Gunvor Gard

Human-centred approaches in slipperiness measurement

A number of human—centred methodologies subjective, objective, and combined are used for slipperiness measurement. They comprise a variety of approaches from biomechanically-oriented experiments to psychophysical tests and subjective evaluations. The objective of this paper is to review some of the research done in the field, including such topics as awareness and perception of slipperiness, postural and balance control, rating scales for balance, adaptation to slippery conditions, measurement of unexpected movements, kinematics of slipping, and protective movements during falling. The role of human factors in slips and falls will be discussed. Strengths and weaknesses of human-centred approaches in relation to mechanical slip test methodologies are considered. Current friction-based criteria and thresholds for walking without slipping are reviewed for a number of work tasks. These include activities such as walking on a level or an inclined surface, running, stopping and jumping, as well as stair ascent and descent, manual exertion (pushing and pulling, load carrying, lifting) and particular concerns of the elderly and mobility disabled persons. Some future directions for slipperiness measurement and research in the field of slips and falls are outlined. Human-centred approaches for slipperiness measurement do have many applications. First, they are utilized to develop research hypotheses and models to predict workplace risks caused by slipping. Second, they are important alternatives to apparatus-based friction measurements and are used to validate such methodologies. Third, they are used as practical tools for evaluating and monitoring slip resistance properties of footwear, anti-skid devices and floor surfaces.

Body awareness therapy for patients with fibromyalgia and chronic pain

There are several therapies designed to increase body awareness. They are commonly known as body awareness therapies (BAT) and include Basic BAT, Mensendieck and Feldenkrais therapy. A focus on emotions is important in all these therapies. In this article the aim and development of Basic BAT is described together with evaluations of treatments including Basic BAT. Multidisciplinary studies have shown that Basic BAT can increase health-related quality of life and cost-effectiveness. However Basic BAT needs to be further studied in relation to patients with fibromyalgia (FM) and chronic pain. Studies so far indicate that Basic BAT has positive effects.

Identifying work ability promoting factors for home care aides and assistant nurses

BackgroundIn workplace health promotion, all potential resources needs to be taken into consideration, not only factors relating to the absence of injury and the physical health of the workers, but also psychological aspects. A dynamic balance between the resources of the individual employees and the demands of work is an important prerequisite. In the home care services, there is a noticeable trend towards increased psychosocial strain on employees at work. There are a high frequency of work-related musculoskeletal disorders and injuries, and a low prevalence of sustainable work ability. The aim of this research was to identify factors promoting work ability and self-efficacy in care aides and assistant nurses within home care services.MethodsThis study is based on cross-sectional data collected in a municipality in northern Sweden. Care aides (n = 58) and assistant nurses (n = 79) replied to a self-administered questionnaire (response rate 46%). Hierarchical multiple regression analyses were performed to assess the influence of several independent variables on self-efficacy (model 1) and work ability (model 2) for care aides and assistant nurses separately.ResultsPerceptions of personal safety, self-efficacy and musculoskeletal wellbeing contributed to work ability for assistant nurses (R2adj of 0.36, p < 0.001), while for care aides, the safety climate, seniority and age contributed to work ability (R2adj of 0.29, p = 0.001). Self-efficacy was associated with the safety climate and the physical demands of the job in both professions (R2adj of 0.24, p = 0.003 for care aides), and also by sex and age for the assistant nurses (R2adj of 0.31, p < 0.001).ConclusionsThe intermediate factors contributed differently to work ability in the two professions. Self-efficacy, personal safety and musculoskeletal wellbeing were important for the assistant nurses, while the work ability of the care aides was associated with the safety climate, but also with the non-changeable factors age and seniority. All these factors are important to acknowledge in practice and in further research. Proactive workplace interventions need to focus on potentially modifiable factors such as self-efficacy, safety climate, physical job demands and musculoskeletal wellbeing.

Swedish anthropometrics for product and workplace design

The present study describes the anthropometrics of the Swedish workforce, aged 18-65, and compares the measurements with data collected four decades earlier. This anthropometric information is based on measurements of a total of 367 subjects, 105 males and 262 females. Of the 367 subjects, 268 responded to advertisements (Study A) and 99 were randomly selected from a community register (Study B). Subjects were scanned in four positions. Manual measuring equipment was used for hands, feet, head and stature. As differences between significant measurements in Studies A and B were negligible, the data were merged. Anthropometric descriptive statistics of women and men are presented for 43 body dimensions. Participants represent the Swedish population fairly well when compared with national statistics of stature and weight. Comparing new anthropometric data with old shows that the breadth, depth, height, and length measurements of Swedes as well as weight have increased and that Swedish anthropometric homogeneity has decreased. The results indicate that there is a need to update ergonomic recommendations and adjust products and workplaces to the new information.

Embodied identity—A deeper understanding of body awareness

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 ones 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 ones emotions and needs through the awareness of the body were understood as the base for self-confidence, trust in one-self, and the ability to take care of oneself and ones needs physically and mentally. The subcategory “living in relation to others and in society” was conceived as an important aspect for the embodied self to interact with others and for societal participation. Working with the body in physiotherapy practice should include an understanding that body awareness is inseparable from the identity and may have an impact on the health of the individual. This implies that interventions to address problems in body awareness should be integrated into physiotherapy practice.

Concepts of functioning and health important to people with systemic sclerosis: a qualitative study in four European countries

Objective To describe the experiences of people with systemic sclerosis (SSc) in different European countries of functioning and health and to link these experiences to the WHO International Classification of Functioning, Disability and Health (ICF) to develop a common understanding from a bio-psycho-social perspective. Method A qualitative multicentre study with focus-group interviews was performed in four European countries: Austria, Romania, Sweden and Switzerland. The qualitative data analysis followed a modified form of ‘meaning condensation’ and the concepts that emerged in the analysis were linked to the ICF. Results 63 people with SSc participated in 13 focus groups. In total, 86 concepts were identified. 32 (37%) of these were linked to the ICF component body functions and structures, 21 (24%) to activities and participation, 26 (30%) to environmental factors, 6 (7%) to personal factors and 1 (1%) to the health condition itself. 19 concepts (22%) were identified in all four countries and included impaired hand function, household activities, paid work, drugs, climate and coldness, support from others and experiences with healthcare institutions, non-pharmacological treatment, social security and benefits. Conclusion Concepts identified in all four countries could be used for guiding clinical assessment, as well as interdisciplinary team care and rheumatological rehabilitation for patients with SSc. For a full understanding of the aspects of the disease that were most relevant to people with SSc, people with SSc from multiple countries needed to be involved.

Prevalence of lower urinary tract symptoms (LUTS) in stroke patients: a cross-sectional, clinical survey.

The aims of this study were primarily to investigate the prevalence, severity and impact on daily life of Lower Urinary Tract Symptoms (LUTS) in a clinical sample of stroke patients and secondly to identify factors associated with LUTS.

Coping after trans-femoral amputation due to trauma or tumour—a phenomenological approach

Purpose: To describe, by use of a phenomenological approach, how relatively young trans-femoral amputees experienced their amputation and their coping strategies in the acute phase and over time. Method: Eleven trans-femoral amputees, median age 33.5 years, were interviewed. The amputation was caused by tumour, motorcycle accidents or work-related traumas. Amputation was made in median 7.5 years before the interview. The informants were community dwelling and managed well indoors. One had a half disablement pension and all the others were working or studying full time. The interviews were tape-recorded and transcribed verbatim. Results: Two themes emerged. In the first theme ‘Experiences of the amputation’ denial and avoidance were the coping strategies mainly used. In the second theme ‘Coping strategies to relate to a new norm’ the informants used downward comparison, positive comparison and repression. Only one informant indicated a full acceptance of his situation. Conclusion: Relatively young, trans-femoral amputees within this sample, have not reached the acceptance level, though a long time has passed since the amputation. They might have benefited from professional support and guidance during the rehabilitation process in order to improve coping strategies to relate to a new norm.

Reliability and validity of the Fatigue Severity Scale in Swedish for patients with systemic lupus erythematosus

Objective: The aim was to translate, test, and describe aspects of reliability and validity of the Fatigue Severity Scale (FSS) in Swedish (FSS‐Swe) in patients with systemic lupus erythematosus (SLE). Methods: Patients with stable SLE, low or moderate disease activity, and low organ damage were included. Forward and back translations of the FSS were performed. Construct validity was tested with 32 women using a first Swedish translation. Feasibility, ceiling and floor effects, internal consistency, test–retest reliability, and content validity were tested on a slightly modified final version of the FSS‐Swe in a non‐selected group of patients (n = 23). Results: There were correlations (p⩽0.05) between the FSS‐Swe and overall disease activity according to the Systemic Lupus Activity Measure (SLAM) (rs = 0.48) and the SLAM Visual Analogue Scale (SLAM‐VAS) (rs = 0.46); between the FSS‐Swe and eight subscales of the Swedish 36‐Item Medical Outcomes Study Short‐Form Health Survey (SF‐36) (rs = –0.41 to –0.65) and between the FSS‐Swe and age (rs = –0.35). All patients answered all FSS‐Swe questions at both test and retest. There was one ceiling effect in one question on one occasion. The Kolmogorov–Smirnov test indicated normal distribution. Cronbachs alpha was 0.94 and corrected item‐to‐total correlation exceeded 0.3. There were no significant systematic test–retest differences, and the median‐weighted kappa coefficient was 0.75. Twenty patients understood the questions in FSS‐Swe, 18 considered they were relevant, reflected their fatigue, and that none should be excluded. Five items were suggested to be included. Conclusions: The FSS‐Swe supports construct validity, is feasible, has no important ceiling or floor effects, has satisfactory internal consistency, substantial test–retest reliability, and satisfactory content validity in the SLE patients studied. However, its sensitivity to change needs to be tested.

The importance of emotions in physiotherapeutic practice

Abstract Emotions are a topic of great relevance, but are not frequently studied within physiotherapy. To identify and express emotions can be seen as a prerequisite for having emotional intelligence, an ability highly needed in treatment situations in physiotherapy. Within psychology, there is a tradition as well as a recognized fact that the identification and expression of emotions are important for good clinical outcomes. The aim of this paper is to review the literature within physiotherapy and psychology about the importance of emotions in treatment situations. Research has shown that physiotherapists have an awareness of underlying emotions in treatment situations, but often respond mostly on an intellectual level. Skills and awareness in identifying and expressing emotions in combination with cognitive and self-monitoring skills can be an effective way of improving the clinical reasoning process and treatment outcomes in physiotherapy. Identifying and expressing emotions in treatment situations may also increase positive treatment outcomes thanks to an increased adherence to transference and countertransference processes in treatment situations. More emphasis can be put on identifying and promoting verbal expression of emotions in treatment situations in physiotherapy practice.