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  • 1.
    Calner, Tommy
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Isaksson, Gunilla
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Michaelson, Peter
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering. Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Physiotherapy treatment experiences of persons with persistent musculoskeletal pain: A qualitative study2021Ingår i: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 37, nr 1, s. 28-37Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to explore and describe the physiotherapy treatment experiences of persons with persistent musculoskeletal pain. Eleven participants with persistent musculoskeletal pain in the back, neck, or shoulders were included in the study. Data was collected via semi-structured interviews and were analysed with qualitative content analysis. The analysis resulted in the theme "Towards acceptance and management of pain", comprising four sub-themes: 1) Establishing and maintaining a therapeutic alliance; 2) Being active, taking initiative and facing challenges; 3) Appreciating guidance, incentive and having a sounding board; and 4) Acquired knowledge and new body awareness change behaviours. The theme and sub-themes describe how the participants used increased knowledge, awareness, movements and exercises learned from the physiotherapy treatment to develop strategies for managing pain and the process of acceptance. A trusting relationship and continual dialogue with the physiotherapist was considered to be important. The participants were actively involved in the process as exercises, activities and other treatment modalities were individualized. This was rewarding but also challenging and required effort on their part. The physiotherapist's initiatives and actions were an important incentive and means of support.

  • 2.
    Calner, Tommy
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Persistent musculoskeletal pain: A web-based activity programme for behaviour change, does it work? Expectations and experiences of the physiotherapy treatment process2018Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    This thesis concerned persons with persistent musculoskeletal pain in primary health care and had three aims. The first aim was to evaluate the effects of a web-based programme for behaviour change. The second aim was to create and evaluate a multimodal intervention. The third aim was to explore and describe expectations andexperiences of the physiotherapy treatment process.

    In Study I, we evaluated the effects of a web-based activity programme for behaviour change added to multidisciplinary rehabilitation (MDR) in primary health care. Ninety-nine participants were randomized to 1) MDR with an additional web-based programme, and 2) MDR. Outcome measures were work ability, pain intensity, pain-relate disability and health-related quality of life. There were no significant effects of the web-based programme for any outcome measure at 4 or 12 months. In conclusion, this study provides no support for adding a self-guided web-based programme to MDR in primary health care.

    In Study II, we evaluated first the web-based programme from Study I compared to the waiting list. Effect measures were workability, pain intensity, disability and self-efficacy. Thereafter, we evaluated the effects and process of a novel multimodal intervention consisting of the web-based programme with additional individual counselling, and individually tailored physiotherapy treatment. Ten participants were included in the study. Effects were evaluated using a Single Subject Experimental Design (SSED) and the process was evaluated by interviews with the participants and log data of usage of the modalities. There were no conclusive effects of the self-managed web-based programme as compared to the waiting list. The SSED analyses of the multimodal intervention showed promising short-term results regarding disability and pain intensity, but no conclusive results for work ability or self-efficacy. The multi-modal intervention process seemed successfully implemented, and the importance of physiotherapy and, to some extent counselling, was emphasized by the participants. In conclusion, the newly designed multimodal intervention in primary health care seemed feasible and showed some promising short-term effects, while the implementation of a self-managed web-based programme as a single intervention seemed without effect.

    In Study III, qualitative interviews were conducted with ten participants to explore their expectations of physiotherapy. Data were analysed with qualitative content analysis and the findings described a multi-faceted picture of the participants’ expectations, encompassing several aspects regarding the treatment process and outcome. Regarding the treatment process, participants expected a good dialogue, to be confirmed as individuals, and to get an explanation for their pain. The participants expected tailored training with frequent follow-ups and their expectations of outcome ranged from hope of the best possible results to being realistic or resigned.

    In Study IV, qualitative interviews were conducted with 11 participants to explore their experiences in physiotherapy treatment. Data were analysed with qualitative content analysis. The findings show how the participants described how they used knowledge, awareness, movements and exercises learned from the physiotherapy treatment to develop strategies to manage pain and the process of acceptance. There were experiences involving the importance of establishing an alliance with the physiotherapist, based on trust and with a continuous dialogue. When exercises, activities and other treatment modalities were individualized, participants were actively involved in the process. This was rewarding but was also considered an effort and a challenge. The physiotherapist’s initiatives and actions were considered important for incentive and support.

    In conclusion, we found no effects of the web-based activity programme on behaviour change for persons with persistent musculoskeletal pain. The newly designed multi-modal intervention in primary health care seemed feasible and showed some promising short-term effects. Expectations of physiotherapy treatment were multi-faceted, encompassing both process and outcome. After finishing physiotherapy, the participants described how they used knowledge, awareness, movements and exercises learned from the physiotherapy treatment to develop strategies to manage pain and the process of acceptance. The importance of alliance and incentives for activities throughout the physiotherapy treatment process were also described.

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  • 3.
    Calner, Tommy
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nordin, Catharina
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Eriksson, Margareta K.
    Department of Public Health, Norrbotten County Council, Luleå.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Michaelson, Peter
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Effects of a self-guided, web-based activity programme for patients with persistent musculoskeletal pain in primary healthcare: A randomized controlled trial2017Ingår i: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 21, nr 6, s. 1110-1120Artikel i tidskrift (Refereegranskat)
    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

  • 4.
    Calner, Tommy
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Isaksson, Gunilla
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Michaelson, Peter
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    I know what I want but I’m not sure how to get it: expectations of physiotherapy treatment of persons with persistent pain2017Ingår i: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 33, nr 3, s. 198-205Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Expectations of physiotherapy treatment of patients with persistent pain have been shown to influence treatment outcome and patient satisfaction, yet this is mostly explored and described in retrospective. The aim of the study was to explore and describe the expectations people with persistent pain have prior to physiotherapy treatment. Ten participants with persistent musculoskeletal pain from the back, neck, or shoulders were included in the study. Data were collected by interviews using a semi-structured interview guide and were analyzed with qualitative content analysis. The analysis resulted in one main category: “The multifaceted picture of expectations” and four categories: 1) Standing in the doorway: curious and uncertain; 2) Looking for respect, confirmation and knowledge; 3) Expecting treatment, regular training, and follow up; and 4) Having dreams, being realistic, or feeling resigned. The main category and the categories describe a multifaceted picture of the participants’ expectations, gradually developed and eventually encompassing several aspects: good dialog and communication, the need to be confirmed as individuals, and getting an explanation for the pain. The results also show that the participants expected tailored training with frequent follow-ups and their expectations of outcome ranged from hope of the best possible results to realistic or resigned regarding pain relief and activity levels.

  • 5.
    Calner, Tommy
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Isaksson, Gunilla
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Michaelson, Peter
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    “I know what I want but I’m not sure how to get it”: Expectations of physiotherapy treatment of persons with persistent pain2016Ingår i: Manual Therapy, ISSN 1356-689X, E-ISSN 1532-2769, Vol. 25, s. e142-e143Artikel i tidskrift (Övrigt vetenskapligt)
  • 6.
    Gard, Gunvor
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Zingmark, Karin
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Eriksson, Margareta K.
    Department of Public Health, Norrbotten County Council, Luleå.
    Michaelson, Peter
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nordin, Catharina
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Calner, Tommy
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Multimodal pain rehabilitation (MMR) with additional tailored web-based pain rehabilitation: an RCT study2014Konferensbidrag (Övrigt vetenskapligt)
  • 7. Arvidsson, Mialinn
    et al.
    Patel, Sonal
    Luleå tekniska universitet.
    Calner, Tommy
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Kroppsmedvetande hos unga indiska kvinnor2005Ingår i: Nordisk fysioterapi, ISSN 1402-3024, Vol. 9, nr 1, s. 40-47Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    Body image is a concept, referring to feelings and attitudes toward: the body. There are many di fervent factors affecting the body image; historical, cultural, social and individual factors. The aim ofthis study was to describe young Indian women's body image. One hundred female university students in India answered the Ben-Tovim Walker Body attitudes questionnaire (BAQ). The result showed that Indian women had a sound body image.

  • 8.
    Rutberg, Stina
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Mikaelsson, Katarina
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Calner, Tommy
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Massage: ett kompendium2004Bok (Övrig (populärvetenskap, debatt, mm))
  • 9.
    Calner, Tommy
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Isaksson, Gunilla
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Michaelson, Peter
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Experiences of physiotherapy treatment of persons with persistent musculoskeletal painManuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    The aim of this study was to explore and describe experiences of physiotherapy treatment of people with persistent musculoskeletal pain. Eleven participants with persistent musculoskeletal pain from the back, neck, or shoulders were included in the study. Data were collected by interviews using a semi-structured interview guide and were analysed with qualitative content analysis. The analysis resulted in one main category “Towards acceptance and management of pain” which was formulated and built up by the four categories “Establishing and maintaining alliance”, “Being active, taking initiative and facing challenge”, “Appreciating guidance, incentive and a sounding board” and “Acquired knowledge and developed awareness”. The main category and the categories describe how the participants used knowledge, awareness, movements and exercises learned from the physiotherapy treatment to develop strategies to manage pain and the process of acceptance. A trustful alliance with the physiotherapist and a continuous dialogue was important. The participants were actively involved in the process when exercises, activities and other treatment modalities were individualized. This was rewarding but also an effort and a challenge. The physiotherapist’s initiatives and actions were considered important as incentive and support.

  • 10.
    Calner, Tommy
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nordin, Catharina
    Department of Primary health care, Norrbotten County Council .
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Nyberg, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Michaelson, Peter
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Physiotherapy in combination with personalized counseling and a web-based programme for persistent pain: an early stage evaluationManuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    Objective

    We evaluated first a self-managed web-based programme for activity compared to waiting list for persons with persistent musculoskeletal pain suited for primary health care. Thereafter, we evaluated the effects and process of a novel multimodal treatment intervention combining the web programme with counselling and physiotherapy. 

     

    Design

    A weekly comparison of measures of outcome data between those using the self-managed web-based programme to those on a waiting list. After that a Single Subject Experimental Design (SSED) evaluation of the multimodal intervention, structured interviews and log data.

     

    Setting

    Clinical setting in primary health care.

     

    Subjects

    Ten participants with persistent musculoskeletal pain.

     

    Intervention

    First, only a self-managed web-based programme for activity. Thereafter a multimodal intervention combining the web programme with counselling and physiotherapy.

     

    Main measures

    Effect measures were work ability, pain intensity, disability and self-efficacy. Process evaluation by interviews of the participants and log data of usage of the modalities.

     

    Results

    There were no conclusive effects of the self-managed web-based programme as compared to waiting list. The SSED analyses of the multi-modal showed promising short-term results regarding disability and pain intensity, but no conclusive results for work ability or self-efficacy. The multimodal intervention process seemed successfully implemented, and the importance of physiotherapy and to some extent counselling was emphasized by the participants.

     

    Conclusion

    For persons with persistent musculoskeletal pain, the newly designed multimodal intervention in primary care seemed feasible and showed some promising short-terms effects, while the implementation of a self-managed web-based programme as a single intervention seemed without effect. 

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