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  • 51.
    Nilsagård, Ylva
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper. Region Örebro län. Health Care Management.
    Westerdahl, Elisabeth
    Örebro universitet, Institutionen för hälsovetenskaper. Region Örebro län. Department of Physical Therapy.
    Forsberg, Anette
    Örebro universitet, Institutionen för hälsovetenskaper. Region Örebro län. Department of Physical Therapy.
    Engagement in performing clinical physiotherapy research: Perspectives from leaders and physiotherapists2019Ingår i: Physiotherapy Research International, ISSN 1358-2267, E-ISSN 1471-2865, Vol. 24, nr 2, artikel-id e1767Artikel i tidskrift (Refereegranskat)
    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.

  • 52.
    Nilsagård, Ylva
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Ctr Hlth Care Sci, Örebro Univ Hosp, Örebro, Sweden.
    Westerdahl, Elisabeth
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Wittrin, A.
    Gunnarsson, Martin
    Örebro universitet, Institutionen för läkarutbildning.
    Correlation between maximal walking distance and self-rated limitations in walking2014Ingår i: Multiple Sclerosis Journal, ISSN 1352-4585, E-ISSN 1477-0970, Vol. 20, nr 7, s. 992-992Artikel i tidskrift (Övrigt vetenskapligt)
  • 53.
    Nilsagård, Ylva
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Westerdahl, Elisabeth
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Wittrin, Anna
    Department of Neurology, Örebro University Hospital, Örebro, Sweden.
    Gunnarsson, Martin
    Örebro universitet, Institutionen för läkarutbildning. Department of Neurology, Örebro University Hospital, Örebro, Sweden.
    Walking Distance as a Predictor of Falls in People With Multiple Sclerosis2016Ingår i: Physiotherapy Research International, ISSN 1358-2267, E-ISSN 1471-2865, Vol. 21, nr 2, s. 102-108Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background and purpose: People with multiple sclerosis (PwMS) experience falls, usually when walking and transferring. The aim was to investigate if walking distance and patient overestimate of walking distance are predictors of falls in PwMS.

    Methods: A prospective study was conducted, with a single test occasion followed by prospective registration of falls for 3 months. All PwMS in Region Örebro County with a previously registered Expanded Disability Status Scale score between 3.0 and 7.0 in the Swedish MS Registry were invited to participate (n = 149). Altogether, data from 49 PwMS being relapse free for at least 3 months and with a confirmed Expanded Disability Status Scale between 1.5 and 7.0 upon study entry were analysed.

    Results: Twenty-two PwMS (45%) fell during the study period, providing information of 66 falls. Walking distance or overestimate of one's walking distance, as compared with test results, did not predict falls in this MS sample.

    Discussion: Walking and standing activities are associated with numerous falls in PwMS. Our data do not clearly support routine measurements of walking distance in assessing individual fall risk.

  • 54.
    Nilsing Strid, Emma
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. University Health Care Research Center.
    Wallin, Lars
    Department of Health and Welfare, Dalarna University, Falun, Sweden.
    Nilsagård, Ylva
    Örebro universitet, Institutionen för hälsovetenskaper. Region Örebro län. University Health Care Research Center.
    Expectations on implementation of a health promotion practice using individually targeted lifestyle interventions in primary health care: a qualitative study2023Ingår i: BMC Primary Care, E-ISSN 2731-4553, Vol. 24, nr 1, artikel-id 122Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: There is moderate to strong evidence of the effectiveness of health-promotion interventions, but implementation in routine primary health care (PHC) has been slow. In the Act in Time project implementation support is provided for a health promotion practice using individually targeted lifestyle interventions in a PHC setting. Identifying health care professionals' (HCPs') perceptions of barriers and facilitators helps adapt implementation activities and achieve a more successful implementation. This study aimed, at a pre-implementation stage, to describe the expectations of managers, appointed internal facilitators (IFs) and HCPs on implementing a healthy lifestyle-promoting practice in PHC.

    METHODS: In this qualitative study five focus group discussions with 27 HCPs and 16 individual interviews with managers and appointed IFs were conducted at five PHC centres in central Sweden. The PHC centres are participating in the Act in Time project, evaluating the process and outcomes of a multifaceted implementation strategy for a healthy lifestyle-promoting practice. A deductive qualitative content analysis based on the Consolidated Framework for Implementation Research (CFIR) was followed using inductive analysis.

    RESULTS: Twelve constructs from four of five CFIR domains were derived: Innovation characteristics, Outer setting, Inner setting, and Characteristics of individuals. These domains are related to the expectations of HCPs to implement a healthy lifestyle-promoting practice, which includes facilitating factors and barriers. The inductive analysis showed that the HCPs perceived a need for a health-promotion approach to PHC. It serves the needs of the patients and the expectations of the HCPs, but lifestyle interventions must be co-produced with the patient. The HCPs expected that changing routine practice into a healthy lifestyle-promoting practice would be challenging, requiring sustainability, improved structures, cooperation in inter-professional teams, and a common purpose. A collective understanding of the purpose of changing practice was vital to successful implementation.

    CONCLUSIONS: The HCPs valued implementing a healthy lifestyle-promoting practice in a PHC setting. However, changing routine methods was challenging, implying that the implementation strategy should address obstacles and facilitating factors identified by the HCPs.

    TRIAL REGISTRATION: This study is part of the Act in Time project, registered in ClinicalTrials.gov with the number NCT04799860. Registered 03 March 2021.

  • 55.
    Nilsing Strid, Emma
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. University Health Care Research Center.
    Wallin, Lars
    School of Health and Welfare, Dalarna University, Falun, Sweden.
    Nilsagård, Ylva
    Örebro universitet, Institutionen för hälsovetenskaper. Region Örebro län. University Health Care Research Center.
    Exploring expectations and readiness for healthy lifestyle promotion in Swedish primary health care: a qualitative analysis of managers, facilitators, and professionals2024Ingår i: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 42, nr 1, s. 201-213Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: Prior to a multifaceted implementation strategy for a healthy lifestyle-promoting practice the expectations of primary health care managers, appointed internal facilitators and health care professionals on supporting change was explored.

    DESIGN: This study had an explorative qualitative design using data gathered from individual interviews and focus groups. Qualitative content analysis with a deductive category development was applied using the Consolidated Framework for Implementation Research.

    SETTING AND PARTICIPANTS: The study was conducted in a primary care setting in central Sweden as a part of the Act in Time research project. Prior to a multifaceted implementation strategy, we held 16 individual interviews with managers and appointed facilitators and five focus groups with 26 health care professionals.

    RESULTS: Managers, facilitators, and professionals held similar expectations, where their expressed need for support corresponded to three constructs: Readiness for implementation, Implementation climate, and Engaging. Our findings indicate the need for strong leadership engagement to focus on how the healthy lifestyle-promoting practice can be anchored among the professionals. Managers at all levels should communicate the vision and goals, enable facilitators and professionals to improve their competencies, build inter-professional teams, and jointly plan the new practice.

    CONCLUSION: To change to a healthy lifestyle promoting practice professionals request support from their managers, who in turn need support from the middle and top managers. The requested support includes helping to prioritise health promotion and enabling the primary care centres to build competence and take ownership of the implementation.

    TRIAL REGISTRATION: ClinicalTrials.gov NCT04799860.

  • 56.
    Nilsing Strid, Emma
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. University Health Care Research Center.
    Wallin, Lars
    Department of Health and Welfare, Dalarna University, Falun, Sweden.
    Nilsagård, Ylva
    Örebro universitet, Institutionen för hälsovetenskaper. Region Örebro län. University Health Care Research Center.
    Implementation of a Health Promotion Practice Using Individually Targeted Lifestyle Interventions in Primary Health Care: Protocol for the "Act in Time" Mixed Methods Process Evaluation Study2022Ingår i: JMIR Research Protocols, E-ISSN 1929-0748, Vol. 11, nr 8, artikel-id e37634Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: There is growing evidence that noncommunicable diseases (NCDs) can be attributable to unhealthy lifestyle habits. However, there has been little application of this knowledge in primary health care (PHC).

    OBJECTIVE: This study aims to evaluate the process and outcomes of a multifaceted implementation strategy for a healthy lifestyle-promoting practice in a PHC setting. This practice is based on national guidelines targeting unhealthy lifestyle habits with a potential risk for NCDs.

    METHODS: A pre-post implementation study design with a control group is used in a PHC setting in central Sweden. The Medical Research Council guidelines for process evaluation of complex interventions will be applied. The implementation process and outcomes will be assessed using a mix of qualitative and quantitative methods. A strategic sample of up to 6 PHC centers will be included as intervention centers, which will receive a 12-month multifaceted implementation strategy. Up to 6 matched PHC centers will serve as controls. Core components in the implementation strategy are external and internal facilitators in line with the integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) framework and the Astrakan change leadership model. Data will be collected at baseline, during the implementation phase, and 4-6 months after the implementation strategy. Questionnaires will be sent to roughly 500 patients in every PHC center and 200 health care professionals (HCPs) before and after implementation. In addition, purposeful sampling will be used for interviews and focus group discussions with managers, HCPs, patient representatives, and internal and external facilitators. Use of data from medical records and activity logs will be an additional data source.

    RESULTS: Recruitment of PHC centers began in March 2021 and ended in Spring 2022. Based on the planned timeline with the 12-month implementation strategy and 4-6-month follow-up, we expect to collect the final data in Summer 2023.

    CONCLUSIONS: This study will explain implementation process and outcomes using a multifaceted implementation strategy for a healthy lifestyle-promoting practice in a real-world PHC context. The study is expected to provide new knowledge about the role of facilitators and their contribution to implementation outcomes. These findings can guide policy makers, managers, and PHC staff to integrate health promotion and disease prevention in PHC and provide methodological support to facilitators.

    TRIAL REGISTRATION: ClinicalTrials.gov NCT04799860; https://clinicaltrials.gov/ct2/show/NCT04799860.

    INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/37634.

  • 57.
    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 universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län. Family Medicine Research Centre, , Region Örebro County, Örebro, Sweden.
    Nilsagård, Ylva
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län. Centre for Health Care Sciences, Örebro University Hospital, Örebro, Sweden.
    Modified Rivermead Mobility Index: a reliable measure in people within 14 days post-stroke2015Ingår i: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 31, nr 2, s. 126-129Artikel i tidskrift (Refereegranskat)
    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.

  • 58.
    Rådman, Lisa
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Occupational and Environmental Medicine, Örebro University, Örebro, Sweden; Department of Physiotherapy, Örebro University, Örebro, Sweden.
    Gunnarsson, Lars-Gunnar
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Occupational and Environmental Medicine, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Nilsagård, Ylva
    Örebro universitet, Institutionen för hälsovetenskaper. Region Örebro län. University Healthcare Research Centre.
    Nilsson, Tohr
    Department of Occupational and Environmental Medicine, Umeå University, Umeå, Sweden.
    Neurosensory findings among electricians with self-reported remaining symptoms after an electrical injury: A case series2016Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 42, nr 8, s. 1712-1720Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: Symptoms described in previous studies indicate that electrical injury can cause longstanding injuries to the neurosensory nerves. The aim of the present case series was to objectively assess the profile of neurosensory dysfunction in electricians in relation to high voltage or low voltage electrical injury and the "no-let-go phenomenon".

    Methods: Twenty-three Swedish male electricians exposed to electrical injury were studied by using a battery of clinical instruments, including quantitative sensory testing (QST). The clinical test followed a predetermined order of assessments: thermal perceptions thresholds, vibration perception thresholds, tactile gnosis (the Shape and Texture Identification test), manual dexterity (Purdue Pegboard Test), and grip strength. In addition, pain was studied by means of a questionnaire, and a colour chart was used for estimation of white fingers.

    Results: The main findings in the present case series were reduced thermal perceptions thresholds, where half of the group showed abnormal values for warm thermal perception and/or cold thermal perception. Also, the tactile gnosis and manual dexterity were reduced. High voltage injury was associated with more reduced sensibility compared to those with low voltage.

    Conclusion: Neurosensory injury can be objectively assessed after an electrical injury by using QST with thermal perception thresholds. The findings are consistent with injuries to small nerve fibres. In the clinical setting thermal perception threshold is therefore recommended, in addition to tests of tactile gnosis and manual dexterity (Purdue Pegboard).

  • 59.
    Rådman, Lisa
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Occupational and Environmental Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Department of Physiotherapy, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Nilsagård, Ylva
    Örebro universitet, Institutionen för hälsovetenskaper. Region Örebro län. Department of Medicine.
    Jakobsson, Kristina
    Division of Occupational and Environmental Medicine, Scania University Hospital, Lund, Sweden.
    Ek, Åsa
    Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, Lund, Sweden.
    Gunnarsson, Lars-Gunnar
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Electrical injury in relation to voltage, "no-let-go" phenomenon, symptoms and perceived safety culture: a survey of Swedish male electricians2016Ingår i: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 89, nr 2, s. 261-270Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Professional electricians are highly subjected to electrical injuries. Previous studies describing symptoms after electrical injury have not included people with less severe initial injuries. The purpose of the present study was to describe symptoms at different time points after electrical injury, the impact of "no-let-go" phenomenon and different electrical potential [high voltage (HV) vs. low voltage (LV)], and the safety culture at the workplace.

    A retrospective survey was conducted with 523 Swedish electricians. Two questionnaires were issued: the first to identify electricians who had experienced electrical injury and the second to gain information about symptoms and safety culture. Self-reported symptoms were described at different time points following injury. Symptoms for HV and LV accidents were compared. Occurrence or nonoccurrence of "no-let-go" phenomenon was analysed using two-tailed Chi-2. Safety culture was assessed with a validated questionnaire.

    Nearly all reported having symptoms directly after the injury, mainly paraesthesia and pain. For the first weeks after injury, pain and muscle weakness dominated. The most frequently occurring symptoms at follow-up were pain, muscle weakness and loss of sensation. HV injuries and "no-let go" phenomenon were associated with more sustained symptoms. Deficiencies in the reporting routines were present, as well as shortage of preventive measures.

    The results indicate that symptoms are reported also long time after an electrical injury and that special attention should be paid to HV injuries and "no-let go" accidents. The workplace routines to reduce the number of work-related electrical injuries for Swedish electricians can be improved.

  • 60.
    Sjöberg, Lis
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Paediatrics, Limb Deficiency and Arm Prosthesis Centre, Örebro University Hospital, Örebro, Sweden.
    Nilsagård, Ylva
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län. Centre for Health Care Sciences, Örebro University, Örebro, Sweden.
    Fredriksson, Carin
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Life situation of adults with congenital limb reduction deficiency in Sweden2014Ingår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 38, nr 18, s. 1562-1571Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To describe the current life situation of adults with congenital limb reduction deficiencies (CLRD), living in Sweden, regarding their main daily occupation, leisure activities and self-reported general health.

    Method: A cross-sectional survey was conducted using a study-specific questionnaire, sent by post. A hundred and seventeen persons with different extent, forms, and levels of CLRD (mean age 33 years) responded to the questionnaire.

    Results: Work or study was the main occupation for 86 % of the participants and 50 % had completed a college or university education. Seven per cent were unemployed and three per cent were on sick leave. The participants were highly involved in social and physical activities during leisure time. The majority reported good or very good general health.

    Conclusion: This study is the first investigation of the life situation of adults with CLRD described with a perspective from Swedish society. The participants were educated and worked to a great extent, which corresponds well to the Swedish population as a whole. Further research is needed especially with a focus on the internal perspective of life situation, different aspects of work capacity, occurences of strain injuries and the benefit of assistive devices among adults with CLRD.

  • 61.
    Westerdahl, Elisabeth
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. Department of Physiotherapy, University Health Care Research Center.
    Gunnarsson, Martin
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län. Department of Neurology.
    Wittrin, Anna
    Department of Neurology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Nilsagård, Ylva
    Örebro universitet, Institutionen för hälsovetenskaper. Region Örebro län. University Health Care Research Center.
    Pulmonary Function and Respiratory Muscle Strength in Patients with Multiple Sclerosis2021Ingår i: Multiple Sclerosis International, ISSN 2090-2654, E-ISSN 2090-2662, Vol. 2021, artikel-id 5532776Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: In patients with multiple sclerosis (MS), there is a decline in muscle strength and physical capacity due to demyelination and axonal loss in the central nervous system. In patients with advanced MS or in a later stage of the disease, also respiratory impairment may occur. The degree of pulmonary dysfunction in the earlier stages of MS has not been thoroughly described. Therefore, the primary aims of this study are to describe pulmonary function and respiratory muscle strength in patients with a moderate disease course and to identify associations between respiratory muscle strength and functional capacity.

    Methods: A sample of 48 patients with a diagnosis of MS and mean age 56 +/- 11 years was studied using a descriptive cross-sectional design. The patients had a disease duration of 24 +/- 11 years and a median Expanded Disability Status Scale (EDSS) score of 4.5 (interquartile range 4.0-6.5). Pulmonary function assessed by spirometry, respiratory muscle strength, peak cough flow and peripheral oxygen saturation, subjective breathing and coughing ability, and physical capacity measured using the 6MWT were evaluated.

    Results: The patients had normal pulmonary function with no significant abnormalities in dynamic spirometry (vital capacity 103 +/- 16% predicted, forced expiratory volume in 1 second 95 +/- 15% predicted). Peak expiratory flow rate 89 +/- 17% predicted was in the lower limit of normal. Respiratory muscle strength, determined by maximal inspiratory (MIP) and expiratory (MEP) static pressures, was normal but with large differences between individuals. MIP ranged from 26 to 143 cmH(2)O (98 +/- 31% predicted); the MEP values ranged from 43 to 166 cmH(2)O (104 +/- 29% predicted), with two patients having values below the lower limit of normal. Significant positive associations between MIP as well as MEP were found in several pulmonary function variables. A significant negative association was found between EDSS score and MEP (r=-0.312, p=0.031). Mean peak cough flow was 389 +/- 70 L/min, which is comparable with the values reported for healthy adults. The patients did not experience a severely decreased ability to take deep breaths or cough. There was a moderate correlation between MEP and physical capacity, as assessed by the 6MWT (r=0.399, p=0.010) and between peak expiratory flow (PEF) and the 6MWT (r=0.311, p=0.048).

    Conclusion: Respiratory muscle strength, pulmonary function assessed by spirometry, and peak cough flow were normal in patients with mild to moderate MS; however, there were large individual differences demonstrating low respiratory muscle strength in some patients. Significant associations between MEP and functional capacity and between MEP and disease severity were found, indicating that patients with impaired respiratory muscle strength have lower functional capacity and more severe disease.

  • 62.
    Westerdahl, Elisabeth
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Wittrin, A.
    Örebro University Hospital, Örebro, Sweden.
    Kånåhols, M.
    Örebro University Hospital, Örebro, Sweden.
    Gunnarsson, Martin
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Nilsagård, Ylva
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Breathing exercises for patient with multiple sclerosis2015Konferensbidrag (Refereegranskat)
  • 63.
    Westerdahl, Elisabeth
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Wittrin, A.
    Örebro University Hospital, Örebro, Sweden.
    Kånåhols, M.
    Örebro University Hospital, Örebro, Sweden.
    Gunnarsson, Martin
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Nilsagård, Ylva
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Breathing exercises for patients with multiple sclerosis: a randomized controlled trial2015Ingår i: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 101, nr Sup. 1, artikel-id e1622Artikel i tidskrift (Refereegranskat)
  • 64.
    Westerdahl, Elisabeth
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Wittrin, A.
    Department of Neurology, Örebro University Hospital, Örebro, Sweden.
    Kånåhols, M.
    Department of Physiotherapy, Örebro University Hospital, Örebro, Sweden.
    Gunnarsson, Martin
    Department of Neurology, Örebro University Hospital, Örebro, Sweden.
    Nilsagård, Ylva
    Centre for Health Care Sciences, Örebro County Council, Örebro, Sweden.
    Breathing exercises for patients with multiple sclerosis: a randomized controlled trial2014Ingår i: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 44, artikel-id 4676Artikel i tidskrift (Refereegranskat)
  • 65.
    Westerdahl, Elisabeth
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län. Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Wittrin, Anna
    Faculty of Medicine and Health, Department of Neurology and Neurophysiology, Örebro University, Örebro, Sweden.
    Kånåhols, Margareta
    Faculty of Medicine and Health, Department of Neurology and Neurophysiology, Örebro University, Örebro, Sweden.
    Gunnarsson, Martin
    Örebro universitet, Institutionen för läkarutbildning. Region Örebro län. Department of Neurology and Neurophysiology, Örebro University Hospital, Örebro, Sweden.
    Nilsagård, Ylva
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län.
    Deep breathing exercises with positive expiratory pressure in patients with multiple sclerosis: a randomized controlled trial2016Ingår i: Clinical Respiratory Journal, ISSN 1752-6981, E-ISSN 1752-699X, Vol. 10, nr 6, s. 698-706Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Breathing exercises with positive expiratory pressure are often recommended to patients with advanced neurological deficits, but the potential benefit in multiple sclerosis (MS) patients with mild and moderate symptoms has not yet been investigated in randomized controlled trials.

    Objectives: To study the effects of 2 months of home-based breathing exercises for patients with mild to moderate MS on respiratory muscle strength, lung function, and subjective breathing and health status outcomes.

    Methods: Forty-eight patients with MS according to the revised McDonald criteria were enrolled in a randomized controlled trial. Patients performing breathing exercises (n = 23) were compared with a control group (n = 25) performing no breathing exercises. The breathing exercises were performed with a positive expiratory pressure device (10-15 cmH2 O) and consisted of 30 slow deep breaths performed twice a day for 2 months. Respiratory muscle strength (maximal inspiratory and expiratory pressure at the mouth), spirometry, oxygenation, thoracic excursion, subjective perceptions of breathing and self-reported health status were evaluated before and after the intervention period.

    Results: Following the intervention, there was a significant difference between the breathing group and the control group regarding the relative change in lung function, favoring the breathing group (vital capacity: P < 0.043; forced vital capacity: P < 0.025). There were no other significant differences between the groups.

    Conclusion: Breathing exercises may be beneficial in patients with mild to moderate stages of MS. However, the clinical significance needs to be clarified, and it remains to be seen whether a sustainable effect in delaying the development of respiratory dysfunction in MS can be obtained.

  • 66.
    Wittrin, A.
    et al.
    Örebro Univ Hosp, Örebro, Sweden.
    Nilsagård, Ylva
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Westerdahl, Elisabeth
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Gunnarsson, Martin
    Örebro universitet, Institutionen för läkarutbildning. Örebro Univ Hosp, Örebro, Sweden.
    Self-assessment of walking ability in patients with multiple sclerosis and its impact on the expanded disability status scale (EDSS) score2013Ingår i: Multiple Sclerosis Journal, ISSN 1352-4585, E-ISSN 1477-0970, Vol. 19, nr 11, s. 118-118Artikel i tidskrift (Övrigt vetenskapligt)
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