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Objective: The aim of this study was to describe the process used to develop a theory‐based, online fall prevention self‐management programme for ambulatory and non‐ambulatory people with multiple sclerosis (pwMS). Methods: The development process was guided by the Medical Research Council framework of complex interventions and began with a scoping review of the literature on self‐management of falls in pwMS. Subsequent phases of development were performed through iterative and concurrent processes and were informed by the perspectives of pwMS and healthcare professionals with MS expertise. Results: Through a systematic and iterative process in close collaboration with pwMS and healthcare professionals, a theory‐based online fall prevention self‐management programme, Fewer Falls in MS, for ambulatory and non‐ambulatory pwMS was developed. The programme is grounded in theory and pedagogical models and features utilization of action plans to address diverse influences on fall risks. Conclusions: A carefully operationalized definition of self‐management and an iterative co‐development process were essential to the creation of the Fewer falls in MS programme. Continuation of the co‐development process and collaboration with end users was needed to refine the programme. Patient or Public Contribution: PwMS and healthcare professionals were involved throughout the development process of the programme. The patient organization Neuro Sweden was contacted in the initial phase to discuss the relevance of a self‐management programme to prevent falls in MS. They supported the research group (all authors) in identification of and contact with pwMS with interest to participate. Three members of the research group (S.T.J., M.F. and C.Y.), that is, the operative group, met neuro Sweden and one pwMS to further discuss the relevance of a self‐management programme to prevent falls. To develop the process and content of the fall prevention programme, a co‐design process was performed together with pwMS and healthcare professionals. The results of the co‐design process are presented in this manuscript. In addition to participating in the co‐design process, pwMS and healthcare professionals provided feedback to the research group on programme process and content on several occasions during the subsequent programme development process. In a pretest (Beta version) of the programme, four pwMS acted as test subjects and provided additional feedback on the programme to the research group. Trial Registration: NCT04317716. [ABSTRACT FROM AUTHOR]

To evaluate the effect of neck-specific exercise (NSE) compared to prescribed physical activity (PPA) on headache and dizziness in individuals with cervical radiculopathy (CR). Also, to investigate associations between headache or dizziness and pain, neck muscle endurance (NME), neck mobility, physical activity, and fear avoidance beliefs. Individuals randomized to either NSE or PPA were selected to a headache subgroup (n = 59) and/or a dizziness subgroup (n = 73). Data were evaluated, according to headache and/or dizziness outcomes at baseline and at 3, 6, and 12-month follow-ups. No significant between-group differences were found between NSE and PPA in either subgroup. In the headache subgroup, significant within-group improvements were seen at all follow-ups for NSE (p <.001) and from baseline to 3 (p =.037) and 12 (p =.003) months for PPA. For dizziness, significant within-group improvements were seen from baseline to 3 months for NSE (p =.021) and from baseline to 3 (p =.001) and 6 (p =.044) months for PPA. Multiple regression models showed significant associations at baseline between headache intensity and neck pain (adjusted R-square = 0.35, p <.001), and for dizziness with neck pain and dorsal NME (adjusted R-square = 0.34, p <.001). NSE and PPA show similar improvements in headache intensity and dizziness in individuals with CR. Headache intensity is associated with neck pain, and dizziness with neck pain and dorsal NME, highlighting the importance of these factors when evaluating headache and dizziness. [ABSTRACT FROM AUTHOR]

Introduction There is a knowledge gap concerning the occurrence of physical complaints/injuries, i.e. musculoskeletal disorders (MSD), among Swedish women who undergo basic military training (BMT). The aims were to describe prevalence and factors related to MSD and explore physical exposure and performance in Swedish female recruits during BMT. Materials and Methods A total of 144 females (mean age 22 years) who underwent BMT in 2016 participated in this cross-sectional study. Data regarding self-reported MSD, physical performance, physical activity and exercise, motivation and mental and physical preparation, and physical exposure during BMT and perceived health were collected at the end of BMT through the Musculoskeletal Screening Protocol questionnaire. Additional data on muscle strength were retrieved from IsoKai isokinetic lift tests. Descriptive and analytic (paired samples t -test and logistic binary regression) statistics were used. Results The prevalence of MSD was high, with 33% (n  = 48) reporting MSD before BMT, 78% (n  = 113) during, and 50% (n  = 72) at the end of BMT. Knee and upper back were the most frequently reported MSD locations. Forty-four (30%) participants felt insufficiently physically prepared for BMT. The physical exposure was high with loaded marches/runs and carrying heavy loads as the most demanding tasks. The longest walking distance was reportedly 55 km, and the reported maximum load was 50 kg. Forty-five participants (31%) had carried a load representing over 50% of their body weight. Most participants reported good to excellent health at the end of BMT. There was a small (8 N) but significant (P  = 0.045) increase in mean force over time. Two variables, MSD before BMT (odds ratio 2.24, P  = 0.03) and being physically unprepared (odds ratio 3.03, P  < 0.01), were associated with MSD at the end of BMT. Conclusion This study showed that the prevalence of MSD in Swedish female recruits was high before, during, and at the end of BMT, with knee and upper back as the most frequent locations. Although the physical exposure during BMT was occasionally high, self-rated health was mainly perceived as good to excellent at the end of BMT. Previous MSD and being physically unprepared were related to MSD at the end of BMT. These important and relevant findings indicate the necessity for implementing interventions to increase physical fitness and treat MSD at the beginning of BMT. [ABSTRACT FROM AUTHOR]

Objective: Falls are common in people with multiple sclerosis. There is rising interest in how the multifactorial and chronic nature of fall risk among people with multiple sclerosis can be addressed through self-management. Thus, the aims were to investigate the extent and the scope of publications on self-management of falls in people with multiple sclerosis, and to identify how the concept of self-management was defined and used. Data sources: A systematic literature search in Medline, Cochrane, Web of Science and PsycInfo was conducted to identify publications until July 2022. Review methods: Published methodological guidance was followed. Articles targeting: (1) people with multiple sclerosis, (2) falls, and (3) self-management were selected. Of 1656 records, 203 publications were assessed for eligibility, of which 173 did not meet the inclusion criteria, and 16 publications did not contain empirical data. The type of publication, study focus, and study design was extracted. If applicable, key findings, self-management tasks and skills, and the definition of self-management were extracted. Results: Fourteen original articles met all inclusion criteria. Ten articles represented six different fall prevention interventions. Three publications were randomized controlled trials. Self-management content was variable and not comprehensive in nature. None of the 14 publications included a self-management definition. Conclusion: The limited number of original articles and the even fewer intervention studies show that the research on self-management of falls in people with multiple sclerosis is in its infancy. To progress in the research area of self-management of falls, a more robust, consensus-based description of self-management frameworks and activities is needed. [ABSTRACT FROM AUTHOR]

To investigate the experience of being the next of kin to patients with amyotrophic lateral sclerosis who use invasive ventilation via tracheostomy. Semi-structured interviews with eight next of kin were conducted and analysed using qualitative content analysis. Three main themes comprising a total of nine subthemes emerged from the analysis: A turbulent care process aiming to extend life, Struggling to cope with the strains of everyday life, and Conflicting roles as next of kin and carer. The results highlight the importance of involving next of kin throughout the whole care process and considering their specific needs. Furthermore, the development of specific support interventions to facilitate the everyday life for next of kin and to ease their burden are much needed. It is important to involve next of kin and consider their needs throughout the whole care process regarding invasive ventilation via tracheostomy. Specific support interventions need to be developed to facilitate the everyday life for next of kin and to ease their burden. [ABSTRACT FROM AUTHOR]

To translate and culturally adapt the Chelsea Critical Care Physical Assessment Tool into Swedish and to test the inter-rater reliability of the Swedish version in critically ill patients. This is an observational study. Translation and cross-cultural adaptation was performed in line with international recommendations, including forward and backward translation and expert round table discussions. The inter-rater reliability of the Chelsea Critical Care Physical Assessment Tool – Swedish was then explored in 50 critically ill adult patients, pragmatically recruited, in a University Hospital clinical setting. Reliability was calculated using intraclass correlation coefficient for aggregated scores and quadratic weighted Cohen's kappa analysis for individual items The expert round table discussion group agreed that the translation was a satisfactory equivalent to the original version and applicable for use within the clinical setting. Reliability of aggregated scores and individual items were very good (intraclass correlation coefficient of 0.97 and quadric weighted kappa values ranging from 0.88 to 0.98). The measurement error for aggregated scores was low, with a standard error of measurement of 1.79, smallest detectable change of 4.95, and limits of agreement of 5.20 and −4.76. The percentage agreement for individual items ranged from 64% to 88%. The Chelsea Critical Care Physical Assessment Tool – Swedish was found applicable and appropriate for assessment of functioning in critically ill patients in an acute setting in Sweden, and it displayed high inter-rater reliability. This implies that the Swedish version can be used as assessment tool within intensive care and acute wards in Sweden. There is a lack of validated instruments to test the functional status of critically ill patients in Sweden. The Chelsea Critical Care Physical Assessment Tool is validated and reliable in English. The Chelsea Critical Care Physical Assessment Tool – Swedish is considered reliable for use by physiotherapist in intensive care settings in Sweden. The Swedish version is feasible for use within clinical practice due to its simplicity and strong clinical relevance. [ABSTRACT FROM AUTHOR]

Background: No previous studies have investigated what biopsychosocial factors are associated with self-reported work ability in conservatively managed patients with cervical radiculopathy.Objective: To develop a theoretical model of factors and potential processes associated with variation in work ability based on a thorough assessment of biopsychosocial variables in conservatively managed patients with cervical radiculopathy.Design: Cross-sectional observational study.Setting: Tertiary neurosurgery clinic.Patients: A total of 144 conservatively managed patients with cervical pain and radiculopathy participated in the study.Methods: From 64 biopsychosocial candidate variables, significant (P < .05) bivariate correlators with Work Ability Index (WAI) were entered as independent variables in a categorical regression. Elastic net regularization maintained the most parsimonious set of independent variables significantly associated with variation in WAI as the dependent variable. Process analysis of significant independent variable associations with WAI was performed.Main Outcome Measurement: WAI.Results: From 42 bivariate correlates of WAI, multivariate regression displayed a total of seven variables that were significantly (F [25,98] = 5.74, P < .05) associated with 65.8% of the variation in WAI. The Neck Disability Index (NDI) and Fear-Avoidance Beliefs Questionnaire Work subscale (FABQ-W) were significant individual factors within the final regression model. Process analysis displayed FABQ-W having a significant specific indirect association with the direct association between NDI and WAI, with the model associated with 77% of the variability in WAI (F [2,84] = 141.17, P < .001).Conclusion: Of 64 candidate biopsychosocial factors, NDI and FABQ-W were the most significant multivariate correlates with work ability. FABQ-W has a significant indirect association with baseline NDI scores and perceived work ability. This warrants future research trialing work-related fear avoidance interventions in conservatively managed patients with cervical radiculopathy.Level Of Evidence: III. [ABSTRACT FROM AUTHOR]