Biomedical subjects

H Dagfinrud

Publications and source records attributed to H Dagfinrud.

5 recordsLinked to original sources

PubMed2005

Activity limitations and participation restrictions in women with hand osteoarthritis: patients' descriptions and associations between dimensions of functioning.

OBJECTIVE: To describe the functional consequences of hand osteoarthritis, and analyse associations between personal factors, hand impairment, activity limitations, and participation restrictions within the framework of the International Classification of Functioning (ICF). METHODS: 87 women with hand osteoarthritis completed a clinical examination including recording of sociodemographic data, measures of hand impairment, and completion of self reported health status measures. The function subscale of the AUSCAN Osteoarthritis Hand Index was used as a measure of hand related activity limitations, while the Canadian Occupational Performance Measure (COPM) was used to describe and measure activity limitations and participation restrictions as perceived by the individual. The study variables were categorised using the dimensions in the ICF framework and analysed using bivariate and multivariate statistical approaches. RESULTS: The patients described problems in many domains of activity and participation. The most frequently described hand related problems were activities requiring considerable grip strength combined with twisting of the hands. On the impairment level, the patients had reduced grip force and joint mobility in the hands, and resisted motion was painful. Regression analyses showed that hand related activity limitations were associated with measures of hand impairment, while activity and participation (as measured by the COPM) were more strongly associated with personal factors than with hand impairment. CONCLUSIONS: Hand osteoarthritis has important functional consequences in terms of pain, reduced hand mobility and grip force, activity limitations, and participation restrictions. Rehabilitation programmes should therefore be multidisciplinary and multidimensional, focusing on hand function, occupational performance, and coping strategies.

Activities of Daily Living↗

PubMed2004

Physiotherapy interventions for ankylosing spondylitis.

BACKGROUND: Ankylosing spondylitis (AS) is a chronic, inflammatory rheumatic disease. Due to the consequences of the disease, physiotherapy is considered to be an important part of the overall management of AS. OBJECTIVES: The objective of this review was to summarise the available scientific evidence on the effectiveness of physiotherapy interventions in the management of AS. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, AMED, CINAHL and PEDro up to February 2004 for all relevant publications, without any language restrictions. The reference lists of relevant articles were checked and the authors of included articles were contacted. SELECTION CRITERIA: We included randomised and quasi-randomised studies with patients classified by the AS New York criteria and where at least one of the comparison groups received some kind of physiotherapy. The main outcomes of interest were pain, stiffness, spinal mobility, physical function and patient global assessment. DATA COLLECTION AND ANALYSIS: Two reviewers independently selected trials for inclusion, extracted data and assessed trial quality. Investigators were contacted to obtain missing information. MAIN RESULTS: Six trials with a total of 561 participants were included in this updated review as compared to three trials and 241 patients in the previous version. Two trials compared individualised home exercise programs with no intervention and reported low quality evidence for effects in spinal mobility (relative percentage differences (RPD) 37%) and physical function, in favour of the home exercise program. Three trials compared supervised group physiotherapy with an individualised home-exercise program and reported moderate quality evidence for small differences in spinal mobility (RPD 18%) and patient global assessment in favour of supervised group exercises. Finally, in one study a three week inpatient spa-exercise therapy followed by 37 weeks of weekly outpatient group physiotherapy (without spa) was compared with weekly outpatient group physiotherapy alone; there was moderate quality evidence for effects in pain (RPD 18%), physical function (RPD 24%) and patient global assessment (RPD 29%), in favour of the combined spa-exercise therapy. REVIEWERS' CONCLUSIONS: The results of this review suggest that a home exercise program is better than no intervention, supervised group physiotherapy is better than home exercises, and that combined inpatient spa-exercise therapy followed by supervised outpatient weekly group physiotherapy is better than weekly group physiotherapy alone. The tendency toward positive effects of physiotherapy in the management of AS calls for further research in this field. New trials should also address other physiotherapy interventions commonly used in clinical practice.

Ambulatory Care↗

PubMed2004

Health status of patients with ankylosing spondylitis: a comparison with the general population.

OBJECTIVE: To examine the subjective health in patients with ankylosing spondylitis (AS) compared with the general population, and to explore the associations between health status and age, sex of the patients, and educational level in AS. METHODS: Health status was assessed with a generic instrument (SF-36) in 314 patients with AS and in 2323 people from the general population. Subgroup analyses were performed according to age, sex, and educational level. Standard difference scores (s-scores) were calculated to ensure the clinical meaningfulness of the norm based comparisons. RESULTS: Both men and women with AS reported significantly impaired health on all scales of the SF-36. Women reported significantly worse health on physical health domains. However, when calculating differences from the general population, numerically larger s-scores were found for men (except for physical role and vitality). The relative impact of AS seems to diminish with increasing age. In AS, better health was significantly associated with higher education across all scales. Deviations from the general population on the non-physical health aspects were especially pronounced in patients with low education. CONCLUSIONS: All key dimensions of health are affected by AS. The physical aspects seem to be most severely affected, but in the less educated group of patients, the disease impact on the mental health aspects was also considerable. Evaluation and management planning should take the complexity of AS into consideration. The focus on physical function should be maintained, and additional attention should be paid to the mental and social consequences of AS.

Adult↗

PubMed2001

Physiotherapy interventions for ankylosing spondylitis.

BACKGROUND: Ankylosing spondylitis (AS) is a chronic rheumatic disease. Due to the consequences of the disease, physiotherapy is regarded to be an important part of the treatment. OBJECTIVES: The objective is to summarise the available scientific evidence on the effectiveness of physiotherapy interventions in the management of AS. SEARCH STRATEGY: We searched the Cochrane Musculoskeletal Group Trial register, Cochrane Controlled Trials Register, MEDLINE, EMBASE, CINAHL and Pedro up to February 2000 for all relevant publications, limited to English and Scandinavian languages. The reference lists of relevant articles were checked and the authors of included articles were contacted. SELECTION CRITERIA: We included randomised and quasi randomised studies where the participants were patients with AS, classified by the New York criteria, and where at least one of the comparison groups received some kind of physiotherapy. The main outcomes of interest were spinal mobility, pain, stiffness, physical function and global assessment of change. DATA COLLECTION AND ANALYSIS: Both reviewers independently selected trials for inclusion, extracted data and assessed trial quality. Investigators were contacted to obtain missing information. MAIN RESULTS: Three trials were included with 241 participants, and all were assessed to have moderate to high risk of bias. Two trials compared the effect of supervised group physical therapy with an individualised home exercise program, and reported differences in favour of the supervised group. For pain and stiffness, the relative difference in change from baseline for the supervised group compared to the home exercise group was 50% after treatment. One trial compared an individual program of exercises and disease education with no intervention, and found differences in favour of the exercise group. REVIEWER'S CONCLUSIONS: The tendency toward positive effects of physiotherapy, in the management of AS, call for further research in this field in order to reach sufficient evidence on which physiotherapy modalities and applications are to be recommended. New trials should address other physiotherapy interventions commonly used in practice. There is not sufficient evidence yet available to base recommendations for or against the use of physiotherapy interventions for ankylosing spondylitis.

Ambulatory Care↗

PubMed1997

Passive knee extension test to measure hamstring muscle tightness.

The purpose of this study was twofold: (a) to examine the reliability of a test designed to measure tightness of the hamstring muscles, and (b) to assess the pelvic motion during this test. The knee was passively extended by a standardized force, while the hip was stabilized in 120 degrees of flexion. The knee angle was measured with a goniometer and represents the hamstring tightness. Twenty-eight test-retests were performed. The correlation coefficient was found to be 0.99, and the CV was found to be 1%. We used a MacReflex measurement system to assess the associated pelvic motion. Eight measurements were taken, and the median of associated pelvic motion was 4.1 degrees. It is concluded that the passive knee extension test is a simple and reliable method, and the associated pelvic motion is minimal.

Female↗