Reach the person behind the dementia: physical therapists' reflections and strategies when composing physical training

Dementia is a disease characterized by cognitive impairment and physical decline that worsens over time. Exercise is one lifestyle factor that has been identified as a potential means of reducing or delaying progression of the symptoms of dementia, maximizing function and independence. The purpose of this study was to explore physical therapists' (PTs) experiences and reflections on facilitating high-intensity functional exercise with older people living with dementia, in residential care home settings. The study used a qualitative design based on interviews, individually or in small groups, with seven PTs engaged as leaders in the training of older people with dementia. The interviews were analyzed with a modified Grounded Theory method with focus on constant comparisons. To increase trustworthiness the study used triangulation within investigators and member checking. The core category "Discover and act in the moment-learn over time" reflects how the PTs continuously developed their own learning in an iterative process. They built on previous knowledge to communicate with residents and staff and to tailor the high intensity training in relation to each individual at that time point. The category "Be on your toes" highlights how the PTs searched for sufficient information about each individual, before and during training, by eliciting the person's current status from staff and by interpreting the person's body language. The category "Build a bond with a palette of strategies" describes the importance of confirmation to build up trust and the use of group members and the room to create an interplay between exercise and social interaction. These findings highlight the continuous iterative process of building on existing knowledge, sharing and reflecting, being alert to any alterations needed for individuals that day, communication skills (both with residents and staff) and building a relationship and trust with residents in the effective delivery of high intensity functional exercise to older people living with dementia in care settings

Prevalence, intensity, and playing related consequences of musculoskeletal pain, and associations with mood among professional orchestra musicians – a pilot study

Prevalence, intensity, and playing related consequences of musculoskeletal pain, and associations with mood among professional orchestra musicians – a pilot studyGodkänd; 2015; 20150530 (ulrroi

Generalised Joint Hypermobility and musculoskeletal pain among professional classical orchestra musicians in Sweden : a pilot study

Godkänd; 2015; 20150529 (ulrroi)Hälsa och prestation vid Musicerand

Generalised Joint Hypermobility and musculoskeletal pain among professional classical orchestra musicians in Sweden : a pilot study

Godkänd; 2015; 20150529 (ulrroi)Hälsa och prestation vid Musicerand

Musculoskeletal pain, work posture and physical activity among professional symphony and opera musicians in Sweden

Godkänd; 2015; 20150530 (ulrroi

“Nature's effect on my mind” : patients’ qualitative experiences of a forest-based rehabilitation programme

Aim: The aim of this study was to investigate the personal experiences and perceived effects on mind from visits to forest environments in a subset of patients with severe exhaustion disorder (ED), who participated in a randomized controlled trial for evaluation of forest-based rehabilitation. Participants: A subsample of 19 patients with diagnosed ED, who completed the three-month forest-based rehabilitation programme in the ForRest project, was interviewed. Method: The forest-based rehabilitation consisted of repeated forest visits with the main objective of spending time in rest and solitude in a chosen forest setting. Semi-structured interviews were carried out and analysed using Grounded Theory. Result: A core category and five subcategories were set up to describe the patients’ experiences and development during the forest-based rehabilitation. As patients mostly reported that they strove to achieve peace of mind during the forest visits, Striving for serenity was chosen to be the core category. At first the patients were frustrated when left alone with their own thoughts in an unfamiliar forest environment. They gradually became familiar with the forest environments and also found their favourite places where they experienced peace of mind. They were then able to rest and begin reflective thinking about their life situation, which led to ambitions to change it.The preferred forest environments were characterised by openness, light and a good view, and were felt to be undemanding, peaceful and stimulating. Conclusion: Visits to the forest provided favourite places for rest, were experienced as restorative, seemed to improved reflection and may have contributed to starting the coping process for these patients. However, forest visits, as the only treatment option, are not sufficient as rehabilitation from severe and long-term ED. We suggest that forest visits should be integrated with cognitive behavioural therapy to further improve the recovery and enhance coping in daily life for these patients