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  • 1.
    Gard, Gunvor
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Sandberg, Ann Christine
    Karolinska institute, Department of Physical Therapy.
    Motivating factors for return to work1998In: Physiotherapy Research International, ISSN 1358-2267, E-ISSN 1471-2865, Vol. 3, no 2, p. 100-108Article in journal (Refereed)
    Abstract [en]

    AB - BACKGROUND AND PURPOSE: A new concept to increase return to work for patients listed as sick with chronic musculoskeletal pain has been used at a rehabilitation centre in Lulea, Sweden. The programme includes work for three days a week and intensive rehabilitation for two days a week, for 12 weeks, as a combination of 'on the job' training and rehabilitation after a period off work sick. The rehabilitation programme focused on pain reduction, identifying and finding solutions to pain problems in actual work and life situations and training of the functional capacities needed in the work and life situation. The aim of the study was to describe patients' perceptions of motivating factors for return to work. METHODS: A phenomenological method was used. A naive reading of interview notes was followed by structural analyses and reflections on the interpreted whole. Inclusion criteria for the study were musculoskeletal pain for at least one year and a period of at least four weeks' sick leave during that time. Ten patients, aged 30-54 years, participated in the study. An initial conceptual framework was developed to inform the scope of the study and to guide data collection and analysis. RESULTS: Different factors in the study framework influenced motivation to return to work. Among structural factors the division of labour at work was the most important motivator, particularly the ability to do as much as work colleagues, quantitatively and qualitatively. All the patients had jobs in the healthcare or service sectors, jobs with many social contacts. They perceived their work task content as being of minor importance compared to whether the tasks were perceived as meaningful or highly needed by others. All wanted a meaningful job content and a job which they could do in a satisfactory way according to their own norms and compared to colleagues. This highly increased motivation for return to work. Relationships (in terms of co-operation with colleagues and service to patients or clients) were important motivating factors for return to work. Self-confidence was a new factor of importance for return to work; work tasks had to be meaningful and needed by others, work must be done in a way satisfactory for the individual and in a way that was acceptable to others in the group. Everyday responsibility, feedback and support in daily work tasks were important. These aspects increased self-confidence. The results supported the development of a new conceptual framework for possible motivating factors for return to work. CONCLUSIONS: Structure, content, relationships, health and self-confidence were all important motivating factors for return to work.

  • 2.
    Gyllensten, Amanda Lundvik
    et al.
    University of Lund, Department of Physical Therapy.
    Gard, Gunvor
    Salford, Eva
    University of Lund, Department of Physical Therapy.
    Ekdahl, Charlotte
    University of Lund, Department of Physical Therapy.
    Interaction between patient and physiotherapist: a qualitative study reflecting the physiotherapist's perspective1999In: Physiotherapy Research International, ISSN 1358-2267, E-ISSN 1471-2865, Vol. 4, no 2, p. 89-109Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND PURPOSE: The interaction between patient and physiotherapist (PT) is central in physiotherapeutic treatment. The purpose of this study was to investigate expert physiotherapists' perception of important factors influencing the quality of the interaction in physiotherapeutic treatment. METHOD: Ten experienced PTs working in primary healthcare were interviewed twice, triangulating a sort of important events, an exemplar and a key informant interview. The data were transcribed, coded and analysed for main themes and categories according to the qualitative technique described by Shepard et al. (1993) and Merriam (1988). RESULTS: Important factors in interaction could be divided into the 'Prerequisites dimension' and the 'Interaction dimension'. In the former, the most dominant theme was 'Internal prerequisites of the PT'. The most-cited category in this theme was 'Practical professional skills and patient experience'. In the latter, the themes 'Establishing contact', 'Ways of contact', 'Frames' and the 'Therapeutic process' emerged. Here, the most-cited categories were 'Establishing contact and confidence', having a 'Therapeutic role', 'Being sensitive and intuitive', 'Encountering', 'Listening' and 'Identification of patient resources'. These factors were seen as essential for promoting a positive patient outcome. Interaction skills were reinforced by reflection on patients' experiences. CONCLUSIONS: Interaction skills of the expert PT were thought to enhance the resources of the patient and lead to a positive patient outcome. Within professional development more emphasis ought to be put on reinforcing the reflective process of the PT, for instance by the use of supervision by an experienced colleague.

  • 3.
    Lundin-Olsson, Lillemor
    et al.
    Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy and Geriatric Medicine.
    Nyberg, Lars
    Gustafson, Yngve
    Umeå University, Department of Community Medicine and Rehabilitation, Physiotherapy and Geriatric Medicine.
    The Mobility Interaction Fall chart2000In: Physiotherapy Research International, ISSN 1358-2267, E-ISSN 1471-2865, Vol. 5, no 3, p. 190-201Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND PURPOSE: The aim of this study was to develop and evaluate a screening tool for the identification of older people living in residential care facilities who are prone to falling. METHOD: Two tests focusing on attentional demands while walking were performed: 'Stops walking when talking' and the 'diffTUG'. Medical assessment, rating for cognition, depression and activities of daily living were also carried out. Falls indoors were followed up prospectively over a period of six months. A flowchart, the Mobility Interaction Fall (MIF) chart, for the identification of older people who are prone to falling was developed. The MIF chart includes an observation of mobility level and 'Stops walking when talking', the diffTUG, a test of vision and a rating of concentration. Study subjects were 78 residents, aged over 65 years, in one residential care facility (22 M; 56 F; median age 82 years, range 66-99 years) in Umea, Sweden. RESULTS: Thirty-three (42%) subjects suffered at least one fall indoors during the follow-up period. The rate of falls differed significantly between those subjects classified as being at risk of falls and those not so classified (log rank test 39.1; p < 0.001; hazard ratio 12.1; 95% CI 4.6-31.8). The positive predictive value for the classification was 78% (95% CI 67-87%) and the negative predictive value was 88% (95% CI 79-95%). CONCLUSION: The initial findings for the MIF chart indicate a promising way of classifying older people at residential care facilities as being at high or low risk of falling. The classification is quick and easy and requires no expensive equipment

  • 4.
    Näslund, Annika
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Tamm, Maare
    Luleå tekniska universitet.
    Ericsson, Ann Kristin
    Sunderby sjukhus, Barnhabiliteringen.
    Wendt, Lennart von
    Helsingfors universitet, Institutionen för barnneurologi.
    Dynamic ankle-foot orthoses as a part of treatment in children with spastic diplegia: parents' perceptions2003In: Physiotherapy Research International, ISSN 1358-2267, E-ISSN 1471-2865, Vol. 8, no 2, p. 59-68Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND PURPOSE: Dynamic ankle-foot orthoses (DAFOs) are often recommended for children with spastic diplegia in order to facilitate better function. The aim of the present study was to explore how the parents of children with diplegic cerebral palsy experience the use of DAFOs. METHOD: A qualitative interview study with a broad research question: 'How do you perceive that DAFOs influence your child?' The parents of 15 children, aged 4-18 years, who all had spastic diplegia and wore DAFOs were interviewed. RESULTS: Content analysis resulted in the following categories: 'Physical effects'; 'New functions and activities'; 'The orthosis as a part of the treatment'; 'Opportunity for independence and play'; and 'Problems with DAFOs'. According to the parents, DAFOs appeared to contribute to the (mechanical) changes in posture affecting the muscular system. They meant that when wearing DAFOs the foot and ankle are more stable. This in turn enables postural control and alignment, contributing to functional activities under more favourable physiological conditions. The psychosocial effects were regarded by parents as being just as important as the physical effects. CONCLUSION: In clinical practice, DAFOs may (according to parents) be regarded as a suitable complement to other treatments in children with diplegic cerebral palsy.

  • 5.
    Sjöholm, Hanna
    et al.
    Rehabilitation Centre, Region Jönköping County, Jönköping and Department of Medical and Health Sciences, Linköping University, Linköping.
    Hägg, Staffan
    Futurum, Region Jönköping County, Jönköping and Department of Medical and Health Sciences, Linköping University, Linköping.
    Nyberg, Lars
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Rolander, Bo
    Futurum, Region Jönköping County, Jönköping.
    Kammerlind, Ann-Sofi
    Futurum, Region Jönköping County, Jönköping.
    The Cone Evasion Walk test: Reliability and validity in acute stroke2018In: Physiotherapy Research International, ISSN 1358-2267, E-ISSN 1471-2865, article id e1744Article in journal (Refereed)
    Abstract [en]

    OBJECTIVETo estimate the reliability and validity of the Cone Evasion Walk test (CEW), a new test assessing the ability to evade obstacles, in people with acute stroke.

    METHODSTo estimate the reliability of the CEW, video recordings of 20 people with acute stroke performing the test were assessed by 10 physiotherapists on two occasions, resulting in a total of 400 ratings. Patients performed the CEW (n = 221), functional ambulation classification (FAC; n = 204), Timed Up and Go (TUG; n = 173), TUG cognitive (TUG-cog; n = 139), Serial 7s attention task from the Montreal Cognitive Assessment (MoCA-S7; n = 127), and the Star Cancellation Test (SCT; n = 151). These tests and side of lesion (n = 143) were used to examine construct validity. The predictive validity was evaluated in relation to falls during the following 6 months (n = 203).

    RESULTSThe intraclass correlation coefficients for intrarater and interrater reliability were 0.88-0.98. For validity, there were significant correlations between the CEW and FAC (rs  = -0.67), TUG (rs  = 0.45), MoCA-S7 (rs  = -0.36), and SCT total score (rs  = -0.36). There was a significant correlation between the number of cones touched on the left side and the proportion of cancelled stars on the left (rs  = -0.23) and right (rs  = 0.23) side in the SCT. Among right hemisphere stroke participants (n = 79), significantly more persons hit cones on the left side (n = 25) than the right side (n = 8), whereas among those with a left hemisphere stroke (n = 64) significantly more persons hit cones on the right side (n = 11) than the left (n = 3). Cox regression showed that participants who touched four to eight cones had an increased risk of falls over time (hazard ratio 2.11, 95% CI [1.07, 4.17]) compared with those who touched none.

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