| 1. |
- Labori, Frida, et al.
(författare)
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The impact of stroke on spousal and family income : a difference-in-difference study from Swedish national registries
- 2024
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Ingår i: Topics in Stroke Rehabilitation. - : Taylor & Francis. - 1074-9357 .- 1945-5119. ; 31:4, s. 381-389
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Tidskriftsartikel (refereegranskat)abstract
- AimTo investigates the financial consequences in the overall population spouses of persons with stroke in Sweden as well as for subgroups based on spouses age, sex and modified Rankin Scale (mRS) of the person with stroke.MethodsThe study population consists of spouses aged <= 60 during the year of their partner's stroke event. Each spouse was matched to four reference individuals. This longitudinal registry data covers spouses and a reference population between 2005 and 2016. We use difference-in-differences to estimate the impact on individual income from paid work, disposable individual income, and disposable family income.ResultsThe primary analysis shows a small and statistically insignificant decrease on spouses' individual income from paid work and disposable individual income. In the subgroup analysis based on mRS, the largest effect is seen in mRS 4-5, where spouses' individual income from paid work and disposable individual income increases after their partner's stroke. Further, younger female spouses' individual income from paid work decreases by 1 614 EUR (p = 0.008) on average.ConclusionThe financial consequences are small in the overall population of spouses. However, for some subgroups, younger women, and spouses of persons with stroke and mRS 4-5, the financial consequences are more prominent.
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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. |
- 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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| 4. |
- 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 3months 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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| 5. |
- 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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| 6. |
- Ma, Christina Zong-Hao, et al.
(författare)
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Changes in gait and plantar foot loading upon using vibrotactile wearable biofeedback system in patients with stroke
- 2018
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Ingår i: Topics in Stroke Rehabilitation. - : Taylor & Francis. - 1074-9357 .- 1945-5119. ; 25:1, s. 20-27
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patients with stroke walk with excessive foot inversion at the affected side, which may disturb their balance and gait.Objectives: This study aimed to investigate the effects of instant biofeedback of plantar force at the medial and lateral forefoot regions on gait and plantar foot loading in patients with stroke.Methods: A total of eight patients with hemiplegic stroke, who had flexible rearfoot varus deformity at the affected side, participated in this study. A vibrotactile biofeedback system was developed and evaluated. It analyzed forces at the medial and lateral forefeet, and instantly provided vibration clues when the plantar force at medial forefoot was less than a threshold. Each subject’s three-dimensional gait parameters and plantar-pressure distribution during walking were measured under two experimental conditions (sequence randomized): with and without the device turned on (Trial-registration number: ChiCTR-IPB-15006530 and HKCTR-1853).Results: Providing biofeedback significantly reduced the foot inversion and increased the mid-stance foot–floor contact area and medial midfoot plantar pressure of the affected limb, bringing the values of these parameters closer to those of the unaffected side. The biofeedback also significantly reduced the unaffected side’s excessive knee flexion and hip abduction.Conclusions: There were signs of improved foot loading characteristics and gait upon provision of instant vibrotactile biofeedback of plantar force. The positive results of this study further support the development of wearable biofeedback devices for improving gait of patients with stroke.
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| 7. |
- Miyasaka, Hiroyuki, et al.
(författare)
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The quantification of task-difficulty of upper limb motor function skill based on Rasch analysis
- 2020
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Ingår i: Topics in Stroke Rehabilitation. - : Taylor & Francis. - 1074-9357 .- 1945-5119. ; 27:1, s. 49-56
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Tidskriftsartikel (refereegranskat)abstract
- Background: The degree of difficulty of skills of paretic upper limbs in daily life has not been investigated. Objective: To determine the internal validity and level of difficulty of items of the Functional Skills Measure After Paralysis (FSMAP), which can be used to evaluate the functional skills of daily living for stroke patients. Method: A total of 105 first-stroke patients were assessed using the FSMAP. The evaluation system consists of 65 items in 15 categories. We examined the internal validity and level of difficulty of these items using Rasch analysis. In this study, an item with either infit or outfit of >= 1.5 was defined as underfit. Results: Rasch analysis showed that 8 items were underfit. The highest infit and outfit logits were 2.47 for "Trouser donning/doffing" and 8.44 for "Paper manipulation". "Shirt donning/doffing" was the easiest item and "Coin manipulation" was the most difficult, with difficulty logits of -35.8 and 41.5, respectively. Conclusion: The therapist can confirm items that the patient can or cannot perform. By understanding the level of difficulty of each item, the most appropriate functional skill to focus on acquiring next can be identified.
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| 8. |
- Persson, Hanna C, 1979, et al.
(författare)
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Transport mobility 5years after stroke in an urban setting.
- 2018
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Ingår i: Topics in stroke rehabilitation. - : Informa UK Limited. - 1945-5119 .- 1074-9357. ; 25:3, s. 180-185
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Tidskriftsartikel (refereegranskat)abstract
- Background People after stroke may have residual problems with mobility that can affect their independence and mode of transport. However, there is limited knowledge about transport mobility several years after stroke. Objective The objective was to survey the outdoor mobility and transportation in an urban setting five years post-stroke. Method This cross-sectional study was based on a mail survey focusing on long-term consequences after stroke. The survey comprises a set of self-evaluated questionnaires and was sent to 457 persons, of whom 281 responded (61.5%). From the survey, items regarding transportation and mobility were selected and analyzed. Results A high level of mobility function was reported with regard to outdoor mobility and different modes of transport. However, one-fifth still reported problems with outdoor mobility and mode of transport. Some perceived barriers were reported, predominantly mobility aspects such as transfer to/from, and getting on/off specific transportation mode/s. The respondents reported some communication problems and cognitive impairments, but these were not reported as prominent barriers when using public transport. A total of 67% were active drivers and were more often men (p=0.002), younger (p≤0.001), and were less dependent at discharge from the acute hospital (p≤0.001). Conclusions Five years post-stroke, mobility problems were the dominant barrier reported when using transport modes. Individualized transport training is needed during rehabilitation to increase possibility to participate. Infrastructure and transportation planning should focus on older, women, and people with impairments to be able to facilitate the use of public transport and mobility.
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| 9. |
- Persson, Josefine, 1981, et al.
(författare)
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All-cause mortality for cohabiting spouses of stroke survivors: Evidence from Swedish national registries.
- 2021
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Ingår i: Topics in stroke rehabilitation. - : Informa UK Limited. - 1945-5119 .- 1074-9357. ; 28:6, s. 432-442
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Tidskriftsartikel (refereegranskat)abstract
- Spousal concordance for cardiovascular risk factors and lifestyle behaviors may affect prevalence rates of diabetes, hypertension, and stroke. Spouses of stroke survivors, therefore, would be expected to have elevated mortality rates, but this has not been established. Thus, the aim of this study was to investigate whether cohabitant spouses of stroke survivors have higher mortality rates compared to a matched reference cohort.Data for this population-based cohort study were extracted from Swedish national registries from 2010 to 2016. The national sample consisted of 13,049 spouses of first ever stroke survivors and a reference cohort of 51,685 cohabitant individuals from the general population matched by age, gender, and place of residence. Effects on mortality were analyzed using Cox proportional hazard survival analyses.Female and male spouses of stroke survivors were found to have 5-year hazard ratios of death of 1.26 (95% confidence interval 1.17, 1.36) and 1.24 (95% confidence interval 1.16, 1.33), respectively, when compared to the reference cohort. Both female and male spouses had higher mortality from diseases in the circulatory system compared to the reference cohort.Spouses of stroke survivors have higher mortality rates than a matched reference population that persist for a minimum of 5years. Policy-makers should acknowledge and address the health status of spouses when evaluating and planning the health and social care of stroke survivors.
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| 10. |
- 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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