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Gard, G., Nyboe, L. & Gyllensten, A. (2019). Clinical reasoning and clinical use of basic body awareness therapy in physiotherapy: a qualitative study?. European Journal of Physiotherapy
Open this publication in new window or tab >>Clinical reasoning and clinical use of basic body awareness therapy in physiotherapy: a qualitative study?
2019 (English)In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background: Clinical reasoning is the ability to integrate and apply different types of knowledge, weigh evidence critically and reflect upon the process to arrive at a diagnosis. Body awareness is an approach directed toward an awareness of how the body is used in terms of body function, behaviour, and interaction with self and others. Methods: In the present study, 36 physiotherapists (PTs) from 13 countries working with body awareness methods, mainly Basic Body Awareness Therapy (BBAT) in mental health were interviewed in six focus groups. Content analysis was used to analyse how the informants’ reasoned around the concept of body awareness therapy, and how they use it in their clinical work with patients. Result: Body awareness was conceived as being in contact with sensations and emotions, to be able to control symptoms, such as pain, to find a balance and to develop one’s identity by relating to oneself and others. BBAT was used as a whole body treatment, to promote balance and stability, to teach about body, movements, and coping strategies, to interact in a therapeutic approach and to be integrated with other methods and professionals. Conclusion: The present results can be used to improve the PTs clinical reasoning.

Place, publisher, year, edition, pages
Taylor & Francis, 2019
Keywords
clinical competence, focus group, health, Physiotherapists perspective
National Category
Physiotherapy
Research subject
Physiotherapy
Identifiers
urn:nbn:se:ltu:diva-72846 (URN)10.1080/21679169.2018.1549592 (DOI)
Available from: 2019-02-11 Created: 2019-02-11 Last updated: 2019-02-11
Skjærven, L. H., Mattsson, M., Catalan-Matamoros, D., Parker, A., Gard, G. & Gyllensten, A. (2019). Consensus on core phenomena and statements describing Basic Body Awareness Therapy within the movement awareness domain in physiotherapy. Physiotherapy Theory and Practice, 35(1), 80-93
Open this publication in new window or tab >>Consensus on core phenomena and statements describing Basic Body Awareness Therapy within the movement awareness domain in physiotherapy
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2019 (English)In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 35, no 1, p. 80-93Article in journal (Refereed) Published
Abstract [en]

Physiotherapists are facing complex health challenges in the treatment of persons suffering from long-lasting musculoskeletal disorders and mental health problems. Basic Body Awareness Therapy (BBAT) is a physiotherapy approach within the movement awareness domain developed to bridge physical, mental, and relational health challenges. The purpose of this study was to reach a consensus on core phenomena and statements describing BBAT. A consensus-building process was conducted using the nominal group technique (NGT). Twenty-one BBAT experts from 10 European countries participated in a concentrated weekend workshop of 20 hours. All participants signed informed consent. Participants reached a consensus on 138 core phenomena, clustered in three overarching categories: clinical core, historical roots, and research and evaluation phenomena. Of the 106 clinical core phenomena, the participants agreed on three categories of phenomena: movement quality, movement awareness practice, and movement awareness therapy and pedagogy. Furthermore, the participants reached 100 percent consensus on 16 of 30 statements describing BBAT. This study provides a consensus on core phenomena and statements describing BBAT. The data reveal phenomena implemented when promoting movement quality through movement awareness. Data provide clarity in some aspects of the vocabulary as fundamental theory. Further reearch will be developed.

Place, publisher, year, edition, pages
Taylor & Francis, 2019
Keywords
Movement quality, movement awareness, movement awareness therapy, movement awareness learning
National Category
Physiotherapy
Research subject
Physiotherapy
Identifiers
urn:nbn:se:ltu:diva-67840 (URN)10.1080/09593985.2018.1434578 (DOI)29482403 (PubMedID)2-s2.0-85056578224 (Scopus ID)
Note

Validerad;2018;Nivå 2;2018-11-29 (svasva)

Available from: 2018-03-05 Created: 2018-03-05 Last updated: 2018-11-29Bibliographically approved
Lindgren, I., Brogårdh, C. & Gard, G. (2019). Pain management strategies among persons with long-term shoulder pain after stroke: a qualitative study. Clinical Rehabilitation, 33(2), 357-364
Open this publication in new window or tab >>Pain management strategies among persons with long-term shoulder pain after stroke: a qualitative study
2019 (English)In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 33, no 2, p. 357-364Article in journal (Refereed) Published
Abstract [en]

Objective: To explore strategies that persons with persistent shoulder pain after stroke use to manage their pain in daily life. Design: A qualitative study using semi-structured face-to-face interviews, analysed by content analysis. Setting: A university hospital. Subjects: Thirteen community-dwelling persons (six women; median age: 65 years; range 57-77) with shoulder pain after stroke were interviewed median two years after the pain onset. Results: An overall theme 'Managing shoulder pain by adopting various practical and cognitive strategies' emerged from the analysis. Three categories were identified: (1) practical modifications to solve daily life problems; (2) changed movement patterns and specific actions to mitigate the pain, by non-painful movements, avoidance of pain-provoking activities and various pain distracting activities and (3) learned how to deal with the pain mentally. Several strategies were used simultaneously and they were experienced successful to various degrees. Conclusion: The findings in the present study indicate that persons with persistent shoulder pain after stroke use both practical and cognitive strategies to manage their pain.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
Stroke, shoulder pain, rehabilitation, interview, coping, qualitative study
National Category
Physiotherapy
Research subject
Physiotherapy
Identifiers
urn:nbn:se:ltu:diva-71089 (URN)10.1177/0269215518802444 (DOI)000456887100021 ()30255715 (PubMedID)2-s2.0-85059692756 (Scopus ID)
Note

Validerad;2019;Nivå 2;2019-02-13 (johcin)

Available from: 2018-10-03 Created: 2018-10-03 Last updated: 2019-02-13Bibliographically approved
Gard, G., Berggård, G., Rosander, P. & Larsson, A. (2018). Pedestrians perceptions of community walking with anti-slip devices: an explorative case study. Journal of Transport and Health, 11, 202-208
Open this publication in new window or tab >>Pedestrians perceptions of community walking with anti-slip devices: an explorative case study
2018 (English)In: Journal of Transport and Health, ISSN 2214-1405, E-ISSN 2214-1405, Vol. 11, p. 202-208Article in journal (Refereed) Published
Abstract [en]

The risk of falls on slippery surfaces during wintertime is a public safety problem in the Nordic region in the Arctic. The aim of this case study was to explore pedestrians perceptions of walking safety, balance, slipping risk, priority for own use and subjective criteria for a well functioning anti-slip device. An experimental set-up was utilised in which nine pedestrians tested 19 anti-slip devices by simulating walking in realistic traffic situations on four different surfaces. The pedestrians favoured devices with a high number of friction points, distributed under the whole sole (in-built) or forefoot (sandpaper). Also, a whole-foot device with a high number of spikes received high ratings in all aspects measured except in balance enabling properties. Identified subjective criteria were safe foothold, comfort, enabling a normal gait, stability, silence, and predictability. The results indicate that both anti-slip properties and balance enabling properties of the device need to be considered for safe community walking

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Anti-slip device, Usability, Walking safety, Balance, Pedestrian, Population health, Arctic
National Category
Physiotherapy Architectural Engineering
Research subject
Physiotherapy; Architecture
Identifiers
urn:nbn:se:ltu:diva-70755 (URN)10.1016/j.jth.2018.09.001 (DOI)000454589000023 ()2-s2.0-85053180535 (Scopus ID)
Note

Validerad;2018;Nivå 2;2018-12-06 (svasva)

Available from: 2018-09-04 Created: 2018-09-04 Last updated: 2019-01-28Bibliographically approved
Lindgren, I., Gard, G. & Brogårdh, C. (2018). Shoulder pain after stroke – experiences, consequences in daily life and effects of interventions: a qualitative study. Disability and Rehabilitation, 40(10), 1176-1182
Open this publication in new window or tab >>Shoulder pain after stroke – experiences, consequences in daily life and effects of interventions: a qualitative study
2018 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 40, no 10, p. 1176-1182Article in journal (Refereed) Published
Abstract [en]

Purpose: To describe experiences of shoulder pain after stroke, how pain affects daily life and perceived effects of interventions.

Method: A qualitative interview study including 13 community-dwelling persons (six women; median age 65 years) with persistent shoulder pain after stroke.

Results: Three categories emerged from the content analysis. In “Multiple pain characteristics” an insidious pain onset was reported. The pain existed both day and night and could be located around the shoulder girdle but also have radiation to the arm and hand. An explanation of the pain was seldom given. In “Limitations caused by the pain” it was described how the pain negatively influenced personal care, household activities and leisure, but also could lead to emotional reactions. In “Multiple pain interventions with various effects” a variety of interventions were described. Self-management interventions with gentle movements were perceived most effective. A restraint attitude to pain medication due to side effects was reported.

Conclusions: Shoulder pain after stroke can lead to a variety of pain characteristics. As the pain is complex and may affect many important areas in a person’s life, multidisciplinary rehabilitation interventions are important.

Place, publisher, year, edition, pages
Taylor & Francis, 2018
National Category
Physiotherapy
Research subject
Physiotherapy
Identifiers
urn:nbn:se:ltu:diva-62313 (URN)10.1080/09638288.2017.1290699 (DOI)000425689100009 ()28637154 (PubMedID)2-s2.0-85014480344 (Scopus ID)
Note

Validerad;2018;Nivå 2;2018-02-26 (andbra)

Available from: 2017-03-06 Created: 2017-03-06 Last updated: 2018-03-15Bibliographically approved
Svensson, I., Gao, C., Halder, A., Gard, G. & Magnusson, M. (2018). Standing balance on inclined surfaces with different friction. Industrial Health, 56(4), 292-299
Open this publication in new window or tab >>Standing balance on inclined surfaces with different friction
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2018 (English)In: Industrial Health, ISSN 0019-8366, E-ISSN 1880-8026, Vol. 56, no 4, p. 292-299Article in journal (Refereed) Published
Abstract [en]

Working and walking environments often involve standing positions on different surfaces with inclination and different friction. In this study, standing balance of thirteen participants during sudden and irregular external perturbation to calf muscles was investigated. The aim of the study was to evaluate the combined effect of surface inclination and friction on standing balance. The main findings when eyes closed revealed that the standing utilised coefficient of friction (mu(SUCOF)) increased when the surface was inclined for both high and low friction materials. The anteriorposterior torque increased more anteriorly when the surface was inclined toes down and when the surface friction was low. The results indicate that the anterior posterior torque is a sensitive parameter when evaluating standing balance ability and slip risk. On inclined surface, particularly on the surface with lower friction, the potential slip and fall risk is higher due to the increase of standing utilised coefficient of friction and increased forward turning torque.

Place, publisher, year, edition, pages
National Institue of Occupational Safety & Health, Japan, 2018
National Category
Physiotherapy
Research subject
Physiotherapy
Identifiers
urn:nbn:se:ltu:diva-70299 (URN)10.2486/indhealth.2018-0005 (DOI)000440093300004 ()2-s2.0-8505080138 (Scopus ID)
Note

Validerad;2018;Nivå 2;2018-08-09 (andbra)

Available from: 2018-08-09 Created: 2018-08-09 Last updated: 2018-08-27Bibliographically approved
Larsson, A., Westerberg, M., Karlqvist, L. & Gard, G. (2018). Teamwork and Safety Climate in home care: a mixed method study. International Journal of Environmental Research and Public Health, 15(11), Article ID 2495.
Open this publication in new window or tab >>Teamwork and Safety Climate in home care: a mixed method study
2018 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 15, no 11, article id 2495Article in journal (Refereed) Published
Abstract [en]

A rapidly changing homecare service sector implies difficulties to control safety and health risks for staff and to guarantee standardised deliveries of services to recipients. This study aimed to describe staff perceptions of safety climate and practices in homecare service teams, and suggestions for improvements. A second aim was to identify if and how the appraisals of safety climate were related to individual perceptions of safety, mental strain and adverse events/injury. A convergent parallel mixed methods design was used. Nursing assistants and care aides (133 in total, representing 11 work teams) in the north of Sweden replied to a survey and participated in focus group interviews. Results were analysed with ANOVA (inter-team differences) and by qualitative content analysis. Significant diversity was identified between the teams in five of seven dimensions of safety climate. Important areas for improvement were: a need to define and agree on criteria for a safe working environment; leadership prioritising safety at work; and management able to provide trust, support and time. A prerequisite for these agreements was improved authority and communication between all parties involved. The safety climate dimensions were related to personal perceptions of safety and mental strain and, partly, to adverse events/injuries.

Place, publisher, year, edition, pages
Basel, Switzerland: MDPI, 2018
Keywords
health services research; risk management; safety climate; teamwork; quality improvement; mental strain; injury
National Category
Physiotherapy Other Engineering and Technologies not elsewhere specified
Research subject
Physiotherapy; Entrepreneurship and Innovation
Identifiers
urn:nbn:se:ltu:diva-71431 (URN)10.3390/ijerph15112495 (DOI)30413052 (PubMedID)2-s2.0-85056383384 (Scopus ID)
Note

Validerad;2018;Nivå 2;2018-11-15 (johcin)

Available from: 2018-11-05 Created: 2018-11-05 Last updated: 2019-03-14Bibliographically approved
Post Sennehed, C., Gard, G., Holmberg, S. A. .., Stigmar, K. G. .., Forsbrand, M. & Grahn, B. E. .. (2017). "Blue flags": development of a short clinical questionnaire on work-related psychosocial risk factors - A validation study in primary care. BMC Musculoskeletal Disorders, 18(1), Article ID 318.
Open this publication in new window or tab >>"Blue flags": development of a short clinical questionnaire on work-related psychosocial risk factors - A validation study in primary care
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2017 (English)In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 18, no 1, article id 318Article in journal (Refereed) Published
Abstract [en]

Background: Working conditions substantially influence health, work ability and sick leave. Useful instruments to help clinicians pay attention to working conditions are lacking in primary care (PC). The aim of this study was to test the validity of a short "Blue flags" questionnaire, which focuses on work-related psychosocial risk factors and any potential need for contacts and/or actions at the workplace. Methods: From the original"The General Nordic Questionnaire" (QPSNordic) the research group identified five content areas with a total of 51 items which were considered to be most relevant focusing on work-related psychosocial risk factors. Fourteen items were selected from the identified QPSNordic content areas and organised in a short questionnaire "Blue flags". These 14 items were validated towards the 51 QPSNordic items. Content validity was reviewed by a professional panel and a patient panel. Structural and concurrent validity were also tested within a randomised clinical trial. Results: The two panels (n = 111) considered the 14 psychosocial items to be relevant. A four-factor model was extracted with an explained variance of 25.2%, 14.9%, 10.9% and 8.3% respectively. All 14 items showed satisfactory loadings on all factors. Concerning concurrent validity the overall correlation was very strong rs = 0.87 (p < 0.001).). Correlations were moderately strong for factor one, rs = 0.62 (p < 0.001) and factor two, rs = 0.74 (p < 0.001). Factor three and factor four were weaker, bur still fair and significant at rs = 0.53 (p < 0.001) and rs = 0.41 (p < 0.001) respectively. The internal consistency of the whole "Blue flags" was good with Cronbach's alpha of 0.76. Conclusions: The content, structural and concurrent validity were satisfactory in this first step of development of the "Blue flags" questionnaire. In summary, the overall validity is considered acceptable. Testing in clinical contexts and in other patient populations is recommended to ensure predictive validity and usefulness.

Place, publisher, year, edition, pages
BioMed Central, 2017
National Category
Physiotherapy
Research subject
Physiotherapy
Identifiers
urn:nbn:se:ltu:diva-65074 (URN)10.1186/s12891-017-1677-z (DOI)000406630800002 ()28738803 (PubMedID)2-s2.0-85025662398 (Scopus ID)
Note

Validerad; 2017; Nivå 2; 2017-08-15 (andbra)

Available from: 2017-08-15 Created: 2017-08-15 Last updated: 2018-07-10Bibliographically approved
Tibaek, S., Gard, G., Dehlendorff, C., Iversen, H. K., Biering-Sorensen, F. & Jensen, R. (2017). Can pelvic floor muscle training improve qualityof life in men with mild to moderate post-strokeand lower urinary tract symptoms?. European Journal of Physical and Rehabilitation Medicine, 53(3), 416-425
Open this publication in new window or tab >>Can pelvic floor muscle training improve qualityof life in men with mild to moderate post-strokeand lower urinary tract symptoms?
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2017 (English)In: European Journal of Physical and Rehabilitation Medicine, ISSN 1973-9087, E-ISSN 1973-9095, Vol. 53, no 3, p. 416-425Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Lower urinary tract symptoms (LUTS) have a significant impact on quality of life (QoL) in post‑stroke patients.AIM: The aim of this study was to evaluate the effect of pelvic floor muscle training (PFMT) on QoL parameters in men with post‑stroke LUTS.DESIGN: Randomized, controlled and single‑blinded trial.SETTING: Outpatients, University Hospital.POPULATION: Thirty‑one men, median age 68 (interquartile range 60-74) years, with post‑stroke LUTS were included. Thirty participants completed the study.METHODS: The participants randomized to the treatment group were treated in a systematic, controlled and intensive PFMT program over 3 months (12 weekly sessions). The participants randomized to the control group did not receive specific LUTS treatment. The effect was measured on the 36-Item Short Form Health Survey (SF-36) and the Nocturia Quality‑of‑Life (N‑QoL) Questionnaire.RESULTS: The results on SF-36 indicated significant improvement within pre- and post‑test in the domains emotional role (median 77 to 100, P=0.03) and vitality (median 65 to 70, P=0.03) in the treatment group, but not the control group. There were no statistically significant differences between groups at pre‑test, post‑test or 6-month follow‑up. The results on N‑QoL indicated statistically significant differences between pre- and post‑test in the bother/concern domain in both groups and in sleep/energy for the control group, but not the treatment group. There were no statistically significant differences between groups.CONCLUSIONS: PFMT may improve the emotional health and vitality domains of QoL in men with mild to moderate post‑stroke and LUTS; however the improvements in the treatment group were not significantly better than for the control group. PFMT did not improve nocturia‑related QoL.CLINICAL REHABILITATION IMPACT: This study is the first to evaluate the effect of PFMT on QoL parameters in men with mild to moderate post‑stroke and LUTS. The results indicate some short‑term effect on SF-36 but none on N‑QoL. However, further studies with larger sample sizes and with less restrictive inclusion and exclusion criteria are requested.

Place, publisher, year, edition, pages
Edizioni Minerva Medica, 2017
National Category
Physiotherapy
Research subject
Physiotherapy
Identifiers
urn:nbn:se:ltu:diva-61207 (URN)10.23736/S1973-9087.16.04119-8 (DOI)27003595 (PubMedID)
Available from: 2016-12-21 Created: 2016-12-21 Last updated: 2017-11-24Bibliographically approved
Calner, T., Nordin, C., Eriksson, M. K., Nyberg, L., Gard, G. & Michaelson, P. (2017). Effects of a self-guided, web-based activity programme for patients with persistent musculoskeletal pain in primary healthcare: A randomized controlled trial (ed.). European Journal of Pain, 21(6), 1110-1120
Open this publication in new window or tab >>Effects of a self-guided, web-based activity programme for patients with persistent musculoskeletal pain in primary healthcare: A randomized controlled trial
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2017 (English)In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 21, no 6, p. 1110-1120Article in journal (Refereed) Published
Abstract [en]

BACKGROUNDWeb-based interventions for pain management are increasingly used with possible benefits, but never used in addition to multimodal rehabilitation (MMR). MMR is recommended treatment for persistent pain in Sweden. The aim was to evaluate the effects of a self-guided, web-based programme added to MMR for work ability, pain, disability and health-related quality of life.METHODSWe included 99 participants with persistent musculoskeletal pain in a randomized study with two intervention arms: (1) MMR and web-based intervention, and (2) MMR. Data was collected at baseline, 4 and 12 months. Outcome measures were work ability, working percentage, average pain intensity, pain-related disability, and health-related quality of life.RESULTSThere were no significant effects of adding the web-based intervention to MMR regarding any of the outcome variables.CONCLUSIONSThis trial provides no support for adding a self-guided, web-based activity programme to MMR for patients with persistent musculoskeletal pain.SIGNIFICANCEThe comprehensive self-guided, web-based programme for activity, Web-BCPA, added to multimodal treatment in primary health care had no effect on work ability, pain, disability or health-related quality of life. Future web-based interventions should be tailored to patients' individual needs and expectations

Place, publisher, year, edition, pages
John Wiley & Sons, 2017
National Category
Physiotherapy
Research subject
Physiotherapy
Identifiers
urn:nbn:se:ltu:diva-60945 (URN)10.1002/ejp.1012 (DOI)000403249400015 ()28464364 (PubMedID)2-s2.0-85018759209 (Scopus ID)
Note

Validerad; 2017; Nivå 2; 2017-06-15 (inah)

Available from: 2016-12-06 Created: 2016-12-06 Last updated: 2018-09-13Bibliographically approved
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