| 1. |
- Awad, Amar, et al.
(författare)
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Preserved somatosensory conduction in a patient with complete cervical spinal cord injury
- 2015
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Ingår i: Journal of Rehabilitation Medicine. - : Foundation of Rehabilitation Information. - 1650-1977 .- 1651-2081. ; 47:5, s. 426-431
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Neurophysiological investigation has shown that patients with clinically complete spinal cord injury can have residual motor sparing ("motor discomplete"). In the current study somatosensory conduction was assessed in a patient with clinically complete spinal cord injury and a novel ethodology for assessing such preservation is described, in this case indicating "sensory discomplete" spinal cord injury. Methods: Blood oxygenation level-dependent functional magnetic resonance imaging (BOLD fMRI) was used to examine the somatosensory system in a healthy subject and in a subject with a clinically complete cervical spinal cord injury, by applying tactile stimulation above and below the level of spinal cord injury, with and without visual feedback. Results: In the participant with spinal cord injury, somatosensory stimulation below the neurological level of the lesion gave rise to BOLD signal changes in the corresponding areas of the somatosensory cortex. Visual feedback of the stimulation strongly modulated the somatosensory BOLD signal, implying that cortico-cortical rather than spino-cortical connections can drive activity in the somatosensory cortex. Critically, BOLD signal change was also evident when the visual feedback of the stimulation was removed, thus demonstrating sensory discomplete spinal cord injury. Conclusion: Given the existence of sensory discomplete spinal cord injury, preserved but hitherto undetected somatosensory conduction might contribute to the unexplained variability related to, for example, the propensity to develop decubitus ulcers and neuropathic pain among patients with clinically complete spinal cord injury.
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| 2. |
- Divanoglou, Anestis, et al.
(författare)
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SELF-REPORTED HEALTH PROBLEMS AND PRIORITIZED GOALS IN COMMUNITY-DWELLING INDIVIDUALS WITH SPINAL CORD INJURY IN SWEDEN
- 2018
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Ingår i: Journal of Rehabilitation Medicine. - : FOUNDATION REHABILITATION INFORMATION. - 1650-1977 .- 1651-2081. ; 50:10, s. 872-878
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To explore self-reported health problems and functional goals in community-dwelling individuals with spinal cord injury in Sweden. Design: Cross-sectional descriptive study that used a survey designed by an experienced peer mentor with spinal cord injury. Subjects: Community-dwelling individuals with spinal cord injury from Sweden. Methods: The survey was distributed online by the community peer-based organization RG Active Rehabilitation. Results: A total of 203 individuals (55% males, 90% acquired spinal cord injury) from all regions in Sweden completed the survey. Of these, 33% reported living with amp;gt; 2 unbearable physical or psychological problems. While some problems (e.g. problems related to bladder and balance) were consistently ranked to be common across all years since injury and type of spinal cord injury, distribution of some other unbearable problems (e.g. type of pain, excessive weight) varied between subgroups. Years since injury, level of acquired spinal cord injury and sex, but not age-group or type of spinal cord injury, explained some of the variation in the goals. Conclusion: The high proportion of reported "unbearable" problems point to the stronger need for systematic, comprehensive, life-long, multi-disciplinary follow-up for people with spinal cord injury. The high rate of goals related to improving strength and fitness across all participants independently of their characteristics highlight the important role of community organizations that offer such lifetime services.
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| 3. |
- Flank, Peter, et al.
(författare)
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Prevalence of risk factors for cardiovascular disease stratified by body mass index categories in patients with wheelchair-dependent paraplegia after spinal cord injury.
- 2012
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Ingår i: Journal of Rehabilitation Medicine. - : Foundation of Rehabilitation Information. - 1650-1977 .- 1651-2081. ; 44:5, s. 440-443
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To assess risk factors for cardiovascular disease at different body mass index values in persons with wheelchair-dependent paraplegia after spinal cord injuries.andlt;br /andgt;Design: Cross-sectional study.andlt;br /andgt;Subjects: A total of 135 individuals, age range 18-79 years, with chronic (≥ 1 year) post-traumatic paraplegia.andlt;br /andgt;Methods: Body mass index was stratified into 6 categorical groups. Cardiovascular disease risk factors for hypertension, diabetes mellitus and a serum lipid profile were analysed and reported by body mass index category.andlt;br /andgt;Results: More than 80% of the examined participants had at least one cardiovascular disease risk factor irrespective of body mass index level. Hypertension was highly prevalent, especially in men. Dyslipidaemia was common at all body mass index categories in both men and women.andlt;br /andgt;Conclusion: Higher body mass index values tended to associate with more hypertension and diabetes mellitus, whereas dyslipidaemia was prevalent across all body mass index categories. Studies that intervene to reduce weight and or percentage body fat should be performed to determine the effect on reducing modifiable cardiovascular disease risk factors.
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| 4. |
- Flank, Peter, et al.
(författare)
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Self-reported physical activity and risk markers for cardiovascular disease after spinal cord injury
- 2014
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 46:9, s. 886-890
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Tidskriftsartikel (refereegranskat)abstract
- Objective:To examine whether self-reported physical activity of a moderate/vigorous intensity influences risk markers for cardiovascular disease in persons with paraplegia due to spinal cord injury.Design:Descriptive, cross-sectional study.Subjects:A total of 134 wheelchair-dependent individuals (103 men, 31 women) with chronic (>= 1 year) post-traumatic spinal cord injury with paraplegia.Methods:Cardiovascular disease markers (hypertension, blood glucose and a blood lipid panel) were analysed and related to physical activity.Results:One out of 5 persons reported undertaking physical activity >= 30 min/day. Persons who were physically active >= 30 min/day were significantly younger than inactive persons. Systolic and diastolic blood pressures were lower in the physically active group. When adjusting for age, the association between systolic blood pressure and physical activity disappeared. Physical activity >= 30 min/day had a tendency to positively influence body mass index and low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio. Men had significantly higher systolic and diastolic blood pressures than women, lower high-density lipoprotein cholesterol, higher low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio and higher triglycerides. No other significant differences between men and women were found.Conclusion:Self-reported physical activity >= 30 min/day in persons with spinal cord injury positively influenced diastolic blood pressure. No other reductions in cardiovascular disease risk markers were seen after controlling for age. These results indicate a positive effect of physical activity, but it cannot be concluded that recommendations about physical activity in cardiovascular disease prevention for the general population apply to wheelchair-dependent persons with spinal cord injury.
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| 5. |
- Hellgren, Lovisa, et al.
(författare)
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Seven Domains of Persisting Problems after Hospital-Treated Covid-19 Indicate a Need For a Multiprofessional Rehabilitation Approach
- 2022
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Ingår i: Journal of Rehabilitation Medicine. - : Foundation for Rehabilitation Information. - 1650-1977 .- 1651-2081. ; 54
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To identify domains of persisting problems at 4 months after discharge in patients previously hospitalized due to COVID-19, with a focus on a subgroup of patients reporting symptoms to an extent indicative of rehabilitation needs. Design: Ambidirectional observational cohort study. Patients: All patients with a laboratory-confirmed COVID-19 diagnosis admitted to hospital in a Swedish healthcare region during the period 1 March to 31 May 2020. After exclusion, 94% of all survivors (n = 433) participated in the study. Forty-three percent (n = 185) of these reported persisting problems indicating rehabilitation needs and formed a subgroup. Methods: Explorative factor analysis based on results from comprehensive telephone interviews covering persisting symptoms, including assessment of impact on daily life. Results: Seven domains were identified, comprising problems related to vision, cognition, mental fatigue, swallowing, voice, sensorimotor dysfunction, and feeling anxious/depressed. The patients in the subgroup reported a median of 8 symptoms/limitations affecting everyday life, and two-thirds reported symptoms/limitations in 3 or more domains. Conclusion: Seven problem domains corresponding to specific modalities of rehabilitative interventions were identified. A majority of patients reported problems from several domains, indicating the need for multiprofessional teams in post-COVID-19 rehabilitation. Screening of patients previously hospitalized due to COVID-19 should cover all 7 domains of persisting problems.
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| 6. |
- Jörgensen, Sophie, et al.
(författare)
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Sound psychometric properties of the Swedish version of the Spinal Cord Independence Measure Self-Report
- 2021
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1651-2081 .- 1650-1977. ; 53:5, s. 00197-00197
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To describe data completeness, targeting and reliability of the Swedish version of the Spinal Cord Independence Measure Self-Report (s-SCIM-SR). DESIGN: Translation and reliability study. SUBJECTS: Programme participants (n = 48) and peer mentors (n = 42) with spinal cord injury enrolled in the INTERnational Project for the Evaluation of "activE Rehabilitation" (inter-PEER). METHODS: The translation process was based on guidelines/recommendations, and involved expert competence, including consumers. The s-SCIM-SR was distributed online, once for programme participants and twice for peer mentors. RESULTS: Sixty-nine individuals (77%) obtained a total score. Most missing data were found in the items Respiration and Using the toilet. Cronbach's alpha for the full scale was 0.89, for Self-care 0.92, for Respiration and sphincter management 0.37 and for Mobility 0.86. The intraclass correlation coefficient was excellent for all subscales and the full scale. Measures of variability showed high sensitivity to changes and Bland Altman analyses revealed no systematic changes between evaluation points. CONCLUSION: These results support the data completeness, targeting and reliability of the Swedish version of the SCIM-SR. However, some problems were found in the subscale Respiration and sphincter management. The s-SCIM-SR can be considered psychometrically sound and suitable to assess physical independence among persons with spinal cord injury in Swedish community settings.
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| 7. |
- Nordgren, Camilla, et al.
(författare)
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Societal services after traumatic spinal cord injury in Sweden
- 2003
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 35:3, s. 121-126
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Societal services after traumatic spinal cord injury in Sweden were investigated, including self-rated levels of satisfaction with the application process and resource allocation.DESIGN: Survey of an incidence population.SUBJECTS: Thirty-four persons of a total regional incidence population (n = 48) with traumatic spinal cord injury.METHODS: Structured interviews using a standardized questionnaire.RESULTS: About 25 separate services were identified being available for persons with traumatic spinal cord injury. The average number of applications per person was 5 (range 0-11). The most common service was "transportation service". Of the applications, 17% were partially or totally rejected. Most subjects received information about available services from a social worker. For 13 available services at least 1 subject claimed ignorance about its existence.CONCLUSIONS: In Sweden, significant resources are allocated for allowing independence and financial compensation for individuals with traumatic spinal cord injury. However, this support system sometimes also results in frustration and disappointment. Insufficient information and co-ordination are reported as weaknesses. The persons' efforts to acquire knowledge of how the system works take time which could be better used for rehabilitation and full integration into the community.
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| 8. |
- Skogberg, Olof, et al.
(författare)
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CHANGES IN BODY COMPOSITION AFTER SPASTICITY TREATMENT WITH INTRATHECAL BACLOFEN
- 2017
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Ingår i: Journal of Rehabilitation Medicine. - : FOUNDATION REHABILITATION INFORMATION. - 1650-1977 .- 1651-2081. ; 49:1, s. 36-39
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To assess changes in body composition, body weight and resting metabolic rate in patients who received intrathecal baclofen therapy for spasticity. Design: Prospective, longitudinal, quasi-experimental, with a pre/post design. Patients: Twelve patients with spasticity, fulfilling study criteria, and due for pump implantation for intrathecal baclofen therapy, completed the study. Methods: Data were obtained before, 6 months and 12 months after commencement of intrathecal baclofen therapy as regards body composition (by skinfold calliper), body weight, and resting metabolic rate (by resting oxygen consumption). Spasticity was assessed according to the Modified Ashworth Scale (MAS) and Penn Spasm Frequency Scale (PSFS). Results: A reduction in spasticity according to MAS occurred. Mean fat body mass increased and mean lean body mass decreased. Mean body weight showed a non-significant increase and resting metabolic rate a non-significant decrease. Conclusion: This explorative study indicates that unfavourable changes in body composition might occur after intrathecal baclofen therapy. Since obesity and increased fat body mass contribute to an increased cardiovascular risk, these findings may indicate a need for initiation of countermeasures, e.g. increased physical activity and/or dietary measures, in conjunction with intrathecal baclofen therapy. Further studies, including larger study samples and control groups, are needed to corroborate these findings.
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| 9. |
- Sköld, Camilla, et al.
(författare)
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Effects of functional electrical stimulation training for six months on body composition and spasticity in motor complete tetraplegic spinal cord-injured individuals.
- 2002
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 34:1, s. 25-32
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Tidskriftsartikel (refereegranskat)abstract
- The effect of functional electrical stimulation (FES) training on body composition, assessed by computed tomography, and the effect of spasticity, assessed by both objective and subjective measures, are evaluated. Fifteen motor-complete spinal-cord-injured men participated in the study. Eight of the 15 subjects undertook FES cycling 3 times weekly for 6 months. Whole body computed tomography scans evaluated changes in body composition. Simultaneous Modified Ashworth Scale and electromyography (EMG) measurements, resistive torque (Kin-Com) and EMG measurements, and self-ratings with Visual Analogue Scale during four consecutive days were used to evaluate changes in spasticity. Lower extremity muscle volume increased by an average of 1300 cm3 (p < 0.001) in the training group compared to the control group, who experienced no change. Otherwise no changes in body composition were seen. Significant correlations (Spearman) were found between individual EMG activity recordings and movement-provoked Modified Ashworth Scale ratings in 26% of the test situations, irrespective of group and time. The objective and subjective evaluation of movement-provoked passive (viscoelastic) and active (spasticity-related) resistance remained unchanged.
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| 10. |
- Stenberg, Maud, et al.
(författare)
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Severe traumatic brain injuries in Northern Sweden : a prospective 2-year study
- 2013
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Ingår i: Journal of Rehabilitation Medicine. - : Stiftelsen Rehabiliteringsinformation. - 1650-1977 .- 1651-2081. ; 45:8, s. 792-800
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Tidskriftsartikel (refereegranskat)abstract
- To assess: (i) the clinical characteristics and injury descriptors of patients with severe traumatic brain injury in Northern Sweden admitted to the single Neurotrauma Center (NC) serving this region; (ii) the care pathway of patients from injury to 3 months after discharge from the NC; and (iii) the outcomes at 3 months post-injury. Population-based prospective 2-year cohort study.Patients age 17–65 years with acute severe traumatic brain injury, lowest non-sedated Glasgow Coma Scale (GCS) score of 3–8 within 24 h post-trauma. Patients were treated according to an intracranial pressure-oriented protocol based on the Lund concept at the NC. They were assessed at 3 weeks after injury with Rancho Los Amigos Cognitive Scale Revised (RLAS-R), Levels of Cognitive functioning, and at 3 months with RLAS-R and Glasgow Outcome Scale Extended (GOSE).A total of 37 patients were included. Hospital deaths within 3 months post-injury occurred in 5 patients. After 3 months the RLAS-R scores were significantly improved (< 0.001). Eight patients had both “superior cognitive functioning” on the RLAS-R and “favourable outcome” on the GOSE. Thirty-four patients (92%) were directly admitted to the NC. By contrast, after discharge patients were transferred back to one of several county hospitals or to one of several local hospitals, and some had multiple transfers between different hospitals and departments. Overall outcomes were surprisingly good in this group of severely injured patients. The routines for transferring patients with severe traumatic brain injury from a geographically large, sparsely populated region to a regional NC to receive well-monitored neurosurgical care seem to work very well. The post-acute clinical pathways are less clearly reflecting an optimized medical and rehabilitative strategy.
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