Bakgrund: Protesen har existerat sedan forntida egypten. Att leva med en protes kan ha både negativ och positiv påverkan hos protesbäraren. Omställningen bidrar till en ny livsstil där varje individ kan påverkas i olika utsträckning både psykiskt och fysiskt. Sjuksköterskan behöver ha kunskap om protesbärarens upplevelser för att kunna hjälpa protesbäraren att anpassa sig till livet med en protes. Syfte: Syftet med studien var att belysa upplevelser av att leva med en protes för nedre extremitet. Metod: Allmän litteraturstudie bestående av tio resultatartiklar som söktes fram i databaserna CINAHL, PubMed, PsycINFO samt Sage Journals. Artiklarna analyserades med hjälp av en guide för kvalitativ forskning gjord av Popenoe et al. (2021). Resultat: Det framkom fem kategorier och dessa var: rörlighet, komfort och funktion, samhällets inverkan, utbildning, jobb och ekonomi och socialt stöd. Alla kategorier belyste hur det kan vara att leva med en protes för nedre extremitet. Konklusion: Protesen kan medföra en känsla av självständighet samtidigt som den kan upplevas som en begränsning med smärtor och problem med passform. Stöd från anhöriga och vårdpersonal var viktigt för återhämtningen. Att vårdpersonal gav god och tillräcklig information var också väsentligt. Ytterligare forskning behövs om protesbärares upplevelser av att leva med en protes för nedre extremitet där sjuksköterskor får den kunskap som krävs för att ge en god omvårdnad. / Background: The prosthesis has existed since ancient Egypt. Living with a prosthesis can have both negative and positive effects on the prosthesis user. The transition contributes to a new lifestyle where each individual can be affected to different extents both psychologically and physically. The nurse needs to have knowledge about the experiences of a prosthesis user in order to be able to help the prosthesis user adapt to life with a prosthesis. Aim: The aim of the study was to illustrate experiences of living with a lower extremity prosthesis. Method: The general literature review study included ten result articles that were searched in the databases CINAHL, PubMed, PsycINFO and Sage Journals. The articles were analyzed using a guide for qualitative research made by Popenoe et al. (2021). Results: Five categories emerged and these were: mobility, comfort and function, impact from the society, education, jobs and finances and social support. All categories highlighted what it can be like to live with a prosthesis for the lower limb. Conclusion: The prosthesis can bring a sense of independence as well as a limitation that includes pain and problems with the fitting of the prosthesis. Support from relatives and healthcare professionals was important for the recovery. It was also essential that healthcare staff provided good and sufficient information to the patient. Further research is needed on prosthesis users’ experiences of living with a lower extremity prosthesis where nurses gain the knowledge required to provide good nursing care.

Due the fear of Sudden Infant Death Syndrome (SIDS), parents have been putting infants on their backs. The American Academy of Pediatrics (AAP) started to recommend balancing sleeping in supine with prone play - also called Tummy Time-to encourage optimal, healthy infant development (Zachry & Kitzman, 2011). Due to various reasons, parents avoid putting the infants in the prone position even when awake. Evidence-based literature has shown that infants sleeping in supine without spending time in prone can lead to motor delay in their first year of life (Barlett & Fanning Kneale, 2003; Dudek-Shriber & Zelazny, 2007). Evidence also shows that weight bearing in prone is associated with motor development (Salls et al. 2002). This doctoral project attempts to identify the links between prone activities, postural control and fine motor development through research on evidence-based literature. It also provides a theoretical foundation, investigates the evidence and best practice in designing an educational package on prone play for typically developing and high risks infants. It also advocates best practice in occupational therapy by addressing a lack of evidenced based literature and attempts to add to the knowledge base in regards to tummy time and its effect on fine motor development. The target audiences are parents and caregivers of infants; the health care professionals that work with them; the funding agencies and policy makers. The qualitative and quantitative benefits of the parent education program will align with health promotion and wellness initiatives of the Ontario government. The project will describes a detailed evaluation plan and dissemination of results with estimated budgets. This will include presentation to the community and the ministries in the government. The project will contribute to these areas of occupational therapy: (1) addressing evidence-based practice in tummy time with typically developing and high risks infants; (2) providing best practice for implementing a Prone to Play program to foster upper extremity motor development; and (3) promoting health and wellness initiatives in occupational therapy.

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Aim and research questions: The aim of this master thesis was to test for test-retest reliability for a newly developed force instrument (FI) and determine if a combined effect of trial, speed and resistance exist on the variable fraction effective force (FEF) for a group of athletes with cerebral palsy (CP-group) and a reference group (AB-group).  1. What is the intraclass correlation coefficient on maximum velocity measured on two occasions with the FI for a CP-group and an AB-group? 2. What is the intraclass correlation coefficient on FEF for a flexion movement measured on two occasions for an AB-group? 3. Is there an interaction effect of; a) trial and group, b) trial, speed and group, c) trial, resistance and group and d) trial, speed, resistance and group, on the variable FEF for a flexion movement for a CP-group and an AB-group?   Method: This master thesis was an experimental cross-sectional study with a test-retest design. Data collection took place in Stockholm and in Elche (Spain), 2022. Participants visited the BMC laboratory at two occasions. Participants completed tasks with their least impaired arm (CP-group) or dominant arm (AB-group) in a horizonal movement at different resistances and speeds on the FI. Maximum velocity together with force in 3 directions was registered. FEF was calculated from the three forces. ICC on Vmax for both groups and FEF for the AB-group was conducted together with a mixed-design ANOVA on de independent variables trial, group, speed and resistance on the dependent variable FEF.    Results: 18 participants in the CP-group and 20 participants in the AB-group was included for statistical analysis. The ICC on Vmax was .944 for the CP-group and .804 for the AB-group. The mean ICC for FEF was .644 for the AB-group. Using a mixed-design ANOVA concluded that there was no significant interaction effect on trial, group, speed and resistance, F(4) =2.069, p=.088, nor in any of the other combinations.    Conclusion: The newly developed FI shows good test-retest reliability for both groups and could be used for measurements of arm coordination. Further studies are needed to further evaluate reliability of the instrument. / Syfte och frågeställningar: Syftet med detta examensarbete var att testa för test-retest reliabilitet för ett nyutvecklat kraftinstrument (FI) och avgöra om det finns en kombinerad effekt av testtillfälle, hastighet och motstånd på variabeln fraction effective force (FEF) för en grupp idrottare med cerebral pares (CP-grupp) och en referensgrupp (AB-grupp). 1. Vad är intraclass correlation coefficient för maximal hastighet mätt vid två tillfällen med för en CP-grupp och AB-grupp? 2. Vad är intraclass correlation coefficient för FEF för en flexionsrörelse mätt vid två tillfällen för en AB-grupp? 3. Finns det en interaktionseffekt mellan; a) testtillfälle och grupp, b) testtillfälle, hastighet och grupp, c) testtillfälle, motstånd och grupp och d) testtillfälle, hastighet, motstånd och grupp, på variabeln FEF för en flexionsrörelse för en grupp med CP och AB-grupp?   Metod: Denna masteruppsats en experimentell tvärsnittsstudie med test-retest design. Datainsamlingen genomfördes i Stockholm och Elche (Spanien), 2022. Deltagarna besökte BMC laboratoriet vid två tillfällen och genomförde rörelser i horisontalplan i olika hastigheter, mot olika motstånd med sin minst funktionsnedsatta arm (CP-gruppen) eller dominanta arm (AB-gruppen) på FI. Den maximala hastigheten tillsammans med kraft i tre riktningar samlades in. FEF beräknades utifrån de tre krafterna. Den statistiska analysen innehöll ICC som genomfördes för Vmax för båda grupperna samt för FEF för AB-gruppen. En mixed-design ANOVA genomfördes med de oberoende variablerna testtillfälle, grupp, motstånd och hastighet på den beroende variabeln FEF.   Resultat: 18 deltagare i CP-gruppen och 20 deltagare i AB-gruppen inkluderades i den statistiska analysen. ICC på Vmax för CP-gruppen var .944 och .804 för AB-gruppen. Ett medelvärde på ICC för FEF i en flexionsrörelse var .644 för AB-gruppen. Det fanns ingen signifikant interaktionseffekt på testtillfälle, grupp, hastighet och motstånd, F (4) = 2.069, p = .088, och inte heller för de andra kombinationerna.    Konklusion: Den nyutvecklade instrumentet visar på god reliabilitet vid upprepade mätningar för båda grupperna och kan användas i framtida för mätningar av arm-koordination hos de två grupperna. Men fortsatta studier behövs för att vidare utvärdera reliabilitet för instrumentet.

<p>Few studies have shown the process of adaptation in muscle activity and joint angle during prolonged repetitive work. Fifteen healthy men performed 1 minute cycles of automotive-related tasks, which included a finger pull, knob turn, drill press and hose connector push. The experiment occurred on two days, separated by 24 hours. Day 1 required 61 cycles, with 5 cycles on day 2. Electromyography and kinematics of the upper extremity were analyzed at 12-minute intervals. Time to complete work cycle decreased by 6.3 s at the end of day 1 and 5.3 s on day 2. Peak EMG decreased for triceps brachii (TB), anterior deltoid (AD) and infraspinatus (IN) during work cycle, TB (finger pull), biceps brachii (BB), TB, AD, middle deltoid (MD) and IN during the hose insertion task. Peak EMG increased for MD and IN during the drill task. Mean EMG decreased for MD (work cycle), BB (hose insertion) and AD (finger pull), while MD and IN increased (drill task) and upper trapezius increased during the work cycle. EMG COV decreased for TB, AD, posterior deltoid and IN during the work cycle, TB during the finger pull task and AD during the hose insertion task. COV increased for BB during the work cycle, AD during the finger pull and for BB and lower trapezius during the drill press. Peak shoulder flexion decreased by 7.0° during the work cycle. Perceived discomfort increased by 1.2 units. This thesis found adaptations to highly repetitive but light work in only one hour, some of these changes persisted through the next day suggesting an adaptive process. This thesis is one of the first to examine adaptations to a highly repetitive simulated assembly work and has provided new insights into the evaluation of repetitive jobs as a whole and as isolated subtasks.</p> / Master of Science in Kinesiology