The event takes place:
Stina Liljes public defence of a doctoral thesis
You are welcome to attend Stina Liljes public defence of a doctoral thesis at the department of Health, Blekinge Institute of Technology
Time: October 9, at 13:15
Place: G340, Campus Gräsvik, Karlskrona
Thesis title: Aspects of musculoskeletal pain interfering with normal life and naprapathic manual therapy from a health technology assessment perspective
Research education subject: Applied Health Technology
External reviewer: Professor Jan Hartvigsen, University of Southern Denmark
Members of the examining committee:
Professor Hans-Christer Holmberg, Mid Sweden University
Professor Hilde Eide, Buskerud and Vestfold University College, Norway
Professor Jon Karlsson, University of Gothenburg
Substitute: Dr. Hanna Tuvesson, Blekinge Institute of Technology
Chairperson: Professor Johan Berglund, Blekinge Institute of Technology
Supervisor: Professor Johan Berglund and Dr. Peter Anderberg, Blekinge Institute of Technology, Dr. Eva E. Skillgate, Karolinska Institutet
The Department of Health is hosting a reception after the seminar. Please respond to firstname.lastname@example.org no later than October 2 if you intend to participate and kindly note if you have any food allergies etc.
The thesis is available at: http://www.bth.se/hal/hal.nsf/bilagor/S%20Lilje%20avhandling_pdf/$file/S%20Lilje%20avhandling.pdf
Musculoskeletal pain is one of the most common reasons for seeking health care. If a patients disorders remain after conventional primary care, a referral to secondary care (orthopaedics) is often made, yet many referrals on the waiting lists concern patients who are not in need of surgery. Manual therapy has a lot of proved experience but is not routine in the Swedish national health care system today, and there is a lack of scientific evidence for its treatment and cost effects.
The overall aim of this thesis was to increase the knowledge of musculoskeletal pain that interferes with normal life. Specific aims were to investigate if musculoskeletal pain interfering with normal life in older adults is associated with heavy physical and negative psychosocial workloads through life, and to deepen the knowledge of the treatment and cost effects of naprapathic manual therapy (NMT), and of older adults' experiences of reminders of home exercises through text messaging.
Study I is a cross sectional study (n=641) that investigates associations between musculoskeletal pain interfering with normal life in older adults and different physical and psychological loads through life. Study II is a randomized controlled trial (n=78) that compares NMT with standard orthopaedic care for low priority orthopaedic outpatients. Study III (n=1) is a case study that describes the treatment effects of NMT in a patient diagnosed with adhesive capsulitis. Study IV is a cost consequence analysis (n=78), where the costs and the health economic gains in study II were analyzed. Study V is a qualitative interview study (n=8) exploring older adults experiences of SMS:s as reminders of home exercises after NMT for recurrent low back pain.
The results in Study I were that psychosocial and physical workloads are associated with musculoskeletal pain that interferes with normal life in older adults. NMT for low priority patients on orthopaedic waiting lists yielded significantly larger improvements in pain, physical function and perceived recovery compared with standard orthopaedic care (Study II). NMT for the acromio-clavicular joint, for adhesive capsulitis resulted in significant pain relief and perceived recovery, decreased sleeping disorders and medication (Study III). The health gains for naprapathy were higher compared with standard orthopaedic care, and the costs significantly lower (Study IV). Study V concluded that the use of SMS:s as reminders of home exercises after NMT were appreciated by the patients, and stimulated them to practice memorising and to create their own routines for continued compliance.
This thesis suggests that pain in older adults is associated with heavy physical and negative psychosocial workloads through life. NMT may be cost effective for low priority orthopaedic outpatients of working age with musculoskeletal disorders that are not likely to benefit from orthopaedic surgery, and was effective in a patient diagnosed with adhesive capsulitis. Text messaging used to remind older adults of home exercises after NMT stimulates the patients to create their own routines for continued compliance.
Organizer, personal / school / organizer:
The department of Health