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| 2. |
- Bach Baunsgaard, Carsten, et al.
(författare)
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Gait training after spinal cord injury: safety, feasibility and gait function following 8 weeks of training with the exoskeletons from Ekso Bionics.
- 2018
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Ingår i: Spinal cord. - : Springer Science and Business Media LLC. - 1476-5624 .- 1362-4393. ; 56, s. 106-116
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Tidskriftsartikel (refereegranskat)abstract
- Prospective quasi-experimental study, pre- and post-design.Assess safety, feasibility, training characteristics and changes in gait function for persons with spinal cord injury (SCI) using the robotic exoskeletons from Ekso Bionics.Nine European rehabilitation centres.Robotic exoskeleton gait training, three times weekly over 8 weeks. Time upright, time walking and steps in the device (training characteristics) were recorded longitudinally. Gait and neurological function were measured by 10 Metre Walk Test (10 MWT), Timed Up and Go (TUG), Berg Balance Scale (BBS), Walking Index for Spinal Cord Injury (WISCI) II and Lower Extremity Motor Score (LEMS).Fifty-two participants completed the training protocol. Median age: 35.8 years (IQR 27.5-52.5), men/women: N=36/16, neurological level of injury: C1-L2 and severity: AIS A-D (American Spinal Injury Association Impairment Scale). Time since injury (TSI)<1 year, N=25;>1 year, N=27. No serious adverse events occurred. Three participants dropped out following ankle swelling (overuse injury). Four participants sustained a Category II pressure ulcer at contact points with the device but completed the study and skin normalized. Training characteristics increased significantly for all subgroups. The number of participants with TSI<1 year and gait function increased from 20 to 56% (P=0.004) and 10MWT, TUG, BBS and LEMS results improved (P<0.05). The number of participants with TSI>1 year and gait function, increased from 41 to 44% and TUG and BBS results improved (P<0.05).Exoskeleton training was generally safe and feasible in a heterogeneous sample of persons with SCI. Results indicate potential benefits on gait function and balance.
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| 3. |
- Baunsgaard, C. B., et al.
(författare)
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EXOSKELETON GAIT TRAINING AFTER SPINAL CORD INJURY: AN EXPLORATORY STUDY ON SECONDARY HEALTH CONDITIONS
- 2018
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 50:9, s. 806-813
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To explore changes in pain, spasticity, range of motion, activities of daily living, bowel and lower urinary tract function and quality of life of individuals with spinal cord injury following robotic exoskeleton gait training. Methods: Three training sessions per week for 8 weeks using an Ekso GT robotic exoskeleton (Ekso Bionics). Included were individuals with recent (<1 year) or chronic (>1 year) injury, paraplegia and tetraplegia, complete and incomplete injury, men and women. Results: Fifty-two participants completed the training protocol. Pain was reported by 52% of participants during the week prior to training and 17% during training, but no change occurred longitudinally. Spasticity decreased after a training session compared with before the training session (p< 0.001), but not longitudinally. Chronically injured participants increased Spinal Cord Independence Measure (SCIM III) from 73 to 74 (p= 0.008) and improved life satisfaction (p= 0.036) over 8 weeks of training. Recently injured participants increased SCIM III from 62 to 70 (p<0.001), but no significant change occurred in life satisfaction. Range of motion, bowel and lower urinary function did not change over time. Conclusion: Training seemed not to provoke new pain. Spasticity decreased after a single training session. SCIM III and quality of life increased longitudinally for subsets of participants.
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| 4. |
- Gjesdal, B. E., et al.
(författare)
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Walking through life with cerebral palsy: reflections on daily walking by adults with cerebral palsy
- 2020
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 15:1
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Walking is a major target in childhood physiotherapy for children with cerebral palsy (CP). Little information exists on the importance or value of walking when these children grow up. The aim of this study was to explore personal reflections on daily walking by adults with CP. Method: Semi-structured individual interviews were conducted and analysed with systematic text condensation, a four-step thematic cross-case analysis. Results: Eight ambulatory adults (26-60 years, four women and four men) with CP were interviewed. Almost all had experienced deteriorated walking ability in adulthood and reported that walking was restricted and affected by intrinsic features, such as pain, fatigue, reduced balance and fear of falling. Extrinsic features such as being looked at due to walking abnormality and environmental factors, such as seasonal changes affected their free walking and was common. Some had accepted using mobility aids for energy conservation. Conclusions: Both intrinsic and extrinsic factors influence walking in adults with CP. Reflections by the adults with CP suggest these features may reduce participation in public spaces and potentially increase acceptance and use of mobility aids.
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| 6. |
- Hoyer, E., et al.
(författare)
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Community living after in-hospital specialized rehabilitation in patients with severe disability after stroke: a long-term follow-up after a randomized controlled trial
- 2023
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 45:11, s. 1822-1829
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Tidskriftsartikel (refereegranskat)abstract
- Purpose Physical functioning after discharge from specialized rehabilitation is a concern. The purpose of this study was to investigate functioning and health after a long period of community living in participants with severe disability after stroke. Materials and methods An observational, longitudinal follow-up design was used to investigate 60 participants from a randomized controlled trial. Assessment tools: Short Form 36 health-survey, Functional Ambulation Categories, EU Walking, 10 Meter Walk Test, and questions concerning health and walking ability. Results Forty-seven participants (78%) responded, mean age 51.2 years. Non-respondents demonstrated poorer function at hospital discharge. At follow-up, median 11.9 months after discharge, all but three respondents lived in their own home, and 85% received physiotherapy. Twenty-nine (64%) perceived their health as good to excellent, while four (9%) reported poor health. Activities requiring substantial strength and endurance were typically restricted. Most participants (83%) were independent walkers, and fewer (a 27% reduction) used a wheelchair. Among independent walkers, mean walking speed improved by 0.14 m/s. Time elapsed since hospital discharge was not found to correlate with change in walking speed. Conclusions This study demonstrates maintenance or progress in important aspects of functioning and health in most participants at long-term follow-up, but not in all.
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| 7. |
- Hoyer, E., et al.
(författare)
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Implementing the exoskeleton Ekso GT(TM) for gait rehabilitation in a stroke unit - feasibility, functional benefits and patient experiences
- 2020
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Ingår i: Disability and Rehabilitation-Assistive Technology. - : Informa UK Limited. - 1748-3107 .- 1748-3115. ; 17:4, s. 473-479
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Tidskriftsartikel (refereegranskat)abstract
- Background: Reports on the implementation of exoskeletons for gait rehabilitation in clinical settings are limited. Objectives: How feasible is the introduction of exoskeleton gait training for patients with subacute stroke in a specialized rehabilitation hospital? What are the functional benefits and the patient experiences with training in the Ekso GT(TM) exoskeleton? Design: Explorative study. Methods: During an 18 months inclusion period, 255 in-patients were screened for eligibility. Inclusion criteria were; walking difficulties, able to stand 10 min in a standing frame, fitting into the robot and able to cooperate. One-hour training sessions 2-3 times per week for approximately 3 weeks were applied as a part of the patients' ordinary rehabilitation programme. Assessments: Functional Independence Measure, Motor Assessment Scale (MAS), Ekso GT(TM) walking data, patient satisfaction and perceived exertion of the training sessions (Borg scale). Results: Two physiotherapists were certified at the highest level of Ekso GT(TM). Twenty-six patients, median age 54 years, were included. 177 training sessions were performed. Statistical significant changes were found in MAS total score (p < 0.003) and in the gait variables walking time, up-time, and a number of steps (p < 0.001). Patients reported fairly light perceived exertion and a high level of satisfaction and usefulness with the training sessions. Few disadvantages were reported. Most patients would like to repeat this training if offered. Conclusions Ekso GT(TM) can safely be implemented as a training tool in ordinary rehabilitation under the prerequisite of a structured organization and certified personnel. The patients progressed in all outcome measures and reported a high level of satisfaction.
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| 9. |
- Langhammer, Birgitta, et al.
(författare)
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Bobath : et tolkningsdilemma for fysioterapeuter i neurologisk rehabilitering: en litteraturgjennomgang : Bobath konsept eller metode? : et tolkings dilemma i neurologisk rehabilitering blant fysioterapeuter.
- 2010
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Ingår i: Fysioterapeuten. - 0016-3384. ; 77:6, s. 2-11
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Tidskriftsartikel (refereegranskat)abstract
- Bakgrunn/hensikt: Det er rettet kritikk mot Langhammer og Stanghelles fortolkning og bruk av Bobathmetoden. Dette inspirerte til å se nærmere på de ulike tolkninger av Bobathmetoden/konseptet. Metode: En litteraturstudie ble gjort i MEDLINE og BIBSYS på definisjon av Bobathmetoden/konseptet. I tillegg ble det gjennomført håndsøk på samme nøkkelord i bøker og fagartikler rundt tema. Resultat: Det ble funnet seks ulike tolkninger av Bobathmetoden: 1) Bobaths bok, 2) Langhammer og Stanghelles tolkning i hovedfagsoppgave og artikkel, 3) Lennons undersøkelse blant Bobathterapeuter, 4) Raines undersøkelse blant Bobathinstruktører, 5) Gjelsvik og Hæstads tolkning i fagkronikk og 6) Gjelsviks og IBITAs beskrivelse av samme metode. Tre av disse beskrivelsene (Raine, Hæstad og Gjelsvik og Gjelsvik og IBITA) avviker til en viss grad fra Bobaths egen beskrivelse og Langhammer og Stanghelles. Forskjellen mellom de tre førstnevnte og beskrivelsene til Bobath, Langhammer og Stanghelle ligger i forklaringsmodellen; refleks-hierarkisk versus systemteoretisk. Behandlingsprinsippene synes å være de samme i alle beskrivelser: sensorisk stimulering, fasilitering av bevegelse i håndtering (handling), demping (inhibering) av spastisitet, begrensning av assosierte reaksjoner og stereotype bevegelser. Oppsummering: Det er liten grunn til å hevde at det er vesentlige forskjeller mellom de seks tolkninger av Bobathmetoden. Langhammer og Stanghelles tolkning av Bobathmetoden skiller seg lite fra Bobaths egen beskrivelse av metoden, noe som tilsier at metodikken i undersøkelsene til Langhammer og Stanghelle synes å være adekvat.
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| 10. |
- Morgan, P., et al.
(författare)
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Gait characteristics, Balance performance and falls in ambulant adults with cerebral palsy: An observational study
- 2016
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Ingår i: Gait & Posture. - : Elsevier BV. - 0966-6362. ; 48, s. 243-248
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Tidskriftsartikel (refereegranskat)abstract
- The relationship between spatiotemporal gait parameters, balance performance and falls history was investigated in ambulant adults with cerebral palsy (CP). Participants completed a single assessment of gait using an instrumented walkway at preferred and fast speeds, balance testing (Balance Evaluation Systems Test; BESTest), and reported falls history. Seventeen ambulatory adults with CP, mean age 37 years, participated. Gait speed was typically slow at both preferred and fast speeds (mean 0.97 and 1.21 m/s, respectively), with short stride length and high cadence relative to speed. There was a significant, large positive relationship between preferred gait speed and BESTest total score (ρ = 0.573; p < 0.05) and fast gait speed and BESTest total score (ρ = 0.647, p < 0.01). The stride lengths of fallers at both preferred and fast speeds differed significantly from non-fallers (p = 0.032 and p = 0.025, respectively), with those with a prior history of falls taking shorter strides. Faster gait speed was associated with better performance on tests of anticipatory and postural response components of the BESTest, suggesting potential therapeutic training targets to address either gait speed or balance performance. Future exploration of the implications of slow walking speed and reduced stride length on falls and community engagement, and the potential prognostic value of stride length on identifying falls risk is recommended. © 2016.
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