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AbstractPurposeMaterials and MethodResultsConclusions\nKEY POINTSReturn to work often requires collaboration between different stakeholders. Rehabilitation coordination is a resource in coordinating efforts during sick leave to facilitate return to work. The purpose of the present study was to describe how people at risk for sick leave or on sick leave with mental health problems experienced rehabilitation coordination.The study had a qualitative approach using qualitative content analysis as described by Graneheim and Lundman. Eleven semi-structured interviews were conducted with persons at risk for sick leave or on sick leave due to mental health problems and with experience of rehabilitation coordination.The participants experience of rehabilitation coordination were described by the overarching theme Building a bridge with many bricks between the person and society. The theme was formed by four categories and eleven subcategories reflecting the complex context of rehabilitation coordination. The categories were Collaboration in a new setting, Unburdened within certain limits, The way back to work is a joint project and Recognising challenges beyond the person.People with mental health problems experienced rehabilitation coordination as a meaningful link between healthcare and work. However, rehabilitation coordination needs to be more recognised within healthcare to increase accessibility. It seems important that interventions are directed not only towards the person, but also include the workplace for a sustainable return to work.It is important to make rehabilitation coordination visible within primary health care and actively inform people on sick leave with mental health problems that it is an option, as they often have difficulties finding information. It will increase their accessibility and enable autonomous decisions.A respectful interplay based on a person-centred care approach seems fundamental for rehabilitation coordination. The interplay with rehabilitation coordinators and with other stakeholders affects the sick leave process and all parties need to collaborate for a sustainable return to work.Three-party meetings with the person on sick leave, the rehabilitation coordinator and the employer, as well as teamwork, may provide better conditions for return to work as this can ensure that all stakeholders are working towards prioritised goals.Targeted interventions at the workplace seem to be important and rehabilitation coordination could be a valuable bridge between healthcare and work for creating sustainable conditions for return to work. [ABSTRACT FROM AUTHOR]

ObjectiveMethodsResultsConclusionsDigital technology has become increasingly relevant in physiotherapy, but little is known about communication and interaction in video-based physiotherapy. Therefore, this study aimed to explore the experiences among patients and physiotherapists, of communication and interaction in digital, video-based physiotherapy.A qualitative interview study with a phenomenological approach was conducted. Participants were purposively recruited from primary health care clinics. Semi-structured, in-depth interviews were conducted with 10 physiotherapists and 6 patients. Interviews were recorded, transcribed, and analyzed using a phenomenological approach.The analysis resulted in the overall theme Reaching for connection, which captured the central meaning of the participants’ experiences. Four categories emerged from the analysis: 1) Closeness at a distance; 2) Overcoming limited bodily communication; 3) The technology as part of the meeting; and 4) Challenging the physical meeting as a norm. The results suggest that communication and interaction in digital settings differ from physical settings, but there is an ongoing adaptation process to this new paradigm.The results of this study show that video-based physiotherapy, while having several benefits according to both patients and physiotherapists, affects the communication in several ways. Physiotherapists need to acknowledge these limitations and seek strategies to adapt and to compensate for the reduced non-verbal elements and lack of touch. Attention to the physical room and shifting between positions (face/full figure) are suggested practical strategies, but also to practice awareness and embodied communication to improve receptivity in the interaction. [ABSTRACT FROM AUTHOR]

Introduction Purpose Methods Results Conclusion Worldwide, there are more than 264 million people with depression, which is the second-leading cause of years lived with disability. Physical activity can be useful in both preventing and treating mild to moderate depression, but few studies have explored patients’ experience of physical activity.To explore experiences of facilitators to initiate and maintain regular physical activity in people with depression.Adults of working age with mild to moderate depression participated in semi-structured interviews. Two researchers analyzed the data using qualitative content analysis.Four categories were identified: 1) Getting over the threshold; 2) Hoping for improvement; 3) A wish to be independent but needing help; and 4) Feeling safe on one’s own terms.The results indicate that knowledge and personal experience of how physical activity affects well-being, and an environment including social support, increase the possibilities for people with depression to initiate and maintain physical activity. To promote physical activity, it is important to be receptive to the person’s experiences, desires, and needs and to involve them in the planning and adjustment of physical activity. Follow-up appointments, a stepwise approach, and encouragement are important to increase motivation. [ABSTRACT FROM AUTHOR]

Introduction Purpose Methods Results Conclusion Vulvodynia is a common and complex pain syndrome with a negative impact on quality of life and sexual health. Physical therapy is still an underexplored treatment for vulvodynia. Women’s experiences of their physical therapy treatment might shed light on meaningful aspects and essential keys to facilitate change.To explore and describe women’s experiences of physical therapy treatment for vulvodynia.A qualitative interview study, using qualitative content analysis. Fourteen women with a median age of 28 years and a median pain duration of 6.5 years participated. Digital interviews were conducted using a semi-structured interview guide with open-ended questions.One theme, four categories and thirteen sub-categories were developed in the analysis. The theme, “Trying to become friends with your vulva,” illuminate how the women approached and reconnected to their bodies in physical therapy. The treatment increased their awareness and provided explanations for their symptoms. Four categories described aspects of the theme: 1) untapped resources in a complex healthcare; 2) a matter of trust; 3) a guide to understanding your body; and 4) a new way forward but not the whole solution.Women with vulvodynia perceive physical therapy as a promising and yet unknown approach. Physical therapy treatment gives the opportunity to reconnect with the body and vulva in a new way, and to manage pain and muscle tension as part of a multidisciplinary treatment. [ABSTRACT FROM AUTHOR]

In mental health physiotherapy, there is a lack of research investigating the assumptions and clinical reasoning strategies of the professionals. A critical view on what is taken for granted within physiotherapy promotes professional development. The purpose of this study was to explore and describe the essence of clinical reasoning of Austrian mental health physiotherapists, and to illuminate the meaning of their experiences. Ten semi-structured individual interviews were conducted with Austrian mental health physiotherapists. The transcripts were analyzed using a phenomenological hermeneutical method. The informants' clinical reasoning emerged as a process of three perspectives: 1) a relational and interactional perspective; 2) a perspective of wholeness; and 3) a perspective of symptoms. The results were then further interpreted using the theories of intercorporeality and bodily resonance. To bring the different clinical reasoning perspectives together to one clinical reasoning process, a discourse of reconciliation is suggested as a favorable strategy, which may be useful both in clinical practice and education. [ABSTRACT FROM AUTHOR]

While physical activity is considered an important part of treatment for people with schizophrenia, little is known about their views on how to successfully commit to an exercise habit over time. This study explored experiences of motivators to start and maintain regular exercise among people with schizophrenia spectrum disorders. Five men and six women with schizophrenia spectrum disorders, 25–62 years old, who had been exercising for at least 6 months, were interviewed using a semi-structured guide. Interviews were analysed using qualitative content analysis. The positive experiences that the participants immediately felt in their bodies were the main motivator for exercise. These experiences were recalled and longed for in between bouts and consisted of physical sensations, mental well-being, and improved self-esteem. This experience-based driving force enabled the participants to pursue exercise despite sometimes feeling low, lacking resources, or struggling with side effects of medication. The positive change in body experience following exercise could be emphasised more when promoting exercise to people with schizophrenia. Exploring the instant body responses can keep up the drive and create hope for more long-term health effects. Physiotherapists have an important role in guiding patients to recognise and interpret body experiences. [ABSTRACT FROM AUTHOR]

PURPOSE: To investigate the association between forward head posture (FHP) and neck pain disability in patients with chronic whiplash associated disorders (WAD). METHODS: This study was a secondary analysis based on data from a randomized controlled study. The study involved patients with chronic WAD reporting their disability using the Neck Disability Index (NDI). FHP was measured with a goniometer. Analyses of correlations and logistic regressions were performed controlling for age, gender, duration of symptoms, WAD-grade (the Quebec Task Force on Whiplash-Associated Disorders classification), bodily pain (the Short-Form 36 Health Survey (SF-36) and kinesiophobia, an irrational fear of physical movement and activity (the Tampa Scale of Kinesiophobia (TSK-SV). RESULTS: The inclusion criteria was fulfilled by 113 patients (81 women, 32 men). Mean age 48.1 years. Mean duration of symptoms 9.7 years. There was no significant correlation between FHP and neck pain disability (rs = 0.004, p = 0.968). A logistic regression analysis showed no significance for FHP neither with (p = 0.418) nor without (p = 0.991) control for age, gender, duration of symptoms, WAD-grade, kinesiophobia and bodily pain. In the multiple model kinesiophobia (p = 0.013) and bodily pain (p = < 0.001) were the only significant predictors. Kinesiophobia was also significantly correlated with both neck pain disability (rs = 0.467, p < 0.001) and FHP (rs = 0.202, p = 0.047), thus being a confounder to the possible correlation between these variables. CONCLUSIONS: There is no significant correlation between neck pain disability and FHP for patients with chronic WAD. Results suggest that physiotherapists should increase their focus on kinesiophobia, since it is associated with both FHP and neck pain disability. [ABSTRACT FROM AUTHOR]

Most people with common mental disorders are working despite symptoms. This study explores individuals' experiences of a work-directed rehabilitation, provided by occupational therapists and physiotherapists, aiming to promote work capacity in persons with common mental disorders. A qualitative content analysis was used, and 11 women and 8 men with depression or anxiety disorder were interviewed. They were 25–66 years old, had different occupations and were working full or part-time. The participants experienced a process interpreted as Increasing belief in one's capacity through supported reflection and practice. This theme reflects the shifting between "reflecting" and "doing" through rehabilitation and the growing hope for change. The increasing belief in one's capacity was developed through three stages, comprised of the categories To be supported by a professional, To realise things about oneself and To try new strategies for change. Strategies suggested by occupational therapists and physiotherapists have the potential to promote work capacity in people who are working while depressed and anxious. The results may deepen the understanding among rehabilitation professionals about the importance of a person-centred approach to people with common mental disorders, and to combine reflection and practical exercises to support the development of work-related strategies. Work-directed rehabilitation provided by occupational therapists and/or physiotherapists is beneficial to people with common mental disorders. Rehabilitation professionals should focus on facilitating self-efficacy among people with common mental disorders. An individualised person-centred approach seems important in order to initiate change. [ABSTRACT FROM AUTHOR]

Objective: To analyze definitions and related requirements, processes, and operationalization of person-centered goal-setting in the physiotherapy research literature; to discuss those findings in relation to underlying principles of person-centeredness; and to provide an initial framework for how person-centered goal-setting could be conceptualized and operationalized in physiotherapy. Methods: A literature search was conducted in the databases: CINAHL, PubMed, PEDro, PsycINFO, REHABdata and Scopus. A content analysis was performed on how person-centered goal-setting was described. Results: A total of 21 articles were included in the content analysis. Five categories were identified: 1) Understanding goals that are meaningful to the patients; 2) Setting goals in collaboration; 3) Facing challenges with person-centered goal-setting; 4) Developing skills by experiences and education; and 5) Changing interaction and reflective practice. These categories were abstracted into two higher-ordered interlaced themes: 1) To seek mutual understanding of what is meaningful to the patient; and 2) To refine physiotherapy interaction skills, which we suggest would be useful for further conceptualization. Conclusion: In this analysis, we interpreted person-centered goal-setting in physiotherapy as a process of interaction toward a mutual understanding of what is meaningful to the patient. Future research may explore how to integrate mindful listening, embodied interaction and continuous ethical reflection with different assessments and treatment methods. [ABSTRACT FROM AUTHOR]

Background: There is a need for high-quality research regarding exercise interventions for persons with anxiety disorders. We investigate whether a 12-week exercise intervention, with different intensities, could reduce anxiety symptoms in patients with anxiety disorders.Methods: 286 patients were recruited from primary care in Sweden. Severity of symptoms was self-assessed using the Beck Anxiety Inventory (BAI) and the Montgomery Åsberg Depression Rating Scale (MADRS-S). Participants were randomly assigned to one of two group exercise programs with cardiorespiratory and resistance training and one control/standard treatment non-exercise group, with 1:1:1 allocation.Results: Patients in both exercise groups showed larger improvements in both anxiety and depressive symptoms compared to the control group. No differences in effect sizes were found between the two groups. To study a clinically relevant improvement, BAI and MADRS-S were dichotomized with the mean change in the control group as reference. In adjusted models the odds ratio for improved symptoms of anxiety after low-intensity training was 3.62 (CI 1.34-9.76) and after moderate/high intensity 4.88 (CI 1.66-14.39), for depressive symptoms 4.96 (CI 1.81-13.6) and 4.36 (CI 1.57-12.08) respectively. There was a significant intensity trend for improvement in anxiety symptoms.Limitations: The use of self-rating measures which bears the risk of an under- or overestimation of symptoms.Conclusions: A 12-week group exercise program proved effective for patients with anxiety syndromes in primary care. These findings strengthen the view of physical exercise as an effective treatment and could be more frequently made available in clinical practice for persons with anxiety issues. [ABSTRACT FROM AUTHOR]

Background: People seeking care at primary healthcare centres may be exposed to work-related stress, increasing the risk of future sick leave. Thus, it is important to identify work-related stress, and to explore how stress relates to work ability and health., Objective: To investigate the association between work-related stress and a) work ability, and b) self-rated health, among working women and men seeking care for physical or mental health complaints., Methods: This cross-sectional study analyzed baseline data (n = 232) from a randomized controlled trial investigating the effects of a brief intervention to prevent sick leave. Data regarding work-related stress, work ability and self-rated health were analyzed using binary logistic regression models., Results: In models adjusted for age, gender and education, high work-related stress measured by the Work Stress Questionnaire was significantly associated with low work ability. The highest odds ratio (OR 3.27, 95% CI 1.66-6.42) was found between the domain "interference between work and leisure time" and work ability, suggesting a more than three times higher odds for low work ability when perceiving that work interferes with leisure time. No significant association was found between work-related stress and self-rated health., Conclusion: Health professionals should explore patients' work-related stress when they seek care for physical or mental complaints in primary healthcare. Patients' perceived balance between work and leisure time seems particularly important to address. Increased awareness might facilitate timely, relevant strategies to reduce stress and promote work ability.