{"id":5992,"date":"2026-10-19T09:48:20","date_gmt":"2026-10-19T09:48:20","guid":{"rendered":"https:\/\/phd.hi.is\/doktorsvorn\/doktorsvorn-i-heilbrigdisvisindum-olof-ragna-amundadottir\/"},"modified":"2026-10-19T09:48:20","modified_gmt":"2026-10-19T09:48:20","slug":"doktorsvorn-i-heilbrigdisvisindum-olof-ragna-amundadottir","status":"publish","type":"phd_defence","link":"https:\/\/phd.hi.is\/en\/doktorsvorn\/doktorsvorn-i-heilbrigdisvisindum-olof-ragna-amundadottir\/","title":{"rendered":"Doktorsv\u00f6rn \u00ed heilbrig\u00f0isv\u00edsindum – \u00d3l\u00f6f Ragna \u00c1mundad\u00f3ttir"},"content":{"rendered":"
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Mi\u00f0vikudaginn 19. febr\u00faar ver \u00d3l\u00f6f Ragna \u00c1mundad\u00f3ttir doktorsritger\u00f0 s\u00edna \u00ed heilbrig\u00f0is-v\u00edsindum vi\u00f0 L\u00e6knadeild H\u00e1sk\u00f3la \u00cdslands. Ritger\u00f0in ber heiti\u00f0: Vakandi og virkur og \u00ed uppr\u00e9ttri st\u00f6\u00f0u \u00ed \u00f6ndunarv\u00e9l \u00e1 gj\u00f6rg\u00e6sludeild. Being awake upright and moving as the basis for physiotherapy in the intensive care unit.<\/strong><\/p>\n

Andm\u00e6lendur eru dr. Rik Gosselink, pr\u00f3fessor vi\u00f0 University Hospitals Leuven \u00ed Belg\u00edu og Gunnar Gu\u00f0mundsson, pr\u00f3fessor vi\u00f0 L\u00e6knadeild H\u00cd.<\/p>\n

Umsj\u00f3narkennari var dr. G\u00edsli H. Sigur\u00f0sson, pr\u00f3fessor emeritus og lei\u00f0beinandi dr. Elizabeth Dean, pr\u00f3fessor. Auk \u00feeirra s\u00e1tu \u00ed doktorsnefnd \u00feau dr. \u00de\u00f3rarinn Sveinsson, pr\u00f3fessor, dr. Helga J\u00f3nsd\u00f3ttir, pr\u00f3fessor og dr. Alma D. M\u00f6ller, landl\u00e6knir.<\/p>\n

Engilbert Sigur\u00f0sson, pr\u00f3fessor og forseti L\u00e6knadeildar H\u00e1sk\u00f3la \u00cdslands, stj\u00f3rnar ath\u00f6fninni sem fer fram \u00ed H\u00e1t\u00ed\u00f0asal H\u00e1sk\u00f3la \u00cdslands og hefst kl. 13.00.<\/p>\n

\u00c1grip af ranns\u00f3kn<\/strong><\/p>\n

Bakgrunnur<\/strong>: Framfarir \u00ed me\u00f0fer\u00f0 alvarlega veikra sj\u00faklinga og h\u00e6kka\u00f0ur l\u00edfaldur hefur leitt til \u00feess a\u00f0 fleira f\u00f3lk lifir n\u00fa af br\u00e1\u00f0 og alvarleg veikindi en \u00e1\u00f0ur. Aflei\u00f0ingar veikindanna \u00e1samt gj\u00f6rg\u00e6slulegunni geta haft \u00e1hrif \u00e1 l\u00edkamlegt og s\u00e1lr\u00e6nt heilsufar sj\u00faklinga sem oft finna fyrir h\u00e6gum og \u00f3n\u00f3gum bata. Sj\u00faklingar sem eru lengi r\u00famliggjandi \u00e1 gj\u00f6rg\u00e6sludeild eiga vi\u00f0 meiri sker\u00f0ingu \u00e1 l\u00edkamlegri heilsu a\u00f0 str\u00ed\u00f0a eftir gj\u00f6rg\u00e6slulegu en \u00feeir sem liggja skemur. Sj\u00fakra\u00fej\u00e1lfun sem felur \u00ed s\u00e9r hreyfingu og uppr\u00e9tta st\u00f6\u00f0u er f\u00fdsilegur kostur til a\u00f0 draga \u00far r\u00famlegu sj\u00faklinga, en s\u00fa tegund \u00fej\u00e1lfunar er b\u00e6\u00f0i illa skilgreind og vann\u00fdtt. Of f\u00e1um gj\u00f6rg\u00e6slusj\u00faklingum er hj\u00e1lpa\u00f0 \u00ed uppr\u00e9tta st\u00f6\u00f0u sitjandi \u00e1 r\u00famstokk e\u00f0a \u00ed standandi st\u00f6\u00f0u \u00e1 me\u00f0an \u00feeir eru \u00ed \u00f6ndunarv\u00e9l, \u00fer\u00e1tt fyrir ni\u00f0urst\u00f6\u00f0ur vi\u00f0urkenndra ranns\u00f3kna \u00e1 \u00f6ryggi, f\u00fdsileika og nau\u00f0synleika \u00feess.<\/p>\n

Markmi\u00f0<\/strong>: Markmi\u00f0 \u00feessarar doktorsranns\u00f3knar var \u00fer\u00ed\u00fe\u00e6tt: A\u00f0 draga fram \u00fe\u00e6tti \u00ed kl\u00edn\u00edskri r\u00f6khugsun og \u00e1kvar\u00f0anat\u00f6ku sj\u00fakra\u00fej\u00e1lfara \u00feegar \u00feeir a\u00f0sto\u00f0a sj\u00faklinga sem eru alvarlega veikir vi\u00f0 \u00fea\u00f0 a\u00f0 setjast fram \u00e1 r\u00famstokk og veita \u00feeim vi\u00f0eigandi \u00fej\u00e1lfun. \u00cd \u00f6\u00f0ru lagi a\u00f0 rannsaka skammt\u00edma- og langt\u00edma\u00e1rangur sj\u00fakra\u00fej\u00e1lfunar me\u00f0 hreyfingu \u00ed uppr\u00e9tta st\u00f6\u00f0u sem hefst \u00e1 \u00feri\u00f0ja degi eftir upphaf \u00f6ndunarv\u00e9larme\u00f0fer\u00f0ar og er framkv\u00e6md tvisvar \u00e1 dag, bori\u00f0 saman vi\u00f0 sj\u00fakra\u00fej\u00e1lfun sem hefst \u00e1 fimmta degi og er framkv\u00e6md einu sinni \u00e1 dag. \u00cd \u00feri\u00f0ja lagi a\u00f0 greina forsp\u00e1\u00fe\u00e6tti fyrir skertum l\u00edkamlegum endurbata sj\u00faklinga \u00e1ri eftir \u00fatskrift af gj\u00f6rg\u00e6slu.<\/p>\n

A\u00f0fer\u00f0ir<\/strong>: Ritger\u00f0in samanstendur af \u00feremur v\u00edsindagreinum. S\u00fa fyrsta bygg\u00f0ist \u00e1 eigindlegri ranns\u00f3kn sem var framkv\u00e6md \u00e1 12 sj\u00fakra\u00fej\u00e1lfurum. \u00c1horfsathugun var framkv\u00e6md \u00e1 s\u00e9rhverjum sj\u00fakra\u00fej\u00e1lfara, fyrir, \u00e1 me\u00f0an og eftir a\u00f0 hann e\u00f0a h\u00fan veitti sj\u00fakra\u00fej\u00e1lfun \u00e1 gj\u00f6rg\u00e6sludeild, sem samanst\u00f3\u00f0 af \u00fev\u00ed a\u00f0 a\u00f0sto\u00f0a alvarlega veikan sj\u00fakling vi\u00f0 a\u00f0 setjast fram \u00e1 r\u00famstokk. S\u00ed\u00f0ar sama dag var teki\u00f0 dj\u00fapvi\u00f0tal vi\u00f0 sama sj\u00fakra\u00fej\u00e1lfarann. G\u00f6gnin voru greind me\u00f0 eigindlegri innihaldsgreiningu. V\u00edsindagrein II bygg\u00f0ist \u00e1 slembira\u00f0a\u00f0ri, einblindri samanbur\u00f0arranns\u00f3kn \u00fear sem borinn var saman \u00e1rangur aukinnar hreyfingar \u00ed uppr\u00e9tta st\u00f6\u00f0u hj\u00e1 fullor\u00f0num sj\u00faklingum sem voru sj\u00e1lfbjarga og \u00e1 f\u00f3tum fyrir alvarleg veikindi sem kr\u00f6f\u00f0ust gj\u00f6rg\u00e6slulegu me\u00f0 \u00f6ndunarv\u00e9larme\u00f0fer\u00f0 lengur en 48 klukkustundir. Sj\u00faklingunum var skipt me\u00f0 tilviljunar\u00fartaki \u00ed tvo h\u00f3pa: Aukin hreyfing tvisvar \u00e1 dag (n=29) og hreyfing einu sinni \u00e1 dag (n=21). \u00datkomum\u00e6lingar voru lengd me\u00f0fer\u00f0ar \u00ed \u00f6ndunarv\u00e9l, lengd gj\u00f6rg\u00e6slu- og sj\u00fakrah\u00faslegu, innihald sj\u00fakra\u00fej\u00e1lfunarinnar, heilsutengd l\u00edfsg\u00e6\u00f0i (m\u00e6ld me\u00f0 Short Form-36 version 2 (SF-36v2) heilsukvar\u00f0anum) og l\u00edkamleg geta (\u00feol m\u00e6lt me\u00f0 6 m\u00edn\u00fatna g\u00f6ngupr\u00f3fi, v\u00f6\u00f0vastyrkur m\u00e6ldur me\u00f0 Medical Research Council \u2013 sum score (MRC-SS) og sj\u00e1lfsbjargargeta m\u00e6ld me\u00f0 Modified Barthel Index (MBI)), m\u00e6ld \u00e1 fimm t\u00edmapunktum fr\u00e1 \u00fatskrift af gj\u00f6rg\u00e6sludeild \u00fear til \u00e1ri eftir \u00fatskrift. V\u00edsindagrein III bygg\u00f0ist \u00e1 a\u00f0hvarfsgreiningu sem ger\u00f0 var \u00e1 \u00fatkomu einstaklinganna \u00ed grein II til a\u00f0 greina forsp\u00e1\u00fe\u00e6tti fyrir slakri l\u00edkamlegri heilsu \u00e1ri eftir \u00fatskrift af gj\u00f6rg\u00e6sludeild. M\u00f6gulegir forsp\u00e1\u00fe\u00e6ttir voru greindir fr\u00e1 grunnbreytum sj\u00faklinganna, breytum sem m\u00e1tu alvarleika veikindanna, breytum tengdum gj\u00f6rg\u00e6slulegunni og lengd gj\u00f6rg\u00e6slu- og sj\u00fakrah\u00faslegu. A\u00f0hvarfsgreining var notu\u00f0 til a\u00f0 meta tengsl \u00e1 milli forsp\u00e1\u00fe\u00e1ttanna og \u00feriggja breyta sem endurspeglu\u00f0u l\u00edkamlegt heilsufar \u00e1ri eftir \u00fatskrift af gj\u00f6rg\u00e6sludeild. \u00de\u00e6r breytur voru v\u00f6\u00f0vastyrkur (m\u00e6ldur me\u00f0 MRC-SS), \u00feol (m\u00e6lt me\u00f0 6 m\u00edn\u00fatna g\u00f6ngupr\u00f3fi) og l\u00edkamleg virkni (m\u00e6ld me\u00f0 SF-36v2 heilsukvar\u00f0anum, undirkvar\u00f0i: L\u00edkamleg virkni).<\/p>\n

Ni\u00f0urst\u00f6\u00f0ur<\/strong>: V\u00edsindagrein I leiddi \u00ed lj\u00f3s sex flokka og fj\u00f3ra umlykjandi \u00fe\u00e6tti sem lei\u00f0beindu sj\u00fakra\u00fej\u00e1lfurunum vi\u00f0 kl\u00edn\u00edska r\u00f6khugsun og \u00e1kvar\u00f0anat\u00f6ku vi\u00f0 a\u00f0 hreyfa og \u00fej\u00e1lfa alvarlega veikan sj\u00fakling \u00ed uppr\u00e9ttri st\u00f6\u00f0u. Flokkarnir voru: 1) Sj\u00faklingur, 2) Gj\u00f6rg\u00e6sla, 3) Sj\u00fakra\u00fej\u00e1lfari, 4) Flutningur \u00ed uppr\u00e9tta st\u00f6\u00f0u, 5) \u00dej\u00e1lfunin og 6) \u00c1\u00e6tlu\u00f0 ni\u00f0ursta\u00f0a. Umlykjandi \u00fe\u00e6ttirnir voru: i) \u00d6ryggi & vell\u00ed\u00f0an, ii) Sko\u00f0un & me\u00f0fer\u00f0 samtvinnu\u00f0, iii) Einstaklingsbundin \u00fej\u00e1lfun bygg\u00f0 \u00e1 vi\u00f0br\u00f6g\u00f0um sj\u00faklings og iv) Hindranir & lausnir. V\u00edsindagrein II: Tilraunah\u00f3purinn h\u00f3f hreyfingu \u00ed uppr\u00e9tta st\u00f6\u00f0u \u00e1 sj\u00f6unda degi eftir a\u00f0 \u00f6ndunarv\u00e9larme\u00f0fer\u00f0 h\u00f3fst og fengu sj\u00faklingarnir sj\u00fakra\u00fej\u00e1lfun me\u00f0 hreyfingu \u00ed uppr\u00e9tta st\u00f6\u00f0u \u00ed 31% gj\u00f6rg\u00e6sludaga samanbori\u00f0 vi\u00f0 vi\u00f0mi\u00f0unarh\u00f3pinn sem h\u00f3f hreyfingu \u00ed uppr\u00e9tta st\u00f6\u00f0u \u00e1 \u00e1ttunda degi (p\u22650.05) og fengu sj\u00faklingarnir sj\u00fakra\u00fej\u00e1lfun sem innih\u00e9lt hreyfingu \u00ed uppr\u00e9tta st\u00f6\u00f0u \u00ed 22% gj\u00f6rg\u00e6sludaga (p=0.03). Dj\u00fap sl\u00e6ving svo d\u00f6gum skipti eftir upphaf \u00f6ndunarv\u00e9larme\u00f0fer\u00f0ar g\u00e6ti hafa hindra\u00f0 hreyfingu \u00ed uppr\u00e9tta st\u00f6\u00f0u \u00ed ranns\u00f3knarh\u00f3pnum. Enginn munur kom fram \u00e1 milli h\u00f3pa \u00e1 lengd \u00f6ndunarv\u00e9lame\u00f0fer\u00f0ar, gj\u00f6rg\u00e6slu- og sj\u00fakrah\u00faslegu, n\u00e9 \u00ed heilsutengdum l\u00edfsg\u00e6\u00f0um og l\u00edkamlegri getu \u00e1 \u00feeim t\u00edmum sem m\u00e6lingar f\u00f3ru fram \u00e1 allt a\u00f0 \u00e1ri eftir \u00fatskrift af gj\u00f6rg\u00e6slu. V\u00edsindagrein III: \u00deeir sem lif\u00f0u af alvarleg veikindi \u00e1ttu vi\u00f0 l\u00e9lega l\u00edkamlega heilsu a\u00f0 str\u00ed\u00f0a \u00e1ri eftir \u00fatskrift af gj\u00f6rg\u00e6sludeild. Tengsl fundust \u00e1 milli \u00feess a\u00f0 vera kona og hafa skertan v\u00f6\u00f0vastyrk (p=0.003), minna \u00feol (p<0.001) og einnig m\u00e1tu konur l\u00edkamlega virkni (p=0.01) s\u00edna verri en karlar \u00e1ri eftir \u00fatskrift af gj\u00f6rg\u00e6sludeild. A\u00f0rir forsp\u00e1\u00fe\u00e6ttir fyrir skertu l\u00edkamlegu heilsufari \u00e1ri eftir \u00fatskrift af gj\u00f6rg\u00e6sludeild, eftir a\u00f0 lei\u00f0r\u00e9tt var fyrir kyni og aldri, voru: h\u00e6rri l\u00edkams\u00feyngdarstu\u00f0ull (BMI), minni sj\u00e1lfsbjargargeta (MBI), fleiri l\u00edkamlegir sj\u00fakd\u00f3mar fyrir (FCI) og skert l\u00edkamleg virkni fyrir upphaf veikinda, v\u00f6\u00f0vaveikleiki vi\u00f0 \u00fatskrift af gj\u00f6rg\u00e6sludeild og lengri sj\u00fakrah\u00fasdv\u00f6l.<\/p>\n

\u00c1lyktanir<\/strong>: Sj\u00fakra\u00fej\u00e1lfararnir sem t\u00f3ku \u00fe\u00e1tt \u00ed ranns\u00f3kninni veittu gj\u00f6rg\u00e6slusj\u00faklingunum einstaklingsbundna hreyfingu \u00ed uppr\u00e9tta st\u00f6\u00f0u og bygg\u00f0u stignun \u00fej\u00e1lfunarinnar \u00e1 vi\u00f0br\u00f6g\u00f0um sj\u00faklinganna. \u00deetta sty\u00f0ur mikilv\u00e6gi \u00feess a\u00f0 sj\u00fakra\u00fej\u00e1lfarar n\u00fdti s\u00e9r lei\u00f0beinandi reglur frekar en skipulag\u00f0ar verklagsreglur \u00feegar \u00feeir a\u00f0sto\u00f0a alvarlega veika sj\u00faklinga vi\u00f0 a\u00f0 setjast \u00ed uppr\u00e9tta st\u00f6\u00f0u. Ni\u00f0urst\u00f6\u00f0ur sty\u00f0ja \u00fea\u00f0 a\u00f0 samh\u00e6fa minnkun \u00e1 sl\u00e6vingu vi\u00f0 hreyfingu \u00ed uppr\u00e9tta st\u00f6\u00f0u hj\u00e1 sj\u00faklingum sem eru \u00ed \u00f6ndunarv\u00e9l, en \u00f3lj\u00f3st er hvort ein e\u00f0a tv\u00e6r me\u00f0fer\u00f0ir \u00e1 dag e\u00f0a hva\u00f0a \u00fej\u00e1lfunar\u00fe\u00e6ttir (val \u00e1 \u00e6fingum\/hreyfingu, t\u00edmalengd \u00fej\u00e1lfunar, \u00e1kef\u00f0 og fj\u00f6ldi me\u00f0fer\u00f0a yfir daginn) skila bestum \u00e1rangri fyrir hvern sj\u00fakling. Konur reyndust l\u00edklegri til a\u00f0 f\u00e1 h\u00e6gan og \u00f3n\u00f3gan l\u00edkamlegan bata samanbori\u00f0 vi\u00f0 karlmenn. \u00deekking \u00e1 forsp\u00e1\u00fe\u00e1ttum um skertan l\u00edkamlegan bata mun au\u00f0velda sj\u00fakra\u00fej\u00e1lfurum a\u00f0 finna \u00fe\u00e1 gj\u00f6rg\u00e6slusj\u00faklinga sem \u00feurfa meiri \u00fej\u00e1lfun og veita \u00feeim s\u00e9rh\u00e6f\u00f0ari sj\u00fakra\u00fej\u00e1lfun \u00e1 r\u00e9ttum t\u00edmapunkti.<\/p>\n

Um doktorsefni\u00f0<\/strong><\/p>\n

\u00d3l\u00f6f Ragna \u00c1mundad\u00f3ttir lauk st\u00fadentspr\u00f3fi af n\u00e1tt\u00farufr\u00e6\u00f0ibraut Menntask\u00f3lans vi\u00f0 Hamrahl\u00ed\u00f0 \u00e1ri\u00f0 1980, BS-pr\u00f3fi \u00ed sj\u00fakra\u00fej\u00e1lfun fr\u00e1 H\u00e1sk\u00f3la \u00cdslands \u00e1ri\u00f0 1984 og MS-pr\u00f3fi \u00ed heilbrig\u00f0isv\u00edsindum fr\u00e1 H\u00e1sk\u00f3la \u00cdslands \u00e1ri\u00f0 2000. \u00d3l\u00f6f hlaut s\u00e9rfr\u00e6\u00f0ileyfi \u00ed gj\u00f6rg\u00e6slusj\u00fakra\u00fej\u00e1lfun \u00e1ri\u00f0 2006. \u00d3l\u00f6f starfar \u00ed sj\u00fakra\u00fej\u00e1lfun Landsp\u00edtala og sinnir stundakennslu vi\u00f0 n\u00e1msbraut \u00ed sj\u00fakra\u00fej\u00e1lfun, L\u00e6knadeild H\u00e1sk\u00f3la \u00cdslands. H\u00fan hefur \u00e1tt \u00fe\u00e1tt \u00ed ger\u00f0 kennslu- og fr\u00e6\u00f0sluefnis \u00e1 s\u00ednu s\u00e9rsvi\u00f0i og flutt fj\u00f6lm\u00f6rg erindi \u00e1 r\u00e1\u00f0stefnum h\u00e9rlendis og erlendis. Foreldrar \u00d3lafar er \u00c1mundi Gunnar \u00d3lafsson og Sigr\u00fan \u00de\u00f3risd\u00f3ttir (l\u00e1tin). \u00d3l\u00f6f \u00e1 d\u00f3tturina Sigr\u00fanu Meng, 17 \u00e1ra menntask\u00f3lanema.<\/p>\n<\/div><\/div>","protected":false},"featured_media":1196,"template":"","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"_phd_date_start":"2020-02-19T13:00:00+00:00","_phd_date_end":"2020-02-19T16:00:00+00:00","_phd_location":"A\u00f0albygging H\u00e1t\u00ed\u00f0asalur","_phd_admission":"A\u00f0gangur \u00f3keypis","_phd_thesis_title":"Vakandi og virkur og \u00ed uppr\u00e9ttri st\u00f6\u00f0u \u00ed \u00f6ndunarv\u00e9l \u00e1 gj\u00f6rg\u00e6sludeild. 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