| 1. |
- Algurén, Beatrix, et al.
(författare)
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A Multidisciplinary Cross-Cultural Measurement of Functioning After Stroke : Rasch Analysis of the Brief ICF Core Set for Stroke
- 2011
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Ingår i: Topics in Stroke Rehabilitation. - : Informa UK Limited. - 1074-9357 .- 1945-5119. ; 18:6, s. 573-586
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To investigate the possibility of constructing a multiprofessional cross-cultural measure of functioning after stroke across categories of the International Classification of Functioning, Disability and Health (ICF). Method: Data on 757 stroke survivors from China, Germany, Italy, and Sweden, including ratings of 15 categories from the Brief ICF Core Set for stroke, were analyzed using the Rasch model. Unidimensionality, reliability, fit of the ICF categories to the model, ordering of response options of the ICF qualifier, and presence of differential item functioning (DIF) were studied. Results: Of the 15 ICF categories, response options for 7 categories were collapsed, 5 categories were deleted due to misfit, and 4 ICF categories showed DIF for country and were accordingly split into country-specific categories. The proposed final clinical measure consists of 20 ICF categories (6 categories were country-common) with an overall fit statistic of χ2180 = 184.87, P = .386, and a person separation index of r = 0.72, which indicates good reliability. Based on an individual's functioning after stroke, the ratings across the different ICF categories can be summed on an interval scale ranging from 0 to 100. Conclusion: A construction of a cross-cultural clinical measure after stroke based on ICF categories across body functions, structures, and activities and participation was possible. With this kind of clinical measure, stroke survivors' functional levels can be compared even across countries. Despite the promising results, further studies are necessary to develop definitive measures based on ICF categories.
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| 2. |
- Bergqvist, Gunilla M, et al.
(författare)
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Authors' response.
- 2019
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Ingår i: Topics in stroke rehabilitation. - : Informa UK Limited. - 1945-5119 .- 1074-9357. ; 27:2
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Tidskriftsartikel (refereegranskat)
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| 3. |
- Bergqvist, G. M., et al.
(författare)
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Inter-rater reliability of the Swedish modified version of the Postural Assessment Scale for Stroke Patients (SwePASS) in the acute phase after stroke
- 2019
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Ingår i: Topics in Stroke Rehabilitation. - : Informa UK Limited. - 1074-9357 .- 1945-5119. ; 26:5, s. 366-372
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Tidskriftsartikel (refereegranskat)abstract
- Background: Before implementation of the new scale, the Swedish modified version of the Postural Assessment Scale for Stroke Patients (SwePASS), to clinical practice, it is fundamental to analyze its measurement properties.Objective: To examine the inter-rater reliability of the SwePASS in the acute phase after stroke. Methods: Day 3 to day 7 after admission to a stroke unit, 64 persons with stroke were assessed twice, using the SwePASS, by two physiotherapists. Inter-rater reliability was determined using percentage-agreement and the rank-invariant method: relative position, relative concentration, and relative rank variance. Results: The raters showed a percentage agreement of >= 75% in the assessments using the SwePASS. For 9 of the 12 items, the percentage agreement was >80%. For 8 of the 12 items, there was a statistically significant change in position, revealed in relative position values between 0.08 and 0.15. Three items had statistically significant positive relative concentration values between -0.11 and 0.10. Except for a statistically significant negligible relative variance value of 0.01 for the items 1 and 8, there was no relative variance. Conclusions: The SwePASS shows an acceptable inter-rater reliability, albeit with potential for improvement. The reliability can be improved by a consensus how to interpret the scale between the raters prior to implementation in the clinic.
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| 4. |
- Blane, Alison, et al.
(författare)
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Investigating cognitive ability and self-reported driving performance of post-stroke adults in a driving simulator
- 2018
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Ingår i: Topics in Stroke Rehabilitation. - : Taylor & Francis. - 1074-9357 .- 1945-5119. ; 25:1, s. 44-53
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Tidskriftsartikel (refereegranskat)abstract
- Background: Safe driving is a complex activity that requires calibration. This means the driver can accurately assess the level of task demand required for task completion and can accurately evaluate their driving capability. There is much debate on the calibration ability of post-stroke drivers.Objectives: The aim of this study was to assess the cognition, self-rated performance, and estimation of task demand in a driving simulator with post-stroke drivers and controls.Methods: A between-groups study design was employed, which included a post-stroke driver group and a group of similarly aged older control drivers. Both groups were observed driving in two simulator-based driving scenarios and asked to complete the NASA Task Load Index (TLX) to assess their perceived task demand and self-rate their driving performance. Participants also completed a battery of psychometric tasks to assess attention and executive function, which was used to determine whether post-stroke cognitive impairment impacted on calibration.Results: There was no difference in the amount of perceived task demand required to complete the driving task. Despite impairments in cognition, the post-stroke drivers were not more likely to over-estimate their driving abilities than controls. On average, the post-stroke drivers self-rated themselves more poorly than the controls and this rating was related to cognitive ability.Conclusion: This study suggests that post-stroke drivers may be aware of their deficits and adjust their driving behavior. Furthermore, using self-performance measures alongside a driving simulator and cognitive assessments may provide complementary fitness-to-drive assessments, as well as rehabilitation tools during post-stroke recovery.
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| 5. |
- Bråndal, Anna, 1966-, et al.
(författare)
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Reliability and validity of the Swedish Fatigue Assessment Scale when self-administrered by persons with mild to moderate stroke
- 2016
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Ingår i: Topics in Stroke Rehabilitation. - : Informa UK Limited. - 1074-9357 .- 1945-5119. ; 23:2, s. 90-97
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To examine internal consistency, test-retest reliability, floor/ceiling effects and construct validity of the Fatigue Assessment Scale (FAS), when self-administrated by persons with mild to moderate stroke.Method: The FAS was translated into Swedish and tested for psychometric properties when self-administrated by persons with mild to moderate stroke. Participants, consequently selected from the stroke unit admission register received a letter with three questionnaires: the FAS, Short Form Health Survey (SF-36) subscale for vitality and Geriatric Depression Scale, GDS-15. Within two weeks, a second letter with FAS was sent for re-test.Result: Seventy-tree persons with mild to moderate stroke participated in the study. Internal consistency was good (Cronbach’s alpha 0.82). The test and retest reliability of individual items showed that five items out of 10 items were good (weighted kappa > 0.60), four were moderate (0.40-0.60), and one was fair (0.22). The relative reliability between total scores was good (ICC 3.1 = 0.73) and the absolute reliability was nine points, meaning that a change of at least nine points in total score implies a real change of fatigue level. Correlation analysis showed that the Swedish FAS correlated with the SF-36 subscale for vitality (rs = - 0.73) and GDS-15 (rs = 0.62), suggesting convergent construct validity. There were no floor or ceiling effects.Conclusion: The Swedish translation of the FAS used as a self-administrated questionnaire is reliable and valid for measuring fatigue in persons with mild to moderate stroke.
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| 6. |
- Bunketorp Käll, Lina, 1975, et al.
(författare)
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Multimodal rehabilitation in the late phase after stroke enhances the life situation of informal caregivers
- 2018
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Ingår i: Topics in Stroke Rehabilitation. - : Informa UK Limited. - 1074-9357 .- 1945-5119. ; 25:3, s. 161-167
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The burden of caregiving for stroke survivors is well known, but the effect of late stroke rehabilitation on the life situation of informal caregivers is unknown. Here, we assessed changes in the life situation of informal caregivers of stroke survivors enrolled in a multimodal intervention trial. Methods: This controlled study was a questionnaire-based survey accompanying a three-armed randomized controlled trial of 123 stroke survivors. The care recipients of 106 caregivers who chose to participate were assigned to rhythm-and-music-based therapy (R-MT; n = 37), horse-riding therapy (H-RT; n = 37), or delayed intervention (control group, n = 32). Perceived changes in the life situation of the caregivers were evaluated with the Life Situation among Spouses after the Stroke Event (LISS) questionnaire before randomization, after the 12-week intervention, and 3 and 6 months later. Results: After the intervention, the change in the median LISS score was significantly higher among intervention caregivers (1.5 [interquartile range (IQR) 8.8]) than controls (1.5 [IQR 8.8] vs. 0.0 [IQR 12.0], p = 0.036). The improvement was maintained at 3 months (1.5 [IQR 9.0] vs. 0.0 [IQR 10.5], p = 0.039) but not at 6 months (p = 0.284). Conclusion: Engaging stroke survivors in multimodal interventions late after stroke appears to have potential to produce gains also in the general life situation of informal caregivers.
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| 7. |
- Dalvandi, Asghar, et al.
(författare)
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Rehabilitation Experts' Experience of Community Rehabilitation Services for Stroke Survivors in Iran
- 2012
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Ingår i: Topics in Stroke Rehabilitation. - : Informa UK Limited. - 1074-9357 .- 1945-5119. ; 19:5, s. 395-404
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Successful stroke rehabilitation is a complex process involving teamwork by members of several professions. The aims of this study were to explore the experiences of Iranian rehabilitationexperts concerning community rehabilitation services for stroke survivors and obtain their opinions on how to further develop and improve these services. Method: A qualitative research method with grounded theory was used, including purposive and theoretical sampling. A constant comparative analysis was conducted. Data were gathered from 2 focus group discussions including 10 Iranian rehabilitation experts and 4 in-depth individual interviews. Results: Nonintegrated rehabilitation services emerged as the core concept of the study. The explored concepts were identified as deficiently allocated budget, inadequate public insurance, lack of availability of rehabilitative care, negative public opinion, lack of consistency in care, and split services and professional separation. Areas identified for potential improvement included need to change policymakers' attitudes, need to refine rehabilitation in the health care system, need to establish a registration system, need to provide information and skills, and need to see the family as a whole. Conclusion: Experts should participate in educational rehabilitation programs to become more aware of current rehabilitationservices within the community. Stroke survivors and their families should also participate in the rehabilitation programs as this would allow them to gain knowledge and skills for dealing withstroke management. This can help reduce problems, change public opinion, and eliminate mistrust between health care providers and families.
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| 8. |
- Dias, Caroline Pieta, et al.
(författare)
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Impaired mechanical properties of Achilles tendon in spastic stroke survivors : an observational study.
- 2019
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Ingår i: Topics in Stroke Rehabilitation. - : Taylor & Francis. - 1074-9357 .- 1945-5119. ; 26:4, s. 261-266
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The spasticity could lead to decreased functional capacity and changes in musculoskeletal tissue.OBJECTIVE: To compare the Achilles tendon properties between the affected and contralateral limbs of participants with spasticity due to stroke and the healthy subjects.METHODS: Fifteen individuals with ankle spasticity due to stroke and 15 healthy subjects were recruited. Maximal isometric ankle joint torque was obtained with an isokinetic dynamometer, and an ultrasound was used to determine tendon length, tendon cross-sectional area, and the medial gastrocnemius myotendinous junction displacement. The Achilles tendon strength, displacement, stress, strain, stiffness, and Young's modulus were obtained during a maximum voluntary isometric plantarflexion contraction.RESULTS: There were no differences between Achilles tendon length among participants. Both limbs of participants with stroke showed reduced tendon cross-sectional area (~18%) compared to healthy limb. The affected limb showed decreased tendon strength (686 ± 293.3 N), displacement (10.6 ± 1.7 mm), Young's modulus values (849 ± 235.6 MPa), and lower stiffness (196.6 ± 67.6 N/mm) compared to the contralateral limb (strength, 1357.1 ± 294.8 N; displacement, 15.2 ± 5.5 mm; Young's modulus, 1431.8 ± 301.9 MPa; stiffness, 337.5 ± 98.1 N/mm) and to the healthy limb. The contralateral limb also showed decreased tendon strength (~26.2%) and stiffness (~21.5%) compared to the healthy group.CONCLUSION: There is a decrement in Achilles tendon morphological and mechanical properties of the affected limb in individuals with spasticity due to stroke. The contralateral limb had a thinner tendon more compliant likely to physical activity reduction.
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| 9. |
- Ekstrand, Elisabeth, et al.
(författare)
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Clinical interpretation and cutoff scores for manual ability measured by the ABILHAND questionnaire in people with stroke.
- 2023
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Ingår i: Topics in stroke rehabilitation. - : Informa UK Limited. - 1945-5119 .- 1074-9357. ; 30:1, s. 21-31
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Tidskriftsartikel (refereegranskat)abstract
- The ABILHAND questionnaire is recommended to assess perceived manual ability after stroke; however, more knowledge on interpretability is needed to improve the clinical applicability.To determine clinically meaningful cutoff scores for different levels of perceived manual ability, assessed by ABILHAND, corresponding to established observed and perceived upper extremity assessments post stroke.This cross-sectional study, part of the Stroke Arm Longitudinal Study (SALGOT) at the University of Gothenburg, included 80 participants with upper extremity impairments after stroke. The self-reported upper extremity functioning was assessed with ABILHAND and Stroke Impact Scale Hand (SIS Hand), and the observed functioning was assessed by Fugl-Meyer Assessment for Upper Extremity (FMA-UE) and Action Research Arm Test (ARAT) at 3 months after stroke. Receiver operating characteristic curve, sensitivity, and specificity analyses were used to determine the cutoffs.The overall discriminating accuracy was excellent (AUC > 0.90) for most of the cutoffs and sensitivity and specificity values ranged from 0.73 to 1.0. The ABILHAND cutoff score 1.78 discriminated well between low and good functioning resulting in a 95% match with SIS Hand and 87.5% match with ARAT and FMA-UE.The determined cutoff scores of the ABILHAND, validated through established upper extremity assessments, will provide a useful tool to clinicians when interpreting the logit scores and when selecting individualized treatment options. ABILHAND matched well with self-reported SIS Hand, but discrepancies found with observed scales implies that self-perceived assessments should be complemented with observed assessments.
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| 10. |
- Ekstrand, Elisabeth, et al.
(författare)
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Grip strength is a representative measure of muscle weakness in the upper extremity after stroke
- 2016
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Ingår i: Topics in Stroke Rehabilitation. - : Informa UK Limited. - 1074-9357 .- 1945-5119. ; 23:6, s. 400-405
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Muscle weakness is the most common impairment in the upper extremity after stroke, leading to a reduced ability to use the arm and the hand in daily activities. Grip strength is easier to measure than precise, but more time-consuming, isokinetic and isometric arm muscle strength measurements. It would therefore be advantageous in a clinical setting if grip strength could be used as a proxy for muscle strength in the entire upper extremity.OBJECTIVE: To investigate the association between grip strength and isometric and isokinetic arm muscle strength in persons with chronic stroke.METHODS: Forty-five persons with mild-to-moderate paresis in the upper extremity, at least 6 months post-stroke participated. Isometric grip strength was measured with a computerized grip dynamometer and arm strength (isometric shoulder abduction and elbow flexion as well as isokinetic elbow extension and flexion) with an isokinetic dynamometer. Pearson's correlation coefficient was used to determine the association between the muscle strength measurements.RESULTS: There were significant correlations (p < .0001) between grip strength and all arm strength measurements in both the more affected (r = 0.77-0.82) and the less affected upper extremity (r = 0.65-0.82).CONCLUSION: This cross-sectional study showed that grip strength is strongly associated with muscle strength in the arm in persons in the chronic phase after stroke. As grip strength is easy to measure and less time-consuming than arm muscle strength measurements, this implies that grip strength can be a representative measure of muscle weakness of the entire upper extremity in the chronic phase after stroke.
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