Gunvor Gard

The interest for effective preventive strategies for slips and falls is growing. Much remains to be done, however, to prevent slips and falls in the traffic environment. Some pedestrians are injured because of slippery pavements and roadways. Using an appropriate anti-skid device may reduce the risk of slips and falls on different surfaces outdoors during winter. The aim of this study was to evaluate new anti-skid devices on the Swedish market representing three different designs of anti-skid devices; heel device, fore-foot device and whole-foot device on different slippery surfaces, gravel, sand, salt, snow and ice. The evaluations were done according to subject's perceived walking safety and balance, videorecordings of walking postures and movements, time to take on and off each anti-skid device, advantages/disadvantages with each anti-skid device and a list of priority for own use according to three criteria; safety, balance and appearance. Practical tests were carried out on different slippery surfaces, gravel, sand, salt, snow and ice. The subject's were randomly selected from the registered population over 55 years in a city in northern Sweden. The results showed that eight or more of the ten subjects perceived all four anti-skid devices as fairly good or good regarding walking safety and balance when walking on gravel, sand, and salt. Anti-skid device 3, a whole-foot device was perceived as having none or bad walking safety and balance on snow by seven subjects and anti-skid device 4, a heel device, as having none or bad walking balance on ice by all ten subjects. Eight subjects walked with a normal muscle function in the hip and knee with all anti-skid devices on all surfaces. Small deviations in walking posture and movements were noted in one to two subjects when walking on different surfaces, but no systematic difference between the devices. Anti-skid device 1 'Rewa', a fixed heel device, was perceived as the most rapid one to take on. All four devices were perceived as easy to use and as giving good foothold. Anti-skid device 1 'Rewa' and 4 'Thulin-spike', both heel devices, had the highest priority according to walking safety. 'Rewa' also had the highest priority according to walking balance as well as own use. When combining the criterias 'Rewa' had the highest priority according to walking safety and balance, priority for own use, time to take on and easiness to use.

Tension-type headaches (TTH) are common among children worldwide and mean a potential risk of disability and medication overuse headache. The associated mechanisms, however, remain unsolved. Our study investigated muscle strength in the neck-shoulder region, aerobic power and pericranial tenderness in girls with TTH compared with healthy controls. A blinded case-control study comprising 41 girls with TTH and 41 age-matched healthy controls. Standardised testing of isometric maximal voluntary contraction (MVC) and force steadiness of neck flexion and extension, as well as MVC and rate-of-force development of dominant shoulder, was conducted. VO2 max was recorded by a submaximal ergometer test and pericranial tenderness by standardised manual palpation. Logistic regression analyses were applied. Girls with TTH demonstrated significantly higher pericranial tenderness than controls, in correlation with headache frequency ( R = 0.66, P < 0.001). Results indicated that the odds ratio o...

Computers are used in the outdoors and in connection with cold store work. Cold hand and fingers limit data input, as studied here. Six input devices; trackballs, pens, and a mouse were tested by 19 participants in a Fitts' target acquisition task with 2 target sizes under 2 experimental conditions; warm and cold right hand. Measures were acquisition times, number of errors, participant's preferences, and observed handling of the devices. Effects of device, target size, and cold were significant. Learning and attempts to improve handgrip were confirmed. Large enough targets, a thick pen, and a mouse make computer work practicable in the cold. Direct visual feedback, as with pen on template with target images, shortened acquisition times by half a second.

Systemic Sclerosis (SSc) is an autoimmune disease where thickening of the skin can lead to reduced body function and limitations in activities. Severe forms can also affect and seriously damage inner organs. Patient--centred rehabilitation emphasises considerations of patients' background, experience and behaviour which highlights the need to know if patient--reported outcome measures (PROMs) include such personal factors. To identify and describe personal factors in the experiences of functioning and health of persons with SSc and to examine if and to what extent PROMs in SSc--research cover these factors. Data from a qualitative study with focus group interviews in patients with SSc were analysed and PROMs in SSc--research were identified in a literature review between 2008--2013. Outpatient clinics at rheumatology department in four European countries. Data from interviews with 63 participants were analysed using a structure of personal factors developed by Geyh et al. Identi...

To assess self-reported activity limitations in a clinical sample of stroke patients and to identify their association with prevalence, severity and impact on daily life of lower urinary tract symptoms (LUTS). A cross-sectional, clinical survey was initiated whereby stroke patients were invited to complete four activity limitations measurements: Barthel Index, mobility velocity, mobility distance, mobility aids and one LUTS measurement: the Danish Prostatic Symptom Score (DAN-PSS-1) questionnaire. Of 519 stroke patients, 482 subjects were eligible. The response rate was 84%. The activity limitations were reported by 17-34% depending on the measurement. Mobility velocity was highly significantly associated (p=0.01) with severity of LUTS. In the LUTS incontinence symptom group, Barthel Index and mobility velocity were significantly associated with prevalence [p=0.03, odds ratio (OR) 2.08 and p=0.05, OR 1.87, respectively]. Barthel Index and mobility distance were also associated with severity (p=0.03 and p=0.04, respectively) and Barthel Index was associated with the prevalence of bother (p=0.02, OR 2.12). This study indicate for the first time that activity limitations are closely related to LUTS in stroke patients and that rehabilitation should also be directed towards the treatment of LUTS.

This study aimed to assess self-reported well-being in a clinical sample of stroke patients and to identify possible associations with prevalence, severity and bother of lower urinary tract symptoms (LUTS). A cross-sectional, clinical survey was initiated whereby stroke patients were invited to complete The WHO-Five Well-Being Index (WHO-5) and a LUTS instrument, the Danish Prostatic Symptom Score (DAN-PSS-1) questionnaire. Of 519 stroke patients invited, 482 subjects were eligible and 407 (84%) respondents answered the questionnaires. Poor well-being (sum score <13) was reported by 22% of all stroke patients, for women 29% and for men 14%. Depression (sum score <8) was reported by 10%, for women 11% and for men 8%. Poor well-being was significantly (p < 0.01) associated with severity and bother of LUTS. Likewise, poor well-being was significantly (p < 0.001) associated with the prevalence of four different symptom groups of LUTS. The results indicate that poor well-being is present in stroke patients with LUTS, especially in women. Likewise, the data showed significant association between poor well-being and LUTS. Screening for well-being and LUTS in stroke patients is strongly recommended.

The aims of this study were to explore and generate an understanding of the meaning of body awareness through explanations of the experience of body awareness given by professionals and patients in psychiatric rehabilitation. A total of 20 strategically selected healthy informants were interviewed individually and in groups. Thirteen previous interviews with physiotherapists and 11 previous interviews with patients in psychiatric rehabilitation, describing their experiences of body awareness therapy and its effects were reanalyzed and included in the data for this study; in all 44 informants were included. Grounded theory methods guided the data construction and analysis. A theoretical understanding was conceptualised from which a core category of body awareness emerged: the embodied identity. This core category was related to two categories: living in the body and living in relation to others and in society. The subcategory "living in the body" was conceived as an important aspect to become more aware of the body and to experience oneself fromwithin in order to recognize one's needs. A key point was the fact that bodily experiences always exists in the present moment. The experience of the body, the balance, and stability of the physical self were basic experiences that were connected to the conception of well-being and control. To understand…

Page 1. Published by Maney Publishing (c) WS Maney & Son Limited Relaxation as treatment for chronic musculoskeletal pain – a systematic review of randomised controlled studies Ann L. Persson1, Hanna Veenhuizen2, Liv Zachrison2 and Gunvor Gard2 ...

Refugees have often been exposed to torture in their countries of origin. Rehabilitation of tortured refugees living in Denmark is offered by the specialized Rehabilitation and Research Centre for Torture Victims in Copenhagen. After an interdisciplinary assessment eligible patients are recommended rehabilitation. To explore tortured refugees' expectations of the multidisciplinary pain rehabilitation programme offered at our centre. Explorative qualitative interview study. Fifteen consecutive Arabic-speaking men, waiting for rehabilitation after having been assessed by a physician, a psychologist, a physiotherapist and a social worker, were interviewed. Individual qualitative interviews were performed by an Arabic-speaking psychologist, and analysed with content analyses. One theme: different expectations of multidisciplinary pain rehabilitation and 4 categories emerged: general expectations of the rehabilitation programme; specific expectations of professional treatment; expectations of mutual participation and communication; and expected rehabilitation outcomes. The tortured refugees had different, mostly positive, expectations of the multidisciplinary pain rehabilitation programme. General expectations of the rehabilitation content, as well as specific expectations of the professionals' treatment, were expressed. Mutual and active participation and communication between patients and therapists were important expectations. In addition, positive outcomes, such as improved health, improved coping ability and decreased pain, were expected.

Tension-type headaches (TTH) are common among children worldwide and mean a potential risk of disability and medication overuse headache. The associated mechanisms, however, remain unsolved. Our study investigated muscle strength in the neck-shoulder region, aerobic power and pericranial tenderness in girls with TTH compared with healthy controls. A blinded case-control study comprising 41 girls with TTH and 41 age-matched healthy controls. Standardised testing of isometric maximal voluntary contraction (MVC) and force steadiness of neck flexion and extension, as well as MVC and rate-of-force development of dominant shoulder, was conducted. VO2 max was recorded by a submaximal ergometer test and pericranial tenderness by standardised manual palpation. Logistic regression analyses were applied. Girls with TTH demonstrated significantly higher pericranial tenderness than controls, in correlation with headache frequency (r = 0.66, p < 0.001). Results indicated that the odds ratio of girls having headache are 7.6 (95% CI 1.4-40.9) for weak to strong shoulder muscles; weak to average neck-shoulder strength OR 3.1 (95% CI 1.2-8.1); neck flexion strength OR 1.3 (95% CI 1.0-1.6) and 5.2 (95% CI: 1.4-19.6) for each unit of decrease in VO2 max. Reduced neck-shoulder strength and aerobic power together with increased pericranial tenderness are associated with TTH in girls. Future interventions should be directed towards health promoting patient educational programmes on enhanced physical exercising. Much more exact and detailed research in young girls and boys are needed.

An integrated IT technology, characterized by a change in information support from a strong specialization towards greater integration has been introduced within the surveying company in Sweden. The aim of this study is to compare and describe effects of the transition to this new information technology in relation to job and organizational characteristics and effectiveness and well-being measures between 1998

Within administrative surveying work in Sweden, a transition to a client-centered team-based organization was made during 1998. The aim of this study was to describe the employees' perceptions and expectations of job and organizational practices when working as a generalist in a client-centered team-based organization; job and organizational practices and well-being and effectiveness measures were examined when introducing a team-based organization. Interventions such as courses in how to cope with the role of a generalist, how to increase service to clients, education in technology, law and economics, as well as computer information support, were ongoing at the time of the study. The Team Work Profile and QPS Nordic questionnaires were used. All the surveyors in five regions in Sweden participated, in total 640 surveyors. The transition to a client-centered team-based organization was expected to improve job control and job content but at the same time lead to impairments in job climate and group cohesion. Distress was associated with negative future expectations of the organization. High job control and group cohesion were the central contributors towards growth in personal competence and social effectiveness of teamwork. Both internal and external client-related activities of team and organization were in focus during the transition.