The effects of aerobic exercise and the impact of migraine and co-existing tension-type headache and neck pain

The overall aims of this thesis were to investigate the effects of an aerobic exercise program and the impact of migraine and co-existing TTH and NP in persons with these combined conditions. This thesis is based on four studies.In study I, a new questionnaire, Impact of Migraine, TTH and NP (Impact M-TTH-NP), was developed. This questionnaire covered pain, triggers, psychosocial,socioeconomic and work related aspects. Face and content validity wereinvestigated together with five additional questionnaires; the International Physical Activity Questionnaire (IPAQ short form), Migraine-Specific Quality of LifeQuestionnaire (MSQ v. 2.1), The World Health Organization five-itemPsychological Well-Being Index (WHO-5), Major Depression Inventory (MDI) andNeck Disability Index (NDI). Face validity was assessed by group interviews ofnine persons with migraine and co-existing TTH and NP. Content validity wasassessed by the degree of relevance by 13 headache experts. Impact M-TTH-NPshowed acceptable face validity and excellent content validity. MSQ, WHO-5, MDIand NDI showed acceptable face validity, and WHO-5, MDI and NDI showed excellent content validity.In study II, the prevalence of co-existing TTH and NP in a clinical sample of persons with migraine was investigated. Also, we investigated level of physical activity, psychological well-being, perceived stress and self-rated health in persons with migraine and co-existing TTH and NP, their perceived ability to engage in physical activity and which among the three conditions (migraine, TTH or NP) was rated as the most burdensome condition. A survey of 148 persons with migraine and 100 healthy controls was conducted. The prevalence of co-existing TTH and NP in persons with migraine was 67%; this group had a low level of physical activity, low psychological well-being, high level of perceived stress and poor self-rated health compared to healthy controls. They reported reduced ability to engage in physical activity owing to migraine (high degree), TTH (moderate degree) and NP (low degree). The most burdensome condition was migraine, followed by TTH and NP.In studies III and IV, the effect of a 12-week aerobic exercise program, with follow-up six months from baseline, in persons with migraine and co-existing TTH and NP was investigated in a prospective, open-label, randomized, clinical trial. Fifty-two persons (26 in exercise group and 26 in control group) completed the six-month study period. The exercise group showed a significant improvement in the ability to engage in daily activities because of reduced impact of migraine compared to controls. Migraine frequency, pain intensity and duration were significantly reduced in the exercise group compared to baseline, although not significant compared to the control group (Study III). The effect of the aerobic exercise program on pain perception was measured in Study IV. We did not identify any significant effect on muscle tenderness and pain thresholds. We concluded that aerobic exercise had positive effects on migraine severity and migraine burden, but these results could not be explained by the applied tests of muscle tenderness and pain thresholds. Thus, the positive effect on migraine burden may rather be explained by positive alteration of avoidance behaviour

Developments in algorithmic management from an IR-perspective : Denmark

The INCODING project studies dynamics in the (co)governance of Algorithmic Management and Artificial Intelligence-techniques from a Comparative Industrial Relations-perspective. By identifying the main challenges for workers and their representatives, it aims to explore how to contribute to Inclusive and Transparent Algorithmic Management. The present stock tacking reports provide an insight on the latest developments in this field in Denmar

Critical thinking dispositions among newly graduated nurses

wangensteen s., johansson i.s., björkström m.e. & nordström g. (2010) Critical thinking dispositions among newly graduated nurses. Journal of Advanced Nursing66(10), 2170–2181

International consensus on the most useful physical examination tests used by physiotherapists for patients with headache: A Delphi study

Background: A wide range of physical tests have been published for use in the assessment of musculoskeletal dysfunction in patients with headache. Which tests are used depends on a physiotherapist's clinical and scientific background as there is little guidance on the most clinically useful tests. Objectives: To identify which physical examination tests international experts in physiotherapy consider the most clinically useful for the assessment of patients with headache. Design/methods: Delphi survey with pre-specified procedures based on a systematic search of the literature for physical examination tests proposed for the assessment of musculoskeletal dysfunction in patients with headache. Results: Seventeen experts completed all three rounds of the survey. Fifteen tests were included in round one with eleven additional tests suggested by the experts. Finally eleven physical examination tests were considered clinically useful: manual joint palpation, the cranio-cervical flexion test, the cervical flexion-rotation test, active range of cervical movement, head forward position, trigger point palpation, muscle tests of the shoulder girdle, passive physiological intervertebral movements, reproduction and resolution of headache symptoms, screening of the thoracic spine, and combined movement tests. Conclusions: Eleven tests are suggested as a minimum standard for the physical examination of musculoskeletal dysfunctions in patients with headache