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- Elmståhl, Sölve, et al.
(författare)
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Caregiver's burden of patients 3 years after stroke assessed by a novel caregiver burden scale
- 1996
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Ingår i: Archives of Physical Medicine and Rehabilitation. - 0003-9993 .- 1532-821X. ; 77:2, s. 177-182
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To assess burden of caregivers to stroke patients three year after a primary stroke and to test validity and reliability of a novel caregiver burden scale (CB scale). Design: A longitudinal community-based 3- year follow-up study of 35 consecutive primary stroke patients initially admitted to an Acute Medical Unit (mean age 82yr). The validity of the CB scale was studied in 150 patients (mean age 77yr):83 demented outpatients assessed for need of group living and 67 outpatients with stroke from a general geriatric day-care unit. Reliability was studied in another 23 outpatients (mean age 72yr) with stroke from the same unit. Methods: A 22- item CB scale for different types of caregiver burden and scales for neuroticism and extroversion (Eysenck Personality Inventory) and quality of life (11-item scale). Activities of daily life were assessed by a 6-item scale, initially and 3 years later. Outcome Measure: Reliability and validity of the CB scale. Improvements of activities of daily life of stroke patients. Results: Factor analyses of the CB scale gave five indices-general strain, isolation, disappointment, emotional involvement, and environment-having good kappa values, .89 to 1.00 and Cronbach's alpha, .70 to .87, except for environment. A higher burden was related to a closer relationship but not to the living situation. The highest caregiver burden was found among patients showing the greatest improvements of ADL, when divided into tertiles. The patient's degree of extroversion and quality of life were negatively correlated to caregiver burden, -.46 (p < .05) and .59 (p < .01). Conclusions: The CB scale proved to be a valid and reliable instrument to assess caregiver burden. To improve the caregiver situation, individual patient personality characteristics, like extroversion, feeling of quality of life, and progression of the disease, must be considered.
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| 2. |
- Karlberg, Mikael, et al.
(författare)
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Head movement restriction and postural stability in patients with compensated unilateral vestibular loss
- 1998
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Ingår i: Archives of Physical Medicine and Rehabilitation. - 0003-9993. ; 79:11, s. 1448-1450
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study whether restriction of head-neck movements improves postural performance in patients with compensated unilateral total vestibular loss. DESIGN: Randomized controlled experimental study. SETTING: Laboratory for clinical and experimental vestibular testing at a tertiary referral center. PATIENTS: Fifteen consecutive patients (seven men, eight women, mean age 53 years) at routine follow-up, 6 months after translabyrinthine extirpation of acoustic neurinomas (mean tumor size 13.5mm, range 5 to 25mm). None of the patients had signs or symptoms of central nervous system dysfunction. INTERVENTION: Posturographic tests comparing patients with and without a semirigid neck collar. Test order was randomized between patients to reduce training effects. MAIN OUTCOME MEASURE: Posturography measuring velocity and variance of quiet stance and measuring body sway induced by vibration at 60, 80, and 100Hz to the calf muscles. Tests were conducted with eyes open and closed. RESULTS: In tests with vibration at 100Hz to the calf muscles and with eyes open, body sway velocity was significantly higher when patients were wearing a neck collar. No significant difference was found in any other test. CONCLUSION: Restricting head-neck movements with a neck collar does not improve postural stability in patients with compensated unilateral total vestibular loss. A tendency toward impaired postural performance leads to the conclusion that it is not appropriate to treat such patients with neck collars to improve their balance.
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| 3. |
- Karlberg, Mikael, et al.
(författare)
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Postural and symptomatic improvement after physiotherapy in patients with dizziness of suspected cervical origin
- 1996
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Ingår i: Archives of Physical Medicine and Rehabilitation. - 0003-9993. ; 77:9, s. 874-882
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To assess postural performance in patients with dizziness of suspected cervical origin in whom extracervical causes had been excluded, and to assess the effects of physiotherapy on postural performance and subjective complaints of neck pain and dizziness. DESIGN: Prospective, randomized, controlled trial. SETTING: Primary care centers and a tertiary referral center. PATIENTS AND SUBJECTS: Of 65 referrals, 43 patients were excluded because extracervical etiology was suspected. Of the remaining 22 patients, 17 completed the study (15 women, 2 men, x age 37 yr, range 26-49). The controls were 17 healthy subjects (15 women, 2 men, x age 36 yr, range 25-55). INTERVENTION: Physiotherapy based on analysis of symptoms and findings, and aimed to reduce cervical discomfort. Patients were randomized either to receive immediate physiotherapy (n = 9), or to wait 2 months, undergo repeat measurements, and then receive physiotherapy (n = 8). MAIN OUTCOME MEASURES: Posturography, measuring velocity and variance of vibration-induced body sway and variance of galvanically induced body sway. Subjective intensity of neck pain (Visual Analog Scale ratings, 0-100), intensity and frequency of dizziness (subjective score 0-4). RESULTS: The patients manifested significantly poorer postural performance than did healthy subjects (.05 > p > .0001). Physiotherapy significantly reduced neck pain and intensity and the frequency of dizziness (p < .01), and significantly improved postural performance (.05 > p > .0007). CONCLUSIONS: Patients with dizziness of suspected cervical origin are characterized by impaired postural performance. Physiotherapy reduces neck pain and dizziness and improves postural performance. Neck disorders should be considered when assessing patients complaining of dizziness, but alternative diagnoses are common.
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| 5. |
- Bernspång, Birgitta, et al.
(författare)
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Differences between persons with right or left cerebral vascular accident on the Assessment of Motor and Process Skills
- 1995
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Ingår i: Archives of Physical Medicine and Rehabilitation. - : WB Saunders. - 0003-9993 .- 1532-821X. ; 76:12, s. 1144-1151
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Persons with right and left cerebral vascular accident (RCVA and LCVA) differ in terms of discrete impairments, but there is limited information with regard to how such impairments translate into differences in disability. The following hypotheses were tested: (1) persons with stroke have lower instrumental or domestic activities of daily living (IADL) ability than do matched nondisabled controls, (2) persons with RCVA do not differ from persons with LCVA in IADL ability, and (3) persons with RCVA and LCVA differ in specific motor and process skills that affect IADL performance.DESIGN: Descriptive comparison.SETTING: Subjects were tested in settings where rehabilitation services were received (home or clinic).SUBJECTS: 71 persons with RCVA, 76 persons with LCVA, and 83 community-living nondisabled individuals drawn from the Assessment of Motor and Process Skills (AMPS) database, matched for age, gender, and number of tasks performed.MAIN OUTCOME MEASURE: AMPS, designed to measure type and severity of impairments manifested in the context of IADL performance. The AMPS was administered to all subjects in accordance with standardized testing procedures.RESULTS: The two stroke groups did not differ significantly in IADL ability, but both stroke groups had significantly lower IADL performance than did the nondisabled subjects. On the AMPS motor scale, persons with RCVA demonstrated greater impairment in pacing, transporting, and coordinating two body parts. Persons with LCVA demonstrated greater impairments in calibrating movements. No differences were found between the two groups in AMPS process skills.CONCLUSIONS: Persons with RCVA and LCVA have hemisphere-specific differences in motor impairments, but do not differ significantly in IADL ability.
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