| 1. |
- Antfolk, Christian, et al.
(författare)
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Sensory feedback from a prosthetic hand based on air-mediated pressure from the hand to the forearm skin.
- 2012
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Ingår i: Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1651-2081. ; 44:8, s. 702-707
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Lack of sensory feedback is a drawback in today's hand prostheses. We present here a non-invasive simple sensory feedback system, which provides the user of a prosthetic hand with sensory feedback on the arm stump. It is mediated by air in a closed loop system connecting silicone pads on the prosthetic hand with pads on the amputation stump. The silicone pads in a "tactile display" on the amputation stump expand when their corresponding sensor-bulb in the prosthesis is touched, evoking an experience of "real touch". Methods: Twelve trans-radial amputees and 20 healthy non-amputees participated in the study. We investigated the capacity of the system to mediate detection of touch, discrimination between different levels of pressure and, on the amputees also, the ability to locate touch. Results: The results showed a median touch threshold of 80 and 60 g in amputees and non-amputees, respectively, and 90% and 80% correct answers, respectively, in discrimination between 2 levels of pressure. The amputees located touch (3 sites) correctly in 96% of trials. Conclusion: This simple sensory feedback system has the potential to restore sensory feedback in hand amputees and thus it could be a useful tool to enhance prosthesis use.
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| 2. |
- Björkman, Anders, et al.
(författare)
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Sensory qualities of the phantom hand map in the residual forearm of amputees
- 2016
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1651-2081 .- 1650-1977. ; 48:4, s. 70-365
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Most amputees experience referred sensations, known as a phantom hand map, on the residual forearm, where touch on specific areas is perceived as touch on the amputated hand. The aim of this study was to evaluate the sensory qualities of the phantom hand map.METHODS: In 10 traumatic forearm-amputees touch thres-holds and discriminative touch of the phantom hand map were assessed and compared with corresponding areas on the contralateral forearm. The study assessed the localization of touch on the phantom hand map, and how distinct and similar to normal touch the referred feeling was.RESULTS: Similar touch thresholds were seen in the phantom hand map and the control site. Tactile discrimination, requiring both detection of stimulus and interpretation, was significantly better in the phantom hand map.CONCLUSION: This explorative study suggests that the phantom hand map and the superior tactile discrimination seen in the phantom hand map are based on adaptations within the brain. Further studies investigating the neural basis for the phantom hand map are needed.
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| 3. |
- Brandt, Ase, et al.
(författare)
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Towards an instrument targeting mobility-related participation: Nordic cross-national reliability
- 2008
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1651-2081 .- 1650-1977. ; 40:9, s. 766-772
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate test-retest reliability and internal consistency of a new instrument for evaluation of mobility device interventions. Material and methods: The instrument comprised 4 scales and one summed index. Two test-retest interviews involved 147 mobility device users (mean age 60 years) with a broad range of functional limitations, living at home. Results: For 2 scales and the summed index the reliability was substantial or almost perfect (K 0.71/ K-W 0.76/intraclass correlation coefficient = 0.93; confidence interval = 0.90-0.95). The reliability of one scale was moderate (K-w 0.4 1), but after reduction of grades and combination with another scale, it was substantial (K-w 0.66). The reliability of the fourth scale was moderate (K-w 0.55). The internal consistency of 3 scales varied from a 0.63 to 0.76. Conclusion: Even thou,,h the test-retest reliability of all but one of the scales of the new instrument was substantial to almost perfect, this study demonstrated that revision is required. The challenges identified were probably due to the highly complex relationship between outdoor participation while using mobility devices and accessibility to the outdoor physical environment. Thus. based on the results of this study the instrument will be revised and subsequently launched as the "Nordic mobility-related participation outcome evaluation of assistive device intervention" (NOMO instrument). More research on the concept of mobility-related participation and the psychometric qualities of the instrument is required.
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| 4. |
- Brandt, Åse, et al.
(författare)
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Older people's use of powered wheelchairs for activity and participation
- 2004
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1651-2081 .- 1650-1977. ; 36:2, s. 70-77
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aims of this study were to investigate outcomes of older people's use of powered wheelchairs and risk factors for negative outcomes. Design: The study was a cross-sectional interview-study including 111 powered wheelchair users over 65 years of age. Results: All participants used their powered wheelchair in the summer; nearly all users regarded it as important and found that it gave them independence. The wheelchair made activity and participation possible for the users. The most frequent activity in the summer was going for a ride, and in the winter it was shopping. However, some could not use the wheelchair for visits, and supplementary travel modes are called for. Users who could not walk at all or who could not transfer without assistance were more likely not to be able to carry out prioritized activities. Furthermore, other risk factors for negative outcomes and need for further research were identified. Conclusion: The use of powered wheelchairs is a relevant societal intervention in relation to older people with limited walking ability in order to make activity and participation possible. It is likely that a larger proportion of older people could benefit from this intervention, in particular if current practices are improved taking activity and participation outcomes into consideration.
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| 5. |
- Brogårdh, Christina, et al.
(författare)
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Experiences of falls and strategies to manage the consequences of falls in persons with late effects of polio : A qualitative study
- 2017
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 49:8, s. 652-658
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To explore how persons with late effects of polio experience falls and what strategies they use to manage the consequences of falls. Design: A qualitative study with face-To-face interviews. Data were analysed by systematic text condensation. Participants: Fourteen ambulatory persons (7 women; mean age 70 years) with late effects of polio. Results: Analysis resulted in one main theme, "Everyday life is a challenge to avoid the consequences of falls", and 3 categories with 7 subcategories. Participants perceived that falls were unpredictable and could occur anywhere. Even slightly uneven surfaces could cause a fall, and increased impairments following late effects of polio led to reduced movement control and an inability to adjust balance quickly. Physical injuries were described after the falls, as well as emotional and psychological reactions, such as embarrassment, frustration and fear of falling. Assistive devices, careful planning and strategic thinking were strategies to prevent falls, together with adaptation and social comparisons to mitigate the emotional reactions. Conclusion: Experiences of falls greatly affect persons with late effects of polio in daily life. To reduce falls and fall-related consequences both problemfocused and emotion-focused strategies are used. In order to increase daily functioning, these findings should be included in a multifaceted falls management programme.
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| 6. |
- Brogårdh, Christina, et al.
(författare)
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Mode of hand training determines cortical reorganisation: A randomized controlled study in healthy adults
- 2010
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1651-2081 .- 1650-1977. ; 42:8, s. 789-794
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate two commonly used forms of hand training with respect to influence on dexterity and cortical reorganization. Subjects: Thirty healthy volunteers (mean age 24.2 years). Methods: The subjects were randomized to 25 min of shaping exercises or general activity training of the non-dominant hand. The dexterity and the cortical motor maps (number of excitable positions) of the abductor pollicis brevis muscle were evaluated pre- and post-training by the Purdue Peg Board test and transcranial magnetic stimulation, respectively. Results: After shaping exercises the dexterity increased significantly (p <= 0.005) for both hands, mostly so in the non-dominant hand. The cortical motor map of the abductor pollicis brevis muscle shifted forwardly into the pre-motor area without expanding. After general activity training, no significant improvements in dexterity were found for the non-dominant hand. The cortical motor map of the non-dominant abductor pollicis brevis muscle expanded significantly (p = 0.03) in the posterior (sensory) direction. Conclusion: These results indicate that shaping exercises, but not general activity training, increase dexterity of the trained non-dominant hand in parallel with a shift of location of active transcranial magnetic stimulation positions. Shifts of active cortical areas might be important for the interpretation of brain plasticity in common behavioural tasks.
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| 7. |
- Brogårdh, Christina, et al.
(författare)
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Shortened constraint-induced movement therapy in subacute stroke - no effect of using a restraint : a randomized controlled study with independent observers
- 2009
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Ingår i: Journal of Rehabilitation Medicine. - : Stiftelsen Rehabiliteringsinformation. - 1650-1977 .- 1651-2081. ; 41:4, s. 231-236
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To examine the effect of using a mitt during shortened constraint-induced movement therapy for patients in the subacute phase after stroke.Subjects: Twenty-four patients with stroke (mean age 57.6 (standard deviation 8.5) years; average 7 weeks post-stroke) with mild to moderate impaired hand function.Methods: The patients were randomized to mitt use or no mitt use on the less affected hand for 90% of waking hours for 12 days. All patients received 3 h of arm and hand training per day for 2 weeks. Assessments were made by blinded observers using the modified Motor Assessment Scale, the Sollerman hand function test, the 2-Point Discrimination test and Motor Activity Log test.Results: Patients in both groups showed significant improvements in arm and hand motor performance and on self-reported motor ability after 2 weeks of therapy and at 3 months follow-up. However, no statistically significant differences between the groups were found in any measures at any point in time.Conclusion: In this study, no effect of using a restraint in patients with subacute stroke was found. Thus, this component in the constraint-induced therapy concept seems to be of minor importance for the outcome.
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| 8. |
- Brycke, Sara, et al.
(författare)
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Implementation of evidence-based interventions according to the Swedish national guidelines for strokecare : a nationwide survey among physiotherapists
- 2024
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden. - 1650-1977 .- 1651-2081. ; 56
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate (i) to what extent physiotherapists (PTs) working in stroke rehabilitation in various parts of the stroke care chain have implemented interventions according to the national guidelines for stroke (NGS), (ii) facilita-ting and hindering factors for the implementation, and (iii) differences between various care settings.Design: A cross-sectional study.Subjects: 148 PTs working in stroke rehabilitation in various parts of the care chain in Sweden.Methods: Data were collected by a web-based survey.Results: Task-specific training for walking (80–98%), impaired motor function (64–100%) and fall prevention (73–92%) were most implemented. Factors that facilitated implementation were: important to comply with the NGS, that PTs had confidence to per-form the interventions, and that interventions were clearly described. Limited time, lack of resources, no clear goals or routines at the workplace hindered the implementation. Significant differences (p < 0.05) between the settings existed. Municipal and primary care reported most challenges in implementing the NGS and providing evidence-based interventions.Conclusion: Most interventions, with high priority according to NGS, are provided by PTs working in stroke rehabilitation, although differences in various parts of the care chain exist. Knowledge, time, education and supportive management are important factors when implementing evidence-based interventions.
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| 9. |
- Cederlund, Ragnhild, et al.
(författare)
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Activity limitations before and after surgical carpal tunnel release among patients with and without diabetes.
- 2012
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Ingår i: Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1651-2081. ; 44:3, s. 261-267
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To evaluate activity limitations before and after carpal tunnel release among patients with and without diabetes, to explore differences between genders and the influence of grip strength on activity limitations. DESIGN: Prospective case-control study. PATIENTS: Thirty-three patients with diabetes and carpal tunnel syndrome (CTS) were age and gender matched with 30 patients without diabetes having idiopathic CTS. METHODS: Activity limitations were assessed pre-operatively, 3 and 12 months after surgery, with the self-administered Evaluation of Daily Activities Questionnaire (EDAQ) containing 102 activity items in 11 dimensions and 3 additional male-activity-oriented dimensions including 22 items. RESULTS: For all dimensions the mean score was higher for patients with diabetes compared with patients without diabetes. This indicates a more pronounced activity limitation for patients with diabetes. However, no statistical differences between the two groups could be demonstrated. In general, females have significantly higher activity limitation scores than males. CONCLUSION: CTS creates a broad variety of activity limitations for affected patients. After carpal tunnel release a significant alleviation of these limitations occurs within the first 3 months. Activity limitations seem not to be related to diabetes, but were more pronounced in women than in men, probably due to reduced grip strength.
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| 10. |
- Denvall, Vera, et al.
(författare)
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Replication and construct validation of the Barrow Neurological Institute Screen for Higher Cerebral Function with a Swedish population.
- 2002
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1651-2081 .- 1650-1977. ; 34:4, s. 153-157
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Tidskriftsartikel (refereegranskat)abstract
- A Swedish translation of the Barrow Neurological Institute Screen for Higher Cerebral Functions was administered to 52 normal control subjects and 36 patients with well-documented brain dysfunction. Findings replicated those reported in American samples. Level of performance was strikingly similar between Swedish controls and American controls, especially in individuals between 15 and 39 years. Swedish patients with brain dysfunction performed at levels significantly below the Swedish control subjects. The sensitivity of the test was 83% (correctly classifying 30 of 36 patients); patients with a higher level of education were misclassified. The present study replicates earlier findings and adds to the construct validity of the Barrow Neurological Institute Screen. This test may also prove useful for studying rehabilitation outcomes in Swedish patients.
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