| 1. |
- Nilsagård, Ylva, 1964-, et al.
(författare)
-
Predicting accidental falls in people with multiple sclerosis : a longitudinal study
- 2009
-
Ingår i: Clinical Rehabilitation. - London : Sage Publications. - 0269-2155 .- 1477-0873. ; 23:3, s. 259-269
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate accidental falls and near fall incidents in people with multiple sclerosis with respect to clinical variables and the predictive values of four tests. Design: A longitudinal, multi-centred cohort study with prospectively collected falls. Procedures: Self-reported incidents during the three months following a standardized test procedure. Subjects: Seventy-six people with multiple sclerosis and an Expanded Disability Status Scale score between 3.5 and 6.0. Main outcome measures: Berg Balance Scale, Timed Up and Go cognitive, Four Square Step Test (FSST) and 12-item Multiple Sclerosis Walking Scale. Results: Forty-eight people (63%) registered 270 falls. Most falls occurred indoors during activities of daily life. We found a correlation of rs=0.57 between near falls and falls, and of rs = 0.82 between registered and retrospectively recalled falls. Fallers and non-fallers differed significantly regarding Expanded Disability Status Score (odds ratio (OR) 1.99, 95% confidence interval (CI) 1.22; 3.40), spasticity (OR 1.14, CI 1.02; 1.31), proprioception (OR 2.50, CI 1.36; 5.12) and use of walking aids (OR 2.27, CI 1.23; 4.37). Reported use of walking aids both indoors and outdoors increased the odds of falling fivefold while disturbed proprioception increased the odds 2.5—15.6 times depending on severity. The odds of falling were doubled for each degree of increased Expanded Disability Status Score and more than doubled for each degree of increased spasticity. The Berg Balance Scale, use of walking aids and Timed Up and Go cognitive best identified fallers (73—94%) and proprioception, Expanded Disability Status Score, 12-item Multiple Sclerosis Walking Scale and Four Square Step Test best identified non-fallers (75—93%). Conclusions: In clinical practice, looking at the use of walking aids, investigating proprioception and spasticity, rating Expanded Disability Status Score and using Berg Balance Scale or Timed Up and Go cognitive all contribute when identifying fallers.
|
|
| 2. |
- Nilsagård, Ylva, et al.
(författare)
-
Evaluation of a single session with cooling garment for persons with multiple sclerosis-a randomized trial
- 2006
-
Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 1748-3107 .- 1748-3115. ; 1:4, s. 225-233
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose. This research investigates the objective and subjective effects of wearing the Rehband® cooling garment. Method. A multi-centre, randomized crossover study was conducted regarding 43 heat-sensitive persons with multiple sclerosis (MS), comparing active treatment with placebo. Subjects were tested immediately before and after intervention. Ten- (10TW) and 30-metre timed walk (30TW), oral temperature, spasticity, standing balance and timed up and go (TUG) and nine-hole peg test (NHPT) performance were measured. A study-specific questionnaire was used to evaluate subjective experiences. Results. Active treatment produced statistically significant objective improvement in 10TW, 30TW, one-legged stance, tandem stance (right) and TUG; statistically significant subjective improvement was also found in fatigue, spasticity, weakness, balance, gait, transfers, ability to think clearly and time to recover. The coherence between the objective and subjective results indicates clinical relevance from the subjects' perspective. There were no statistically significant differences between treatments in terms of oral temperature, spasticity (measured by the modified Ashworth scale), tandem stance (left), step test or NHPT, or subjective signs such as difficulty in dressing, dysarthria or pain. Conclusions. Active cooling with a Rehband® vest is likely to have a positive effect on everyday life in heat-sensitive persons with MS.
|
|
| 3. |
- Nilsagård, Ylva, et al.
(författare)
-
Self-perceived limitations of gait in persons with multiple sclerosis
- 2007
-
Ingår i: Advances in Physiotherapy. - London : Informa UK Limited. - 1403-8196 .- 1651-1948. ; 9:3, s. 136-143
-
Tidskriftsartikel (refereegranskat)abstract
- This study aimed to describe the self-perceived walking limitations of those with multiple sclerosis (MS) using the Swedish translation of the 12-item MS Walking Scale [MSWS-12 (S)], and to investigate it for concurrent validity and internal consistency. Eighty-one persons, recruited from five centres in Sweden, were tested using the Four Square Step Test (FSST), the Timed Up and Go cognitive (TUGcog) and the Berg Balance Scale (BBS) in randomized order, besides filling in the MSWS-12 (S). Perceived limitations were reported in 89-96% of the sample, i.e. performance of activities related to standing or walking, decreased speed and distance, and qualitative aspects; and self-perception regarding the ability to run being most extremely affected. Correlations between the MSWS-12 (S) and the objective tests were low, as were correlations between items in the MSWS-12 (S) and the BBS or time taken to complete the TUGcog or the FSST. The internal consistency was acceptable for nine of the 12 items (0.7-0.84). The majority of the sample experienced limitations in several aspects of their walking ability. Concurrent validity was not established between the MSWS-12 (S) and the other tests. There may be a discrepancy in self- perception of disability and objective measures. The use of subjective, as well as objective measures is recommended.
|
|
