| 1. |
- Bunketorp Käll, Lina, 1975, et al.
(author)
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The Impact of a Physical Activity Intervention Program on Academic Achievement in a Swedish Elementary School Setting
- 2014
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In: Journal of School Health. - : Wiley. - 0022-4391. ; 84:8, s. 473-480
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Journal article (peer-reviewed)abstract
- BACKGROUND: Despite the emerging body of research on the potential of physical activity to improve learning and academic achievement, conclusive evidence regarding the effects of physical activity on academic achievement is lacking. The objective of this study was to determine the impact of a physical activity intervention program on academic performance. METHODS: A controlled cross-sectional design was used to investigate the hypothesis that the intervention program would increase the proportion of students in grade 5 who achieved the national learning goals in Swedish, mathematics, and English compared with 3 reference schools. Academic results from the years prior to and during the intervention program were analyzed. Logistic regression analyses assessed the odds of achieving the national learning goals when the intervention program was integrated into the elementary curricula. RESULTS: Higher proportions of students in the intervention school achieved the national goals in all 3 subjects compared with the reference schools after initiation of the intervention program. The odds for achieving the national learning goals in the intervention school increased 2-fold (p < .05), whereas these odds either did not change or decreased in the reference schools. CONCLUSION: Promoting physical activity in school by means of a curriculum-based intervention program may improve children's educational outcome.
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| 2. |
- Grahn, Anna, 1973, et al.
(author)
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Cognitive impairment 3 years after neurological Varicella-zoster virus infection: a long-term case control study
- 2013
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In: Journal of Neurology. - : Springer Science and Business Media LLC. - 0340-5354 .- 1432-1459. ; 260:11, s. 2761-2769
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Journal article (peer-reviewed)abstract
- Varicella-zoster virus (VZV) is one of the most common viruses causing central nervous system (CNS) infection, sometimes with severe neurological complications and sequelae despite appropriate antiviral treatment. Whether the neurological sequelae of VZV CNS infections include long-term cognitive impairment and how this impairment might affect the patients is still largely unknown. In this study, 14 patients with predominant CNS manifestations caused by VZV infection underwent cognitive testing 3 years (median 39.5 months, range 31-52 months) after acute disease. The results were compared with those for 28 controls, matched for age and gender. The tests covered the cognitive domains of speed and attention, memory and learning, visuospatial function, language and executive function. To further assess the cognitive dysfunction caused by neurological VZV infection, patients were classified into the concept of mild cognitive impairment (MCI), which is associated with development of dementia in other pathologies. The VZV patients performed significantly worse than controls on four tests covering the domains of speed and attention, memory and learning and executive function. The cut-off was set at 1.5 SD below mean age. In addition, a greater proportion of VZV patients were classified with MCI as compared with controls. In conclusion, patients with previous VZV infection affecting the brain had signs of long-term cognitive impairment in the domains of speed and attention, memory and learning and executive function. However, larger study populations are needed to confirm these results.
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| 3. |
- Jerndal, Mikael, et al.
(author)
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A systematic review and meta-analysis of erythropoietin in experimental stroke.
- 2010
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In: Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism. - : SAGE Publications. - 1559-7016. ; 30:5, s. 961-8
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Research review (peer-reviewed)abstract
- Erythropoietin (EPO) has shown promise as a neuroprotectant in animal models of ischemic stroke. EPO is thought not only to protect neurons from cell death, but also to promote regeneration after stroke. Here, we report a systematic review and meta-analysis of the efficacy of EPO in animal models of focal cerebral ischemia. Primary outcomes were infarct size and neurobehavioral outcome. Nineteen studies involving 346 animals for infarct size and 425 animals for neurobehavioral outcome met our inclusion criteria. Erythropoietin improved infarct size by 30.0% (95% CI: 21.3 to 38.8) and neurobehavioral outcome by 39.8% (33.7 to 45.9). Studies that randomized to treatment group or that blinded assessment of outcome showed lower efficacy. Erythropoietin was tested in animals with hypertension in no studies reporting infarct size and in 7.5% of the animals reporting neurobehavioral outcome. These findings show efficacy for EPO in experimental stroke, but when the impact of common sources of bias are considered, this efficacy falls, suggesting we may be overestimating its potential benefit. As common human co-morbidities may reduce therapeutic efficacy, broader testing to delineate the range of circumstances in which EPO works best would be beneficial.
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| 4. |
- Sjöholm, Anna, et al.
(author)
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Sedentary behaviour and physical activity of people with stroke in rehabilitation hospitals
- 2014
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In: Stroke Research and Treatment. - : Hindawi Publishing Corporation. - 2042-0056 .- 2090-8105.
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Journal article (peer-reviewed)abstract
- Background. Sedentary behaviour is associated with health risks, independent of physical activity. This study aimed to investigate patterns of sedentary behaviour and physical activity among stroke survivors in rehabilitation hospitals. Methods. Stroke survivors admitted to four Swedish hospital-based rehabilitation units were recruited ≥7 days since stroke onset and their activity was measured using behavioural mapping. Sedentary behaviour was defined as lying down or sitting supported. Results. 104 patients were observed (53% men). Participants spent an average of 74% (standard deviation, SD 21%) of the observed day in sedentary activities. Continuous sedentary bouts of ≥1 hour represented 44% (SD 32%) of the observed day. A higher proportion (30%, SD 7%) of participants were physically active between 9:00 AM and 12:30 PM, compared to the rest of the observed day (23%, SD 6%, P < 0.0005). Patients had higher odds of being physically active in the hall (odds ratio, OR 1.7, P = 0.001) than in the therapy area. Conclusions. The time stroke survivors spend in stroke rehabilitation units may not be used in the most efficient way to promote maximal recovery. Interventions to promote reduced sedentary time could help improve outcome and these should be tested in clinical trials. © 2014 Anna Sjöholm et al.
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| 5. |
- Skarin, Monica, et al.
(author)
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A mapping study on physical activity in stroke rehabilitation: Establishing the baseline
- 2013
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In: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977. ; 45:10, s. 997-1003
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Journal article (peer-reviewed)abstract
- Objective: To establish physical activity level, environment and social interaction in routine stroke rehabilitation practice. Methods: Patients at 4 hospital stroke rehabilitation units in Sweden at least 7 days post-stroke were observed over 1 week-day at 10 min intervals between 08.00 h and 17.00 h. At each observation, physical activity, location and people present were ascertained. Results: Patients (n=104) had a mean age of 70.3 (standard deviation (SD) 14.4) years. Median time since stroke was 19 (range 7-142) days. Patients were alone for 52% of the day, during this time 7% was spent in standing/walking activities. While with a physiotherapist patients were standing/walking for 43% of the time. Using median regression it was found that the median percentage of time spent in standing/walking was associated with gait independence and age. Gait independence increased the median percentage of time spent in standing/walking by 16.5% (95% confidence interval (CI) 12.1-20.9, p<0.001), while an increase of 1 year of age reduced the median percentage of time spent in standing/walking by 0.16% (95% CI -0.31 to -0.01, p < 0.05). Conclusion: Patients had low levels of physical activity and social interaction. This study suggests that there is a huge potential to increase patients' activity level and augment social interaction above current levels.
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| 6. |
- Skarin, Monica, et al.
(author)
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'Better wear out sheets than shoes': a survey of 202 stroke professionals' early mobilisation practices and concerns
- 2011
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In: International Journal of Stroke. - 1747-4949. ; 6:1, s. 10-15
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Journal article (peer-reviewed)abstract
- Background Stroke unit care improves the outcome for patients. One component responsible for this may be that patients are mobilised earlier and more intensively. An ongoing randomised controlled trial is investigating the potential benefits of early mobilisation, but currently there is limited evidence for the practice. Therefore, current practices may be driven by historical precedent and/or clinical opinion, and varying approaches to mobilisation are likely. This study aims to examine different health professionals' concerns regarding early mobilisation in acute stroke. In this study, early mobilisation was defined as frequent out of bed activities within the first 24 h after stroke onset. Methods A nine-item anonymous questionnaire exploring benefits and harms with early mobilisation after stroke was used during interviews of stroke care professionals attending the annual Australasian stroke conference in 2008. Results The survey was completed by 202 professionals, representing 38% of all conference attendees. Sixty-five per cent were females, 50% under 40-years old, 46% worked in acute stroke and 31% in rehabilitation. Thirty-five per cent were nurses, 26% medical doctors, 19% physiotherapists and 12% occupational therapists. Two-thirds had <10-years experience with stroke. Sixty per cent of the surveyed professionals had concerns about early mobilisation and there were significantly more professionals concerned about early mobilisation for haemorrhagic (59%) than ischaemic (23%) stroke patients. Conclusion Our study shows that most clinicians had concerns in relation to early mobilisation of stroke patients and more clinicians had concerns for haemorrhagic than for ischaemic stroke. The evidence underlying these concerns is shallow.
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| 7. |
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| 8. |
- Cumming, T B, et al.
(author)
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Little evidence for different phenomenology in poststroke depression.
- 2010
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In: Acta psychiatrica Scandinavica. - : Wiley. - 1600-0447 .- 0001-690X. ; 121:6, s. 424-30
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Journal article (peer-reviewed)abstract
- Cumming TB, Churilov L, Skoog I, Blomstrand C, Linden T. Little evidence for different phenomenology in poststroke depression. Objective: It remains unclear whether mood depressive disorders after stroke have a distinct phenomenology. We evaluated the symptom profile of poststroke depression (PSD) and assessed whether somatic symptoms were reported disproportionately by stroke patients. Method: The sample was 149 stroke patients at 18 months poststroke and 745 age- and sex-matched general population controls. A comprehensive psychiatric interview was undertaken and depression was diagnosed according to DSM-III-R criteria. Results: Depressed controls reported more 'inability to feel' (P = 0.002) and 'disturbed sleep' (P = 0.008) than depressed stroke patients. Factor analysis of the 10 depressive symptoms identified two main factors, which appeared to represent somatic and psychological symptoms. There was no difference in scores on these two factors between stroke patients and controls. Conclusion: Phenomenology of depression at 18 months poststroke is broadly similar but not the same as that described by controls. Somatic symptoms of depression were not over-reported by stroke patients.
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| 9. |
- Cumming, T. B., et al.
(author)
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Montreal Cognitive Assessment and Mini-Mental State Examination are both valid cognitive tools in stroke
- 2013
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In: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314. ; 128:2
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Journal article (peer-reviewed)abstract
- Objective - To determine the validity of the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) as screening tools for cognitive impairment after stroke. Materials and methods - Cognitive assessments were administered over 2 sessions (1 week apart) at 3 months post-stroke. Scores on the MoCA and MMSE were evaluated against a diagnosis of cognitive impairment derived from a comprehensive neuropsychological battery (the criterion standard). Results - Sixty patients participated in the study [mean age 72.1 years (SD = 13.9), mean education 10.5 years (SD = 3.9), median acute NIHSS score 5 (IQR 3-7)]. The MoCA yielded lower scores (median = 21, IQR = 17-24; mean = 20.0, SD = 5.4) than the MMSE (median = 26, IQR = 22-27; mean = 24.2, SD = 4.5). MMSE data were more skewed towards ceiling than MoCA data (skewness = -1.09 vs -0.73). Area under the receiver operator curve was higher for MoCA than for MMSE (0.87 vs 0.84), although this difference was not significant (chi(2) = 0.48, P = 0.49). At their optimal cut-offs, the MoCA had better sensitivity than the MMSE (0.92 vs 0.82) but poorer specificity (0.67 vs 0.76). Conclusions - The MoCA is a valid screening tool for post-stroke cognitive impairment; it is more sensitive but less specific than the MMSE. Contrary to the prevailing view, the MMSE also exhibited acceptable validity in this setting.
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