Hanne Solveig Dagfinrud

• Nordén, Kristine Røren; Dagfinrud, Hanne Solveig & Smedslund, Geir (2026). Reporting of exercise interventions in spondyloarthritis research: a systematic review of randomised controlled trials. BMJ Open sport & exercise medicine. 12(1). doi: 10.1136/bmjsem-2025-002877. Full text in Research Archive
• Nellemann, Birgitte; Fongen, Birgit Camilla; Dagfinrud, Hanne Solveig; Berg, Inger Jorid; Kristianslund, Eirik & Sexton, Joseph [Show all 13 contributors for this article] (2026). Remote personalised exercise in axial spondyloarthritis: the SPARK trial – protocol for a 6-month randomised controlled trial. BMJ Open. 16(3). doi: 10.1136/bmjopen-2025-112420. Full text in Research Archive
• Rimehaug, Stein Arne; Moe, Rikke Helene; Dagfinrud, Hanne; Fischer, Felix; Johansen, Thomas & Kjeken, Ingvild [Show all 12 contributors for this article] (2025). Measurement properties of the PROMIS-29 profile v2.1 in a Norwegian rehabilitation context. Journal of Patient-Reported Outcomes. 9(1). doi: 10.1186/s41687-025-00929-7. Full text in Research Archive Show summary

  Abstract Introduction Psychometric properties of the Patient-Reported Outcomes Measurement Information System ® Profile 29 (PROMIS-29) Norwegian version has previously been examined in a general population. This multicenter study aimed to examine the internal consistency, construct validity, responsiveness, score distribution and floor/ceiling effects of PROMIS-29 v2.1 in a Norwegian rehabilitation context. Methods Patients receiving rehabilitation services participating in a longitudinal cohort study answered PROMIS-29 at baseline and at 3-month follow-up. Internal consistency was assessed by Cronbach’s alpha and McDonald’s omega. Construct validity was examined through hypothesis testing, using EQ-5D-5L as comparator measure. Hypotheses for correlations of change scores for both questionnaires were tested as an expression of responsiveness. Score distribution and floor/ceiling effects were examined with histograms and descriptive statistics. Results A total of 828 patients with a mean age of 54.3 years were included for analysis. The internal consistency for each PROMIS-29 domain was confirmed, with alpha and omega values exceeding the threshold of ≥ 0.70. Regarding correlations between PROMIS-29 and EQ-5D-5L, 34 out of 40 hypotheses were confirmed for construct validity and 19 out of 24 for responsiveness, both meeting our a priori criterion of ≥ 75% confirmed hypotheses. There was no floor effect of any PROMIS-29 domain in our sample, and ceiling effect only for anxiety and depression domain scores. Still, this confirmed the applicability of PROMIS-29 in a rehabilitation context. Conclusion The Norwegian PROMIS-29 has sufficient internal consistency, construct validity and responsiveness for use as an outcome measure for health status and health-related quality of life in rehabilitation. Trial registration number ClinicalTrials.gov NCT03764982 RehabNytte study, registered 2018-12-04.

• Sand-Svartrud, Anne-Lene; Dagfinrud, Hanne; Fossen, Johanne; Framstad, Heidi; Irgens, Eirik Lind & Morvik, Hild Kristin [Show all 9 contributors for this article] (2025). Impact of provider feedback on quality improvement in rehabilitation services: an interrupted time series analysis. Frontiers in Rehabilitation Sciences. 6. doi: 10.3389/fresc.2025.1564346. Full text in Research Archive
• Sand-Svartrud, Anne-Lene; Kjeken, Ingvild; Skardal, Renate Foss; Gjerset, Gunhild Maria; Johnsen, Tonje Jossie & Lyken, Anne Dorte [Show all 8 contributors for this article] (2024). Completeness of repeated patient-reported outcome measures in adult rehabilitation: a randomized controlled trial in a diverse clinical population. BMC Health Services Research. 24(1). doi: 10.1186/s12913-024-12103-8. Full text in Research Archive
• Sagen, Joachim Støren; Kjeken, Ingvild; Habberstad, Andreas Hanssønn; Linge, Anita Dyb; Simonsen, Ann Elisabeth & Lyken, Anne Dorte [Show all 12 contributors for this article] (2024). Patient Involvement in the Rehabilitation Process Is Associated with Improvement in Function and Goal Attainment: Results from an Explorative Longitudinal Study. Journal of Clinical Medicine. 13(2). doi: 10.3390/jcm13020320. Full text in Research Archive
• Mulrooney, Elisabeth; Neogi, Tuhina; Dagfinrud, Hanne; Hammer, Hilde Berner; Pettersen, Pernille Steen & Kvien, Tore Kristian Aaserud [Show all 8 contributors for this article] (2024). Hand osteoarthritis phenotypes based on a biopsychosocial approach, and their associations with cross-sectional and longitudinal pain. Osteoarthritis and Cartilage. ISSN 1063-4584. doi: 10.1016/j.joca.2024.04.011. Full text in Research Archive Show summary

  Objective Hand osteoarthritis (OA) pain is characterized as heterogeneous and multifactorial. Differences in pain may be explained by underlying phenotypes, which have not been previously explored Design Latent class analysis determined classes of participants with hand OA from the Nor-Hand study baseline examination (2016–17) based on a biopsychosocial framework. Outcomes were hand and overall bodily pain intensity (Numeric Rating Scale, 0–10) at baseline and follow-up (2019–21), The relations of the classes to pain outcomes at baseline, follow-up, and change over time were analysed in separate models by linear regression, using the overall healthiest class as reference. Results Five classes differing in radiographic hand OA burden and OA burden in the lower extremities by ultrasound, demographic factors, psychosocial burden and pain sensitization was identified. Persons with the least severe OA but higher burden of biopsychosocial factors reported the most hand pain (beta 3.65, 95% CI 2.53, 4.75). Pain was less pronounced in persons with the most severe hand OA but low burden of biopsychosocial factors (beta 1.03, 95% CI 0.41, 1.65). Results were similar for overall bodily pain and at follow-up. Changes in pain were small, but the association between a separate class defined by higher levels of biopsychosocial burden and pain changes was significant. Conclusion The five hand OA phenotypes were associated with pain at baseline and 3.5 years later. The phenotype with the least OA severity, but higher burden of biopsychosocial factors reported more pain than the phenotype with the most severe OA, reflecting the symptom-structure discordance of the hand OA pain experience.

• Nordén, Kristine Røren; Semb, Anne Grete; Dagfinrud, Hanne; Hisdal, Jonny; Sexton, Joseph & Fongen, Camilla [Show all 12 contributors for this article] (2024). Effect of high-intensity interval training in physiotherapy primary care for patients with inflammatory arthritis: The ExeHeart randomised controlled trial. RMD Open. 10(1). doi: 10.1136/rmdopen-2023-003440. Full text in Research Archive Show summary

  Objectives To assess the effect of high-intensity interval training (HIIT) delivered in physiotherapy primary care on the primary outcome of cardiorespiratory fitness (CRF) in patients with inflammatory arthritis (IA). Additionally, to explore the effects of HIIT on secondary outcomes, including cardiovascular disease (CVD) risk factors and disease activity. Methods Single-blinded randomised controlled trial with 60 patients randomly assigned to either a control group receiving usual care or an exercise group receiving usual care and 12 weeks of individualised HIIT at 90%–95% peak heart rate. Outcomes were assessed at baseline, 3 months and 6 months post baseline and included CRF measured as peak oxygen uptake (VO2peak), classic CVD risk factors, disease activity, anthropometry and patient- reported physical activity, pain, fatigue, disease impact and exercise beliefs and self-efficacy. Results Intention-to-treat analysis demonstrated a significant between-group difference in VO2peak at 3 months (2.5 mL/kg/min, 95% CI 0.9 to 4.0) and 6 months (2.6 mL/kg/min, 95% CI 0.8 to 4.3) in favour of the exercise group. A beneficial change in self-reported physical activity in favour of the exercise group was observed at 3 and 6 months. The HIIT intervention was well-tolerated with minimal adverse events and no apparent impact on disease activity. Differences in secondary outcomes related to CVD risk factors, disease impact, pain, fatigue and exercise beliefs and self-efficacy were generally small and non-significant. Conclusion After 12 weeks of supervised HIIT delivered in physiotherapy primary care, patients with IA demonstrated a favourable improvement in CRF, with sustained effects at 6-month follow-up.

• Nordén, Kristine Røren; Dagfinrud, Hanne; Semb, Anne Grete; Hisdal, Jonny; Metsios, George S. & Sexton, Joseph [Show all 9 contributors for this article] (2023). Criterion Validity and Responsiveness of Estimated Cardiorespiratory Fitness Models in Patients with Inflammatory Joint Disease. Journal of Clinical Medicine. 12(21). doi: 10.3390/jcm12216753. Full text in Research Archive Show summary

  Cardiorespiratory fitness (CRF) is an excellent marker of overall health. This study aimed to assess criterion validity and responsiveness of estimated CRF models (eCRF) in patients with inflammatory joint disease (IJD). CRF was measured directly as peak oxygen uptake (VO2peak) by a Cardiopulmonary Exercise Test (CPET), while one generic eCRF model (eCRFGEN) and two disease-specific eCRF models (eCRFALT and eCRFPGA) were used to estimate CRF at baseline and after 3 months in 55 Norwegian patients with IJD. Moderate correlations were observed between eCRFGEN, eCRFALT, eCRFPGA, and VO2peak at baseline (ICC 0.60, 0.64 and 0.62, respectively) and 3 months (ICC 0.62, 0.65 and 0.57, respectively). All eCRF models overestimated measured VO2peak, and there was large variability in agreement of individual measurements at baseline and at 3 months. Weak correlations were observed for responsiveness of eCRFGEN (ICC 0.39), eCRFALT (ICC 0.40) and eCRFPGA (ICC 0.39). Mean differences between change in eCRF models and change in VO2peak were small, but the wide limits of agreement exceeded the pre-defined clinically acceptable margins. The eCRF models possessed adequate ability to detect ≥3.5 mL/kg/min improvement in VO2peak. eCRF may suffice for group-level assessment, but caution is advised when applying eCRF to individual patients with IJD.

• Liegl, Gregor; Roorda, Leo D.; Terwee, Caroline B.; Steultjens, Martijn; Roos, Ewa M. & Guillemin, Francis [Show all 10 contributors for this article] (2023). Suitability of the animated activity questionnaire for use as computer adaptive test: establishing the AAQ-CAT. Quality of Life Research. ISSN 0962-9343. doi: 10.1007/s11136-023-03402-4. Full text in Research Archive
• Fongen, Camilla; Dagfinrud, Hanne Solveig; Bilberg, Annelie & Sveaas, Silje Halvorsen (2023). Reduced sleep quality is highly prevalent and associated with physical function and cardiorespiratory fitness in patients with axial spondyloarthritis: a cross-sectional study. Scandinavian Journal of Rheumatology. ISSN 0300-9742. 53(2), p. 130–139. doi: 10.1080/03009742.2023.2281069. Full text in Research Archive Show summary

  Objectives To assess sleep quality, and its associations with physical function, cardiorespiratory fitness, and spinal mobility, in axial spondyloarthritis (axSpA) patients. Method Baseline data from the Exercise for Spondyloarthritis trial were used. Assessments included [Pittsburgh Sleep Quality Index (PSQI), 0–21, 21 = worst], performance-based physical function [Ankylosing Spondylitis Performance Index (ASPI), seconds, higher = worse], patient-reported physical function [Bath Ankylosing Spondylitis Functional Index (BASFI), 0–10, 10 = worst], cardiorespiratory fitness [peak oxygen uptake (V O2peak), mL/kg/min, lower = worse], and spinal mobility [Bath Ankylosing Spondylitis Metrology Index (BASMI), 0–10, 10 = worst]. Associations were examined in separate models using multiple linear regression. Results Ninety-nine patients with axSpA were included, 53% female, mean age 46 years, and 72% with high disease activity (ASDAS-C-reactive protein ≥ 2.1), of whom 84 (85%) had reduced sleep quality. Sleep disturbance was most frequently reported (65%), followed by poor subjective sleep quality (53%), daytime dysfunction (41%), and increased sleep latency (41%). Positive associations were observed between PSQI and ASPI [β = 0.10, 95% confidence interval (CI) 0.01, 0.19] and PSQI and BASFI (β = 0.85, 95% CI 0.51, 1.20), and there was an inverse association between PSQI and V O2peak (β = −0.14, 95% CI −0.27, −0.01), adjusted for age and sex. There was no association between PSQI and BASMI. Conclusion Reduced sleep quality was common in axSpA patients with moderate to high disease activity. Better sleep quality was associated with better physical function and higher cardiorespiratory fitness. There was no association between sleep quality and spinal mobility.

• Sand-Svartrud, Anne-Lene; Berdal, Gunnhild; Aanerud, Gerd Jenny; Azimi, Maryam; Bjørnerud, Anne Merete & Dager, Turid Nygaard [Show all 11 contributors for this article] (2023). Delivery of a quality improvement program in team-based rehabilitation for patients with rheumatic and musculoskeletal diseases: a mixed methods study. Disability and Rehabilitation. ISSN 0963-8288. doi: 10.1080/09638288.2023.2204247. Full text in Research Archive Show summary

  Purpose: To investigate how a quality improvement program (BRIDGE), designed to promote coordination and continuity in rehabilitation services, was delivered and perceived by providers in routine practice for patients with rheumatic and musculoskeletal diseases. Methods: A convergent mixed methods approach was nested within a stepped-wedge, randomized controlled trial. The intervention program was developed to bridge gaps between secondary and primary healthcare, comprising the following elements: motivational interviewing; patient-specific goal setting; written rehabilitation-plans; personalized feedback on progress; and tailored follow-up. Data from health professionals who delivered the program were collected and analyzed separately, using two questionnaires and three focus groups. Results were integrated during the overall interpretation and discussion. Results: The program delivery depended on the providers' skills and competence, as well as on contextual factors in their teams and institutions. Suggested possibilities for improvements included follow-up with sufficient support from next of kin and external services, and the practicing of action and coping plans, standardized outcome measures, and feedback on progress. Conclusions: Leaders and clinicians should discuss efforts to ensure confident and qualified rehabilitation delivery at the levels of individual providers, teams, and institutions, and pay equal attention to each component in the process from admission to follow-up. Keywords: Quality in healthcare; delivery of healthcare; goal setting; mixed methods; quality improvement; rehabilitation; rheumatic and musculoskeletal diseases; self-management.

• Joseph, Kenth-Louis Hansen; Dagfinrud, Hanne; Nordén, Kristine Røren; Fongen, Camilla & Tveter, Anne Therese (2023). Adherence to a Web-based Exercise Programme: A Feasibility Study Among Patients with Hip or Knee Osteoarthritis. Journal of Rehabilitation Medicine. ISSN 1650-1977. 55. doi: 10.2340/jrm.v55.7139. Full text in Research Archive
• Mulrooney, Elisabeth; Neogi, Tuhina; Dagfinrud, Hanne; Hammer, Hilde Berner; Pettersen, Pernille Steen & Gløersen, Marthe [Show all 9 contributors for this article] (2023). Comorbidities in people with hand OA and their associations with pain severity and sensitization: Data from the longitudinal Nor-Hand study. Osteoarthritis and Cartilage Open. 5(3). doi: 10.1016/j.ocarto.2023.100367. Full text in Research Archive Show summary

  Objective To determine whether the comorbidity burden and co-existing comorbidities are cross-sectionally and/or longitudinally associated with pain and pain sensitization in a cohort study of people with hand OA. Design We examined whether comorbidity burden and individual comorbidities based on the self-administered Comorbidity Index (range: 0–42) at baseline were associated with pain outcomes at baseline and 3 years follow-up. Pain outcomes included hand and overall bodily pain (range: 0–10) as well as pressure pain thresholds at the tibialis anterior muscle (kg/cm2) and temporal summation (distal radioulnar joint) as measures of central pain sensitization. We performed linear regression analyses adjusted for age, sex, body mass index, physical exercise and education. Results We included 300 and 196 participants in cross-sectional and longitudinal analyses, respectively. Using baseline data, the burden of comorbidities was associated with greater pain in hands (beta ​= ​0.61, 95% CI 0.37, 0.85) and overall body (beta ​= ​0.60, 95% CI 0.37, 0.87). Similar strength of associations was found between comorbidity burden (baseline) and follow-up pain. Among the individual comorbidities, back pain and depression were associated with nearly one unit higher pain score in hands and overall body at both baseline and follow-up. Only back pain was related to lower pressure pain thresholds at follow up (beta ​= ​−0.24, 95% CI −0.50, −0.001). Conclusion People with hand OA and greater comorbidity burden, co-existing back pain or depression reported greater pain severity than their counterparts, also 3 years later. These results acknowledge the relevance of accounting for comorbidities in the pain experience in people with hand OA.

• Sveaas, Silje Halvorsen; Smedslund, Geir; Walsh, David A. & Dagfinrud, Hanne Solveig (2023). Effects of Analgesics on Self-Reported Physical Function and Walking Ability in People With Hip or Knee Osteoarthritis: A Systematic Review and Meta-Analysis. Physical Therapy. ISSN 0031-9023. 104(2). doi: 10.1093/ptj/pzad160. Full text in Research Archive Show summary

  Objective Hip and knee osteoarthritis are among the leading causes of global disability, and one of the main aims of the management is to improve physical function. The objective of this review was to investigate the effect of analgesics on physical function (self-reported physical function and walking ability). Methods A systematic review and meta-analysis of the findings were performed. Randomized controlled trials investigating the effect of analgesics on self-reported physical function and walking ability were included. Analgesics were orally administered acetaminophen, nonsteroidal antiinflammatory drugs (NSAIDs), or opioids. Data were pooled in a random-effects model, and the standardized mean difference (SMD) with 95% CI was calculated (SMDs: 0.2–0.4 = small, 0.5–0.7 = medium, and ≥0.8 = large effect sizes). The quality of the evidence was evaluated according to the Grading of Recommendations Assessment, Development, and Evaluation approach. Results A total of 1454 studies were identified, of which 33 were included. On self-reported physical function, the results showed low- to moderate-quality evidence for a small beneficial effect of acetaminophen (SMD = −0.13 [95% CI = −0.26 to 0.00]), NSAIDs (SMD = −0.32 [95% CI = −0.37 to −0.27]), or opioids (SMD = −0.20 [95% CI = −0.32 to −0.09]). There was moderate-quality evidence for a small effect of NSAIDs on pain during walking (SMD = −0.34 [95% CI = −0.45 to −0.23]). Conclusion In people with hip or knee osteoarthritis, there was low- to moderate-quality evidence for small beneficial effects of analgesics on physical function and walking ability. Impact Analgesics may improve physical function by reducing pain during exercise and walking.

• Ullensvang, Gyda; Kringeland, Ester Anne; Ikdahl, Eirik; Provan, Sella Aarrestad; Berg, Inger Jorid & Rollefstad, Silvia Christin Hellerud [Show all 10 contributors for this article] (2023). Cardiovascular organ damage in relation to hypertension status in patients with ankylosing spondylitis. Blood Pressure. ISSN 0803-7051. 32(1). doi: 10.1080/08037051.2023.2205956. Full text in Research Archive Show summary

  Purpose Hypertension is a major cardiovascular (CV) risk factor in ankylosing spondylitis (AS) patients. Less is known about the prevalence of CV organ damage in relation to hypertension status in AS patients. Materials and Methods CV organ damage was assessed by echocardiography, carotid ultrasound and pulse wave velocity (PWV) by applanation tonometry in 126 AS patients (mean age 49 ± 12 years, 39% women) and 71 normotensive controls (mean age 47 ± 11 years, 52% women). CV organ damage was defined as presence of abnormal left ventricular (LV) geometry, LV diastolic dysfunction, left atrial (LA) dilatation, carotid plaque or high pulse wave velocity (PWV). Results Thirty-four percent of AS patients had hypertension. AS patients with hypertension were older and had higher C-reactive protein (CRP) levels compared to AS patients without hypertension and controls (p < 0.05). The prevalence of CV organ damage was 84% in AS patients with hypertension, 29% in AS patients without hypertension and 30% in controls (p < 0.001). In multivariable logistic regression analyses, having hypertension was associated with a fourfold increased risk of CV organ damage independent of age, presence of AS, gender, body mass index, CRP, and cholesterol (odds ratio (OR) 4.57, 95% confidence interval (CI) 1.53 to 13.61, p = 0.006). In AS patients, presence of hypertension was the only covariable significantly associated with presence of CV organ damage (OR 4.40, 95% CI 1.40 to 13.84, p = 0.011). Conclusions CV organ damage in AS was strongly associated with hypertension, pointing to the importance of guideline-based hypertension management in AS patients.

• Nordén, Kristine Røren; Semb, Anne Grete; Dagfinrud, Hanne; Hisdal, Jonny; Ødegård, Sigrid & Sexton, Joseph [Show all 11 contributors for this article] (2023). Associations between cardiovascular risk factors, disease activity and cardiorespiratory fitness in patients with inflammatory joint disease: a cross-sectional analysis. BMC sports science, medicine and rehabilitation. 15, p. 1–11. doi: 10.1186/s13102-023-00678-4. Full text in Research Archive Show summary

  Background Inflammatory joint diseases (IJD) are accompanied by an increased risk of cardiovascular disease (CVD). Cardiorespiratory fitness (CRF) is a modifiable CVD risk factor and low levels of CRF associate with an elevated CVD risk. This study aimed to investigate the associations between CVD risk factors, disease activity and CRF in patients with IJD and to explore differences between patients with normal versus low levels of CRF. Methods CRF was measured as peak oxygen uptake (VO2peak) with a cardiopulmonary exercise test. Participants were also evaluated for: Body composition, blood pressure, blood lipids, inflammatory markers and disease activity. Patient-reported use of cigarettes/snuff, medication, disease duration, pain, fatigue, CVD history, habitual physical activity and exercise beliefs and self-efficacy were collected by questionnaire. Cross-sectional associations between CVD risk factors, disease-related factors and CRF were analyzed by multiple linear regression. CRF was categorized to normal CRF (VO2peak ≥ 80%) or low CRF (VO2peak < 80%) according to age- and gender-stratified reference data. Differences in demographic, CVD and disease-related factors between patients with normal versus low CRF were explored. Results In 60 Norwegian patients with IJD [34 females, age 59 years (IQR: 52–63)], mean VO2peak was 30.2 (± 6.9) mL/kg/min, corresponding to 83% (± 18) of normative reference values. Age (coefficient: − 0.18 years, p = 0.01) and fat mass (coefficient: − 0.67 %, p < 0.001) were inversely associated with CRF, while physical activity index (coefficient: 0.13 points, p = 0.05) was positively associated with CRF (R2 = 0.66). There were no significant associations between CRF, classical CVD risk factors and disease-related variables. Compared to patients with low CRF (n = 30), patients with normal CRF (n = 30) had higher peak oxygen uptake (+ 9.4 mL/kg/min, p < 0.001), high-density lipoprotein cholesterol (+ 0.5 mmol L−1, p < 0.001), and exercise self-efficacy (+ 6.9, p < 0.01) as well as lower fat mass (− 8.7%, p < 0.001), resting heart rate (− 8.0 beats/min, p < 0.01) and triglycerides (− 0.5 mmol L−1, p < 0.01). Conclusions In this sample of IJD-patients, age, fatmass and physical activity level were associated with CRF. CRF was lower than reference values and patients with normal CRF presented with a more favorable health profile. There is a continued need for exercise interventions to improve CRF in patients with IJD. Trial registration: NCT04922840.

• Sagen, Joachim Støren; Smedslund, Geir; Simonsen, Ann Elisabeth; Habberstad, Andreas Hanssønn; Kjeken, Ingvild & Dagfinrud, Hanne [Show all 7 contributors for this article] (2023). Patient engagement in the development and delivery of healthcare services: a systematic scoping review. BMJ Open Quality. 12(2). doi: 10.1136/bmjoq-2023-002309. Full text in Research Archive Show summary

  Background Patient engagement (PE) is required to improve future healthcare services. PE in the development and delivery of healthcare services is likely to be complex but is scarcely described. Objectives The objective of this scoping review was to summarise primary studies on mesolevel PE regarding structure, process and outcomes. More specifically, the aim was to explore barriers and facilitators to successful PE, how persons are engaged in the process and summarise reported consequences. Method A systematic scoping review was conducted, searching the MEDLINE, EMBASE, Cochrane and PsycINFO databases. Primary studies, published between 7 July 2005 and 4 October 2022, were considered for inclusion. Two reviewers extracted data about PE (eg, attributes of PE settings, facilitators and barriers, and outcomes to PE) and the first author coded the extracted data into structural, processual and outcome themes. Results Of 8588 identified records, 37 studies were eligible. Most of the included studies were conducted in Europe (n=19; 51%) and North America (n=13; 35%). Structures that ensure sufficient stakeholder representativeness and PE knowledge through education may facilitate the PE process further, regardless of the environmental setting. Interpersonal relationships with uneven power dynamics were reported as noteworthy processual barriers to meaningful PE, while clearly described roles and tasks were reported as important facilitators. In contrast to hard outcomes with operationalised PE effects, the most noteworthy outcomes of PE were reported as soft processual consequences such as patient representatives improving their self-esteem and feeling valued. Conclusions Unfortunately, there is a dearth of studies exploring hard and operationalised PE outcomes on healthcare services and patients receiving healthcare. The PE process may be facilitated by dedicated finances to PE education and by ensuring sufficient stakeholder representativeness.

• Garratt, Andrew; Sagen, Joachim Støren; Børøsund, Elin; Varsi, Cecilie; Kjeken, Ingvild & Dagfinrud, Hanne [Show all 7 contributors for this article] (2022). The Public and Patient Engagement Evaluation Tool: forward-backwards translation and cultural adaption to Norwegian. BMC Musculoskeletal Disorders. 23(1). doi: 10.1186/s12891-022-05514-3. Full text in Research Archive Show summary

  Background: Patient engagement is recommended for improving health care services, and to evaluate its organisa- tion and impact appropriate, and rigorously evaluated outcome measures are needed. Methods: Interviews (N = 12) were conducted to assess relevance of the Canadian Public and Patient Engagement Evaluation Tool (PPEET) in a Norwegian setting were performed. The tool was translated, back translated, and assessed following cognitive interviews (N = 13), according to the COSMIN checklist. Data quality was assessed in a cross-sec- tional survey of patient advisory board members from different rehabilitation institutions (N = 47). Results: Interviews with patient board representatives confirmed the relevance of the PPEET Organisational ques- tionnaire in a Norwegian setting and contributed five additional items. Translation and back translation of the original PPEET showed no major content differences. Differences in vocabulary and sentence structure were solved by discus- sion among the translators. Comments from cognitive interviews mainly related to the use of different synonyms, layout, and minor differences in semantic structure. Results of the cross-sectional survey support the data quality and construct validity of PPEET items, including 95 score comparisons where 76 (80%) were as hypothesized. Conclusions: The PPEET Organisational questionnaire has been thoroughly translated and tested, and the resulting Evalueringsverktøy for Brukermedvirkning (EBNOR) has adequate levels of comprehensibility and content validity. Fur- ther testing for measurement properties is recommended, but given these results, the EBNOR should be considered for assessing patient engagement in a Norwegian health care organisational context

• Mulrooney, Elisabeth; Neogi, Tuhina; Dagfinrud, Hanne; Hammer, Hilde Berner; Pettersen, Pernille Steen & Gaarden, Torfinn Lødøen [Show all 10 contributors for this article] (2022). The associations of psychological symptoms and cognitive patterns with pain and pain sensitization in people with hand osteoarthritis. Osteoarthritis and Cartilage Open. 4(2), p. 1–7. doi: 10.1016/j.ocarto.2022.100267. Full text in Research Archive Show summary

  Objective To examine whether psychological symptoms and cognitive patterns are associated with self-reported pain and pain sensitization in people with hand osteoarthritis (OA). Design In the Nor-Hand study (n ​= ​300), people with hand OA self-reported psychological symptoms (Hospital Anxiety and Depression Scale), cognitive patterns (Pain catastrophizing Scale and Arthritis Self-Efficacy Scale) as well as their pain severity in hands, overall pain and multi-joint pain. Central pain sensitization was measured clinically by temporal summation and pressure pain threshold tests. We examined whether psychological symptoms and cognitive patterns were cross-sectionally associated with pain using linear regression. Beta coefficients (β) per one standard deviation of the independent variable were presented. Stratified analyses were performed in cases of significant interactions (p ​< ​0.10). Results Higher levels of anxiety, depressive symptoms and pain catastrophizing and low levels of self-efficacy were statistically significantly associated with higher levels of hand pain by Numeric Rating Scale (β ​= ​0.43, 0.48 and −0.57, respectively). Similar associations were found for overall pain, but not for measures of central pain sensitization. In stratified analyses, anxiety and depressive symptoms were more strongly related with pain in subgroups with younger age and higher comorbidity burden. Pain catastrophizing was more strongly related with pain in subgroups with younger age, overweight/obesity, higher comorbidity burden and poor sleep. Conclusion Psychological symptoms and cognitive patterns were associated with self-reported OA pain, especially in people with younger age, overweight/obesity, higher comorbidity burden and poor sleep. No associations were found for psychological symptoms and cognitive patterns with pain sensitization.

• Sand-Svartrud, Anne-Lene; Berdal, Gunnhild; Azimi, Maryam; Bø, Ingvild; Dager, Turid Nygaard & Eppeland, Siv Grødal [Show all 16 contributors for this article] (2022). Associations between quality of health care and clinical outcomes in patients with rheumatic and musculoskeletal diseases: a rehabilitation cohort study. BMC Musculoskeletal Disorders. 23(357), p. 1–14. doi: 10.1186/s12891-022-05271-3. Full text in Research Archive
• Sagen, Joachim Støren; Børøsund, Elin; Simonsen, Ann Elisabeth; Habberstad, Andreas Hanssønn; Kjeken, Ingvild & Dagfinrud, Hanne [Show all 7 contributors for this article] (2022). Organisation, influence, and impact of patient advisory boards in rehabilitation institutions—an explorative cross-sectional study. BMC Musculoskeletal Disorders. 23(1). doi: 10.1186/s12891-022-05678-y. Full text in Research Archive
• Joseph, Kenth-Louis Hansen; Dagfinrud, Hanne; Hagen, Kåre Birger; Nordén, Kristine Røren; Fongen, Camilla & Wold, Ole-Martin [Show all 10 contributors for this article] (2022). The AktiWeb study: feasibility of a web-based exercise program delivered by a patient organisation to patients with hip and/or knee osteoarthritis. Pilot and Feasibility Studies. 8(1). doi: 10.1186/s40814-022-01110-3. Full text in Research Archive Show summary

  Background Patient organisations may be an under-utilised resource in follow-up of patients requiring long-term exercise as part of their disease management. The purpose of this study was to explore the feasibility of a web-based exercise program delivered by a patient organisation to patients with hip and/or knee osteoarthritis (OA). Methods In this pre–post feasibility study, patients aged 40–80 years with hip and/or knee OA were recruited from Diakonhjemmet Hospital. The 12-week intervention was delivered through a patient organisation’s digital platform. Feasibility was evaluated by proportion of eligible patients enrolled, proportion of enrolled patients who provided valid accelerometer data at baseline, and proportion completing the cardiorespiratory exercise test according to protocol at baseline and completed follow-up assessments. Patient acceptability was evaluated for website usability, satisfaction with the initial exercise level and comprehensibility of the exercise program. Change in clinical outcomes were assessed for physical activity, cardiorespiratory fitness and patient-reported variables. Results In total, 49 eligible patients were identified and 35 were enrolled. Thirty (86%) of these attended baseline assessments and provided valid accelerometer data and 18 (51%) completed the maximal cardiorespiratory exercise test according to protocol. Twenty-two (63%) patients completed the follow-up questionnaire, and they rated the website usability as ‘acceptable’ [median 77.5 out of 100 (IQR 56.9, 85.6)], 19 (86%) reported that the initial exercise level was ‘just right’ and 18 (82%) that the exercise program was ‘very easy’ or ’quite easy’ to comprehend. Improvement in both moderate to vigorous physical activity (mean change 16.4 min/day; 95% CI 6.9 to 25.9) and cardiorespiratory fitness, VO2peak (mean change 1.83 ml/kg/min; 95% CI 0.29 to 3.36) were found in a subgroup of 8 patients completing these tests. Across all patient-reported outcomes 24–52% of the patients had a meaningful improvement (n = 22). Conclusion A web-based exercise program delivered by a patient organisation was found to be feasible and acceptable in patients with hip and/or knee OA. Trial registration ClinicalTrials.gov, NCT04084834 (registered 10 September 2019). The Regional Committee for Medical and Health Research Ethics south-east, 2018/2198. URL: Prosjekt #632074 - Aktiv med web-basert støtte. - Cristin (registered 7 June 2019).

• Navarro-Compán, Victoria; Boel, Anne; Boonen, Annelies; Mease, Philip J; Dougados, Maxime & Kiltz, Uta [Show all 27 contributors for this article] (2022). Instrument selection for the ASAS core outcome set for axial spondyloarthritis. Annals of the Rheumatic Diseases. ISSN 0003-4967. doi: 10.1136/annrheumdis-2022-222747. Full text in Research Archive
• Nordén, Kristine Røren; Dagfinrud, Hanne; Semb, Anne Grete; Hisdal, Jonny; Viktil, Kirsten Kilvik & Sexton, Joseph [Show all 11 contributors for this article] (2022). Effect of high-intensity exercise on cardiorespiratory fitness, cardiovascular disease risk and disease activity in patients with inflammatory joint disease: Protocol for the ExeHeart randomised controlled trial. BMJ Open. 12(2). doi: 10.1136/bmjopen-2021-058634. Full text in Research Archive Show summary

  Introduction Inflammatory joint disease (IJD) is associated with increased risk of cardiovascular disease (CVD) fostered by systemic inflammation and a high prevalence of CVD risk factors. Cardiorespiratory fitness (CRF) is an important health parameter and CRF-measures are advocated in routine health evaluations. CRF associates with CVD risk, and exercise modalities such as high intensity interval training (HIIT) can increase CRF and mitigate CVD risk factors. In IJD, exercise is rarely used in CVD risk management and the cardioprotective effect of HIIT is unclear. Furthermore, the clinical applicability of HIIT to primary care settings is largely unknown and warrants investigation. The primary aim is to assess the effect of a HIIT programme on CRF in patients with IJD. Second, we will evaluate the effect of HIIT on CVD risk and disease activity in patients with IJD, feasibility of HIIT in primary care and validity of non-exercise algorithms to detect change in CRF. Methods and analysis ExeHeart is a single-blinded, randomised controlled trial. Sixty patients with IJD will be recruited from the Preventive Cardio-Rheuma clinic at Diakonhjemmet Hospital, Norway. Patients will be assigned to receive standard care (relevant lifestyle advice and cardio-preventive medication) or standard care plus a 12-week HIIT intervention by physiotherapists in primary care. HIIT sessions will be prescribed at 90%–95% of peak heart rate. Outcomes include CRF (primary outcome), CVD risk factors, anthropometric measures, disease activity and patient-reported outcomes related to pain, fatigue, disease, physical activity and exercise and will be assessed at baseline, 3 months (primary endpoint) and 6 months postbaseline. Ethics and dissemination Ethical approval has been obtained from the Regional Committee for Medical and Health Research Ethics (201227). Participants are required to sign a written informed consent form. Results will be discussed with patient representatives, submitted to peer-reviewed journals and presented at relevant platforms. Trial registration number NCT04922840.

• Navarro-Compán, Victoria; Boel, Anne; Boonen, Annelies; Mease, Philip; Landewé, Robert & Kiltz, Uta [Show all 29 contributors for this article] (2021). The ASAS-OMERACT core domain set for axial spondyloarthritis. Seminars in Arthritis & Rheumatism. ISSN 0049-0172. 51(6), p. 1342–1349. doi: 10.1016/j.semarthrit.2021.07.021. Full text in Research Archive Show summary

  Background: The current core outcome set for ankylosing spondylitis (AS) has had only minor adaptations since its development 20 years ago. Considering the significant advances in this field during the preceding decades, an update of this core set is necessary. Objective: To update the ASAS-OMERACT core outcome set for AS into the ASAS-OMERACT core outcome set for axial spondyloarthritis (axSpA). Methods: Following OMERACT and COMET guidelines, an international working group representing key stakeholders (patients, rheumatologists, health professionals, pharmaceutical industry and drug regulatory agency representatives) defined the core domain set for axSpA. The development process consisted of: i) Identifying candidate domains using a systematic literature review and qualitative studies; ii) Selection of the most relevant domains for different stakeholders through a 3-round Delphi survey involving axSpA patients and axSpA experts; iii) Consensus and voting by ASAS; iv) Endorsement by OMERACT. Two scenarios are considered based on the type of therapy investigated in the trial: symptom modifying therapies and disease modifying therapies. Results: The updated core outcome set for axSpA includes 7 mandatory domains for all trials (disease activity, pain, morning stiffness, fatigue, physical function, overall functioning and health, and adverse events including death). There are 3 additional domains (extra-musculoskeletal manifestations, peripheral manifestations and structural damage) that are mandatory for disease modifying therapies and important but optional for symptom modifying therapies. Finally, 3 other domains (spinal mobility, sleep, and work and employment) are defined as important but optional domains for all trials. Conclusion: The ASAS-OMERACT core domain set for AS has been updated into the ASAS-OMERACT core domain set for axSpA. The next step is the selection of instruments for each domain.

• Sand-Svartrud, Anne-Lene; Berdal, Gunnhild; Azimi, Maryam; Bø, Ingvild; Dager, Turid Nygaard & Eppeland, Siv Grødal [Show all 15 contributors for this article] (2021). A quality indicator set for rehabilitation services for people with rheumatic and musculoskeletal diseases demonstrates adequate responsiveness in a pre–post evaluation. BMC Health Services Research. 21(164). doi: 10.1186/s12913-021-06164-2. Full text in Research Archive
• Joseph, Kenth-Louis Hansen; Dagfinrud, Hanne; Christie, Anne; Hagen, Kåre Birger & Tveter, Anne Therese (2021). Criterion validity of The International Physical Activity Questionnaire-Short Form (IPAQ-SF) for use in clinical practice in patients with osteoarthritis. BMC Musculoskeletal Disorders. 22. doi: 10.1186/s12891-021-04069-z. Full text in Research Archive Show summary

  Background To tailor physical activity treatment programs for patients with osteoarthritis, clinicians need valid and feasible measurement tools to evaluate habitual physical activity. The widely used International Physical Activity Questionnaire-Short Form (IPAQ-SF) is not previously validated in patients with osteoarthritis. Purpose To assess the concurrent criterion validity of the IPAQ-SF in patients with osteoarthritis, using an accelerometer as a criterion-method. Method Patients with osteoarthritis (n = 115) were recruited at The Division of Rheumatology and Research at Diakonhjemmet Hospital (Oslo, Norway). Physical activity was measured by patients wearing an accelerometer (ActiGraph wGT3X-BT) for seven consecutive days, followed by reporting their physical activity for the past 7 days using the IPAQ-SF. Comparison of proportions that fulfilled physical activity recommendations as measured by the two methods were tested by Pearson Chi-Square analysis. Differences in physical activity levels between the IPAQ-SF and the accelerometer were analyzed with Wilcoxon Signed-Rank Test and Spearman rank correlation test. Bland-Altman plots were used to visualize the concurrent criterion validity for total- and intensity-specific physical activity levels. Results In total, 93 patients provided complete physical activity data, mean (SD) age was 65 (8.7) years, 87% were women. According to the IPAQ-SF, 57% of the patients fulfilled the minimum physical activity recommendations compared to 31% according to the accelerometer (p = 0.043). When comparing the IPAQ-SF to the accelerometer we found significant under-reporting of total physical activity MET-minutes (p = < 0.001), sitting (p = < 0.001) and walking (p < 0.001), and significant over-reporting of moderate-to-vigorous physical activity (p < 0.001). For the different physical activity levels, correlations between the IPAQ-SF and the accelerometer ranged from rho 0.106 to 0.462. The Bland-Altman plots indicated an increased divergence between the two methods with increasing time spent on moderate-to-vigorous intensity physical activity. Conclusion Physical activity is a core treatment of osteoarthritis. Our finding that patients tend to over-report activity of higher intensity and under-report low-intensity activity and sitting-time is of clinical importance. We conclude that the concurrent criterion validity of the IPAQ-SF was weak in patients with osteoarthritis.

• Bilberg, Annelie; Dagfinrud, Hanne & Sveaas, Silje Halvorsen (2021). Supervised Intensive Exercise for Strengthening Exercise Health Beliefs in Patients With Axial Spondyloarthritis: A Multicenter Randomized Controlled Trial. Arthritis care & research. ISSN 2151-464X. doi: 10.1002/acr.24556. Full text in Research Archive
• Exarchou, Sofia; Turesson, Carl; Lindström, Ulf; Ramonda, Roberta; Landewe, Robert B. & Dagfinrud, Hanne [Show all 9 contributors for this article] (2021). Lifestyle Factors and Disease Activity Over Time in Early Axial Spondyloarthritis: The SPondyloArthritis Caught Early (SPACE) Cohort. Journal of Rheumatology. ISSN 0315-162X. 49(4), p. 365–372. doi: 10.3899/jrheum.210046. Full text in Research Archive Show summary

  Objective: Our aim was to study the importance of baseline BMI, smoking, and alcohol consumption (AC) for disease activity (DA) over 1 year in early axial spondyloarthritis (axSpA), stratified by sex. Methods: In the SPondyloArthritis Caught Early cohort (patients with chronic back pain onset at age < 45 yrs, with pain for ≥ 3 months and ≤ 2 yrs), the Ankylosing Spondylitis Disease Activity Score (ASDAS) was recorded at inclusion, 3, and 12 months. All patients included in the analysis had axSpA based on a high physician's level of confidence at baseline. Differences in ASDAS over 1 year by BMI (normal < 25 kg/m2 , overweight 25-29.9 kg/m2 , and obese ≥ 30 kg/m2 ), smoking history (never/previous/current), and AC (none, 0.1-2 units/week, 3-5 units/week, and ≥ 6 units/week) at baseline were estimated using mixed linear regression models. Results: There were 344 subjects (mean age of 30.3 yrs; 49.4% men). In women, obesity was associated with 0.60 (95% CI 0.28-0.91) higher ASDAS compared to normal BMI. In both sexes, AC tended to be associated with lower DA over 1 year, with a significant association only in women with the highest AC (mean difference of -0.55, 95% CI -1.05 to -0.04). Smoking was associated with higher ASDAS over 1 year compared to never smoking in both sexes, although the difference reached statistical significance only in female former smokers. Results were similar in multivariable analysis, adjusted for all lifestyle factors and other confounders.

• Sand-Svartrud, Anne-Lene; Berdal, Gunnhild; Azimi, Maryam; Bø, Ingvild; Dager, Turid Nygaard & Eppeland, Siv Grødal [Show all 15 contributors for this article] (2021). A quality indicator set for rehabilitation services for people with rheumatic and musculoskeletal diseases demonstrates adequate responsiveness in a pre–post evaluation. BMC Health Services Research. 21(1). doi: 10.1186/s12913-021-06164-2. Full text in Research Archive Show summary

  Abstract Background Quality of care is gaining increasing attention in research, clinical practice, and health care planning. Methods for quality assessment and monitoring, such as quality indicators (QIs), are needed to ensure health services in line with norms and recommendations. The aim of this study was to assess the responsiveness of a newly developed QI set for rehabiliation for people with rheumatic and musculoskeletal diseases (RMDs). Methods We used two yes/no questionnaires to measure quality from both the provider and patient perspectives, scored in a range of 0–100% (best score, 100%). We collected QI data from a multicenter stepped-wedge cluster-randomized controlled trial (the BRIDGE trial) that compared traditional rehabilitation with a new BRIDGE program designed to improve quality and continuity in rehabilitation. Assessment of the responsiveness was performed as a pre–post evaluation: Providers at rehabilitation centers in Norway completed the center-reported QIs ( n  = 19 structure indicators) before (T1) and 6–8 weeks after (T2) adding the BRIDGE intervention. The patient-reported QIs comprised 14 process and outcomes indicators, measuring quality in health services from the patient perspective. Pre-intervention patient-reported data were collected from patients participating in the traditional program (T1), and post-intervention data were collected from patients participating in the BRIDGE program (T2). The patient groups were comparable. We used a construct approach, with a priori hypotheses regarding the expected direction and magnitude of PR changes between T1 and T2. For acceptable responsivess, at least 75% of the hypotheses needed to be confirmed. Results All eight participating centers and 82% of the patients (293/357) completed the QI questionnaires. Responsiveness was acceptable, with 44 of 53 hypotheses (83%) confirmed for single indicators and 3 of 4 hypotheses (75%) confirmed for the sum scores. Conclusion We found this QI set for rehabilitation to be responsive when applied in rehabilitation services for adults with various RMD conditions. We recommend this QI set as a timely method for establishing quality-of-rehabilitation benchmarks, promoting important progress toward high-quality rehabilitation, and tracking trends over time. Trial registration The study is part of the larger BRIDGE trial, registered at ClinicalTrials.gov (Identifier: NCT03102814).

• Fongen, Camilla; Dagfinrud, Hanne Solveig; Bilberg, Annelie; Pedersen, Elisabeth; Johansen, Melissa Woll & Weely, Salima van [Show all 8 contributors for this article] (2020). Responsiveness and Interpretability of 2 Measures of Physical Function in Patients with Spondyloarthritis. Physical Therapy. ISSN 0031-9023. 100(4), p. 728–738. doi: 10.1093/ptj/pzaa004. Full text in Research Archive
• Bindesbøll, Christian; Garrido-Cumbrera, Marco; Bakland, Gunnstein & Dagfinrud, Hanne (2020). Obesity Increases Disease Activity of Norwegian Patients with Axial Spondyloarthritis: Results from the European Map of Axial Spondyloarthritis Survey. Current Rheumatology Reports. ISSN 1523-3774. 22. doi: 10.1007/s11926-020-00917-4. Full text in Research Archive
• Sveaas, Silje Halvorsen; Dagfinrud, Hanne; Berg, Inger Jorid; Provan, Sella Aarrestad; Johansen, Melissa Woll & Pedersen, Elisabeth Alexandersen [Show all 7 contributors for this article] (2020). High-Intensity Exercise Improves Fatigue, Sleep, and Mood in Patients With Axial Spondyloarthritis: Secondary Analysis of a Randomized Controlled Trial. Physical Therapy. ISSN 0031-9023. 100(8), p. 1323–1332. doi: 10.1093/ptj/pzaa086. Full text in Research Archive Show summary

  <i>Objective</i> - Although exercise is recommended in the treatment of axial spondyloarthritis (axSpa), the focus has been on flexibility, and the effect of high-intensity exercises is unknown. The purpose of this study was to investigate the effect of high-intensity exercises on fatigue, sleep, and mood in patients with axSpA.<br><br> <i>Methods</i> - In this secondary analysis of a randomized controlled trial, participants were recruited from outpatient clinics at 4 hospitals in Scandinavia. A total of 100 patients with axSpA were randomized to either an exercise group (n = 50) or a control group (n = 50). High-intensity exercise was provided 3 times per week for 3 months and supervised by a physical therapist. The controls received no intervention. Measurements were self-reported at baseline, 3 months, and 12 months: fatigue, using the Fatigue Severity Scale (range = 0–7, 7 = worst, ≥5 = severe); vitality, using the RAND 36-item short-form health survey (SF-36, range = 0–100, 100 = best); sleep, using the Pittsburgh Sleep Quality Index (range = 0–21, 21 = worst, >5 = poor quality); mood, using the General Health Questionnaire 12 (range = 0–36, 36 = worst); and general health, using the EUROQoL (range = 0–100, 100 = best).<br><br> <i>Results</i> - A total of 38 participants (76%) in the exercise group followed ≥80% of the exercise protocol. At 3 months, there was a significant beneficial effect on fatigue (mean group differences = −0.4, 95% CI = −0.7 to −0.1), vitality (5.0, 95% CI = 1.1 to 10.5), mood (−2, 95% CI = −3.7 to −0.04), and general health (9.0, 95% CI = 3.3 to 14.7) but no effect on sleep (−1.1, 95% CI = −2.1 to 0.2). Compared with the control group, the exercise group had a reduced rate of severe fatigue and poor sleep. No differences were seen between the groups at 12 months.<br><br> <i>Conclusions</i> - A 3-month exercise program had a beneficial effect on fatigue, sleep, mood, and general health in patients with axSpA at the end of the intervention; however, no long-term effects were seen.<br><br> <i>Impact</i> - High-intensity cardiorespiratory and strength exercises should be considered as important in exercise programs for patients with axSpA.

• Moseng, Tuva; Dagfinrud, Hanne Solveig; Bodegom-Vos, Leti van; Dziedzic, Krysia; Hagen, Kåre Birger & Natvig, Bård [Show all 9 contributors for this article] (2020). Low adherence to exercise may have influenced the proportion of OMERACT-OARSI responders in an integrated osteoarthritis care model: secondary analyses from a cluster-randomised stepped-wedge trial. BMC Musculoskeletal Disorders. 21. doi: 10.1186/s12891-020-03235-z. Full text in Research Archive Show summary

  Background: To address the well-documented gap between hip and knee osteoarthritis (OA) treatment recommendations and current clinical practice, a structured model for integrated OA care was developed and evaluated in a stepped-wedge cluster-randomised controlled trial. The current study used secondary outcomes to evaluate clinically important response to treatment through the Outcome Measures in Rheumatology Clinical Trials clinical responder criteria (OMERACT-OARSI responder criteria) after 3 and 6 months between patients receiving the structured OA care model vs. usual care. Secondly, the study aimed to investigate if the proportion of responders in the intervention group was influenced by adherence to the exercise program inherent in the model. Methods: The study was conducted in primary healthcare in six Norwegian municipalities. General practitioners and physiotherapists received training in OA treatment recommendations and use of the structured model. The intervention group attended a physiotherapist-led OA education program and performed individually tailored exercises for 8–12 weeks. The control group received usual care. Patient-reported pain, function and global assessment of disease activity during the last week were evaluated using 11-point numeric rating scales (NRS 0–10). These scores were used to calculate the proportion of OMERACT-OARSI responders. Two-level mixed logistic regression models were fitted to investigate differences in responders between the intervention and control group. Results: Two hundred eighty-four intervention and 109 control group participants with hip and knee OA recruited from primary care in six Norwegian municipalities. In total 47% of the intervention and 35% of the control group participants were responders at 3 or 6 months combined; showing an uncertain between-group difference (ORadjusted 1.38 (95% CI 0.41, 4.67). In the intervention group, 184 participants completed the exercise programme (exercised ≥2 times/week for ≥8 weeks) and 55% of these were classified as responders. In contrast, 28% of the 86 non-completers were classified as responders. Conclusions: The difference in proportion of OMERACT-OARSI responders at 3 and 6 months between the intervention and control group was uncertain. In the intervention group, a larger proportion of responders were seen among the exercise completers compared to the non-completers.

• Bilberg, Annelie; Sveaas, Silje Halvorsen; Dagfinrud, Hanne & Mannerkorpi, Kaisa (2020). How Do Patients With Axial Spondyloarthritis Experience High-Intensity Exercise? ACR Open Rheumatology. 2(4), p. 207–213. doi: 10.1002/acr2.11128. Full text in Research Archive
• Risum, Kristine; Edvardsen, Elisabeth; Selvaag, Anne Marit G; Dagfinrud, Hanne & Sanner, Helga (2019). Measurement properties and performance of an eight-minute submaximal treadmill test in patients with juvenile idiopathic arthritis: A controlled study. Pediatric Rheumatology. 17. doi: 10.1186/s12969-019-0316-7. Full text in Research Archive Show summary

  Background Poor cardiorespiratory fitness is previously reported in patients with juvenile idiopathic arthritis (JIA) measured both by maximal and submaximal exercise tests, but a submaximal exercise test with acceptable measurement properties is currently lacking for both clinical and research purposes in this patient population. The objectives of this study were to evaluate the measurement properties and performance of a submaximal treadmill test in patients with JIA, and to compare the results with those obtained in controls. Methods Fifty-nine patients (50 girls), aged 10–16 years, with oligo- (n = 30) and polyarticular (n = 29) JIA, and 59 age- and sex-matched controls performed an eight-minute submaximal treadmill test for estimating peak oxygen uptake (VO2peak) followed by a maximal treadmill test measuring VO2peak directly. During the submaximal treadmill test, the study participants walked with no inclination at a speed between 3.2–7.2 km/h for four minutes, and then continued to walk at the same speed for four minutes with five % inclination. VO2peak was directly measured during a continuous graded exercise test on treadmill until exhaustion. Thirty-seven patients participated in the evaluation of the reliability. Criterion validity and reliability were evaluated with interclass correlation coefficient (ICC); measurement errors by Bland-Altman plot, standard error of measurement and smallest detectable change. Results In patients with JIA, the ICC (95% CI) for criterion validity was acceptable at group level 0.71 (0.51, 0.82), but not at individual level. The test-retest reliability and inter-rater reliability were acceptable at individual (0.84 (0.71, 0.91) and 0.92 (0.83, 0.96), respectively) and group levels (0.91 (0.83, 0.96) and 0.96 (0.91, 0.98), respectively). The measurement errors (for test-retest reliability/inter-rater reliability) were large. Bland-Altman plots showed no systematic differences, but a large variability for both the validity and reliability. The performance of and estimated VO2peak from the submaximal test were not associated with disease variables and were comparable between patients and controls. Conclusion The submaximal treadmill test is valid for use in patients with JIA on group level, but not on individual level. The reliability is acceptable. Due to large measurement errors, the submaximal treadmill test is not optimal for use in daily clinical practice to estimate VO2peak in individual patients.

• Moseng, Tuva; Dagfinrud, Hanne & Østerås, Nina (2019). Implementing international osteoarthritis guidelines in primary care: uptake and fidelity among health professionals and patients. Osteoarthritis and Cartilage. ISSN 1063-4584. 27(8), p. 1138–1147. doi: 10.1016/j.joca.2019.03.010. Full text in Research Archive
• Joseph, Kenth-Louis Hansen; Hagen, Kåre Birger; Tveter, Anne Therese; Magnusson, Karin; Provan, Sella Aarrestad & Dagfinrud, Hanne (2019). Osteoarthritis-Related Walking Disability and Arterial Stiffness: Results From a Cross-Sectional Study. Arthritis care & research. ISSN 2151-464X. 71(2), p. 252–258. doi: 10.1002/acr.23697. Full text in Research Archive
• Sveaas, Silje Halvorsen; Dagfinrud, Hanne; Johansen, Melissa Woll; Pedersen, Elisabeth Alexandersen; Wold, Ole-Martin & Bilberg, Annelie (2019). Beneficial Long-Term Effect on Leisure Time Physical Activity Level in Individuals With Axial Spondyloarthritis: Secondary Analysis of a Randomized Controlled Trial. Journal of Rheumatology. ISSN 0315-162X. 47(8), p. 1189–1197. doi: 10.3899/jrheum.190317. Full text in Research Archive Show summary

  Objective: To explore the longterm effect of a 3-month exercise program on leisure time physical activity level in individuals with axial spondyloarthritis (axSpA). Methods: A secondary analysis was performed on data from 100 individuals with axSpA who were included in a randomized controlled trial. The exercise group (EG) participated in a 3-month exercise program while the control group (CG) received no intervention. Physical activity during leisure time was measured with a questionnaire (physically active: ≥ 1 h/week with moderate/vigorous intensity physical activity). Disease activity was measured with the Ankylosing Spondylitis Disease Activity Scale (ASDAS; higher score = worst). Statistical analyses were performed on an intention-to-treat basis using chi-square tests, logistic regression, and mixed models. Results: At the 12-month followup, significantly more individuals in the EG than in the CG were physically active [29 (67%) vs 13 (30%), p < 0.001] and exercised 2–3 times/week [25 (58%) vs 15 (34%), p = 0.02], and fewer exercised at light intensity [3 (8%) vs 14 (44%), p = 0.002]. “Participation in the EG” (OR 6.7, 95% CI 2.4–18.6, p < 0.001) and “being physically active at baseline” (OR 4.7, 95% CI 1.4–15.8, p = 0.01) were the factors most associated with being physically active. There were no differences between the groups in ASDAS (p = 0.79). Conclusion: A 3-month exercise program had a beneficial longterm effect on leisure time physical activity in individuals with axSpA, thus indicating a more beneficial health profile. Still, few individuals continued the intensive program, and there was no difference between the groups in disease activity after 12 months. (ClinicalTrials.gov: NCT02356874)

• Sveaas, Silje Halvorsen; Bilberg, Annelie; Berg, Inger Jorid; Provan, Sella Aarrestad; Rollefstad, Silvia Christin Hellerud & Semb, Anne Grete [Show all 10 contributors for this article] (2019). High intensity exercise for 3 months reduces disease activity in axial spondyloarthritis (axSpA): A multicentre randomised trial of 100 patients. British Journal of Sports Medicine. ISSN 0306-3674. doi: 10.1136/bjsports-2018-099943. Full text in Research Archive
• Osthoff, Anne-Kathrin Rausch; Niedermann, Karin; Braun, Jürgen; Adams, Jo; Brodin, Nina & Dagfinrud, Hanne [Show all 22 contributors for this article] (2018). 2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis. Annals of the Rheumatic Diseases. ISSN 0003-4967. 77(9), p. 1251–1260. doi: 10.1136/annrheumdis-2018-213585. Full text in Research Archive
• Berdal, Gunnhild; Sand-Svartrud, Anne-Lene; Bø, Ingvild; Dager, Turid Nygaard; Dingsør, Anne & Eppeland, Siv Grødal [Show all 14 contributors for this article] (2018). Aiming for a healthier life: a qualitative content analysis of rehabilitation goals in patients with rheumatic diseases. Disability and Rehabilitation. ISSN 0963-8288. 40(7), p. 765–778. doi: 10.1080/09638288.2016.1275043. Full text in Research Archive
• Berg, Inger Jorid; Semb, Anne Grete; Sveaas, Silje Halvorsen; Fongen, Camilla; Heijde, Desirée van der & Kvien, Tore Kristian [Show all 8 contributors for this article] (2018). Associations Between Cardiorespiratory Fitness and Arterial Stiffness in Ankylosing Spondylitis: A Cross-sectional Study. Journal of Rheumatology. ISSN 0315-162X. 45(11), p. 1522–1525. doi: 10.3899/jrheum.170726. Full text in Research Archive
• Risum, Kristine; Edvardsen, Elisabeth; Godang, Kristin; Selvaag, Anne Marit G; Hansen, Bjørge Hermann & Molberg, Øyvind [Show all 10 contributors for this article] (2018). Physical Fitness in Patients With Oligoarticular and Polyarticular Juvenile Idiopathic arthritis diagnosed in the era of biologics: A controlled cross-sectional study. Arthritis care & research. ISSN 2151-464X. 71(12), p. 1611–1620. doi: 10.1002/acr.23818. Full text in Research Archive
• Sveaas, Silje Halvorsen; Hagen, Kåre Birger; Smedslund, Geir & Dagfinrud, Hanne (2018). Meta-analyse: kondisjon- og styrketrening reduserer sykdomsaktivitet hos pasienter med inflammatoriske revmatiske sykdommer. Best Practice, Revmatologi. Oktober. Full text in Research Archive
• Fongen, Camilla; Dagfinrud, Hanne; Berg, Inger Jorid; Ramiro, Sofia; Gaalen, Floris van & Landewé, Robert [Show all 9 contributors for this article] (2018). Frequency of Impaired Spinal Mobility in Patients with Chronic Back Pain Compared to Patients with Early Axial Spondyloarthritis. Journal of Rheumatology. ISSN 0315-162X. 45(12), p. 1643–1650. doi: 10.3899/jrheum.170786. Full text in Research Archive
• Berdal, Gunnhild; Bø, Ingvild; Dager, Turid Nygaard; Dingsør, Anne; Eppeland, Siv Grødal & Hagfors, Jon [Show all 15 contributors for this article] (2018). Structured goal planning and supportive telephone followup in rheumatology care: results from a pragmatic stepped‐wedge cluster‐randomized trial. Arthritis care & research. ISSN 2151-464X. 70(11), p. 1576–1586. doi: 10.1002/acr.23520. Full text in Research Archive
• Osthoff, Anne-Kathrin Rausch; Juhl, Carsten Bogh; Knittle, Keegan; Dagfinrud, Hanne; Hurkmans, Emailie & Braun, Jürgen [Show all 9 contributors for this article] (2018). Effects of exercise and physical activity promotion: Meta-analysis informing the 2018 EULAR recommendations for physical activity in people with rheumatoid arthritis, spondyloarthritis and hip/knee osteoarthritis. RMD Open. 4(2). doi: 10.1136/rmdopen-2018-000713. Full text in Research Archive
• Klokkerud, Mari; Dagfinrud, Hanne; Uhlig, Till; Dager, Turid Nygaard; Furunes, Kari Anita & Klokkeide, Åse [Show all 11 contributors for this article] (2018). Developing and testing a consensus-based core set of outcome measures for rehabilitation in musculoskeletal diseases. Scandinavian Journal of Rheumatology. ISSN 0300-9742. 47(3), p. 225–234. doi: 10.1080/03009742.2017.1347959. Full text in Research Archive
• Ortolan, Augusta; Lunteren, Miranda van; Ramiro, Sofia; Ramonda, Roberta; Landewé, Robert B.M. & Dagfinrud, Hanne [Show all 9 contributors for this article] (2018). Are gender-specific approaches needed in diagnosing early axial spondyloarthritis? Data from the SPondyloArthritis Caught Early cohort. Arthritis Research & Therapy. ISSN 1478-6354. 20(218). doi: 10.1186/s13075-018-1705-x. Full text in Research Archive
• Lunteren, Miranda van; Ez-Zaitouni, Zineb; Koning, Anoek de; Dagfinrud, Hanne; Ramonda, Roberta & Jacobsson, Lennart [Show all 9 contributors for this article] (2018). In Early Axial Spondyloarthritis, Increasing Disease Activity Is Associated with Worsening of Health-related Quality of Life over Time. Journal of Rheumatology. ISSN 0315-162X. 45(6), p. 779–784. doi: 10.3899/jrheum.170796. Full text in Research Archive
• Risum, Kristine; Hansen, Bjørge Hermann; Selvaag, Anne Marit G; Molberg, Øyvind; Dagfinrud, Hanne & Sanner, Helga (2018). Physical activity in patients with oligo- and polyarticular juvenile idiopathic arthritis diagnosed in the era of biologics: A controlled cross-sectional study. Pediatric Rheumatology. 16(64). doi: 10.1186/s12969-018-0281-6. Full text in Research Archive Show summary

  Background: Knowledge about objectively measured levels of physical activity (PA) and PA participation (included facilitators and barriers for PA) in patients with juvenile idiopathic arthritis (JIA) diagnosed in the era of biologics is limited. We aimed to compare objectively measured PA in patients with oligo- and polyarticular JIA diagnosed in the biologic era with controls and to examine associations between PA and disease variables; furthermore, to explore participation in PA, physical education (PE) and facilitators and barriers for PA participation in patients and controls. Methods: The study cohort included 60 patients (30 persistent oligo JIA/30 poly-articular disease) and 60 age- and sex-matched controls. Age range was 10–16 years and 83% were female. PA was measured with accelerometry for seven consecutive days. Disease activity, current treatment, disease duration, functional ability, pain and fatigue were assessed. Structured interviews were applied to explore participation in PA and PE, and PA facilitators and barriers. Results: Patients spent less time in daily vigorous PA than controls, (mean(SE) 21(2) min vs. 26(2) min, p = 0.02), while counts per minute (cpm), steps daily, sedentary time and light and moderate PA did not differ. No differences were found between JIA subgroups. The use of biologic medication was associated with higher cpm and lower sedentary time. Most patients and controls participated in organized or unorganized PA and PE, and enjoyment was the most reported facilitator for PA participation. More patients than controls reported pain as a PA barrier. Conclusion: The PA levels and participation in patients with oligo- and polyarticular JIA are mostly comparable to controls, but patients still need to be encouraged to increase vigorous PA. Enjoyment is the most important facilitator for PA participation in patients with JIA.

• Provan, Sella Aarrestad; Olstad, Daniela Schäfer; Solberg, Erik Ekker; Smedslund, Geir & Dagfinrud, Hanne (2017). Evidence of reduced parasympathetic autonomic regulation in inflammatory joint disease: A meta-analyses study. Seminars in Arthritis & Rheumatism. ISSN 0049-0172. 48(1), p. 134–140. doi: 10.1016/j.semarthrit.2017.11.010. Full text in Research Archive
• Robinson, Hilde Stendal & Dagfinrud, Hanne (2017). Reliability and screening ability of the StarT Back screening tool in patients with low back pain in physiotherapy practice, a cohort study. BMC Musculoskeletal Disorders. 18(1). doi: 10.1186/s12891-017-1553-x. Full text in Research Archive Show summary

  Background Low back pain (LBP) is the most common reported musculoskeletal disorder, with large prevalence numbers and high costs. Focus on early identification of patients at risk of developing chronic LBP has increased. The Keele Start Back Tool (SBT) is a questionnaire aiming at screening prognostic indicators in LBP patients, categorizing patients into risk-groups and guide treatment. The aim of this study was to explore the Norwegian version of the SBT with regard to reliability of the SBT-scoring and the screening ability in LBP patients in primary care physiotherapy. Methods LBP patients answered a package of questionnaires twice, with 1-3 days in between, containing SBT, Hannover functional ability questionnaire, pain intensity questions and demographics. The relative and absolute reliability of SBT was calculated using intraclass correlation coefficient (ICC) and the smallest detectable change respectively. Independent sample t-tests were used for group comparisons. Results Fifty-two patients with LBP. Mean age (SD) was 45 (12) years and 62% were female. The ICC (95% CI) for SBT total score and psychosocial subscore was 0.89 (0.82, 0.94) and 0.82 (0.70, 0.90) respectively. None of the participants were allocated to the high risk group. The medium risk group reported significantly more pain last week and more activity limitations than the low risk group at both test and retest (0.001 ≤ p ≤ 0.003), whereas no significant difference between the groups was found on pain now (0.05 ≤ p ≤ 0.16). Conclusions The Norwegian version of the SBT was reliable and the screening ability was good as the subgrouping of patients into risk-groups reflected the severity of their back problems. The SBT may be an applicable and useful tool in physiotherapy practice.

• Moseng, Tuva; Dagfinrud, Hanne; Smedslund, Geir & Østerås, Nina (2017). The importance of dose in land-based supervised exercise for people with hip osteoarthritis. A systematic review and meta-analysis. Osteoarthritis and Cartilage. ISSN 1063-4584. 25(10), p. 1563–1576. doi: 10.1016/j.joca.2017.06.004. Full text in Research Archive
• Sveaas, Silje Halvorsen; Smedslund, Geir; Hagen, Kåre Birger & Dagfinrud, Hanne (2017). Effect of cardiorespiratory and strength exercises on disease activity in patients with inflammatory rheumatic diseases: a systematic review and meta-analysis. British Journal of Sports Medicine. ISSN 0306-3674. 51(14), p. 1065–1072. doi: 10.1136/bjsports-2016-097149. Full text in Research Archive
• Leister, Wolfgang; Fongen, Camilla; Soldal, Dag; Hagen, Kåre Birger; Schulz, Trenton Wade & Aursand, Peder [Show all 16 contributors for this article] (2017). Evidence-Based Self-Management for Spondyloarthritis Patients. International Journal on Advances in Life Sciences. 9(3&4), p. 92–105. Full text in Research Archive Show summary

  We present a concept including a set of tools for selfmanagement for patients suffering from axial spondyloarthritis (SpA). This concept involves patient-recorded outcome measures, both subjective assessment and clinical measurements, that are used to present recommendations. We report from experiences made while implementing a proof of this concept and analyse it from several perspectives. Our work resulted in proposing a self-management tool for the patient, improving the methodology for clinical measurements of rotation exercises, and proof the viability for using on-board sensors in smart phones. Further, since sensors collect data in a medical setting, we present ethical considerations.

• Heijde, Désirée van der; Ramiro, Sofia; Landewé, Robert; Baraliakos, Xenofon; Bosch, Filip van den & Sepriano, Alexandre [Show all 29 contributors for this article] (2017). 2016 update of the ASAS-EULAR management recommendations for axial spondyloarthritis. Annals of the Rheumatic Diseases. ISSN 0003-4967. 76(6), p. 978–991. doi: 10.1136/annrheumdis-2016-210770. Full text in Research Archive
• Helland, Ylva; Dagfinrud, Hanne; Hauge, Mona-Iren; Kjeken, Ingvild & Zangi, Heidi Andersen (2017). Patients' Perspectives on Information and Communication About Sexual and Relational Issues in Rheumatology Health Care. Musculoskeletal Care. ISSN 1478-2189. 15(2), p. 131–139. doi: 10.1002/msc.1149. Full text in Research Archive
• Bruin, Freek de; Horst, Simone ter; Bloem, J.L.; berg, R. Van den; Hooge, M. de & Gaalen, Floris van [Show all 11 contributors for this article] (2017). Prevalence and clinical significance of lumbosacral transitional vertebra (LSTV) in a young back pain population with suspected axial spondyloarthritis: results of the SPondyloArthritis Caught Early (SPACE) cohort. Skeletal Radiology. ISSN 0364-2348. 46(5), p. 633–639. doi: 10.1007/s00256-017-2581-1. Full text in Research Archive
• Sveaas, Silje Halvorsen; Berg, Inger Jorid; Fongen, Camilla; Provan, Sella Aarrestad & Dagfinrud, Hanne (2017). High-intensity cardiorespiratory and strength exercises reduced emotional distress and fatigue in patients with axial spondyloarthritis: a randomized controlled pilot study. Scandinavian Journal of Rheumatology. ISSN 0300-9742. doi: 10.1080/03009742.2017.1347276. Full text in Research Archive
• Christie, Anne & Dagfinrud, Hanne (2017). Utvikling av kvalitetsindikatorer i fysioterapi :. Fysioterapeuten. ISSN 0016-3384. 84(2), p. 20–23. Full text in Research Archive
• Christie, Anne; Bø, Ingvild; Enger, Kirsten; Hagfors, Jon; Jarret, Gilles & Liland, Karen Marie [Show all 12 contributors for this article] (2016). Utvikling av en kunnskapsbasert fagprosedyre. Fysioterapeuten. ISSN 0016-3384. 83(7), p. 26–29. Full text in Research Archive
• Peter, Wilfred F.; Vet, Henrika C.W. de; Boers, Maarten; Harlaar, Jaap; Roorda, Leo D. & Poolman, Rudolf W. [Show all 16 contributors for this article] (2016). Cross-cultural and construct validity of the Animated Activity Questionnaire. Arthritis care & research. ISSN 2151-464X. doi: 10.1002/acr.23127. Full text in Research Archive
• Bartels, Else Marie; Juhl, Carsten B.; Christensen, Robin; Hagen, Kåre Birger; Danneskiold-Samsøe, Bente & Dagfinrud, Hanne [Show all 7 contributors for this article] (2016). Aquatic exercise for the treatment of knee and hip osteoarthritis. Cochrane Database of Systematic Reviews. 2016(3). doi: 10.1002/14651858.CD005523.pub3. Full text in Research Archive
• Norén, Kristine Røren; Dagfinrud, Hanne; Løvstad, Amund T. & Raastad, Truls (2016). Reduced appendicular lean body mass, muscle strength, and size of type II muscle fibers in patients with spondyloarthritis versus healthy controls: A cross-sectional study. Scientific World Journal. 2016. doi: 10.1155/2016/6507692. Full text in Research Archive Show summary

  Introduction. The purpose of this study was to investigate body composition, muscle function, and muscle morphology in patients with spondyloarthritis (SpA). Methods. Ten male SpA patients (mean ± SD age 39 ± 4.1 years) were compared with ten healthy controls matched for sex, age, body mass index, and self-reported level of physical exercise. Body composition was measured by dual energy X-ray absorptiometry. Musculus quadriceps femoris (QF) strength was assessed by maximal isometric contractions prior to test of muscular endurance. Magnetic resonance imaging of QF was used to measure muscle size and calculate specific muscle strength. Percutaneous needle biopsy samples were taken from m. vastus lateralis. Results. SpA patients presented with significantly lower appendicular lean body mass (LBM) (𝑝 = 0.02), but there was no difference in bone mineral density, fat mass, or total LBM. Absolute QF strength was significantly lower in SpA patients (𝑝 = 0.03) with a parallel trend for specific strength (𝑝 = 0.08). Biopsy samples from the SpA patients revealed significantly smaller cross-sectional area (CSA) of type II muscle fibers (𝑝 = 0.04), but no difference in CSA type I fibers. Conclusions. Results indicate that the presence of SpA disease is associated with reduced appendicular LBM, muscle strength, and type II fiber CSA.

• Leister, Wolfgang; Fongen, Camilla; Soldal, Dag; Hagen, Kåre Birger; Schulz, Trenton Wade & Bai, Aleksander [Show all 15 contributors for this article] (2016). Towards Evidence-Based Self-Management for Spondyloarthritis Patients. In Khachfe, Hassan & Leister, Wolfgang (Ed.), GLOBAL HEALTH 2016, The Fifth International Conference on Global Health Challenges. International Academy, Research and Industry Association (IARIA). ISSN 9781612085111. p. 43–48. Full text in Research Archive Show summary

  We developed a concept including a set of tools for self-management for patients suffering from axial spondyloarthritis (SpA). This concept involves patient-recorded outcome measures, both subjective assessment and clinical measurements, that are used to present recommendations. We report from experiences made while implementing a proof of this concept. Besides giving the patient a self-management tool, our work also improved the methodology for clinical measurements.

• Peter, Wilfred; Dagfinrud, Hanne; Østerås, Nina & Terwee, CB (2016). Animated Activity Questionnaire (AAQ), a new method of self-reporting activity limitations in patients with hip and knee osteoarthritis: Comparisons with observation by spouses for construct validity. Musculoskeletal Care. ISSN 1478-2189. doi: 10.1002/msc.1172. Full text in Research Archive
• Vargas, Roxana Rubio; Berg, Rosaline van den; Lunteren, Miranda van; Ez-Zaitouni, Zineb; Bakker, Pauline A.C. & Dagfinrud, Hanne [Show all 11 contributors for this article] (2016). Does body mass index (BMI) influence the Ankylosing Spondylitis Disease Activity Score in axial spondyloarthritis? Data from the SPACE cohort. RMD Open. 2(1). doi: 10.1136/rmdopen-2016-000283. Full text in Research Archive
• Christie, Anne; Dagfinrud, Hanne; Mowinckel, Petter & Hagen, Kåre Birger (2015). Variation in fatigue may be poorly explained by pain: results from a longitudinal, exploratory study. Rheumatology International. ISSN 0172-8172. p. 1–4. doi: 10.1007/s00296-015-3357-3. Full text in Research Archive
• Berg, Inger Jorid; Heijde, Desirée van der; Dagfinrud, Hanne; Seljeflot, Ingebjørg; Olsen, Inge Christoffer & Kvien, Tore Kristian [Show all 8 contributors for this article] (2015). Disease activity in ankylosing spondylitis and associations to markers of vascular pathology and traditional cardiovascular disease risk factors: A cross-sectional study. Journal of Rheumatology. ISSN 0315-162X. 42(4), p. 645–653. doi: 10.3899/jrheum.141018. Full text in Research Archive
• Sveaas, Silje Halvorsen; Berg, Inger Jorid; Provan, Sella Aarrestad; Semb, Anne Grete; Olsen, Inge Christoffer & Ueland, Thor [Show all 11 contributors for this article] (2015). Circulating levels of inflammatory cytokines and cytokine receptors in patients with ankylosing spondylitis: A cross-sectional comparative study. Scandinavian Journal of Rheumatology. ISSN 0300-9742. 44(2), p. 118–124. doi: 10.3109/03009742.2014.956142. Full text in Research Archive
• Fongen, Camilla; Sveaas, Silje Halvorsen & Dagfinrud, Hanne (2015). Barriers and facilitators for being physically active in patients with ankylosing spondylitis: a cross-sectional comparative study. Musculoskeletal Care. ISSN 1478-2189. 13(2), p. 76–83. doi: 10.1002/msc.1088. Full text in Research Archive
• Christie, Anne; Hagen, Kåre Birger; Mowinckel, Petter & Dagfinrud, Hanne (2015). Aquatic Exercises were Associated with an Acceptable State of Symptoms in Patients with Inflammatory Rheumatic Diseases: Results from a Study with Interrupted Time-Series Design. Musculoskeletal Care. ISSN 1478-2189. 13(3), p. 139–147. doi: 10.1002/msc.1092. Full text in Research Archive Show summary

  Abstract Aim of study The aim of this study was two-fold: to compare symptoms and daily activity in patients with inflammatory rheumatic diseases across periods with and without aquatic exercises, and to examine whether the patients reached an acceptable state of symptoms during the periods with aquatic exercises. Methods Thirty-six patients reported pain, fatigue, stiffness and ability to carry out daily activities across periods with and without aquatic exercises. The study has an interrupted time-series design and variables were collected with text messages on mobile phones twice a week over a period of 35 weeks. Results There was a significant reduction in pain, fatigue, stiffness and enhanced level of daily activity (p > 0.05) during periods of aquatic exercises compared to periods without. Further, a significantly higher proportion of patients reached an acceptable state for both pain and fatigue during periods with aquatic exercises. Conclusions Living with an inflammatory rheumatic disease is a lifelong challenge. Pain and fatigue are considered major obstacles for daily functioning and adequate self-management strategies are requested. Based on the high proportion of patients reporting to be in an acceptable state of both pain and fatigue during periods with aquatic exercises, the intervention should be regarded as an important self-management tool rather than a treatment option assuming long-lasting effects. Copyright © 2014 John Wiley & Sons, Ltd.

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• Pavia, Fabiola; Provan, Sella Aarrestad; Aas, Eline; Dagfinrud, Hanne; Sveaas, Silje Halvorsen & Berg, Inger Jorid [Show all 8 contributors for this article] (2026). COST-EFFECTIVENESS OF A HIGH-INTENSITY EXERCISE PROGRAM FOR AXIAL SPONDYLOARTHRITIS: A MODELLING STUDY. doi: https:/scientific.sparx-ip.net/archiveeular/?c=a&searchfor=gunhild%20hagen&view=1&item=2026POS0192. Full text in Research Archive
• Nordén, Kristine Røren; semb, anne grete; Dagfinrud, Hanne; Sexton, Joe; Fongen, Birgit Camilla & Blanck, Thalita [Show all 9 contributors for this article] (2024). Studie: Intensiv trening er effektivt og trygt for pasienter med inflammatorisk leddsykdom. [Journal]. Dagens Medisin. Full text in Research Archive
• Nordén, Kristine Røren; Tveter, Anne Therese; Dagfinrud, Hanne; Semb, Anne Grete & Daniloff, Kathrine (2024). Ny forskning: Revmatikere kan få bedre hjertehelse på 12 uker. [Journal]. VG online og papirutgave. Full text in Research Archive
• Nordén, Kristine Røren; Fongen, Birgit Camilla; Tveter, Anne Therese; Dagfinrud, Hanne & Semb, Anne Grete (2024). HIIT-trening har positiv effekt på pasienter med leddsykdommer. [Journal]. Fysioterapeuten. Full text in Research Archive
• Daniloff, Kathrine; Nordén, Kristine Røren; Tveter, Anne Therese; Dagfinrud, Hanne & Semb, Anne Grete (2024). Ny forskning: Denne treningen gir pasienter med leddsykdommer bedre helse. [Journal]. Forskning.no. doi: https:/www.forskning.no/diakonhjemmet-sykehus-hjertet-medisinske-metoder/ny-forskning-denne-treningen-gir-pasienter-med-leddsykdommer-bedre-helse/2431498. Full text in Research Archive
• Sand-Svartrud, Anne-Lene; Berdal, Gunnhild; Aanerud, Gerd Jenny; Azimi, Maryam; Bjørnerud, Anne Merete & Dager, Turid Nygaard [Show all 11 contributors for this article] (2023). Kvalitet i rehabiliteringstjenester for pasienter med muskelskjelettskader, - sykdommer og -plager. Resultater fra BRIDGE-studien. Full text in Research Archive Show summary

  Purpose: To investigate how a quality improvement program (BRIDGE), designed to promote coordination and continuity in rehabilitation services, was delivered and perceived by providers in routine practice for patients with rheumatic and musculoskeletal diseases. Methods: A convergent mixed methods approach was nested within a stepped-wedge, randomized controlled trial. The intervention program was developed to bridge gaps between secondary and primary healthcare, comprising the following elements: motivational interviewing; patient-specific goal setting; written rehabilitation-plans; personalized feedback on progress; and tailored follow-up. Data from health professionals who delivered the program were collected and analyzed separately, using two questionnaires and three focus groups. Results were integrated during the overall interpretation and discussion. Results: The program delivery depended on the providers' skills and competence, as well as on contextual factors in their teams and institutions. Suggested possibilities for improvements included follow-up with sufficient support from next of kin and external services, and the practicing of action and coping plans, standardized outcome measures, and feedback on progress. Conclusions: Leaders and clinicians should discuss efforts to ensure confident and qualified rehabilitation delivery at the levels of individual providers, teams, and institutions, and pay equal attention to each component in the process from admission to follow-up.

• Sand-Svartrud, Anne-Lene; Kjeken, Ingvild; Skardal, Renate Foss; Gjerset, Gunnhild M; Johnsen, Tonje Jossie & Lyken, Anne Dorte [Show all 8 contributors for this article] (2023). Grad av komplette data for pasientrapporterte utfallsmål i rehabiliteringforløp. En RCT-studie. Full text in Research Archive Show summary

  Formål: Å undersøke forskjeller i andel komplette data i et kort og et langt sett med PROMs brukt som repeterte målinger i rehabiliteringsforløp for pasienter med varierte diagnoser. Metode: I denne randomiserte kontrollerte studien ble voksne pasienter ved 16 private rehabiliteringsinstitusjoner i Norge randomisert til å besvare enten en kort eller en lang skjemapakke med PROMs. Pasientene fikk tilgang til digitale spørreskjema ved innkomst og utreise fra rehabilitering i spesialisthelsetjenesten, og deretter hjemmefra etter 3, 6 og 12 måneder. Begge skjemapakker inkluderte sosiodemografiske variabler besvart ved innkomst, samt repeterte målinger som omfattet arbeidsevne, smerte, aksept av nåværende helsestatus og opplevd nytte av rehabilitering. Begge skjemapakker inkluderte også helserelatert livskvalitet, målt med EQ-5D-5L. Tilleggsinstrumenter i lang skjemapakke var PROMIS-29 for måling av funksjon og Pasientspesifikk funksjons-skala (PSFS) for måling av individuelle rehabiliteringsmål og måloppnåelse. Resultater:Studien inkluderte totalt 2904 pasienter. Pasientene var i gjennomsnitt 54 år (SD: 14 år), 69% var kvinner og 47% hadde høyere utdanning. De fleste (94%) hadde et skandinavisk språk som morsmål og 29% hadde en aktiv arbeidslivstilknytning. Totalt 39% av pasientene var henvist til rehabilitering i spesialisthelsetjenesten grunnet muskelskjelettskader, - sykdommer og -plager. Et flertall (78%) av alle inkluderte pasienter hadde smerter, og disse var oftest spredt til flere kroppsområder (67%), med varighet ≥3 måneder (90%). På gruppenivå, på tvers av alle måletidspunkt, var andel komplette datasett-besvarelser signifikant høyere (71%) for pasientgruppen med kort skjemapakke, sammenlignet med lang skjemapakke (62%). På individnivå var andel pasienter som helt eller delvis besvarte PROMs ved alle måletidspunkt lavere enn forventet: Andelen var bare 32% for dem med kort skjemapakke og 28% for dem med lang skjemapakke. Frafall underveis var signifikant lavere for dem med kort skjemapakke (18%) sammenlignet med lang pakke (22%). Andel pasienter med sporadisk ubesvart respons ved ett eller flere måletidspunkt var lik i begge grupper (50%). I begge grupper var grad av komplette data høyere ved innkomst sammenlignet med oppfølgingstiden (3, 6 og 12 måneder). Et overraskende funn var at laveste grad av komplette besvarelser var ved utreise fra rehabilitering i spesialisthelsetjenesten. For hvert måletidspunkt var andel komplette EQ-5D-5L-data sammenlignbar med andel komplette data for variablene arbeidsevne, smerte, helsestatus og rehabiliteringsnytte. Andel komplette data for PSFS og PROMIS-29 var 1-8 prosentpoeng lavere enn andel komplette EQ-5D-5L-data. Forskjellen mellom instrumentene var større ved innkomst enn i oppfølgingstiden. Grad av komplette data varierte med institusjonstilhørighet, diagnose og pasientkarakteristika. Andel komplette data var høyest for pasienter med kreft eller hjerte-/kar-sykdom. Blant dem med mest komplette data var det flere kvinner, høyere gjennomsnittsalder, høyere utdanning og høyere inntekt. Blant dem med mangelfulle besvarelser var det flere enslige, flere med omsorgsansvar for andre, flere med ikke-skandinavisk morsmål, flere med smerte og flere med angst/depresjon. Konklusjon:Grad av komplette data var høyest når lengden på skjemapakken var kort. For å oppnå god datakvalitet gjennom longitudinelle rehabiliteringsforløp bør man derfor vurdere nøye hva som er nødvendig innhold og lengde på skjemapakker. Forbedring av andre forhold som fremmer pasientenes muligheter og motivasjon for repeterte målinger bør vurderes i tillegg. Dette inkluderer dialogen mellom helsepersonell og pasienter om hensikt og nytte med PROMs, optimalisering av lokale administrasjonsrutiner og tilpasninger til subgrupper.

• Sand-Svartrud, Anne-Lene; Berdal, Gunnhild; Aanerud, Gerd Jenny; Azimi, Maryam; Bjørnerud, Anne Merete & Dager, Turid Nygaard [Show all 11 contributors for this article] (2023). Kvalitet i rehabiliteringstjenester for pasienter med muskelskjelettskader, - sykdommer og -plager. Resultater fra BRIDGE-studien. Full text in Research Archive Show summary

  Purpose: To investigate how a quality improvement program (BRIDGE), designed to promote coordination and continuity in rehabilitation services, was delivered and perceived by providers in routine practice for patients with rheumatic and musculoskeletal diseases. Methods: A convergent mixed methods approach was nested within a stepped-wedge, randomized controlled trial. The intervention program was developed to bridge gaps between secondary and primary healthcare, comprising the following elements: motivational interviewing; patient-specific goal setting; written rehabilitation-plans; personalized feedback on progress; and tailored follow-up. Data from health professionals who delivered the program were collected and analyzed separately, using two questionnaires and three focus groups. Results were integrated during the overall interpretation and discussion. Results: The program delivery depended on the providers' skills and competence, as well as on contextual factors in their teams and institutions. Suggested possibilities for improvements included follow-up with sufficient support from next of kin and external services, and the practicing of action and coping plans, standardized outcome measures, and feedback on progress. Conclusions: Leaders and clinicians should discuss efforts to ensure confident and qualified rehabilitation delivery at the levels of individual providers, teams, and institutions, and pay equal attention to each component in the process from admission to follow-up.

• Svanes, Mari Flem; Dagfinrud, Hanne; Sanner, Helga & Risum, Kristine (2022). Helserelatert livskvalitet, fysisk aktivitet og fysisk form hos pasienter med juvenil idiopatisk artritt. Full text in Research Archive
• Risum, Kristine; Hansen, Bjørge Hermann; Selvaag, Anne Marit G; Molberg, Øyvind; Dagfinrud, Hanne & Sanner, Helga (2018). Fysisk aktivitet hos pasienter med juvenil idiopatisk artritt- en kontrollert tverrsnittsstudie. Full text in Research Archive
• Risum, Kristine; Selvaag, Anne Marit; Molberg, Øyvind; Dagfinrud, Hanne & Sanner, Helga (2018). Estimated peak oxygen uptake and submaximal parameters from a submaximal treadmill test are comparable between patients with oligo- and polyarticular juvenile idiopathic arthritis diagnosed in the era of biologics and controls- a controlled cross-sectional study. Full text in Research Archive
• Risum, Kristine; Edvardsen, Elisabeth; Selvaag, Anne Marit; Molberg, Øyvind; Dagfinrud, Hanne & Sanner, Helga (2018). Kardiorspiratorisk form hos pasienter med juvenile idiopatisk artritt- en kontrollert tverrsnittsstudie. Full text in Research Archive
• Risum, Kristine; Edvardsen, Elisabeth; Selvaag, Anne Marit; Molberg, Øyvind; Dagfinrud, Hanne & Sanner, Helga (2018). Criterion validity and reliability of a submaximal treadmill test in juvenile idiopathic arthritis patients. Full text in Research Archive
• Risum, Kristine; Godang, Kristin; Selvaag, Anne Marit; Hansen, Bjørge Hermann; Molberg, Øyvind & Bollerslev, Jens [Show all 9 contributors for this article] (2018). Suboptimal muscle strength and bone health in patients with oligo- and polyarticular juvenile idiopathic arthritis diagnosed in the era of biologics. Full text in Research Archive
• Moseng, Tuva; Dagfinrud, Hanne; Smedslund, Geir & Østerås, Nina (2018). Corrigendum to 'The importance of dose in land-based supervised exercise for people with hip osteoarthritis. A systematic review and meta-analysis' [Osteoarthritis Cartilage 25 (2017) 1563?1576]. Osteoarthritis and Cartilage. ISSN 1063-4584. 26(5), p. 707–709. doi: 10.1016/j.joca.2018.03.001. Full text in Research Archive
• Moseng, Tuva; Dagfinrud, Hanne; Andreassen, Øyvor; Dziedzic, Krysia; Hagen, Kåre Birger & Hansen, Jorun Nygren [Show all 13 contributors for this article] (2018). Implementing international osteoarthritis guidelines in primary care: results on symptom-related outcomes in secondary analyses from a randomised controlled study. Full text in Research Archive
• Risum, Kristine; Selvaag, Anne Marit; Molberg, Øyvind; Dagfinrud, Hanne & Sanner, Helga (2017). Facilitators and barriers for participation in physical activities in juvenile idiopathic arthritis patients and healthy controls. Full text in Research Archive
• Risum, Kristine; Selvaag, Anne Marit; Molberg, Øyvind; Dagfinrud, Hanne & Sanner, Helga (2017). Physical activity level measured by accelerometer is comparable between juvenile idiopathic arthritis patients and controls, but patients spend less time in vigorous physical activity. Full text in Research Archive
• Berdal, Gunnhild; Hagen, Kåre Birger; Dagfinrud, Hanne; Mowinckel, Petter; Bø, Ingvild & Dager, Turid Nygaard [Show all 15 contributors for this article] (2017). An add-on programme improved the short-term, but not the long-term effect of rehabilitation in patients with rheumatic diseases: results from a pragmatic multi-centre stepped-wedge cluster randomized controlled trial. Full text in Research Archive
• Provan, Sella Aarrestad; Olstad, Daniela Schäfer; Solberg, Erik Ekker; Smedslund, Geir & Dagfinrud, Hanne (2017). Heart rate variability in inflammatory joint disease: a meta-analysis. Full text in Research Archive
• Dagfinrud, Hanne; Sveaas, Silje Halvorsen; Smedslund, Geir & Hagen, Kåre Birger (2017). Pasienter med inflammatorisk leddsykdom som gjennomfører kondisjon- og styrketrening reduserer også sykdomsaktiviteten. Full text in Research Archive
• Moseng, Tuva; Dagfinrud, Hanne; Smedslund, Geir & Østerås, Nina (2017). Dose matters in exercise for patients with hip osteoarthritis. Full text in Research Archive
• Risum, Kristine; Edvardsen, Elisabeth; Selvaag, Anne Marit; Molberg, Øyvind; Dagfinrud, Hanne & Sanner, Helga (2016). Cardiorespiratory Fitness in Children with Juvenile Idiopathic Arthritis Treated in the Biological Era is Comparable with Controls: a Cross-Sectional Study. Full text in Research Archive
• Leister, Wolfgang; Schulz, Trenton Wade; Boye, Lars Thomas; Berre, Vebjørn; Hagen, Kåre Birger & Soldal, Dag [Show all 14 contributors for this article] (2016). The MOSKUS Architecture and Implementation. Norsk Regnesentral. Full text in Research Archive Show summary

  This research note is the Deliverable D3.1 of the MOSKUS project. We implemented a prototype of a self-management support system for patients with spondyloarthritis (SpA), a rheumatic disease. This prototype is based on the treat-to-target method and follows a concept that supports tools for self-management, clinical assessment, and better communication between patient and health personnel. The outcome of the implementation is twofold; first, a novel assessment methodology using sensors was developed and tested clinically; and second, a software system that can be used on smart phones currently implemented on the Android platform) was developed. This note describes the implementation aspects of the MOSKUS project.

• Leister, Wolfgang; Hagen, Kåre Birger; Soldal, Dag; Boye, Lars Thomas; Berre, Vebjørn & Fongen, Camilla [Show all 15 contributors for this article] (2016). Final Report of the MOSKUS Project. Norsk Regnesentral. Full text in Research Archive

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