Ellen Arntzen | University of Tromsø (original) (raw)

Papers by Ellen Arntzen

Physiotherapy Theory and Practice

Multiple Sclerosis and Related Disorders

Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on ... more Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

Physiotherapy Research International, 2022

Physiotherapy Theory and Practice, 2019

Background: Group-based physiotherapy is effective for individuals with MS; nevertheless individu... more Background: Group-based physiotherapy is effective for individuals with MS; nevertheless individualization within groups is questioned and little is known regarding individuals´experiences with individualization in small groups. Objective: We aimed to explore the short-and long-term experiences of individuals with MS participating in a 6-week, group-based, individualized physiotherapy-intervention. Methods: Within a randomized controlled trial (RCT), 25 in-depth interviews with a strategic sample of 13 people (9 women; age 25-79 years old; European Disability Status Scale (EDSS) 1-6.5) were conducted at weeks 7 and 30 using systematic text condensation, with dynamic systems theory and phenomenology as analytical frameworks. Results: The main categories were: 1) movement control, orientation and insights: Bodily improvements were associated with targeted exercises, specific adjustments by the physiotherapist, emotional engagement and re-access to activities; and 2) the individual within the group: Equal distributions of one-to-one interactions and attention were important for experiencing success. Less attention and improvements turned attention toward own disability. Physical changes felt particularly emotional short term, implying that individuals' feelings of ownership and control of body and movement, new views of themselves and changed affordances in daily life were involved. Conclusion: Equally distributed attention and engagement, targeted exercises and hands-on adjustments resulting in visible and perceived bodily changes were experienced as key factors of individualization in small groups.

European Journal of Physiotherapy, 2018

Abstract Purpose: To investigate the feasibility and preliminary effects of new intervention emph... more Abstract Purpose: To investigate the feasibility and preliminary effects of new intervention emphasising core stability training integrated in functional activity (I-CoreDIST), supported by clinical Skype sessions to coordinate between health care levels among acute stroke patients. Methods: A baseline-, 4- and 12-week post-test design, including 13 individuals with acute stroke who received I-CoreDIST 5–6 day/week for 30–60 min as inpatients and three times a week as outpatients, for a total of 12 weeks. Primary outcomes: Trunk Impairment Scale-Norwegian Version (TIS-NV) and Swedish Postural Assessment Scale for Stroke-Norwegian Version (SwePASS-NV). Secondary outcomes: The Mini-BESTest, 10-m Walk Test, 2-min Walk Test, ActiGraphWgt3X-BT monitors and Questback. Linear mixed models and non-parametric tests were used for the analysis. Results: The TIS-NV demonstrated significant within-group improvements: mean difference 2.36 points at 4 weeks (p = .006) and 5.09 points at 12 weeks (p < .000) compared to baseline. The SwePASS-NV showed significant within-group improvements compared to baseline: mean difference 6.91 points at 4 weeks (p = .005) and 9.64 points at 12 weeks (p < .000). The secondary outcomes showed significant within-group improvements at 12 weeks. The Skype sessions are valuable but not applicable prior to discharge. Conclusions: I-CoreDIST is feasible, indicate effects, and Skype sessions should be re-scheduled. Randomised controlled trials are warranted.

Physiotherapy Research International, 2019

Objectives: Walking impairments are common in individuals with multiple sclerosis. Trunk control ... more Objectives: Walking impairments are common in individuals with multiple sclerosis. Trunk control is a prerequisite for walking; however, knowledge regarding whether core stability and balance training influence walking is limited. This study aimed to investigate the immediate and long-term effects of a group-based, individualized, comprehensive core stability and balance intervention (GroupCoreDIST) compared with those of standard care on walking. Methods: This assessor-blinded, prospective randomized controlled trial included 80 participants (Expanded Disability Status Scale scores 1-6.5) randomly allocated to GroupCoreDIST, conducted in groups of three for 60 min three times per week for 6 weeks (18 sessions) or standard care (n = 40/40). One participant attended no posttests, leaving 79 subjects for intention-to-treat analysis. The assessments were performed at baseline and at Weeks 7, 18, and 30. Outcomes included the 2-min walk test (2MWT), 10-m walk test-preferred/fast/slow speed (10MWT), Multiple Sclerosis Walking Scale-12 (MSWS-12), Patient Global Impression of Change-walking (PGICwalking), Rivermead Visual Gait Assessment (RVGA), and ActiGraphsWgt3X-BT activity monitors (ActiGraph). The statistical analyses included repeated-measures mixed models performed in IBM SPSS Version 24. Results: There were no significant between-group differences in the outcome measurements at baseline. The mean differences between groups were significant at all follow-up time points in favour of GroupCoreDIST for the 2MWT, 16.7 m at 7 weeks

Physical Therapy, 2019

Background Balance and trunk control are often impaired in individuals with multiple sclerosis (M... more Background Balance and trunk control are often impaired in individuals with multiple sclerosis (MS). Interventions addressing these issues are needed. Objective The objective of this study was to compare the immediate and long-term effects of a 6-week individualized, group-based, comprehensive core stability intervention (GroupCoreDIST) with standard care on balance and trunk control in individuals with MS. Design This study was a prospective, assessor-masked, randomized controlled trial. Setting The GroupCoreDIST intervention was conducted by 6 physical therapists in 6 municipalities in Norway. Standard care included the usual care for individuals with MS in the same municipalities. Assessments at all time points took place at a Norwegian hospital. Participants Eighty people with Expanded Disability Status scores of 1 to 6.5 participated in this trial. Intervention Randomized, concealed allocation was used to assign the participants to the GroupCoreDIST intervention (n = 40) or to ...

Journal of Clinical Trials, 2016

European Journal of Physiotherapy, 2016

Abstract Group-based physiotherapy is underexplored in people with multiple sclerosis (MS) and in... more Abstract Group-based physiotherapy is underexplored in people with multiple sclerosis (MS) and interventions integrating underlying aspects of balance are required. This study aimed to investigate the feasibility of a new group-based individualized core stability intervention (GroupCoreSIT) and the short-term effects on balance and walking in people with MS. A test–retest design was chosen and 12 ambulant people with MS included. GroupCoreSIT was performed three times a week for 5 weeks. Outcomes were measured using the Trunk Impairment Scale – Norwegian Version (TIS-NV), Timed 25 Foot Walking (T25FW), Two-Minute Walk Test (2MWT), Six-Minute Walk Test (6MWT), MS Walking Scale 12 (MSWS-12), Multiple Sclerosis Impact Scale 29 – Norwegian Version (MSIS 29-NV), Patient Global Impression of Change (PGICwalking, PGICgeneral health) and Visual Analogue Scale balance and walking (VASbalance/VASwalking). Significant improvement was demonstrated in sitting balance, TIS-NV (p = 0.003*), and walking tests T25FW (usual speed, p = 0.008, fastest speed, p = 0.005*), 2MWT (p = 0.026*) and 6MWT (p = 0.006*). Self-reported outcomes showed significant improvements: MSWS-12 (p = 0.003*), MSIS 29-NV (p = 0.005*) and VASbalance (p = 0.017*), but VASwalking did not show significant improvement (p = 0.088) (*significant p values after Bonferroni correction). This study provides preliminary evidence for the feasibility and effectiveness of GroupCoreSIT. An assessor-blinded randomized controlled trial is required to confirm these findings.

European Journal of Physiotherapy, 2020

Abstract Purpose This study aimed to identify relationships between trunk control, balance and wa... more Abstract Purpose This study aimed to identify relationships between trunk control, balance and walking in individuals with multiple sclerosis (MS) with minor to moderate disability to guide the content of interventions to optimise balance and walking. Methods and materials Correlation analysis of baseline data from a prospective randomised controlled study comprising 79 individuals with MS was conducted using the Expanded Disability Status Scale (EDSS) 1.0–6.5 (mean 2.36), Trunk Impairment Scale-Norwegian Version (TIS-modNV), Mini Balance Evaluation Systems Test (Mini-BESTest), 2-min walk test (2MWT), 10-m walk test (10MWT), MS Walking Scale-12 (MSWS-12), Rivermead Visual Gait Assessment (RVGA) and number of steps using ActiGraphsWgt3X-BT. Log-transformations of skewed variables were conducted and Pearson correlation coefficients were calculated. Results Strong correlations (r = 0.70–0.90) between the 2MWT and 10MWT, the 10MWT preferred speed and number of steps, and the Mini-BESTest and 2MWT and 10MWT were identified. Moderate relationships (r = 0.50–0.70) were detected between the TIS-modNV and Mini-BESTest, as well as the 2MWT, 10MWT and RVGA. Conclusions The strong relationships support the need to address several aspects of balance to improve walking, while the moderate associations suggest that dynamic trunk control should be considered addressed in interventions for individuals with minor to moderate disability to optimise balance and walking.

Multiple Sclerosis and Related Disorders

European Journal of Physical and Rehabilitation Medicine

Physiotherapy Theory and Practice

Multiple Sclerosis and Related Disorders

Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on ... more Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

Physiotherapy Research International, 2022

Physiotherapy Theory and Practice, 2019

Background: Group-based physiotherapy is effective for individuals with MS; nevertheless individu... more Background: Group-based physiotherapy is effective for individuals with MS; nevertheless individualization within groups is questioned and little is known regarding individuals´experiences with individualization in small groups. Objective: We aimed to explore the short-and long-term experiences of individuals with MS participating in a 6-week, group-based, individualized physiotherapy-intervention. Methods: Within a randomized controlled trial (RCT), 25 in-depth interviews with a strategic sample of 13 people (9 women; age 25-79 years old; European Disability Status Scale (EDSS) 1-6.5) were conducted at weeks 7 and 30 using systematic text condensation, with dynamic systems theory and phenomenology as analytical frameworks. Results: The main categories were: 1) movement control, orientation and insights: Bodily improvements were associated with targeted exercises, specific adjustments by the physiotherapist, emotional engagement and re-access to activities; and 2) the individual within the group: Equal distributions of one-to-one interactions and attention were important for experiencing success. Less attention and improvements turned attention toward own disability. Physical changes felt particularly emotional short term, implying that individuals' feelings of ownership and control of body and movement, new views of themselves and changed affordances in daily life were involved. Conclusion: Equally distributed attention and engagement, targeted exercises and hands-on adjustments resulting in visible and perceived bodily changes were experienced as key factors of individualization in small groups.

European Journal of Physiotherapy, 2018

Abstract Purpose: To investigate the feasibility and preliminary effects of new intervention emph... more Abstract Purpose: To investigate the feasibility and preliminary effects of new intervention emphasising core stability training integrated in functional activity (I-CoreDIST), supported by clinical Skype sessions to coordinate between health care levels among acute stroke patients. Methods: A baseline-, 4- and 12-week post-test design, including 13 individuals with acute stroke who received I-CoreDIST 5–6 day/week for 30–60 min as inpatients and three times a week as outpatients, for a total of 12 weeks. Primary outcomes: Trunk Impairment Scale-Norwegian Version (TIS-NV) and Swedish Postural Assessment Scale for Stroke-Norwegian Version (SwePASS-NV). Secondary outcomes: The Mini-BESTest, 10-m Walk Test, 2-min Walk Test, ActiGraphWgt3X-BT monitors and Questback. Linear mixed models and non-parametric tests were used for the analysis. Results: The TIS-NV demonstrated significant within-group improvements: mean difference 2.36 points at 4 weeks (p = .006) and 5.09 points at 12 weeks (p < .000) compared to baseline. The SwePASS-NV showed significant within-group improvements compared to baseline: mean difference 6.91 points at 4 weeks (p = .005) and 9.64 points at 12 weeks (p < .000). The secondary outcomes showed significant within-group improvements at 12 weeks. The Skype sessions are valuable but not applicable prior to discharge. Conclusions: I-CoreDIST is feasible, indicate effects, and Skype sessions should be re-scheduled. Randomised controlled trials are warranted.

Physiotherapy Research International, 2019

Objectives: Walking impairments are common in individuals with multiple sclerosis. Trunk control ... more Objectives: Walking impairments are common in individuals with multiple sclerosis. Trunk control is a prerequisite for walking; however, knowledge regarding whether core stability and balance training influence walking is limited. This study aimed to investigate the immediate and long-term effects of a group-based, individualized, comprehensive core stability and balance intervention (GroupCoreDIST) compared with those of standard care on walking. Methods: This assessor-blinded, prospective randomized controlled trial included 80 participants (Expanded Disability Status Scale scores 1-6.5) randomly allocated to GroupCoreDIST, conducted in groups of three for 60 min three times per week for 6 weeks (18 sessions) or standard care (n = 40/40). One participant attended no posttests, leaving 79 subjects for intention-to-treat analysis. The assessments were performed at baseline and at Weeks 7, 18, and 30. Outcomes included the 2-min walk test (2MWT), 10-m walk test-preferred/fast/slow speed (10MWT), Multiple Sclerosis Walking Scale-12 (MSWS-12), Patient Global Impression of Change-walking (PGICwalking), Rivermead Visual Gait Assessment (RVGA), and ActiGraphsWgt3X-BT activity monitors (ActiGraph). The statistical analyses included repeated-measures mixed models performed in IBM SPSS Version 24. Results: There were no significant between-group differences in the outcome measurements at baseline. The mean differences between groups were significant at all follow-up time points in favour of GroupCoreDIST for the 2MWT, 16.7 m at 7 weeks

Physical Therapy, 2019

Background Balance and trunk control are often impaired in individuals with multiple sclerosis (M... more Background Balance and trunk control are often impaired in individuals with multiple sclerosis (MS). Interventions addressing these issues are needed. Objective The objective of this study was to compare the immediate and long-term effects of a 6-week individualized, group-based, comprehensive core stability intervention (GroupCoreDIST) with standard care on balance and trunk control in individuals with MS. Design This study was a prospective, assessor-masked, randomized controlled trial. Setting The GroupCoreDIST intervention was conducted by 6 physical therapists in 6 municipalities in Norway. Standard care included the usual care for individuals with MS in the same municipalities. Assessments at all time points took place at a Norwegian hospital. Participants Eighty people with Expanded Disability Status scores of 1 to 6.5 participated in this trial. Intervention Randomized, concealed allocation was used to assign the participants to the GroupCoreDIST intervention (n = 40) or to ...

Journal of Clinical Trials, 2016

European Journal of Physiotherapy, 2016

Abstract Group-based physiotherapy is underexplored in people with multiple sclerosis (MS) and in... more Abstract Group-based physiotherapy is underexplored in people with multiple sclerosis (MS) and interventions integrating underlying aspects of balance are required. This study aimed to investigate the feasibility of a new group-based individualized core stability intervention (GroupCoreSIT) and the short-term effects on balance and walking in people with MS. A test–retest design was chosen and 12 ambulant people with MS included. GroupCoreSIT was performed three times a week for 5 weeks. Outcomes were measured using the Trunk Impairment Scale – Norwegian Version (TIS-NV), Timed 25 Foot Walking (T25FW), Two-Minute Walk Test (2MWT), Six-Minute Walk Test (6MWT), MS Walking Scale 12 (MSWS-12), Multiple Sclerosis Impact Scale 29 – Norwegian Version (MSIS 29-NV), Patient Global Impression of Change (PGICwalking, PGICgeneral health) and Visual Analogue Scale balance and walking (VASbalance/VASwalking). Significant improvement was demonstrated in sitting balance, TIS-NV (p = 0.003*), and walking tests T25FW (usual speed, p = 0.008, fastest speed, p = 0.005*), 2MWT (p = 0.026*) and 6MWT (p = 0.006*). Self-reported outcomes showed significant improvements: MSWS-12 (p = 0.003*), MSIS 29-NV (p = 0.005*) and VASbalance (p = 0.017*), but VASwalking did not show significant improvement (p = 0.088) (*significant p values after Bonferroni correction). This study provides preliminary evidence for the feasibility and effectiveness of GroupCoreSIT. An assessor-blinded randomized controlled trial is required to confirm these findings.

European Journal of Physiotherapy, 2020

Abstract Purpose This study aimed to identify relationships between trunk control, balance and wa... more Abstract Purpose This study aimed to identify relationships between trunk control, balance and walking in individuals with multiple sclerosis (MS) with minor to moderate disability to guide the content of interventions to optimise balance and walking. Methods and materials Correlation analysis of baseline data from a prospective randomised controlled study comprising 79 individuals with MS was conducted using the Expanded Disability Status Scale (EDSS) 1.0–6.5 (mean 2.36), Trunk Impairment Scale-Norwegian Version (TIS-modNV), Mini Balance Evaluation Systems Test (Mini-BESTest), 2-min walk test (2MWT), 10-m walk test (10MWT), MS Walking Scale-12 (MSWS-12), Rivermead Visual Gait Assessment (RVGA) and number of steps using ActiGraphsWgt3X-BT. Log-transformations of skewed variables were conducted and Pearson correlation coefficients were calculated. Results Strong correlations (r = 0.70–0.90) between the 2MWT and 10MWT, the 10MWT preferred speed and number of steps, and the Mini-BESTest and 2MWT and 10MWT were identified. Moderate relationships (r = 0.50–0.70) were detected between the TIS-modNV and Mini-BESTest, as well as the 2MWT, 10MWT and RVGA. Conclusions The strong relationships support the need to address several aspects of balance to improve walking, while the moderate associations suggest that dynamic trunk control should be considered addressed in interventions for individuals with minor to moderate disability to optimise balance and walking.

Multiple Sclerosis and Related Disorders

European Journal of Physical and Rehabilitation Medicine