| 1. |
- Anens, Elisabeth, et al.
(författare)
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Reactive grip force control in persons with cerebellar stroke : effects on ipsilateral and contralateral hand
- 2010
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Ingår i: Experimental Brain Research. - : Springer. - 0014-4819 .- 1432-1106. ; 203:1, s. 21-30
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Tidskriftsartikel (refereegranskat)abstract
- This study investigates the cerebellar contribution to reactive grip control by examining differences between (22-48 years) subjects with focal cerebellar lesion due to ischaemic stroke (CL) and healthy subjects (HS). The subjects used a pinch grip to grasp and restrain an instrumented handle from moving when it was subject to unpredictable load forces of different rates (2, 4, 8, 32 N/s) or amplitudes (1, 2, 4 N). The hand ipsilateral to the lesion of the cerebellar subjects showed delayed and more variable response latencies, e.g., 278 +/- 162 ms for loads delivered at 2 N/s, compared to HS 180 +/- 53 ms (P = 0.005). The CL also used a higher pre-load grip force with the ipsilateral hand, 1.6 +/- 0.8 N, than the HS, 1.3 +/- 0.6 N (P = 0.017). In addition, the contralateral hand in subjects with unilateral cerebellar stroke showed a delayed onset of the grip response compared to HS. Cerebellar lesions thus impair the reactive grip control both in the ipsilateral and contralateral hand.
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| 2. |
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| 3. |
- Sandlund, Marlene, 1972-, et al.
(författare)
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Using motion interactive games to promote physical activity and enhance motor performance in children with cerebral palsy
- 2011
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Ingår i: Developmental Neurorehabilitation. - : Taylor & Francis. - 1751-8423 .- 1751-8431. ; 14:1, s. 15-21
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To explore the feasibility of using low-cost motion interactive games as a home-based intervention for children with cerebral palsy (CP).Methods: Fourteen children with CP, 6–16 years old, practiced with the EyeToy for PlayStation2® in their homes during 4 weeks. Outcome measures were physical activity monitors, Movement Assessment Battery for Children-2 (mABC-2), Bruininks-Oseretsky Test of Motor Proficiency (sub-test 5 : 6), 1 Minute Walk Test and gaming diaries.Results: Motivation for practice and compliance of training were high. The children's physical activity increased during the intervention and activity monitors were feasible to use, although data loss may be a concern. According to mABC-2 the children's motor performance improved, but there were both floor and ceiling effects. The two additional motor tests showed only non-significant progress.Conclusion: It is highly feasible to use motion interactive games in home rehabilitation for children with CP. Specific motor effects need to be further explored.
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| 4. |
- Eklund, Elsine, et al.
(författare)
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Hand function and disability of the arm, shoulder and hand in Charcot-Marie-Tooth disease
- 2009
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Ingår i: Disability and Rehabilitation. - : Taylor & Francis. - 0963-8288 .- 1464-5165. ; 31:23, s. 1955-1962
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of the present study was to examine hand function and disability in persons with Charcot-Marie-Tooth disease (CMT) and to evaluate the possible correlations between hand function and disability.Methods: Nine male, 11 female (24-73 yrs) persons with CMT in northern Sweden and a matched control group of 18 men, 22 women (21-73 yrs) participated in the study. Measurements applied were tests of dexterity (Box and Block Test; Nine-Hole Peg test), grip strength (Grippit®), tactile gnosis (Shape Texture Identification test) and upper-limb disability (Disabilities of the Arm Shoulder and Hand questionnaire, DASH).Results: Hand function in CMT was reduced (p<0.001) to about 60% of normal, as indicated by each of the separate outcome measures as well as by a constructed summary index of hand function. DASH score median was 38.8 (range 0-66.7) and was clearly related to hand function (r=0.64-0.83).Conclusion: Reduced hand function in CMT was found at different dimensions according to the International Classification of Functioning, Disability and Health (ICF). We suggest that DASH can be used in persons with CMT though clinicians should be aware that patients might score lower than expected, possibly due to a long process of adaptation when learning to live with a slowly progressive disease.
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| 5. |
- Sandlund, Marlene, et al.
(författare)
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Interactive games in motor rehabilitation for children with sensor motor disorders
- 2007
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Ingår i: 2007 virtual rehabilitation. - New York : IEEE conference proceedings. - 9781424412044 ; , s. 78-78
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Konferensbidrag (refereegranskat)abstract
- Interactive computer environments may be a good way to make motor practice more fun and motivating for children with sensorimotor disorders. However, appropriate computer environments that could be used for this purpose need to be systematically tested in rehabilitation settings in order to evaluate their impact on motor aspects as well as on motivation and activity levels. This abstract describes pilot data from an ongoing intervention study involving children diagnosed with cerebral palsy. The interactive environment used is the Sony's EyeToy system for PlayStation2. The intervention is evaluated through interviews as well as with activity monitoring and motor assessments, including 3D motion analysis. Here we will report pilot data based on the interviews.
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| 6. |
- Svensson, Elisabeth, 1975-
(författare)
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Hand function in children and in persons with neurological disorders : aspects of movement control and evaluation of measurements
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Hand function is of great importance in the many daily activities that require well-coordinated hand and arm movements. Measurement of hand function is an essential element in the rehabilitation process, in order to facilitate medical diagnosis and determine developmental stages, functional levels, and the efficacy of treatment interventions. Basic requirements for any measurement used in clinics are that they are easy to use, relevant to the function being assessed, and valid and reliable. When scrutinizing the literature on hand function, important gaps were found with regard to measurement. For example, the reliability of grip strength with the Grippit in children has yet to be determined, and there are few evaluations of hand function measurements in Charcot-Marie-Tooth disease (CMT). Furthermore, laboratory measurements of hand function, which have the potential to provide more detailed information and insight into hand control, such as the role of the cerebellum in reactive grip control – have not been fully explored. The overall aim of the thesis was to achieve more knowledge on hand function; on the evaluation of measurements in different target populations; and on movement control of the hand.In the first study, the aim was to evaluate the test-retest reliability of the peak and sustained grip strength with Grippit in a sample of healthy children (n=58, 6-, 10- and 14-y-olds). This was followed by two studies examining hand function in an adult sample (n=20) diagnosed with CMT. The test-retest reliability of grip and pinch strength using Grippit, sensation with the Shape Texture Identification test (STI) and dexterity with the Box and Block Test (BBT) and Nine-Hole Peg test (NHP) were studied. The impact of the disease on daily life, measured with the Disability of the Arm, Shoulder and Hand questionnaire (DASH), and correlations between disability and various aspects of hand function, were also explored in this condition. The aim of the fourth study was to examine grip force response to unpredictable loadings of an object held in a pinch grip in subjects (n=9, 22-48 yrs) who had been diagnosed with a cerebellar lesion, compared with a healthy control group (n=11). The first study showed that test-retest reliability was good for both peak and sustained grip strength in healthy children. The mean and best of three trials were equally reliable, but differences in reliability were detected within different age groups. For example, the peak grip strength, best of three trials, was more reliable for the 6-y-olds (intraclass correlation coefficient (ICC)=0.96, standard error of measurement in percentage (SEM%)=6.3) and 14-y-olds (ICC=0.96, SEM%=5.2) compared with the 10-y-olds (ICC=0.78, SEM%=12.5). In the second study, evaluating measurements of hand function in subjects with CMT, grip strength proved to be reliable (ICC=0.99, coefficient of repeatability (CR)=26.7 N, coefficient of variation (CV)=6.6 %), but pinch strength was less reliable. The reliability was also good for the BBT (ICC=0.95, CR=11.5 blocks/min, CV=8.4%) and the NHP (ICC=0.99, CR=4.3 s, CV=3.9 %). However, a bias towards higher values was noted on the second test occasion with the BBT. The reliability of the STI test (kappa=0.87) was also very good in subjects with CMT. A limitation in this latter test was noted in terms of its ability to describe subjects either performing very well or very poorly. The results of the third study showed that hand function in CMT was reduced (p<0.001) to about 60% of that in healthy controls in each of the separate outcome measures, as well as by a constructed summary index of hand function. The median DASH score was 38.8 (range 0-66.7) and was clearly related to hand function (r=0.64-0.83). The results of the final study in subjects with cerebellar lesions showed that the ipsilateral hand had delayed and more variable response latencies e.g. 278±166 ms for loads delivered at 2 N/s, compared with healthy subjects (HS) 80±53 ms (p=0.005). The cerebellar subjects also used a higher pre-load grip force with the ipsilateral hand (1.6±0.8 N) than the HS (1.3±0.6 N (p=0.017)). Even the contralateral hand in subjects with unilateral cerebellar stroke showed a delayed onset of the grip response.In conclusion: Grip strength assessment in children with Grippit results in good reliability for peak and sustained grip strength, although the 10-y-olds were less reliable. In CMT the tested instruments can all be used to evaluate hand function, but certain factors, such as the number of trials used should be taken into consideration. The CMT subjects’ hand function was reduced and correlated with their self-experienced disability. However, clinicians should be aware that patients might score lower than expected on DASH, possibly due to a long process of adaptation. Cerebellar lesions can impair the reactive grip control in both the ipsilateral and the contralateral hand. These investigations have thus, as intended increased the knowledge of hand function. The studies have evaluated some measurements in different samples, which will help clinicians testing hand function.
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| 7. |
- Dahlgren, Gunilla, et al.
(författare)
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Test-retest reliability of step counts with the ActivPAL™ device in common daily activities.
- 2010
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Ingår i: Gait & Posture. - : Elsevier. - 0966-6362 .- 1879-2219. ; 32:3, s. 386-90
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Tidskriftsartikel (refereegranskat)abstract
- The ActivPAL device is a well-established physical activity monitor for assessment of physical activity. AIM: To investigate test-retest reliability of step counts and establish minimal detectable changes (MDC) in step count to account for intra device error over time in various physical activities. METHODS: Healthy participants (n=24, age range, 19-28 years) performed activities on two occasions, 1 week apart, in a laboratory setting; self-paced floor walking, treadmill walking at three different speeds (3.2 km/h, 4.5 km/h and 4.5 km/h with incline), treadmill jogging (8.0 km/h), stair walking and cycling on an exercise bike at three speeds (45 rpm, 60 rpm and 75 rpm). Relative reliability was calculated using intraclass correlation coefficient (ICC) and Spearman correlation. Absolute reliability was assessed using standard error of measurement (SEM) and coefficient of repeatability (CR). RESULTS: The ActivPAL showed high to very high relative reliability for treadmill walking at all speeds and stair walking, while self-paced normal floor walking showed moderate reliability. The absolute reliability was the best for treadmill walking activities, slightly increased for self-paced walking, followed by stair walking and jogging. The use of activity monitors during cycling has been questioned and our results confirm a low absolute and relative reliability. MDC values varied according to the type of activity e.g. treadmill walking 4.5 km/h (10 steps), walking on the floor (45 steps). Data loss in this study (10-13%) was higher than previously reported. CONCLUSIONS: The ActivPAL is reliable for treadmill walking, jogging and self-paced walking. MCD varies according to the activity and should be considered when establishing true change over time.
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| 8. |
- Elmgren Frykberg, Gunilla, 1957-
(författare)
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Movement Control after Stroke : Studies on Sit-to-walk and on the Relations between Clinical and Laboratory Measures
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aims: The principal aims of this research were 1) to extend existing knowledge of the everyday sit-to-walk (STW) transfer in subjects with stroke and in matched controls by exploring temporal, kinematic, and kinetic aspects, and 2) to investigate the relations between some clinical and laboratory measures of postural control and locomotion in stroke rehabilitation and research. Methods: Ten community-living subjects with stroke (mean age 59 years) and ten matched controls were enrolled in the STW studies (Studies I, II, and IV). In the study regarding relations between clinical and laboratory measures the same samples (part of Study II) and also 20 outpatient subjects with stroke (mean age 50 years) participated (Study III). Data collections were performed in laboratory environments with clinical assessment instruments, video cameras, force plates and a movement analysis system. Results: 1) Study I: A temporal aspect of STW was studied. Four phases were defined. The subjects with stroke used significantly more time during the 2nd STW phase, defined from seat-off to the loading peak of the 1st swing leg. Study II: A movement aspect of STW was investigated. The stroke subjects generated significantly less centre of mass momenta in horizontal and vertical directions, and the momenta peaks occurred significantly earlier than in the controls. Study IV: A force aspect of STW was explored. The subjects with stroke generated significantly larger propulsive impulse beneath the (non-paretic) stance buttock and significantly more braking impulses were exerted by both buttocks and particularly by the stance foot. 2) Part of Study II: A strong correlation was found between the clinical measure Fluidity Scale and the laboratory measure Fluidity Index. Study III: Moderate correlations were shown between Berg Balance Scale, ratings of weight distribution during quiet stance, and force measures. Conclusions: The findings of the STW studies show a changed force interaction between the lower extremities post-stroke, likely influencing movement patterns and temporal characteristics of the everyday transfer. The results are considered to reflect compensatory motor strategies. The results of the studies on relations between some clinical and laboratory measures indicate that the strength of the relation is multidimensional.
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| 9. |
- Grenholm, Anton, et al.
(författare)
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Kinematic analyses during stair descent in young women with patellofemoral pain
- 2009
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Ingår i: Clinical Biomechanics. - : Elsevier BV. - 0268-0033 .- 1879-1271. ; 24:1, s. 88-94
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Compensatory movement strategies may develop in response to pain to avoid stress on the affected area. Patellofemoral pain is characterised by intermittent periods of pain and the present study addresses whether long-term pain leads to compensatory movement strategies that remain even when the pain is absent. METHOD: Lower extremity kinematics in three dimensions was studied in stair descent in 17 women with patellofemoral and in 17 matched controls. A two-dimensional geometric model was constructed to normalise kinematic data for subjects with varying anthropometrics when negotiating stairs of fixed proportions. RESULTS: There were minor differences in movement patterns between groups. Knee joint angular velocity in the stance leg at foot contact was lower and the movement trajectory tended to be jerkier in the patellofemoral group. The two-dimensional model showed greater plantar flexion in the swing leg in preparation for foot placement in the patellofemoral group. INTERPRETATION: The results indicate that an altered stair descent strategy in the patellofemoral group may remain also in the absence of pain. The biomechanical interpretation presumes that the strategy is aimed to reduce knee joint loading by less knee joint moment and lower impact force.
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| 10. |
- Mulligan, Hilda, et al.
(författare)
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Promoting physical activity for people with neurological disability : perspectives and experiences of physiotherapists
- 2011
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Ingår i: Physiotherapy Theory and Practice. - : Informa UK Limited. - 0959-3985 .- 1532-5040. ; 27:6, s. 399-410
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Tidskriftsartikel (refereegranskat)abstract
- Both New Zealand and Sweden have health and disability policies that promote recreational exercise within society for people with disability. Despite these policies, levels of physical activity by people with disability in these countries are low. Physiotherapists are equipped to assist people with disabling conditions into physical activity. This qualitative study explored the perspectives and experiences of physiotherapists in New Zealand and Sweden toward promoting physically active recreation for adults with chronic neurological conditions. Nine physiotherapists who worked with adults with neurological disability in a range of long-term rehabilitation and community (home) health services were interviewed and the data analysed for themes. The physiotherapists described innovative and resourceful expertise to assist patients to be physically active. However, they perceived a lack of support for their work from within the health system and a lack of knowledge of disability issues within the recreational arena, both of which they perceived hindered their promotion of physical activity for people with neurological disability. Physiotherapists feel unable to fully support health and disability policies for the promotion of physically active recreation for people with neurological conditions, because of perceived constraints from within the recreational arena and their own health systems. If these constraints were addressed, then physiotherapists could be better agents to promote physical activity for people with neurological conditions.
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