18 results on '"Cecilia Fridén"'
Search Results
2. Home visits as an interprofessional learning activity for students in primary healthcare
- Author
-
Christina B. Olsson, Stefano Torres Asenjo, Cecilia Fridén, and Eva Toth-Pal
- Subjects
Adult ,Male ,Students, Medical ,020205 medical informatics ,Interprofessional Relations ,media_common.quotation_subject ,education ,02 engineering and technology ,03 medical and health sciences ,Patient safety ,0302 clinical medicine ,Health care ,ComputingMilieux_COMPUTERSANDEDUCATION ,0202 electrical engineering, electronic engineering, information engineering ,House call ,Humans ,Medical history ,030212 general & internal medicine ,Cooperative Behavior ,Care Planning ,Aged ,media_common ,undergraduate ,Teamwork ,Medical education ,ComputingMilieux_THECOMPUTINGPROFESSION ,Primary Health Care ,business.industry ,Research ,Public Health, Environmental and Occupational Health ,Middle Aged ,Home Care Services ,Focus group ,House Calls ,Home visits ,Female ,Students, Nursing ,Job satisfaction ,teamwork ,Psychology ,business - Abstract
Aim: To evaluate person-centred home visits as an interprofessional learning (IPL) activity for undergraduate students during clinical placements in primary healthcare. Background: Interprofessional collaboration is known to improve patient safety, increase job satisfaction, and reduce stress among healthcare professionals. Students should already during their basic training experience interprofessional collaboration. Methods: Students from six different educational programmes and supervisors and adjunct clinical lecturers from different professions participated in the learning activity. The students read a description of the patient history before the visit together with a supervisor. During the home visit, the students were responsible for history-taking and for performing relevant examinations. Afterwards, the students made a joint care plan for the patient. Students, supervisors, and adjunct clinical lecturers discussed the outcomes in a seminar and reflected on each other’s professional roles. The students and the patients answered a questionnaire about the activity, and the supervisors and the adjunct clinical lecturers were interviewed in focus groups. Findings: Thirty interprofessional home visits were conducted, involving 109 students from six different healthcare professions. The students reported that they had gained insights into how different professions could collaborate and an increased understanding of teamwork. All patients were satisfied with the visits and felt that they had been listened to. The interview analysis showed one overarching theme: ‘Interprofessional home visits in primary healthcare were an appreciated and effective pedagogical learning activity with a sustainability dependent on organisational factors’. Conclusions: The students felt that participation in the activity increased their understanding of collaboration and of other professions’ skills. The supervisors found the home visits to be an appreciated and effective learning activity. The results indicate that this learning activity can be used in primary healthcare settings to promote students’ IPL, but organisational factors need to be considered in order to support sustainability. more...
- Published
- 2020
- Full Text
- View/download PDF
Catalog
3. Pain sensitivity at rest and during muscle contraction in persons with rheumatoid arthritis: a substudy within the Physical Activity in Rheumatoid Arthritis 2010 study
- Author
-
Ingrid Demmelmaier, Ingrid E. Lundberg, Monika Löfgren, Cecilia Fridén, Eva Kosek, Birgitta Nordgren, and Christina H. Opava
- Subjects
Male ,medicine.medical_specialty ,lcsh:Diseases of the musculoskeletal system ,Rest ,Arthritis ,Pain ,Arthritis, Rheumatoid ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Isometric Contraction ,Surveys and Questionnaires ,Threshold of pain ,medicine ,Humans ,Exercise ,Rest (music) ,Aged ,030203 arthritis & rheumatology ,Pain measurement ,Hypoalgesia ,business.industry ,Middle Aged ,medicine.disease ,Rheumatology ,Exercise Therapy ,Pain threshold ,Rheumatoid arthritis ,Orthopedic surgery ,Physical therapy ,Female ,medicine.symptom ,lcsh:RC925-935 ,business ,030217 neurology & neurosurgery ,Muscle contraction ,Research Article ,Muscle Contraction - Abstract
Background We aimed to explore pressure pain sensitivity and the function of segmental and plurisegmental exercise-induced hypoalgesia (EIH) in persons with rheumatoid arthritis (RA) compared with healthy control subjects (HC). Methods Forty-six participants with RA (43 female, 3 male) and 20 HC (16 female, 4 male) participated in the study. Pressure pain thresholds, suprathreshold pressure pain at rest, and segmental and plurisegmental EIH during standardised submaximal contractions were assessed by algometry. Assessments of EIH were made by performing algometry alternately at the contracting (30% of the individual maximum) right m. quadriceps and the resting left m. deltoideus. Results Participants with RA had higher sensitivity to pressure pain (RA, 318 kPa; HC, 487 kPa; p 0.05). Conclusions Our results indicate a generally increased pain sensitivity but normal function of EIH among persons with RA and offer one possible explanation for pain reduction observed in this group of patients following clinical exercise programmes. Trial registration ISRCTN registry, ISRCTN25539102. Retrospectively registered on 4 March 2011. more...
- Published
- 2018
- Full Text
- View/download PDF
4. Too little sleep and an unhealthy diet could increase the risk of sustaining a new injury in adolescent elite athletes
- Author
-
P. von Rosen, Anders Kottorp, Anna Frohm, Annette Heijne, and Cecilia Fridén
- Subjects
Male ,Youth ,Logistic regression ,0302 clinical medicine ,Nutritional status ,Risk Factors ,Surveys and Questionnaires ,Orthopedics and Sports Medicine ,Child ,Elite sports ,media_common ,Self-confidence ,Surveillance ,biology ,Incidence ,Incidence (epidemiology) ,Logistic model ,Sleep in non-human animals ,Athletic Injuries ,Female ,Human ,medicine.medical_specialty ,Adolescent ,media_common.quotation_subject ,Physical Therapy, Sports Therapy and Rehabilitation ,Survey and Questionnaire ,Odds ,03 medical and health sciences ,Athlete ,medicine ,Humans ,Elite athletes ,Risk factor ,Athletic injury ,Athletes ,business.industry ,Prevention ,305: Soziale Gruppen ,030229 sport sciences ,biology.organism_classification ,Diet ,Logistic Models ,610: Medizin und Gesundheit ,Physical therapy ,Sleep ,business ,030217 neurology & neurosurgery ,Demography - Abstract
Little is known about health variables and if these variables could increase the risk of injuries among adolescent elite athletes. The primary aim was to present overall data on self-perceived stress, nutrition intake, self-esteem, and sleep, as well as gender and age differences, on two occasions among adolescent elite athletes. A secondary aim was to study these health variables as potential risk factors on injury incidence. A questionnaire was e-mailed to 340 adolescent elite athletes on two occasions during a single school year: autumn semester and spring semester. The results show that during autumn semester, the recommended intake of fruits, vegetables, and fish was not met for 20%, 39%, and 43% of the adolescent elite athletes, respectively. The recommended amount of sleep during weekdays was not obtained by 19%. Multiple logistic regression showed that athletes sleeping more than 8 h of sleep during weekdays reduced the odds of injury with 61% (OR, 0.39; 95% CI, 0.16-0.99) and athletes reaching the recommended nutrition intake reduced the odds with 64% (OR, 0.36; 95% CI, 0.14-0.91). Our findings suggest that nutrition intake and sleep volume are of importance in understanding injury incidence. more...
- Published
- 2016
- Full Text
- View/download PDF
5. General practitioners’ reasoning on risk screening and primary prevention of stroke – a focus group study
- Author
-
Kerstin Tham, Gustav Mickols, Ann-Helen Patomella, Gunnar Nilsson, Anders Kottorp, Bo Christer Bertilson, Eric Asaba, and Cecilia Fridén
- Subjects
Adult ,Male ,medicine.medical_specialty ,Medicin och hälsovetenskap ,Attitude of Health Personnel ,Clinical Decision-Making ,Medical and Health Sciences ,Grounded theory ,03 medical and health sciences ,0302 clinical medicine ,General Practitioners ,Qualitative research ,Systematic risk ,medicine ,Humans ,Mass Screening ,030212 general & internal medicine ,Practice Patterns, Physicians' ,Stroke ,Risk management ,Reimbursement ,Primary health care ,Aged ,lcsh:R5-920 ,Data collection ,Primary prevention ,Primary Health Care ,business.industry ,Focus Groups ,Middle Aged ,medicine.disease ,Focus group ,Family medicine ,Female ,Family Practice ,business ,lcsh:Medicine (General) ,030217 neurology & neurosurgery ,Research Article - Abstract
Background By screening and modifying risk factors, stroke incidence can be reduced. Clinical guidelines states that primary prevention of stroke is a responsibility and task of primary health care, but research shows that this not always the case. The aim of the study was to explore and describe what characterizes GPs’ reasoning around risk screening and primary prevention among persons at risk for stroke in primary health care. Methods A qualitative design based in a grounded theory approach was chosen in order to investigate this unexplored research area. Data collection was done using focus group interviews and data was analysed using a constant comparative method. Twenty-two GPs were interviewed in four focus groups. Results Findings showed that GPs perceived difficulties in prioritizing patients with an unhealthy lifestyle and described a lack of systematicity in their procedures, which complicated their clinical decisions concerning patients with stroke risk factors. The results showed a lack of systematic risk screening methods. Time constraints and the reimbursement system were described as hindering the preventive work. Conclusion There is a need for a more proactive, transparent and systematic approach in the distribution of GPs’ time and reimbursement of prevention in primary health care. The findings suggest, by developing new methods and approaches such as digital clinical decision-making tools and by implementing inter-professional team-work, the quality of the primary prevention of stroke could be improved. Electronic supplementary material The online version of this article (10.1186/s12875-018-0883-6) contains supplementary material, which is available to authorized users. more...
- Published
- 2018
6. Long-term, health-enhancing physical activity is associated with reduction of pain but not pain sensitivity or improved exercise-induced hypoalgesia in persons with rheumatoid arthritis
- Author
-
Ingrid E. Lundberg, Cecilia Fridén, Monika Löfgren, Ingrid Demmelmaier, Eva Kosek, Birgitta Nordgren, and Christina H. Opava
- Subjects
Male ,Pain Threshold ,medicine.medical_specialty ,lcsh:Diseases of the musculoskeletal system ,Strength training ,Visual analogue scale ,Pain ,Arthritis ,Exercise-induced hypoalgesia ,Arthritis, Rheumatoid ,03 medical and health sciences ,0302 clinical medicine ,Surveys and Questionnaires ,Internal medicine ,Activities of Daily Living ,Threshold of pain ,medicine ,Humans ,Aerobic exercise ,Long-term follow-up ,Exercise ,Aged ,Retrospective Studies ,030203 arthritis & rheumatology ,Pain measurement ,Hypoalgesia ,business.industry ,Pain Perception ,Middle Aged ,medicine.disease ,Rheumatology ,Exercise Therapy ,Rheumatoid arthritis ,Physical therapy ,Female ,lcsh:RC925-935 ,business ,030217 neurology & neurosurgery ,Research Article ,Muscle Contraction - Abstract
Background We aimed to evaluate the 1-year and 2-year outcome of a health-enhancing physical activity (HEPA) support program on global pain, pressure pain sensitivity, and exercise-induced segmental and plurisegmental hypoalgesia (EIH) in persons with rheumatoid arthritis (RA). Methods Thirty participants (27 women and 3 men) were recruited from a larger intervention cohort that engaged in strength training and moderate-intensity aerobic activity. Assessments were performed before the HEPA intervention and at 1-year and 2-year follow-ups. Global pain was assessed on a visual analogue scale (0–100). Pressure pain thresholds (PPTs) and suprathreshold pressure pain at rest corresponding to 4/10 (medium pain) (SP4) and 7/10 (strong pain) (SP7) on Borg CR 10 scale were assessed by algometry. In a subsample (n = 21), segmental and plurisegmental EIH were assessed during standardized submaximal static contraction (30% of the individual maximum), by algometry, alternately at the contracting right M. quadriceps and the resting left M. deltoideus. Results Global pain decreased from before the intervention to 2-year follow-up (median 11 to median 6, P = 0.040). PPTs and SP4 pressure pain at rest did not change from before the intervention to 2-year follow-up, while SP7 decreased from mean 647 kPa to mean 560 kPa (P = 0.006). Segmental EIH during static muscle contraction increased from the assessment before the intervention (from mean 1.02 to mean 1.42, P = 0.001), as did plurisegmental EIH (from mean 0.87 to mean 1.41, P more...
- Published
- 2018
- Full Text
- View/download PDF
7. Effects of acute psychological stress on athletic performance in elite male swimmers
- Author
-
Frida Eek, Cecilia Fridén, and Jacqueline Rano
- Subjects
Adult ,Male ,Hydrocortisone ,Provocation test ,Physiology ,Physical Therapy, Sports Therapy and Rehabilitation ,Athletic Performance ,medicine.disease_cause ,Affect (psychology) ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Stress, Physiological ,Medicine ,Psychological stress ,Humans ,Orthopedics and Sports Medicine ,Testosterone ,Lactic Acid ,Young adult ,Swimming ,Physiological Stress Responses ,business.industry ,Case-control study ,Repeated measures design ,030229 sport sciences ,Case-Control Studies ,business ,030217 neurology & neurosurgery ,Stress, Psychological - Abstract
BACKGROUND: While physical activity has been shown to affect psychological as well as physiological stress responses, less research has explored the effects of acute stress on athletic performance. The current study hence aimed to investigate the effect of an Acute Psychological Stress (APS) provocation on performance and plasma lactate concentration during a following 200m swim race among male elite swimmers. Furthermore, associations between physiological stress responses (salivary cortisol and testosterone), and outcome measures (speed and lactate) were explored.METHODS: Twenty-three elite male swimmers participated in an experimental counterbalanced within-group repeated measures design consisting of an APS provocation followed by a 200m race and, on a separate day, a control race without prior stress exposure. Salivary cortisol and testosterone were collected prior to each race. Race time was recorded, and serum lactate were collected immediately following, and five min after completed race.RESULTS: Race speed was significantly slower (1.53 (95% CI: 0.08-2.79) seconds) following the APS provocation than under control conditions. Pre-race cortisol levels were positively associated with lactate response when preceding stress exposure was present (rho =.483 immediately, and rho=.429 five minutes post race, p's more...
- Published
- 2018
8. Young, talented and injured: Injury perceptions, experiences and consequences in adolescent elite athletes
- Author
-
Philip von Rosen, Anna Frohm, Annette Heijne, Cecilia Fridén, and Anders Kottorp
- Subjects
Male ,Adolescent ,media_common.quotation_subject ,Physical Therapy, Sports Therapy and Rehabilitation ,Athletic injury ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Perception ,Surveys and Questionnaires ,Humans ,Orthopedics and Sports Medicine ,Lack of knowledge ,Elite athletes ,media_common ,030222 orthopedics ,biology ,Athletes ,Youth Sports ,030229 sport sciences ,General Medicine ,biology.organism_classification ,Self Concept ,Elite ,Athletic Injuries ,Female ,Psychology ,Clinical psychology - Abstract
Even though injury is common in elite sports, there is still a lack of knowledge of young athletes' injury perception both during and after injury. The aim of this mixed-method study was, therefore, to explore, in-depth, data on injury consequences and adolescent elite athletes' perceptions and experience of injury. Three hundred and forty adolescent elite athletes (age range 15-19), from 16 different sports, were bi-weekly monitored over 52 weeks using a valid questionnaire. Twenty athletes from the same cohort were interviewed in focus groups about injury experience and perceptions. The results show that the average bi-weekly prevalence of injury was 38.7% (95% CI 37.3-40.1), with 30.0% (n = 102) of the athletes injured for more than half of all reporting times. An overarching theme from the focus groups highlighted the risk among young athletes of a loss of identity while injured. The findings support several suggestions that may improve the rehabilitation process and enhance rehabilitation outcomes: (a) provide clear pathways to the medical team, (b) recognize the identity loss, (c) involve the injured athletes with the rest of the teammates and (d) educate athletes about how to interpret pain signals. Future research should explore and evaluate the effectiveness and generalization of such interventions. more...
- Published
- 2018
9. An Outsourced Health-enhancing Physical Activity Program for People with Rheumatoid Arthritis: Study of the Maintenance Phase
- Author
-
Cecilia Fridén, Ingrid Demmelmaier, Birgitta Nordgren, Christina H. Opava, Thomas Nessen, Gunnar Bergström, Ingrid E. Lundberg, and Alyssa B. Dufour
- Subjects
Male ,medicine.medical_specialty ,Strength training ,Immunology ,Health Behavior ,Arthritis, Rheumatoid ,03 medical and health sciences ,Grip strength ,0302 clinical medicine ,Rheumatology ,HEPA ,medicine ,Immunology and Allergy ,Aerobic exercise ,Humans ,030212 general & internal medicine ,Exercise ,Aerobic capacity ,Aged ,030203 arthritis & rheumatology ,business.industry ,Behavior change methods ,Middle Aged ,medicine.disease ,Self Efficacy ,Exercise Therapy ,Clinical trial ,Rheumatoid arthritis ,Physical therapy ,Quality of Life ,Patient Compliance ,Female ,business ,Follow-Up Studies - Abstract
Objective.To describe changes of health-enhancing physical activity (HEPA), health perception, and functioning during the second year of a 2-year support program, determine aspects of adherence and response, and describe perceptions of the program.Methods.Out of 220 individuals with rheumatoid arthritis (RA), 177 participated in the followup. Group support, strength training, and moderate-intensity aerobic activity were encouraged. Data collection included HEPA, perceived health, functioning, and perceptions of the program. Participants with unchanged/improved general health perception and at least 2 of aerobic capacity, grip strength, or timed standing were considered responders.Results.Current and maintained HEPA decreased from 82% to 75% (p = 0.0141) and from 41% to 27% (p < 0.0001) during the second year. Minor declines in quality of life and activity limitation occurred (p = 0.0395 and 0.0038, respectively), while outcome expectations for benefits of physical activity increased (p = 0.0010 and 0.0186) and waist circumference tapered off (p = 0.0070). Strength training was performed on average 41 and 35 times among responders (n = 54) and nonresponders (n = 105), respectively (p = 0.2708); HEPA 194 and 171 days, respectively (p = 0.0828); and support group meetings 12 and 10 times, respectively (p = 0.0943). Strength training, aerobic activity, and short text message reminders were perceived as most valuable; step registration and the self-monitoring walk tests were less appreciated.Conclusion.About one-fourth of the originally sedentary individuals with RA sustained their new HEPA behaviors after 2 years and most improvements of health and functioning were sustained. Structured use of behavior change techniques and a second year to support maintenance with a reduced program might help patients with RA to sustain HEPA behavior. more...
- Published
- 2018
10. Enhanced ventricular-arterial coupling during a 2-year physical activity programme in patients with rheumatoid arthritis : a prospective substudy of the physical activity in rheumatoid arthritis 2010 trial
- Author
-
Cecilia Fridén, Ingrid E. Lundberg, Ashwin Venkateshvaran, Lars Lund, Philip Sarajlic, Susanna C. Larsson, Aristomenis Manouras, Birgitta Nordgren, Christina H. Opava, and Magnus Bäck
- Subjects
Cardiac function curve ,Male ,medicine.medical_specialty ,pulse wave velocity ,Diastole ,Inflammation ,Blood Pressure ,030204 cardiovascular system & hematology ,augmentation index ,Arthritis, Rheumatoid ,03 medical and health sciences ,Ventricular Dysfunction, Left ,0302 clinical medicine ,Vascular Stiffness ,Internal medicine ,Internal Medicine ,medicine ,Aerobic exercise ,Humans ,echocardiography ,Prospective Studies ,Sjukgymnastik ,Pulse wave velocity ,Exercise ,Physiotherapy ,Aged ,030203 arthritis & rheumatology ,business.industry ,Resistance Training ,Middle Aged ,medicine.disease ,Exercise Therapy ,Blood pressure ,Echocardiography ,inflammation ,Rheumatoid arthritis ,Cohort ,Cardiology ,Physical therapy ,Female ,Vascular Resistance ,medicine.symptom ,business - Abstract
Objective To establish how guided physical activity in patients with rheumatoid arthritis (RA) without known cardiovascular disease affected vascular and cardiac function, and how these two entities were prospectively interconnected in this patient group. Methods Prospective substudy of 29 participants in the Physical Activity in RA (PARA) 2010 trial. All subjects were examined at baseline, at year 1 and 2 with measures of pulse wave velocity and arterial augmentation index, as well as echocardiographic evaluation of diastolic parameters and ventricular-arterial coupling. Muscle strength and aerobic exercise capacity were assessed at baseline and yearly. All participants performed physiotherapist-guided aerobic and muscle strength exercise during two years and were reminded through SMS to report physical activity progress. Results This cohort of patients with RA exhibited increased vascular stiffness despite normal blood pressure. At baseline, lower muscle strength was associated with increased vascular stiffness (β = 0.68; P = 0.004), whereas lower aerobic working capacity was associated with left ventricular diastolic dysfunction (β = 0.85; P = 0.03). There was a significant positive correlation between vascular stiffness and diastolic dysfunction at baseline (R2 = 0.64) and for the changes in those parameters observed during two years of guided physical activity. Finally, a significant improvement in ventricular-arterial coupling was observed after exercise (P < 0.001). Conclusion These results indicate that although differentially associated with physical capacity parameters, improved vascular stiffness, and improved diastolic dysfunction are interrelated, and that an optimization of the ventricular-arterial coupling may contribute to the beneficial effects of physical activity in RA patients. This article is protected by copyright. All rights reserved. more...
- Published
- 2018
11. Multiple factors explain injury risk in adolescent elite athletes : applying a biopsychosocial perspective
- Author
-
P. von Rosen, Annette Heijne, Anders Kottorp, Cecilia Fridén, and Anna Frohm
- Subjects
Biopsychosocial model ,Male ,medicine.medical_specialty ,Youth ,Adolescent ,Self concept ,617: Chirurgie ,Poison control ,Physical Therapy, Sports Therapy and Rehabilitation ,Survey and questionnaire ,Stress ,Occupational safety and health ,03 medical and health sciences ,0302 clinical medicine ,Athlete ,Risk Factors ,Surveys and Questionnaires ,Injury prevention ,Self-esteem ,Medicine ,Humans ,Orthopedics and Sports Medicine ,Young adult ,Sweden ,Athletic injury ,business.industry ,Proportional hazards model ,Hazard ratio ,Human factors and ergonomics ,030229 sport sciences ,Diet ,Human physical conditioning ,Athletes ,Athletic Injuries ,Physical therapy ,Female ,Risk factor ,business ,Sleep ,Regression analysis ,030217 neurology & neurosurgery ,Demography ,Physical Conditioning, Human ,Human ,Sports - Abstract
Many risk factors for injury are presented in the literature, few of those are however consistent and the majority is associated with adult and not adolescent elite athletes. The aim was to identify risk factors for injury in adolescent elite athletes, by applying a biopsychosocial approach. A total of 496 adolescent elite athletes (age range 15-19), participating in 16 different sports, were monitored repeatedly over 52 weeks using a valid questionnaire about injuries, training exposure, sleep, stress, nutrition, and competence-based self-esteem. Univariate and multiple Cox regression analyses were used to calculate hazard ratios (HR) for risk factors for first reported injury. The main finding was that an increase in training load, training intensity, and at the same time decreasing the sleep volume resulted in a higher risk for injury compared to no change in these variables (HR 2.25, 95% CI, 1.46-3.45, P more...
- Published
- 2017
12. An outsourced health-enhancing physical activity programme for people with rheumatoid arthritis: exploration of adherence and response
- Author
-
Gunnar Bergström, Cecilia Fridén, Ingrid Demmelmaier, Ingrid E. Lundberg, Birgitta Nordgren, Christina H. Opava, and Alyssa B. Dufour
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,sports ,medicine.medical_treatment ,Health Behavior ,Physical fitness ,Physical strength ,Support group ,Arthritis, Rheumatoid ,Young Adult ,Rheumatology ,health behaviour ,HEPA ,medicine ,Humans ,Pharmacology (medical) ,Aged ,Circuit training ,exercise ,business.industry ,clinical trial ,self-efficacy social cognitive theory ,Clinical Science ,Middle Aged ,Self Efficacy ,Exercise Therapy ,Clinical trial ,Treatment Outcome ,physical fitness ,Quality of Life ,sports.sport ,Physical therapy ,Patient Compliance ,Female ,Self Report ,trans-theoretical model ,business ,muscular strength ,Psychosocial ,Cohort study - Abstract
Objectives. The aims of this study were to document adherence to and changes in health-enhancing physical activity (HEPA) levels and self-reported and assessed functioning and to explore aspects of adherence and response during the first year of an outsourced 2-year HEPA programme in people with RA. Methods. Two-hundred and twenty patients participated in this observational cohort study, which included daily physical activity, twice-weekly circuit training and biweekly support group meetings. Self-reported data included current (past week) and maintained (past 6 months) HEPA levels, sociodemographics and disease-related and psychosocial factors. Tests of aerobic capacity and muscle function were performed and anthropometric data were collected. Results. Eighty-eight per cent of the participants completed 1 year assessments. Self-reported current and maintained HEPA increased. General health perception and a number of other self-reported disease-related and psychosocial factors improved, while exercise self-efficacy declined. Aerobic capacity, timed standing and grip strength improved and waist circumference decreased. The mean number of circuit training sessions performed was 48, the mean number of days with HEPA was 189 and the mean number of support group meetings attended was 9. Better adherence to circuit training improved general health, and better adherence to group meetings improved timed standing. Exercise self-efficacy improved among those adhering more to circuit training or support group meetings. Conclusion. The outsourced HEPA programme had high retention and reasonable adherence. A number of health outcomes improved. Relationships between adherence to the programme components and response were not clear-cut and need further attention. Trial registration: ISRCTN register; http://www.controlled-trials.com. Trial registration number ISRCTN25539102. more...
- Published
- 2014
- Full Text
- View/download PDF
13. Who Makes It to the Base? Selection Procedure for a Physical Activity Trial Targeting People With Rheumatoid Arthritis
- Author
-
Cecilia Fridén, Ingrid Demmelmaier, Birgitta Nordgren, and Christina H. Opava
- Subjects
Male ,medicine.medical_specialty ,Physical activity ,Rheumatoid Arthritis ,Motor Activity ,Arthritis, Rheumatoid ,Physical medicine and rehabilitation ,Rheumatology ,Surveys and Questionnaires ,medicine ,Humans ,Prospective Studies ,Motor activity ,Prospective cohort study ,Exercise ,Selection (genetic algorithm) ,Aged ,business.industry ,Patient Selection ,Exercise therapy ,Middle Aged ,medicine.disease ,Exercise Therapy ,Rheumatoid arthritis ,Physical therapy ,Female ,business - Abstract
Objective To compare those who were finally included in a large well-defined sample of individuals with rheumatoid arthritis (RA) at target for a physical activity (PA) trial with those who were not. Methods In total, 3,152 individuals answered questionnaires on sociodemographic, disease-related, and psychosocial factors and PA levels. The differences between individuals making it to the baseline assessments and those who did not were analyzed in 3 steps. Results In a first step, 1,932 individuals were eligible for the trial if they were interested in participating, not physically active enough, and fluent in Swedish and if they were not participating in any other study. The participants were mainly younger women, had higher education and income, were more likely to live with children, and had better support for exercise and had higher outcome expectations of PA than the 1,208 ineligible individuals. In a second step, the 286 individuals accepting participation had higher income and education, more support for exercise, less fear-avoidance beliefs, and higher outcome expectations of PA than the 1,646 individuals declining participation. In a third step, the 244 individuals assessed at baseline reported less fatigue than the 42 withdrawing before assessment. Conclusion To our knowledge, this is the first study describing the entire selection procedure, from a target sample for a PA trial to the sample assessed at baseline, in individuals with RA. Factors other than those related to the disease seemed to mainly determine participation and largely resembled determinants in the general population. Sociodemographic and psychosocial factors should be recognized as important for PA in people with RA. more...
- Published
- 2014
- Full Text
- View/download PDF
14. Musculoskeletal Pain and Related Risks in Skydivers: A Population-Based Survey
- Author
-
Cecilia Fridén, Viktoria Burén, Björn O. Äng, Jenny Nilsson, Peter Lindholm, and Anton Westman
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Population ,Poison control ,Occupational safety and health ,Young Adult ,Musculoskeletal Pain ,Risk Factors ,Shoulder Pain ,Surveys and Questionnaires ,Injury prevention ,Epidemiology ,Prevalence ,Humans ,Medicine ,education ,Sweden ,Neck pain ,education.field_of_study ,Neck Pain ,business.industry ,Public Health, Environmental and Occupational Health ,Human factors and ergonomics ,Logistic Models ,Back Pain ,Parachuting ,Physical therapy ,Female ,medicine.symptom ,Aviation ,business ,Sports - Abstract
INTRODUCTION: Sport parachuting from aircraft (skydiving) is a major aerial activity in which parachutists are subject to decelerating forces during parachute opening shock (POS), possibly as much as 3-5 G. While traumatic incidents related to POS have been reported, epidemiological data on musculoskeletal pain among skydivers is absent in the literature. The aim was therefore to examine the prevalence of self-rated musculoskeletal pain related to POS in a skydiver population and elicit related risk factors. METHODS: There were 658 Swedish sport skydivers who completed a structured web-based questionnaire (70% response rate; email invitation) validated for use in skydivers. The questionnaire concerned individual and skydiving-related risk indicators, and musculoskeletal pain experiences. Multiple regression analysis was used to estimate the relationship between risk indicators and musculoskeletal pain related to POS. RESULTS: The 12-mo prevalence of musculoskeletal pain related to POS was highest for the neck region, 25% (95% CI = 21.4-28.2). Other upper-body regions were as follows: shoulder 16% thoracic spine 10%, and lower back 18%. A high number of parachute jumps in the last 12 mo, i.e., 30-90 jumps (RR = 1.7, 95% CI = 1.1-2.7), > 90 jumps (RR = 2.1, 95% CI = 1.3-3.4), and a high main parachute wing-loading, i.e., > 1.4 lb/ft2 (RR = 1.7, 95% CI = 1.1-2.6) were independent risk factors. CONCLUSIONS: Neck pain related to POS was common among skydivers. A high number of parachute jumps the last 12 mo and high wing-loading emerged as risk factors, suggesting that highly active skydivers using small canopies may be at risk. Studies on biomechanics under POS are suggested. Language: en more...
- Published
- 2013
- Full Text
- View/download PDF
15. Criterion validation of two submaximal aerobic fitness tests, the self-monitoring Fox-walk test and the Åstrand cycle test in people with rheumatoid arthritis
- Author
-
Wilhelmus Johannes Andreas Grooten, Anette Rickenlund, Eva Jansson, Ted Österlund, Birgitta Nordgren, Christina H. Opava, and Cecilia Fridén
- Subjects
Adult ,Male ,medicine.medical_specialty ,Physical fitness ,Walking ,Aerobic power ,Arthritis, Rheumatoid ,Oxygen Consumption ,Rheumatology ,Aerobic capacity ,Heart rate ,medicine ,Humans ,Aerobic exercise ,Orthopedics and Sports Medicine ,Exercise physiology ,Exercise ,Peak oxygen uptake ,Aged ,business.industry ,VO2 max ,Middle Aged ,medicine.disease ,Test (assessment) ,Self Care ,Physical Fitness ,Rheumatoid arthritis ,Maximal oxygen uptake ,Exercise Test ,Physical therapy ,Female ,business ,human activities ,Research Article - Abstract
Background Aerobic capacity tests are important to evaluate exercise programs and to encourage individuals to have a physically active lifestyle. Submaximal tests, if proven valid and reliable could be used for estimation of maximal oxygen uptake (VO2max). The purpose of the study was to examine the criterion-validity of the submaximal self-monitoring Fox-walk test and the submaximal Åstrand cycle test against a maximal cycle test in people with rheumatoid arthritis (RA). A secondary aim was to study the influence of different formulas for age predicted maximal heart rate when estimating VO2max by the Åstrand test. Methods Twenty seven subjects (81% female), mean (SD) age 62 (8.1) years, diagnosed with RA since 17.9 (11.7) years, participated in the study. They performed the Fox-walk test (775 meters), the Åstrand test and the maximal cycle test (measured VO2max test). Pearson’s correlation coefficients were calculated to determine the direction and strength of the association between the tests, and paired t-tests were used to test potential differences between the tests. Bland and Altman methods were used to assess whether there was any systematic disagreement between the submaximal tests and the maximal test. Results The correlation between the estimated and measured VO2max values were strong and ranged between r = 0.52 and r = 0.82 including the use of different formulas for age predicted maximal heart rate, when estimating VO2max by the Åstrand test. VO2max was overestimated by 30% by the Fox-walk test and underestimated by 10% by the Åstrand test corrected for age. When the different formulas for age predicted maximal heart rate were used, the results showed that two formulas better predicted maximal heart rate and consequently a more precise estimation of VO2max. Conclusions Despite the fact that the Fox-walk test overestimated VO2max substantially, the test is a promising method for self-monitoring VO2max and further development of the test is encouraged. The Åstrand test should be considered as highly valid and feasible and the two newly developed formulas for predicting maximal heart rate according to age are preferable to use when estimating VO2max by the Åstrand test. Electronic supplementary material The online version of this article (doi:10.1186/1471-2474-15-305) contains supplementary material, which is available to authorized users. more...
- Published
- 2014
- Full Text
- View/download PDF
16. Long-term health-enhancing physical activity in rheumatoid arthritis - the PARA 2010 study
- Author
-
Birgitta Nordgren, Christina H. Opava, Ingrid Demmelmaier, Cecilia Fridén, and Gunnar Bergström
- Subjects
Male ,medicine.medical_treatment ,Social Cognitive Theory ,Arthritis ,Arthritis, Rheumatoid ,Cohort Studies ,Study Protocol ,Behavior change ,Surveys and Questionnaires ,Epidemiology ,Health care ,Health Status Indicators ,Longitudinal Studies ,Registries ,Fatigue ,Perceived health ,Rehabilitation ,Intervention study ,Muscles ,lcsh:Public aspects of medicine ,Middle Aged ,Self Efficacy ,Self-Help Groups ,Treatment Outcome ,Cardiovascular Diseases ,Rheumatoid arthritis ,Longitudinal study ,Attitude to Health ,Cohort study ,Adult ,medicine.medical_specialty ,Exercise therapy ,Pain ,Health Promotion ,Young Adult ,medicine ,Humans ,Intensive care medicine ,Exercise ,Aged ,Sweden ,business.industry ,Public health ,Public Health, Environmental and Occupational Health ,lcsh:RA1-1270 ,medicine.disease ,Resistance training ,Muscle function ,Physical therapy ,business - Abstract
Background People with rheumatoid arthritis (RA) suffer increased risk of disability andpremature mortality. Health-enhancing physical activity (HEPA) could be one importantfactor to reduce this risk. Rising health care costs call for the development and evaluation ofnew modes of rehabilitation, including physical activity in settings outside the health caresystem. Methods/Design This cohort study targets 450 patients with RA that do not currently meet HEPA recommendations, recruited from six hospitals reporting to the Swedish Rheumatology Quality Registers (SRQ). We have developed a two-year real-life intervention program including a minimum of twice-weekly circuit training, moderately intense physical activity the remaining days of the week and group meetings to support behavior change every other week. Our hypothesis is that increased physical activity and exercise will improve perceived health, reduce pain and fatigue, increase muscle function and aerobic capacity, impact psychosocial factors and prevent future cardiovascular events. Research questions regard outcomes, retention rates, dose–response matters and the exploration of responder characteristics. This protocol outlines recruitment procedure, design, assessment methods and the intervention program of the study. Discussion The PARA 2010 project is designed to expand the knowledge on HEPA in RA by a progressive approach regarding population, setting, intervention, time frames and outcome measures. To our knowledge this is the first long-term HEPA program based on Social Cognitive Theory, and performed in a real life environment to demonstrate if this new setting can promote increased and maintained physical activity in people with RA. Trial registration number ISRCTN25539102 more...
- Published
- 2012
17. Reliability of the Fox-walk test in patients with rheumatoid arthritis
- Author
-
Cecilia Fridén, Cornelia Antonia Verberkt, Christina H. Opava, and Wilhelmus Johannes Andreas Grooten
- Subjects
Adult ,Male ,medicine.medical_specialty ,Psychometrics ,Intraclass correlation ,Quality of nursing and allied health care [NCEBP 6] ,Physical fitness ,Arthritis ,Walking ,Motor Activity ,Severity of Illness Index ,Arthritis, Rheumatoid ,Disability Evaluation ,Oxygen Consumption ,Surveys and Questionnaires ,Medicine ,Humans ,Reliability (statistics) ,Aged ,Exercise Tolerance ,business.industry ,Rehabilitation ,Reproducibility of Results ,Middle Aged ,medicine.disease ,Test (assessment) ,Standard error ,Rheumatoid arthritis ,Physical therapy ,Exercise Test ,Quality of Life ,Female ,business - Abstract
Item does not contain fulltext PURPOSE: The Fox-walk test is a new method used to estimate aerobic capacity outside a clinical environment, which may be useful in the implementation of daily health-enhancing physical activity. The aim of our study was to investigate the reliability of the test in people with rheumatoid arthritis (RA). METHOD: Fifteen participants performed the Fox-walk test three times with weekly intervals. The intraclass correlation coefficient (ICC), the standard error of measurement (SEM) and the smallest detectable change (SDC) were used to estimate the reliability. General health perception, lower limb pain and fatigue were measured to determine their potential influence on the reliability. RESULTS: There were no systematic differences between the three test occasions (p = 0.190) and the reliability was almost perfect (ICC = 0.982). None of the covariates influenced the reliability. The SEM was 0.999 ml/kg/min or 3.4% and the SDC was 2.769 ml/kg/min or 9.4%. CONCLUSIONS: These findings demonstrate that the Fox-walk test is reliable in people with RA and enables differentiation between people with RA and monitoring progress. The validity of the test among people with RA is still to be determined. IMPLICATIONS FOR REHABILITATION: * The Fox-walk test is a new method to estimate aerobic capacity and could be performed walking or running. * The test is self administered without expensive equipment and is available in 150 public places in Sweden and several other European countries. * The Fox-walk test is a reliable test for use among people with rheumatoid arthritis monitoring the progress of their physical activity. more...
- Published
- 2012
18. Ankle-joint mobility and standing squat posture in elite junior cross-country skiers. A pilot study
- Author
-
Conradsson D, Cecilia Fridén, Nilsson-Wikmar L, and Bo, Ang
- Subjects
Male ,Young Adult ,Adolescent ,Arthrometry, Articular ,Skiing ,Posture ,Humans ,Female ,Pilot Projects ,Range of Motion, Articular ,Ankle Joint - Abstract
Skating technique in cross-country skiing is a complex multi-joint movement with kinematics comparable to those of the standing squat exercise where any restricted joint mobility in the lower extremity-chain may change the movement pattern. The aim of this pilot study was to investigate the effect of ankle mobility on trunk posture during squat exercise in cross-country skiers.Seven elite junior cross-country skiers (age range 17-19 years) performed two different standing squats, one with hands on hips and one with arms extended above the head. The squats were recorded on video and analyzed in selected positions: 90 degrees and maximal knee flexion. Segment angles for shank and trunk were calculated from anatomical references relative to vertical/horizontal orientation in space. Recordings from passive ankle dorsiflexion were correlated with 1) trunk flexion, and 2) angle index (trunk flexion relative to shank angle).Reduced ankle dorsiflexion was moderately associated with increased trunk flexion with hands on hips (r=-0.51 to -0.57), and arms above head (r=-0.61 to -0.64). Further, reduced dorsiflexion was also moderately associated with decreased angle index with hands on hip (r=0.60 to 0.67) but highly associated with decreased angle index with arms above head (r=0.75 to 0.76).The results imply that reduced ankle dorsal mobility is related to decreased angle index as well as increased trunk flexion during squat exercise, thus indicating the relevance of good ankle joint mobility for appropriate upper-body posture during squat exercise. more...
- Published
- 2010
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.