whether it has an effect on core symptoms of ADHD as well as physical, cognitive, mental and everyday functioning compared with usual treatment. A secondary aim is to investigate the participants' experiences of the intervention and its possible benefits, and to evaluate the cost-effectiveness of START compared with usual treatment.

    Methods: This is a randomized controlled trial planned to be conducted in 120 adults with ADHD, aged 18-65. The intervention will be given as an add-on to standard care. Participants will be randomized to three groups. Group 1 will be given a physiotherapist-led mixed exercise programme for 12 weeks. Group 2 will receive the same intervention as group 1 with the addition of occupational therapist-led cognitive skills training. Group 3 will be the control group who will receive standard care only. The primary outcome will be reduction of ADHD symptoms measured using the World Health Organization (WHO) Adult ADHD Self-Report Scale (ASRS-v1.1), Clinical Global Impression-Severity scale (CGI-S) and CGI-Improvement scale (CGI-I). The effect will be measured within 1 week after the end of the intervention and 6 and 12 months later.

    Discussion: Data collection began in March 2021. The final 12-month follow-up is anticipated to be completed by autumn 2024.

    Trial registration: ClinicalTrials.gov (Identifier: NCT05049239). Registered on 20 September 2021 (last verified: May 2021).

  • 14.
    Axelsson Svedell, Lena
    et al.
    Örebro University, School of Health Sciences. Department of Psychiatry, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Lidström-Holmqvist, Kajsa
    Örebro University, School of Health Sciences. Örebro University Hospital. Department of Neurology and Rehabilitation Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Arvidsson Lindvall, Mialinn
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Center.
    Cao, Yang
    Örebro University, School of Medical Sciences. Örebro University Hospital. Clinical Epidemiology and Biostatistics, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Msghina, Mussie
    Örebro University, School of Medical Sciences. Department of Psychiatry, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Feasibility and tolerability of moderate intensity regular physical exercise as treatment for core symptoms of attention deficit hyperactivity disorder: a randomized pilot study2023In: Frontiers in Sports and Active Living, E-ISSN 2624-9367, Vol. 5, article id 1133256Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is associated with sedentary lifestyle, low quality of life and low physical fitness. Studies in children with ADHD have shown that regular physical exercise can help reduce core ADHD symptoms, but evidence for this is lacking in adults. Although guidelines recommend multi-modal treatment, central stimulants (CS) remain the mainstay of treatment. CS are effective in the short-term, but their long-term efficacy remains to be established. There is thus huge unmet need for developing non-pharmacological treatment options, and for well-designed randomized controlled trials (RCTs).

    OBJECTIVE: The study aimed to test the feasibility and tolerability of structured moderate-intensity 12-week physical exercise program for adults with ADHD, as a prelude to an adequately powered RCT which includes long-term follow-up.

    MATERIALS AND METHODS: Fourteen adults with ADHD were recruited, 9 randomized to an intervention group and 5 to a control group. The intervention group received physiotherapist-led 50-minute mixed exercise program, three times a week for 12 weeks, and the control group treatment as usual. Participants were assessed at baseline and after 6 and 12 weeks using clinical and physical evaluations, self-rating questionnaires, and functional magnetic resonance imaging (fMRI) together with paradigms that tested attention, impulsivity and emotion regulation.

    RESULTS: Three participants (21%) dropped out shortly after inclusion before receiving any intervention, while roughly 80% completed the intervention according to protocol. One participant from the intervention group participated in less than 60% of treatment sessions, and one who had done baseline fMRI was unwilling to do post-intervention imaging. Four participants in the intervention group (67%) reported increased stress in prioritizing the intervention due to time-management difficulties. Overall, consistent trends were observed that indicated the feasibility and potential benefits of the intervention on core ADHD symptoms, quality of life, body awareness, sleep and cognitive functioning.

    CONCLUSION: Physiotherapist-led twelve-week regular physical exercise is a feasible and potentially beneficial intervention for adults with ADHD. There was a 20% drop-out initially and 67% of those who completed the intervention reported stress with time management difficulties due to participation. A third arm was thus added to the planned RCT where cognitive intervention administered by an occupational therapist will be given together with physical exercise. Clinical Trial Registration: https://clinicaltrials.gov, identifier NCT05049239.

  • 15.
    Drakenberg, Anna
    et al.
    Örebro University, School of Health Sciences.
    Arvidsson Lindvall, Mialinn
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Ericsson, Elisabeth
    Örebro University, School of Health Sciences.
    Ågren, Susanna
    Department of Health, Medical and Caring Sciences, Linköping University, Linköping, Sweden.
    Sundqvist, Ann-Sofie
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Side-by-side joint display integration: an example from a mixed-methods study on interprofessional attitudes to family involvement in care2023Conference paper (Refereed)
    Abstract [en]

    Background

    Family involvement improves patient outcomes after surgery and is important for the family´s well-being. Attitudes to family involvement in care among health care professionals influence how families are treated and cared for. We therefore aimed to describe these attitudes, held by nurses and medical doctors, working in the open-heart surgical care context.

    Methods

    A mixed-methods convergent parallel design was applied. A questionnaire with scaled and open-ended questions generated a qualitative (n=206) and a quantitative (n=267) dataset from nurses. In parallel with this data collection, qualitative interviews with medical doctors (n=20) generated a second qualitative dataset. Data were analyzed separately and thereafter merged into mixed-methods concepts using a side-by-side joint display. Meta-inferences of the concepts convergence and divergence were discussed and presented in a visual side-by-side joint display.

     

    Results

    Seven categories from the qualitative results were merged with the inference of statistical results into four mixed-methods concepts: Supporting, informing and improving care, Caring for the family, Impairing care and Depending on the situation. Out of these concepts, presenting interprofessional attitudes to family involvement in open-heart surgical care, two were convergent and two divergent. 

    Conclusion

    The side-by-side joint display was useful in both the integration and presentation of meta-inference. Even though attitudes, as described by nurses and medical doctors, are foremost positive, the importance of family involvement in open-heart surgical care depends on the situation. 

  • 16.
    Drakenberg, Anna
    et al.
    Örebro University, School of Health Sciences. Department of Cardiothoracic and Vascular Surgery, Örebro University Hospital, Örebro, Sweden.
    Arvidsson Lindvall, Mialinn
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Centre, Örebro University, Örebro, Sweden.
    Ericsson, Elisabeth
    Örebro University, School of Health Sciences.
    Ågren, Susanna
    Department of Health, Medical and Caring Sciences, Linköping University, Linköping, Sweden; Department of Cardiothoracic Surgery and Department of Health, Medical and Caring Sciences, Linköping University, Linköping, Sweden.
    Sundqvist, Ann-Sofie
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Centre, Örebro University, Örebro, Sweden.
    The symphony of open-heart surgical care: A mixed-methods study about interprofessional attitudes towards family involvement2023In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 18, no 1, article id 2176974Article in journal (Refereed)
    Abstract [en]

    Purpose: The overall aim of this study was to describe the attitudes towards family involvement in care held by nurses and medical doctors working in open-heart surgical care and the factors influencing these attitudes.

    Methods: Mixed-methods convergent parallel design. A web-based survey was completed by nurses (n = 267) using the Families’ Importance in Nursing Care-Nurses Attitudes (FINC-NA) instrument and two open-ended questions, generating one quantitative and one qualitative dataset. Qualitative interviews with medical doctors (n = 20) were conducted in parallel, generating another qualitative dataset. Data were analysed separately according to each paradigm and then merged into mixed-methods concepts. Meta-inferences of these concepts were discussed.

    Results: The nurses reported positive attitudes in general. The two qualitative datasets from nurses and medical doctors resulted in the identification of seven generic categories. The main mixed-methods finding was the attitude that the importance of family involvement in care depends on the situation.

    Conclusions: The dependence of family involvement on the situation may be due to the patient’s and family’s unique needs. If professionals’ attitudes rather than the family’s needs and preferences determine how the family is involved, care runs the risk of being unequal.

  • 17.
    Lindvall, Mialinn Arvidsson
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Family Medicine Research Centre, 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, Örebro County Council, Örebro, Sweden .
    Body awareness therapy in persons with stroke: a pilot randomised controlled trial2014In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 28, no 12, p. 1180-1188Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate the effects of body awareness therapy on balance, mobility, balance confidence, and subjective health status in persons with stroke.

    Design: A pilot randomized controlled study with follow-up at one and 4–6 weeks after the intervention period.

    Setting: Four primary healthcare centres in Örebro County Council.

    Subjects: Persons more than six months post stroke, with walking ability of 100 metres.

    Intervention: The experimental intervention was body awareness therapy in groups once a week for eight weeks. The controls were instructed to continue their usual daily activities.

    Main measures: Berg Balance Scale, Timed Up and Go Test, Timed Up and Go Test with a cognitive component, 6-minute walk test, and Timed-Stands Test. Self-rated balance confidence was assessed using the Activities-specific Balance Confidence Scale, and subjective health status using the Short Form 36 (SF-36) questionnaire.

    Results: A total of 46 participants were included (mean age 64 years); 24 in the experimental intervention group and 22 in the control group. No significant differences in changed scores over time were found between the groups. Within the experimental intervention group, significant improvements over time was found for the tests Berg Balance Scale, Timed Up and Go cognitive, and 6-minute walk test. Within the control group, significant improvements over time were found for the Timed Up and Go Cognitive, and the Timed-Stands Test.

    Conclusion: In comparison to no intervention, no effects were seen on balance, mobility, balance confidence, and subjective health status after eight weeks of body awareness therapy.

  • 18.
    Matérne, Marie
    et al.
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Appelros, Peter
    University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Arvidsson Lindvall, Mialinn
    Örebro University, School of Health Sciences. Örebro University Hospital.
    STROKE SURVIVORS IN THE MUNICIPALITY OF KUMLA SWEDEN: PREVALENCE, CO-MORBIDITY, DISABILITY, SOCIAL SITUATION AND QUALITY OF LIFE2020In: International Journal of Stroke, ISSN 1747-4930, E-ISSN 1747-4949, Vol. 15, no Suppl. 1, p. 413-413Article in journal (Other academic)
    Abstract [en]

    Background and Aims: About 25,000 people in Sweden suffer a stroke every year. Four-fifths of patients having a first-ever stroke are over 60 years of age. Stroke is the disease that causes the most hospital days in Sweden. The total costs of stroke have been estimated at SEK 18.3 billion per year. The aim of this study is to evaluate stroke survivors’ medical, functional and social situation, with focus on identifying possible improvements in rehabilitation, secondary prevention and social life.

    Methods: Kumla municipality in Sweden, through its mixed population, size, and location, provides an opportunity for a cross-sectional study. 274 patients living with consequences of stroke have been identified so far. Physical tests, reviews of medical records, questionnaires about demographic data, assistive technology, quality of life, fatigue and cognition will be carried through. Data will be analyzed using descriptive statistics and linear regression, to show relations between medical, functional and psychosocial variables. Patient´s experience of living with stroke will be examined with interviews.

    Results: Expected Results: There are few studies examining the whole population of stroke victims within an area. The results will demographically describe the patients, what rehabilitation efforts have been given, their function and activity, medical status, social situation and quality of life. The result can be used to develop rehabilitation measures and to other improvements in stroke care.

    Conclusions: Examining a whole stroke population, by including all living patients, may lead to more effective stroke rehabilitation and intervention studies focusing on stroke prevention and post-stroke rehabilitation.

  • 19.
    Matérne, Marie
    et al.
    Örebro University Hospital. Örebro University, School of Law, Psychology and Social Work. University Health Care Research Center.
    Simpson, Grahame
    John Walsh Centre of Rehabilitation Research, University of Sydney, Sydney, Australia; Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, Australia.
    Jarl, Gustav
    Örebro University Hospital. Örebro University, School of Health Sciences. University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Department of Prosthetics and Orthotics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden .
    Appelros, Peter
    University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Arvidsson Lindvall, Mialinn
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Center.
    Contribution of participation and resilience to quality of life among persons living with stroke in Sweden: a qualitative study2022In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 17, no 1, article id 2119676Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Resilience contributes to positive adaptation after many health conditions, but little is known about its contribution to long-term recovery after stroke. This study investigated the lived experience of resilience and participation and their relationship to quality of life after stroke in Sweden.

    MATERIAL AND METHOD: Semi-structured telephone interviews were conducted with 19 informants (10 male, 9 female), aged from 44-89 years and between 1 and 19 years post-stroke. Stroke severity ranged from mild (n = 8), moderate (n = 9) to severe (n = 2). Interviews were analysed using content analysis.

    RESULTS: The analysis resulted in an overarching theme; Life with stroke has been adapted to but not accepted, built on five subthemes: 1) Adapting and adjusting life, 2) Meaningful values in life, 3) Inner resources, 4) Support and treatment from social relations, and 5) Support and treatment from external resources.

    CONCLUSION: Participants described a tension between adapting and accepting life after stroke. Resilience was a useful framework, highlighting the contribution of inner, social and societal resources to recovery and quality of life, both directly and as enhanced through increased participation. Important factors for adaptation are meaningful values in life, individual strategies for adaptation and support from both social relationship and the society.

  • 20.
    Matérne, Marie
    et al.
    Örebro University, School of Behavioural, Social and Legal Sciences. Örebro University Hospital. University Health Care Research Center.
    Simpson, Grahame
    John Walsh Centre of Rehabilitation Research, University of Sydney, Sydney, Australia; Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, Australia.
    Jarl, Gustav
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Department of Prosthetics and Orthotics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Appelros, Peter
    University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Arvidsson Lindvall, Mialinn
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Center.
    Stroke Survivors expericence of quality of life, participation and resilience2023Conference paper (Refereed)
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  • 21.
    Matérne, Marie
    et al.
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Center.
    Simpson, Grahame
    John Walsh Center of Rehabilitation Research, University of Sydney, Sydney, Australia; Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, Australia.
    Jarl, Gustav
    Örebro University Hospital. Örebro University, School of Health Sciences. University Health Care Research Center.
    Appelros, Peter
    University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Arvidsson Lindvall, Mialinn
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Center.
    Stroke survivors experience of quality of life, participation and resilience2023In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 37, no Suppl. 1, p. 92-92, article id 251Article in journal (Other academic)
    Abstract [en]

    Background: Within a Swedish context, the lived experience of stroke in the acute phase has been documented in a number of studies using a biopsychosocial perspective. However less is known about the challenges in the chronic long-term phase.

    Objective: In this study we wanted to explore the lived experience from stroke survivors in Sweden about their resilience and participation, and the relationship between these two constructs and quality of life.

    Materials and Method: Kumla is a medium-sized municipality in Sweden in which 330 people living with stroke were identified at the 31st December 2019. A purposive sample of 19 informants were selected based on age, gender, occupation and severity of stroke. Semi-structured telephone interviews were conducted with 10 male and 9 females. The informants were aged between 44–89 years and had lived with their stroke between 1 and 19 years. The interviews were transcribed verbatim and analyzed using qualitative content analysis.

    Results: The informants described how the stroke had affected their lives and that they had to ‘adapt life’ due to their stroke. They described their experience as while having found ways to cope with life after stroke, they did not accept the situation. This was captured in the material with an overarching theme; Life with stroke has been adapted to but not accepted. However, the lack of acceptance was explained by some as a resignation, that their lives had changed for good and it has to be accommodated, while others’ experience was one of still working to overcome many of the limitations that they faced. The overarching theme was linked to five sub-themes: 1) Adapting and adjusting to life, 2) Meaningful values in life, 3) Inner resources, 4) Support and treatment from social relations, and 5) Support and treatment from external resources.

    Conclusion: Informants explored a tension between adapting to the circumstances and accepting life after stroke. Factors associated with adaptation in life included meaningful values, the informants’ own strategies for adaptation and also support from relationship and society. Resilience strategies were useful, and the contribution of individual, social and societal resources for recovery was important. Quality of life was enhanced both directly and through increased participation.

  • 22.
    Ohlsson-Nevo, Emma
    et al.
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Center.
    Arvidsson Lindvall, Mialinn
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Center.
    Hellerstedt Börjeson, Susanne
    Department of Public Health and Caring Sciences, Center for Clinical Research, Uppsala University, Uppsala, Sweden.
    Hagberg, Lars
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Center.
    Hultgren Hörnquist, Elisabeth
    Örebro University, School of Medical Sciences.
    Valachis, Antonios
    Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Oncology.
    Wickberg, Åsa
    Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Surgery.
    Duberg, Anna
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Center.
    Digitally distributed Yoga Intervention in Breast Cancer Rehabilitation (DigiYoga CaRe): protocol for a randomised controlled trial2022In: BMJ Open, E-ISSN 2044-6055, Vol. 12, no 11, article id e065939Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Breast cancer is the most prevalent cancer among women. The treatment is extensive; in addition to surgery, various combinations of radiation therapy, chemotherapy and antibody and endocrine treatment can be applied. Cancer-related fatigue (CRF) is high in patients with breast cancer, peaking during chemotherapy, but may persist for several years. Physical activity has proven to be effective in reducing CRF in breast cancer rehabilitation, but many patients tend to be less active after the diagnosis. Yoga has a previously demonstrated effect on energy levels and digitally distributed yoga intervention can potentially increase accessibility in pandemic times and facilitate participation for patients susceptible to infection and those living far from organised rehabilitation opportunities. The purpose of this study, Digital Yoga Intervention in Cancer Rehabilitation (DigiYoga CaRe) is to investigate whether a 12-week digitally distributed yoga intervention can reduce CRF and stress, improve health-related quality of life (HRQL) and affect pro-inflammatory and metabolic markers in patients with breast cancer.

    METHODS AND ANALYSIS: This multicentre study will adopt a randomised controlled design including 240 persons after their breast cancer surgery. They will be randomised to a 12-week digitally distributed yoga intervention or to a control group. The intervention group practice yoga two times a week, one yoga class live-streamed to the patient's computer or mobile device and one prerecorded video class for self-training. The controls receive standardised care, gift cards for flowers and access to yoga video links after the data collection has ended. The primary analysis will be performed following the principle of intention to treat. Data will be collected by questionnaires, blood samples, accelerometers and interviews.

    ETHICS AND DISSEMINATION: The DigiYoga CaRe study was approved by the Regional Ethical Review Board in Lund. The final results of this study will be disseminated to conference, patient and public involvements and peer-reviewed publications.

    TRIAL REGISTRATION NUMBER: NCT04812652.

  • 23.
    Ohlsson-Nevo, Emma
    et al.
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Arvidsson Lindvall, Mialinn
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Hellerstedt Börjesson, Susanne
    Uppsala University, Uppsala, Sweden.
    Hagberg, Lars
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Hultgren Hörnquist, Elisabeth
    Örebro University, School of Medical Sciences.
    Valachis, Antonis
    Örebro University, School of Medical Sciences.
    Wickberg, Åsa
    Örebro University, School of Medical Sciences. Örebro University Hospital.
    Duberg, Anna
    Örebro University, School of Health Sciences. Örebro University Hospital.
    A Digitally Distributed Yoga Intervention in Breast Cancer Rehabilitation (DigiYogaCaRe): Protocol for a Randomized Controlled Trial2023Conference paper (Other academic)
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