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  • 1.
    Brorsson, Sofia
    et al.
    Högskolan i Halmstad, Akademin för ekonomi, teknik och naturvetenskap, Bio- och miljösystemforskning (BLESS).
    Hilliges, Marita
    Högskolan i Halmstad, Akademin för ekonomi, teknik och naturvetenskap, Bio- och miljösystemforskning (BLESS).
    Sollerman, Christer
    Department of Hand Surgery, Sahlgrenska University Hospital, Göteborg.
    Nilsdotter, Anna
    R & D Center, Spenshults Hospital of Rheumatic Diseases .
    A six-week hand exercise programme improves strength and hand function in patients with rheumatoid arthritis2009Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 41, nr 5, s. 338-342Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE:

    To evaluate the effects of hand exercise in patients with rheumatoid arthritis, and to compare the results with healthy controls.

    METHODS:

    Forty women (20 patients with rheumatoid arthritis and 20 healthy controls) performed a hand exercise programme. The results were evaluated after 6 and 12 weeks with hand force measurements (with a finger extension force measurement device (EX-it) and finger flexion force measurement with Grippit). Hand function was evaluated with the Grip Ability Test (GAT) and with patient relevant questionnaires (Disability of the Arm, Shoulder, and Hand (DASH) and Short Form-36). Ultrasound measurements were performed on m. extensor digitorum communis for analysis of the muscle response to the exercise programme.

    RESULTS:

    The extension and flexion force improved in both groups after 6 weeks (p < 0.01). Hand function (GAT) also improved in both groups (p < 0.01). The rheumatoid arthritis group showed improvement in the results of the DASH questionnaire (p < 0.05). The cross-sectional area of the extensor digitorum communis increased significantly in both groups measured with ultrasound.

    CONCLUSION:

    A significant improvement in hand force and hand function in patients with rheumatoid arthritis was seen after 6 weeks of hand training; the improvement was even more pronounced after 12 weeks. Hand exercise is thus an effective intervention for rheumatoid arthritis patients, leading to better strength and function.

  • 2.
    Brorsson, Sofia
    et al.
    Högskolan i Halmstad, Akademin för ekonomi, teknik och naturvetenskap, Bio- och miljösystemforskning (BLESS).
    Nilsdotter, Anna
    Department of Research and Education, Halmstad County Hospital, Halmstad, Sweden.
    Pedersen, Eja
    Högskolan i Halmstad, Akademin för ekonomi, teknik och naturvetenskap, Bio- och miljösystemforskning (BLESS).
    Bremander, Ann
    Högskolan i Halmstad, Akademin för ekonomi, teknik och naturvetenskap, Bio- och miljösystemforskning (BLESS).
    Thorstensson, Carina
    Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden.
    Relationship between finger flexion and extension force in healthy women and women with rheumatoid arthritis2012Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 44, nr 7, s. 605-608Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: Balance between flexor and extensor muscle activity is essential for optimal function. The purpose of this pilot study was to compare the relationship between maximum finger flexion force and maximum finger extension force in women with rheumatoid arthritis and healthy women.

    METHODS: Twenty healthy women (median age 61 years) and 20 women with rheumatoid arthritis (median age 59.5 years, median disease duration 16.5 years) were included in the study. Finger extension force was measured with an electronic device, EX-it, and finger flexion force using Grippit. The Grip Ability Test and the score from the patient-reported outcome Disability Arm Shoulder and Hand were used to evaluate activity limitations.

    RESULTS: Patients with rheumatoid arthritis showed significantly decreased hand function compared with healthy controls. A correlation was found between extension force and flexion force in the healthy group (r = 0.65, p = 0.002),but not in the rheumatoid arthritis group (r = 0.25, p = 0.289).

    CONCLUSION: Impaired hand function appears to influence the relationship between maximum finger flexion and extension force. This study showed a difference in the relationship between maximum finger flexion and extension force in healthy controls and those with rheumatoid arthritis. © 2012 Foundation of Rehabilitation Information.

  • 3.
    Grotle, Margreth
    et al.
    Diakonhjemmets hospital, Oslo, Norway.
    Klokkerud, Mari
    Diakonhjemmets hospital, Oslo, Norway.
    Kjeken, Ingvild
    Diakonhjemmets hospital, Oslo, Norway.
    Bremander, Ann
    Högskolan i Halmstad, Akademin för ekonomi, teknik och naturvetenskap, Bio- och miljösystemforskning (BLESS).
    Hagel, Sofia
    Lund University, Lund, Sweden.
    Strömbeck, Britta
    Lund University, Lund, Sweden.
    Hørslev-Petersen, Kim
    King Christian Xth Hospital for Rheumatic Diseases, Gråsten, Denmark.
    Meesters, Jorit
    Leiden University Medical Center, Leiden, The Netherlands.
    Vliet Vlieland, Thea P. M.
    Leiden University Medical Center, Leiden, The Netherlands.
    Hagen, Kåre B.
    Diakonhjemmets hospital, Oslo, Norway.
    What’s in the black box of arthritis rehabilitation?: A comparison of rehabilitation practice for patients with inflammatory arthritis in Northern Europe2013Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 45, nr 5, s. 458-466Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: In evaluating complex interventions, it is a challenge for researchers to provide transparent reporting of the intervention content with sufficient detail and clarity such that effects can be compared across studies or countries.

    OBJECTIVE: To describe and compare the content of current rehabilitation for patients with inflammatory arthritis across 4 northern European countries. Patients and methods: A total of 731 patients with inflammatory rheumatic diseases participated in a multicentre, longitudinal observational study carried out in Sweden, The Netherlands, Denmark and Norway. Data on context, structure and process were reported by patients and teams at the different participating study sites according to the Scandinavian Team Arthritis Register – European Team Intiative for Care Research (STAR-ETIC) framework.

    RESULTS: Although large similarities were found in the context, there were important differences between the Netherlands and the Scandinavian countries. Regarding structure, there were considerable differences in the length of the rehabilitation period across settings and countries. The most evident differences concerned process variables, especially the type and dosage of individual treatment modalities.

    CONCLUSION: The variation in important aspects of arthritis rehabilitation found in the present study underline the need for transparent and standardized description of these variables when comparing effects across settings and countries. A standardized description of current practice can be achieved by the STAR-ETIC framework.

    © 2013 The Authors

  • 4.
    Hagel, Sofia
    et al.
    Department of Clinical Sciences in Lund, Section of Rheumatology & Orthopaedics, Lund University & Skane University Hospital, Lund, Sweden.
    Lindqvist, Elisabet
    Department of Clinical Sciences in Lund, Section of Rheumatology & Orthopaedics, Lund University & Skane University Hospital, Lund, Sweden.
    Petersson, Ingemar F
    Department of Clinical Sciences in Lund, Section of Rheumatology & Orthopaedics, Lund University & Skane University Hospital, Lund, Sweden.
    Meesters, Jorit J L
    Department of Rheumatology, Department of Physical Therapy, Leiden University Medical Center, Leiden, Netherlands & National Resource Center for Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway .
    Klokkerud, Mari
    National Resource Center for Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway .
    Aanerud, Gerd J
    National Resource Center for Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway .
    Stovgaard, Inger H
    King Christian Xth Hospital for Rheumatic Diseases, University of Southern Denmark, Gråsten, Denmark.
    Hørslev-Petersen, Kim
    King Christian Xth Hospital for Rheumatic Diseases, University of Southern Denmark, Gråsten, Denmark.
    Strömbeck, Britta
    Department of Clinical Sciences in Lund, Orthopaedics, Lund University, Lund, Sweden.
    Vliet Vlieland, Thea P M
    Department of Orthopaedics, Leiden University Medical Center, Leiden, Netherlands .
    Bremander, Ann
    Högskolan i Halmstad, Akademin för ekonomi, teknik och naturvetenskap, Bio- och miljösystemforskning (BLESS). Department of Clinical Sciences Lund, Section of Rheumatology, Lund University, Lund, Sweden & School of Business and Engineering, Department of Exercise Physiology, Biomechanics and Health, Spenshult, Halmstad, Sweden.
    Which patients improve the most after arthritis rehabilitation? A study of predictors in patients with inflamatory arthritis in northern Europe, the STAR-ETIC collaboration2014Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 46, nr 3, s. 250-257Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To study health-related quality of life (HRQoL) in arthritis rehabilitation performed by multidisciplinary teams in patients with chronic inflammatory arthritis. Predictors of change in health-related quality of life and the proportion of patients with clinical improvement were investigated.

    DESIGN: Multicentre prospective observational study in 4 European countries.

    METHODS: HRQoL was measured with the European Quality 5 Dimensions (EQ-5D) and the Short Form 36 Health Survey (SF-36) in 731 patients who underwent multidisciplinary rehabilitation. Potential predictors were physical functioning (Health Assessment Questionnaire (HAQ)), self-efficacy (Arthritis Self Efficacy Scale (ASES)), psychological health (Hopkins Symptom Check List (HSCL-25)), pain/fatigue (numeric rating scales (NRS)), age, sex, diagnosis, comorbidity, education, clinical setting and change of medication during rehabilitation. Analysis of covariance (ANCOVA) was used to assess for potential predictors and interactions. The minimal important differences for HRQoL were analysed.

    RESULTS: Reporting worse function (b 0.05, p = 0.01), less psychological well-being (b 0.09, p = 0.000), and experiencing more pain (b 0.03, p = 0.000) or fatigue (b 0.02, p = 0.000) at admission predicted improved HRQoL. Change in medication during rehabilitation (b 0.08, p = 0.013) was associated with greater improvement in HRQoL. These EQ-5D findings were supported by SF-36 findings. Positive minimal important differences were noted in 46% (EQ-5D) and 23-47% (SF-36 subscales) of the patients.

    CONCLUSION: Patients with more severe symptoms experienced the largest gain in HRQoL post-intervention. The results of this study are of value for selecting the right patients for rheumatological team rehabilitation. © 2014 The Authors

  • 5.
    Hagel, Sofia
    et al.
    Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skåne University Hospital, Sweden.
    Lindqvist, Elisabet
    Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skåne University Hospital, Sweden.
    Petersson, Ingemar F
    Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skåne University Hospital, Sweden.
    Nilsson, Jan-Åke
    Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skåne University Hospital, Sweden.
    Bremander, Ann
    Department of Clinical Sciences Lund, Orthopaedics, Lund University, Lund, Sweden.
    Validation of outcome measurement instruments used in a multidisciplinary rehabilitation intervention for patients with chronic inflammatory arthritis: linking of the International Classification of Functioning, Disability and Health, construct validity and responsiveness to change.2011Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 43, nr 5, s. 411-9Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To determine the validity of 15 standardized instruments frequently used to measure the outcome of chronic arthritis treatment.

    METHODS: Analyses were performed on data collected at a rehabilitation programme (n=216). The outcome measures evaluated were health-related quality of life, global health, pain, physical function and aerobic capacity. The instrument items were linked to the International Classification of Functioning, Disability and Health (ICF) (content validity), construct validity was analysed based on predetermined hypothesis (Spearman's correlations, rs), and responsiveness (after 18 days and 12 months) by the standardized response mean.

    RESULTS: Most instruments covered the ICF component body function and/or activity-participation, only a few covered the environmental component. The short Euroqol-5 Dimensions performed as well as the longer health-related quality of life instruments in covering the ICF and in responsiveness. The health-related quality of life instruments did not measure similar constructs as hypothesized, neither did pain measures. The Bath Ankylosing Spondylitis indices covered several components of the ICF often exhibiting a large responsiveness. Aerobic capacity had the largest responsiveness of all measures.

    CONCLUSION: Many instruments are not highly correlated, although at face value they appear to measure the same construct, information also applying to content validity and responsiveness. Results from this study can assist in choosing outcome measures in the clinic and in research.

  • 6.
    Klokkerud, Mari
    et al.
    University of Oslo, Institute of Health and Society, Norway.
    Hagen, Kåre Birger
    University of Oslo, Institute of Health and Society, Norway.
    Kjeken, Ingvild
    University of Oslo, Institute of Health and Society, Norway.
    Bremander, Ann
    Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, Halmstad, Sweden.
    Hørslev-Petersen, Kim
    King Christian Xth Hospital for Rheumatic Diseases, Gråsten, Denmark.
    Vlieland, Thea Vliet
    Department of Orthopaedics, Leiden University Medical Center, Leiden, Netherlands.
    Grotle, Margreth
    FORMI (Communication Unit for Musculoskeletal Disorders), Oslo University Hospital, Ullevaal, Oslo, Norway.
    Development of a framework identifying domains and elements of importance for arthritis rehabilitation2012Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 44, nr 5, s. 406-13Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Rehabilitation is effective and beneficial for patients with arthritis. The lack of a common structure for describing the content of rehabilitation makes it difficult to compare, transfer and implement research evidence into clinical practice.

    OBJECTIVE: To develop a framework comprising domains and elements of importance when describing arthritis rehabilitation.

    METHODS: On the basis of a systematic literature search and review, the framework was developed through a 9-step development process, including 5 Delphi consensus rounds within the Scandinavian Team Arthritis Register - European Team Initiative for Care Research (STAR-ETIC) collaboration, a group of clinicians, researchers and patients from northern Europe.

    RESULTS: Based on Donabedian's healthcare model, the Inter-national Classification of Function, Disability and Health, and a rehabilitation model by D. T. Wade, 4 domains (context, structure, process and outcome) were defined. Within each domain, the most important and relevant key elements for describing rehabilitation were selected. This framework contains 1 key element under context, 9 under structure, 3 under process, and 9 under outcome.

    CONCLUSION: The STAR-ETIC framework can be used to describe arthritis rehabilitation, by emphasizing key elements in 4 main domains. A common framework may facilitate comparisons of rehabilitation programmes across countries and different levels of care, and may improve the implementation of rehabilitation research in clinical practice. © 2012 Foundation of Rehabilitation Information.

  • 7.
    Lydell, Marie
    et al.
    Physiotherapy Unit, Primary Health Care, PO Box 113, SE-311 22 Falkenberg, Sweden.
    Baigi, Amir
    Research and Development Unit, Primary Health Care, PO Box 113, SE-311 22 Falkenberg, Sweden.
    Marklund, Bertil
    Research and Development Unit, Primary Health Care, PO Box 113, SE-311 22 Falkenberg, Sweden.
    Månsson, Jörgen
    Research and Development Unit, Primary Health Care, PO Box 113, SE-311 22 Falkenberg, Sweden.
    Predictive factors for work capacity in patients with musculoskeletal disorders2005Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 37, nr 5, s. 281-285Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To identify predictive factors for work capacity in patients with musculoskeletal disorders. 

    Design: A descriptive, evaluative, quantitative study. Subjects/Patients: The study was based on 385 patients who participated in a rehabilitation programme. 

    Methods: Patients were divided into 2 groups depending on their ability to work. The groups were compared with each other with regard to sociodemographicfactors, diagnoses, disability pension and number of sick days. The patient's level of exercise habits, ability to undertake activities, physical capacity, pain and quality of life were compared further using logistic regression analysis. 

    Results: Predictive factors for work capacity, such as ability to undertake activities, quality of life and fitness on exercise, were identified as important independent factors. Other well-known factors, i.e. gender, age, education, pain and earlier sickness certification periods, were also identified. Factors that were not significantly different between the groups were employment status, profession, diagnosis and levels of exercise habits. 

    Conclusion: Identifying predictors for ability to return to work is an essential task for deciding on suitable individual rehabilitation. This study identified newpredictive factors, such as ability to undertake activities, quality of life and fitness on exercise.

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