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| 2. |
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| 3. |
- Abzhandadze, Tamar, 1980, et al.
(författare)
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DEVELOPMENT OF A SWEDISH SHORT VERSION OF THE MONTREAL COGNITIVE ASSESSMENT FOR COGNITIVE SCREENING IN PATIENTS WITH STROKE
- 2023
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden. - 1650-1977 .- 1651-2081. ; 55
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The primary objective was to develop a Swedish short version of the Montreal Cognitive Assessment (s-MoCA-SWE) for use with patients with stroke. Secondary objectives were to iden-tify an optimal cut-off value for the s-MoCA-SWE to screen for cognitive impairment and to compare its sensitivity with that of previously developed short forms of the Montreal Cognitive Assessment. Design: Cross-sectional study.Subjects/patients: Patients admitted to stroke and rehabilitation units in hospitals across Sweden. Methods: Cognition was screened using the Mont-real Cognitive Assessment. Working versions of the s-MoCA-SWE were developed using supervised and unsupervised algorithms.Results: Data from 3,276 patients were analysed (40% female, mean age 71.5 years, 56% minor stroke at admission). The suggested s-MoCA-SWE compri-sed delayed recall, visuospatial/executive function, serial 7, fluency, and abstraction. The aggregated scores ranged from 0 to 16. A threshold for impai-red cognition & LE; 12 had a sensitivity of 97.41 (95% confidence interval, 96.64-98.03) and positive pre-dictive value of 90.30 (95% confidence interval 89.23-91.27). The s-MoCA-SWE had a higher abso-lute sensitivity than that of other short forms.Conclusion: The s-MoCA-SWE (threshold & LE; 12) can detect post-stroke cognitive issues. The high sensitivity makes it a potentially useful "rule-out" tool that may eliminate severe cognitive impair-ment in people with stoke.
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| 4. |
- Adolfsson, Margareta, 1950-, et al.
(författare)
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Exploring changes over time in habilitation professionals' perceptions and applications of the International Classification of Functioning, Disability and Health, version for Children and Youth (ICF-CY).
- 2010
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 42:7, s. 670-678
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE This study explored how professionals in inter-disciplinary teams perceived the implementation of the World Health Organization's International Classification of Functioning, Disability and Health, version for Children and Youth (ICF-CY) in Swedish habilitation services. DESIGN Descriptive longitudinal mixed-methods design. METHODS Following participation in a 2-day in-service training on the ICF-CY, 113 professionals from 14 interdisciplinary teams described their perceptions of the implementation of the ICF-CY at 3 consecutive time-points: during in-service training, after 1 year, and after 2.5 years. RESULTS Implementation of the ICF-CY in daily work focused on assessment and habilitation planning and required adaptations of routines and materials. The ICF-CY was perceived as useful in supporting analyses and in communication about children's needs. Professionals also perceived it as contributing to new perspectives on problems and a sharpened focus on participation. CONCLUSION Professionals indicated that the ICF-CY enhanced their awareness of families' views of child participation, which corresponded to organizational goals for habilitation services. An implementation finding was a lack of tools fitting the comprehensive ICF-CY perspective. The study points to the need for ICF-CY-based assessment and intervention methods focusing on child participation
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| 5. |
- Agnew, Louise, et al.
(författare)
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Factors associated with work ability in patients with chronic whiplash-associated disorder grade II-III : a cross-sectional analysis
- 2015
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Ingår i: Journal of Rehabilitation Medicine. - : FOUNDATION REHABILITATION INFORMATION. - 1650-1977 .- 1651-2081. ; 47:6, s. 546-551
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the factors related to self-perceived work ability in patients with chronic whiplash-associated disorder grades II-III.Design: Cross-sectional analysis.Patients: A total of 166 working age patients with chronic whiplash-associated disorder.Methods: A comprehensive survey collected data on work ability (using the Work Ability Index); demographic, psychosocial, personal, work- and condition-related factors. Forward, stepwise regression modelling was used to assess the factors related to work ability.Results: The proportion of patients in each work ability category were as follows: poor (12.7%); moderate (39.8%); good (38.5%); excellent (9%). Seven factors explained 65% (adjusted R-2 = 0.65, p < 0.01) of the variance in work ability. In descending order of strength of association, these factors are: greater neck disability due to pain; reduced self-rated health status and health-related quality of life; increased frequency of concentration problems; poor workplace satisfaction; lower self-efficacy for performing daily tasks; and greater work-related stress.Conclusion: Condition-specific and psychosocial factors are associated with self-perceived work ability of individuals with chronic whiplash-associated disorder.
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| 6. |
- Ahlgren, Christina, et al.
(författare)
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Effects on physical performance and pain from three dynamic training programs for women with work-related trapezius myalgia
- 2001
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Ingår i: Journal of Rehabilitation Medicine. - : Taylor & Francis. - 1650-1977 .- 1651-2081 .- 0000-0000. ; 33:4, s. 162-9
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Tidskriftsartikel (refereegranskat)abstract
- To compare training programs for women with trapezius myalgia regarding physical performance and pain, 102 women were randomized to strength, endurance, co-ordination and non-training groups. Before and after the intervention, static strength and dynamic muscular endurance in shoulder muscles were measured on a Cybex II dynamometer. Muscle activity in shoulder muscles was monitored via surface EMG. The signal amplitude ratio between the active and passive phase of repeated contractions indicated the ability to relax. Pain at present, pain in general and pain at worst were measured on visual analogue scales. After training, within group comparisons showed that the training groups rated less pain, and in the strength training group ratings of pain at worst differed from the non-training group. Using the non-training group as a reference, static strength increased in the strength and endurance training groups and muscular endurance in all training groups. The study indicates that regular exercises with strength, endurance or co-ordination training of neck/shoulder muscles might alleviate pain for women with work-related trapezius myalgia.
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| 7. |
- Ahlgren, Åsa, et al.
(författare)
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Selection of clients for vocational rehabilitation at six local social insurance offices. : a combined register and questionnaire study on rehabilitation measures and attitudes among social insurance officers.
- 2008
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081 .- 0001-5555. ; 40:3, s. 178-184
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of this study was to evaluate possible differences between local social insurance offices with regard to their selection of clients for vocational rehabilitation. A further aim was to determine whether social insurance officers from different local insurance offices have uniform attitudes regarding professional practice in their application of the insurance system. METHODS: A register-based investigation of 815 vocational rehabilitees served by 6 local social insurance offices in a Swedish county. The study was supplemented with a questionnaire to 30 officers about attitudes to social insurance. RESULTS: The office with the lowest rate of sick-listing periods exceeding one year, and a high frequency of employment training, showed the highest degree of work resumption and the lowest pension rate after vocational rehabilitation. There were wide differences in attitude among the local social insurance officers regarding professional practice in their application of the system. CONCLUSION: Intra-county differences occur in handling people on sick-leave who undergo vocational rehabilitation. The local social insurance offices with the highest and lowest outcome rates of work resumption and disability pension, respectively, select clients for vocational rehabilitation from different categories of cases. Social insurance officers from different local offices differ in their attitudes towards the social insurance system and its clients.
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| 8. |
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| 9. |
- Alföldi, Peter, 1959-, et al.
(författare)
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SPREADING OF PAIN AND INSOMNIA IN PATIENTS WITH CHRONIC PAIN: RESULTS FROM A NATIONAL QUALITY REGISTRY (SQRP)
- 2017
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Ingår i: Journal of Rehabilitation Medicine. - : FOUNDATION REHABILITATION INFORMATION. - 1650-1977 .- 1651-2081. ; 49:1, s. 63-70
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To explore how demographics, pain, psychosocial factors and insomnia relate to the spread of chronic pain. Methods: The study included 708 patients (68% women; median age 46 years; interquartile range 3557 years) with chronic pain who were referred to a multidisciplinary pain centre. Spreading of pain was assessed using a questionnaire covering 36 anatomically predefined pain regions. Data were collected on demographics, pain symptoms, psychological distress, and insomnia (Insomnia Severity Index). Four sub-categories of chronic pain were established: chronic local pain, chronic regional pain medium, chronic regional pain heavy, and chronic widespread pain. Results: The median number of pain regions was 10 (interquartile range 6-18). Prevalence of chronic pain was as follows: chronic local pain 9%, chronic regional pain medium 21%, chronic regional pain heavy 39%, and chronic widespread pain 31%. In the regression models, being a woman and persistent pain duration had the strongest associations with spreading of pain, but anxiety, pain interference, and insomnia were also important factors. Conclusion: Spreading of chronic pain can only partly be explained by the simultaneous levels of insomnia. Female sex, pain duration, pain interference and anxiety appear to have more significant relationships with the spread of pain. Targeting these factors may lead to improvements in treatment and prevention strategies.
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| 10. |
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| 11. |
- Alt Murphy, Margit, 1970, et al.
(författare)
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Comparison of Accelerometer-Based Arm, Leg and Trunk Activity at Weekdays and Weekends During Subacute Inpatient Rehabilitation After Stroke
- 2019
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 51:6, s. 426-433
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To determine whether there are differences in arm, leg and trunk activity measured by acceleration between weekdays and weekends in people undergoing rehabilitation in the subacute stage after stroke. Patients: Twenty-eight individuals with stroke (mean age 55.4 years; severe to mild impairment) and 10 healthy controls. Methods: A set of 5 3-axial accelerometers were used on the trunk, wrists and ankles during 2 48-h sessions at weekdays and over a weekend. Day-time acceleration raw data were expressed as the signal magnitude area. Asymmetry between the affected and less-affected limb was calculated as a ratio. Results: Participants with stroke used their both arms and legs less at weekends than on weekdays (p<0.05, effect size 0.3 2-0.5 7). Asymmetry between the affected and less-affected arm was greater at weekends (p < 0.05, effect size 0.32). All activity measures, apart from the less-affected arm on weekdays, were lower in stroke compared with controls (p<0.05, effect size 0.4-0.8). No statistically significant differences were detected between weekday and weekend activity for the control group. One-third of participants perceived the trunk sensor as inconvenient to wear. Conclusion: Increased focus needs to be applied on activities carried out during weekends at rehabilitation wards.
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| 12. |
- Alt Murphy, Margit, 1970, et al.
(författare)
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Implementation of evidence-based assessment of upper extremity in stroke rehabilitation: From evidence to clinical practice
- 2021
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 53:1
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Tidskriftsartikel (refereegranskat)abstract
- Objective: There is an evidence-practice gap in assessment of the upper extremities during acute and subacute stroke rehabilitation. The aim of this study was to target this gap by describing and evaluating the implementation of, and adherence to, an evidence-based clinical practice guideline for occupational therapists and physiotherapists. Methods: The upper extremity assessment implementation process at Sahlgrenska University Hospital comprised 5 stages: mapping clinical practice, identifying evidence-based outcome measures, development of a guideline, implementation, and evaluation. A systematic theoretical framework was used to guide and facilitate the implementation process. A survey, answered by 44 clinicians (23 physiotherapists and 21 occupational therapists), was used for evaluation. Results: The guideline includes 6 primary standardized assessments (Shoulder Abduction, Finger Extension (SAFE), 2 items of the Actions Research Arm Test (ARAT-2), Fugl-Meyer Assessment of Upper Extremity (FMA-UE), Box and Block Test (BBT), 9-Hole Peg Test (9HPT), and grip strength (Jamar hand dynamometer)) performed at specified time-points post-stroke. More than 80% (35 to 42) clinicians reported reported being content with the guideline and the implementation process. Approximately 60-90% of the clinicians reported good adherence to specific assessments, and approximately 50% reported good adherence to the agreed time-points. Comprehensive scales were more difficult to implement compared with the shorter screening scales. High levels of work rotation among staff, and the need to prioritize other assessments during the first week after stroke, hindered to implementation. Conclusion: The robustness of evidence, adequate support and receptive context facilitated the implementation process. The guideline enables a more structured, knowledge-based and consistent assessment, and thereby supports clinical decision-making and patient involvement.
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| 13. |
- Alvsaker, Kristin, et al.
(författare)
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INTER-RATER RELIABILITY OF THE EARLY FUNCTIONAL ABILITIES SCALE
- 2011
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Ingår i: Journal of Rehabilitation Medicine. - : Foundation for Rehabilitation Information. - 1650-1977 .- 1651-2081. ; 43:10, s. 892-899
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the inter-rater reliability of the Early Functional Abilities (EFA) scale. less thanbrgreater than less thanbrgreater thanDesign: An observational study of inter-rater reliability in an open cohort. less thanbrgreater than less thanbrgreater thanPatients: Twenty-four patients with traumatic brain injury in need of medical or surgical intervention in the early rehabilitation section of the intensive care unit. less thanbrgreater than less thanbrgreater thanMethods: The EFA was assessed by 4 different professions in the rehabilitation team. Inter-rater reliability was assessed using linear weighted kappa statistics. less thanbrgreater than less thanbrgreater thanResults: The overall weighted kappa values of the different EFA items varied from 0.27 to 0.60. The items in the sensorimotor functional area had the highest pairwise agreement, with a mean kappa range of 0.68-0.76. The vegetative stability, position tolerance and wakefulness items had the lowest mean kappa values (0.49, 0.33 and 0.49, respectively). Agreement was good to excellent between the occupational therapist and physiotherapist across the majority of the items, whereas the physician and nurse agreed less with one another. less thanbrgreater than less thanbrgreater thanConclusion: The inter-rater reliability of the EFA scale was good for most items among all the raters. The scale may be used by all members of the interdisciplinary team after training in administration and scoring. A reduction in the number of items in the vegetative functional domain is recommended.
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| 14. |
- Andersson, Jenni, et al.
(författare)
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Long-term perceived disabilities up to 10 years after transient ischaemic attack
- 2021
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 53:3
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The long-term impact of transient ischaemic attack is largely unknown.OBJECTIVES: To assess the long-term perceived impact of transient ischaemic attack and explore the influence of sex and age on these perceptions; and to evaluate the relationships between activities of daily living, participation and overall recovery, and the other domains of the Stroke Impact Scale 3.0 (SIS).METHODS: A retrospective study among adult community-dwelling individuals from 6 months up to 10 years after onset of transient ischaemic attack. A total of 299 survivors of transient ischaemic attack responded to the SIS.RESULTS: Most self-reported disabilities involved emotion, strength, and participation domains of SIS and remained stable until 10 years post-transient ischaemic attack. Women reported significantly more disabilities for emotion and hand function. Elderly subjects (age > 65 years) reported more disabilities for strength, mobility, hand function, activities of daily living/instrumental activities of daily living, and participation. The activities of daily living/instrumental activities of daily living, participation, and overall recovery demonstrated significant, although low-to-moderate, associations with other SIS domains after transient ischaemic attack.CONCLUSION: The broadly perceived disabilities were demonstrated consistently and played a significant meaningful role in everyday life and recovery among community-dwelling individuals up to 10 years after a transient ischaemic attack. These findings indicate the need for long-term multi-professional follow-up with holistic rehabilitation to improve overall recovery among survivors of transient ischaemic attack.
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| 15. |
- Andersson, Sofi A., 1970, et al.
(författare)
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Arm impairment and walking speed explain real-life activity of the affected Arm and leg after stroke
- 2021
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Ingår i: Journal of Rehabilitation Medicine. - : Foundation for Rehabilitation Information. - 1650-1977 .- 1651-2081. ; 53:6
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To determine to what extent accelerometer-based arm, leg and trunk activity is associated with sensorimotor impairments, walking capacity and other factors in subacute stroke. Design: Cross-sectional study. Patients: Twenty-six individuals with stroke (mean age 55.4 years, severe to mild motor impairment). Methods: Data on daytime activity were collected over a period of 4 days from accelerometers placed on the wrists, ankles and trunk. A forward stepwise linear regression was used to determine associations between free-living activity, clinical and demographic variables. Results: Arm motor impairment (Fugl-Meyer Assessment) and walking speed explained more than 60% of the variance in daytime activity of the more-affected arm, while walking speed alone explained 60% of the more-affected leg activity. Activity of the less-affected arm and leg was associated with arm motor impairment (R2=0.40) and independence in walking (R2=0.59). Arm activity ratio was associated with arm impairment (R2=0.63) and leg activity ratio with leg impairment (R2=0.38) and walking speed (R2=0.27). Walking-related variables explained approximately 30% of the variance in trunk activity. Conclusion: Accelerometer-based free-living activity is dependent on motor impairment and walking capacity. The most relevant activity data were obtained from more-affected limbs. Motor impairment and walking speed can provide some information about real-life daytime activity levels.
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| 16. |
- Andersson, Åsa, 1963-, et al.
(författare)
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How to identify potential fallers in a stroke unit : validity indexes of 4 test methods
- 2006
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 38:3, s. 186-191
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of this study was to describe general characteristics of patients with stroke who have a tendency to fall and to determine whether certain test instruments can identify fallers. METHODS: Patients treated in a stroke unit during a 12-month period were included. At inclusion assessments were made with Berg Balance Scale Berg Balance Scale, Stops Walking When Talking, Timed Up & Go (TUG) and diffTUG. At follow-up 6 or 12 months later, patients who had fallen were identified. RESULTS: During the time from discharge to follow-up on 159 patients, 68 patients fell and 91 did not. Fallers fell more often during their initial hospital stay, used sedatives more often and were more visually impaired, compared with non-fallers. The Berg Balance Scale, Stops Walking When Talking and TUG results differed between fallers and non-fallers. The combined results of Berg Balance Scale and Stops Walking When Talking increased the possibility of identifying fallers. CONCLUSION: Berg Balance Scale, Stops Walking When Talking and TUG can be used to evaluate which patients have a tendency to fall in order to carry out preventive measures. Berg Balance Scale can be used in all patients. Stops Walking When Talking can give additional information if the patient is able to walk. TUG is a possible choice, but fewer patients can perform it.
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| 17. |
- Andréll, Paulin, 1978, et al.
(författare)
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HEALTH-RELATED QUALITY OF LIFE IN FIBROMYALGIA AND REFRACTORY ANGINA PECTORIS: A COMPARISON BETWEEN TWO CHRONIC NON-MALIGNANT PAIN DISORDERS
- 2014
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 46:4, s. 341-347
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To compare health-related quality of life in 2 different populations with chronic pain: patients with fibromyalgia and patients with refractory angina pectoris. Previous separate studies have indicated that these patient groups report different impacts of pain on health-related quality of life. Methods: The Short-Form 36 was used to assess health-related quality of life. In order to adjust for age and gender differences between the groups, both patient groups were compared with age- and gender-matched normative controls. The difference in health-related quality of life between the 2 patient groups was assessed by transforming the Short-Form 36 subscale scores to a z-score. Results: The patients with fibromyalgia (n=203) reported poorer health-related quality of life in all the subscale scores of Short-Form 36 (p < 0.05-0.0001) than the patients with refractory angina (n = 146) when both groups were compared with their corresponding normal population (z-score). Conclusion: Patients with fibromyalgia experience greater impairment in health-related quality of life compared with the normal population than do patients with refractory angina pectoris, despite the fact that the latter have a potentially life-threatening disease. The great impairment in health-related quality of life in patients with fibromyalgia should be taken into consideration when planning rehabilitation.
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| 18. |
- Antfolk, Christian, et al.
(författare)
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Sensory feedback from a prosthetic hand based on air-mediated pressure from the hand to the forearm skin.
- 2012
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Ingår i: Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1651-2081. ; 44:8, s. 702-707
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Lack of sensory feedback is a drawback in today's hand prostheses. We present here a non-invasive simple sensory feedback system, which provides the user of a prosthetic hand with sensory feedback on the arm stump. It is mediated by air in a closed loop system connecting silicone pads on the prosthetic hand with pads on the amputation stump. The silicone pads in a "tactile display" on the amputation stump expand when their corresponding sensor-bulb in the prosthesis is touched, evoking an experience of "real touch". Methods: Twelve trans-radial amputees and 20 healthy non-amputees participated in the study. We investigated the capacity of the system to mediate detection of touch, discrimination between different levels of pressure and, on the amputees also, the ability to locate touch. Results: The results showed a median touch threshold of 80 and 60 g in amputees and non-amputees, respectively, and 90% and 80% correct answers, respectively, in discrimination between 2 levels of pressure. The amputees located touch (3 sites) correctly in 96% of trials. Conclusion: This simple sensory feedback system has the potential to restore sensory feedback in hand amputees and thus it could be a useful tool to enhance prosthesis use.
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| 19. |
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| 20. |
- Árnadóttir, Guðrún, et al.
(författare)
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Difference in impact of neurobehavioural dysfunction on Activities of Daily Living performance between right and left hemispheric stroke
- 2010
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Ingår i: Journal of Rehabilitation Medicine. - : Foundation of Rehabilitation Information. - 1650-1977 .- 1651-2081. ; 42:10, s. 903-907
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To explore whether persons with right- and left-sided cerebrovascular accidents differ significantly in mean impact of neurobehavioural impairments on ability to perform activities of daily living. Design and subjects: Retrospective study of data from 215 persons (103 right-sided, 112 left-sided cerebrovascular accident). The Activities of daily living-focused Occupation-based Neurobehavioral Evaluation was used to evaluate ability on an activities of daily living scale and the impact of neurobehavioural impairment on ability on another scale. Methods: To control for possible differences in activities of daily living ability between groups, analysis of covariance, with activities of daily living ability as a covariate, was used to test for a significant difference in impact of neurobehavioural impairments on activities of daily living ability between groups. Results: Expected moderate correlation (r=-0.57) was obtained between activities of daily living ability and neurobehavioural impact measures, and there was no difference in mean neurobehavioural impact measures between groups (F [1, 212] = 2.910,p = 0.090). Conclusion: This study is the first: to explore directly the impact of neurobehavioural impairment on activities of daily living ability. While persons with right-sided and left-sided cerebrovascular accidents may differ in type of neurobehavioural impairments, direct evaluation of the impact of such impairments on activities of daily living ability reveals no difference between groups.
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| 21. |
- Arvidsson, Patrik, et al.
(författare)
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International classification of functioning, disability and health categories explored for selfrated participation in swedish adolescents and adults with a mild intellectual disability
- 2012
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Ingår i: Journal of Rehabilitation Medicine. - Uppsala, Sweden : Foundation Rehabilitation Information. - 1650-1977 .- 1651-2081. ; 44:7, s. 562-569
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To explore internal consistency and correlations between perceived ability, performance and perceived importance in a preliminary selection of self-reported items representing the activity/participation component of the International Classification of Functioning, Disability and Health (ICF).Design: Structured interview study. Subjects: Fifty-five Swedish adolescents and adults with a mild intellectual disability.Methods: Questions about perceived ability, performance and perceived importance were asked on the basis of a 3-grade Likert-scale regarding each of 68 items representing the 9 ICF domains of activity/participation.Results: Internal consistency for perceived ability (Cron-bach's alpha for all 68 items): 0.95 (values for each domain varied between 0.57 and 0.85), for performance: 0.86 (between 0.27 and 0.66), for perceived importance: 0.84 (between 0.27 and 0.68). Seventy-two percent of the items showed correlations >0.5 (mean =0.59) for performance vs perceived importance, 41% >0.5 (mean =0.47) for perceived ability vs performance and 12% >0.5 (mean =0.28) for perceived ability vs perceived importance.Conclusion: Measures of performance and perceived importance may have to be based primarily on their estimated clinical relevance for describing aspects of the ICF participation concept. With a clinimetric approach, parts of the studied items and domains may be used to investigate factors related to different patterns and levels of participation, and outcomes of rehabilitation.
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| 22. |
- Aspegren Kendall, Sally, et al.
(författare)
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Are perceived muscle tension, electromyographic hyperactivity and personality traits correlated in the fibromyalgia syndrome?
- 2002
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Ingår i: Journal of Rehabilitation Medicine. - Olso, Norway : Taylor & Francis. - 1650-1977 .- 1651-2081. ; 34:2, s. 73-79
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Tidskriftsartikel (refereegranskat)abstract
- The study was performed to investigate the relationship between perceived muscle tension and electromyographic hyperactivity and to what extent electromyographic (EMG) hyperactivity relates to personality traits in fibromyalgics. Thirty-six females with fibromyalgia performed isokinetic maximal forward flexions of the shoulder combined with surface EMG recordings of the trapezius and infraspinatus muscles. Signal amplitude ratio and peak torque were calculated in the initial and endurance test phases. Pain intensity, perceived general and local shoulder muscle tension, and personality traits using the Karolinska Scales of Personality were assessed pre-test. Neither perceived muscle tension nor muscular tension personality trait correlated with EMG muscle hyperactivity. Perceived general muscle tension correlated with aspects of anxiety proneness (including muscle tension) of the Karolinska Scales of Personality. Pain intensity interacted with many of the variables. We propose that when patients with fibromyalgia report muscle tension that they may be expressing something other than physiological muscle tension.
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| 23. |
- 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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| 24. |
- 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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| 25. |
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| 26. |
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| 27. |
- Bergstrom, Aileen L., et al.
(författare)
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Perceived occupational gaps one year after stroke : An explorative study
- 2012
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Ingår i: Journal of Rehabilitation Medicine. - Uppsala : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 44:1, s. 36-42
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To explore and describe factors associated with occupational gaps and to identify factors at 3 months that predict occupational gaps one year post-stroke. A gap, a restriction in participation, is considered to be present when there is a discrepancy between what the individual wants to do and what they actually do in everyday life. Design: Prospective longitudinal study. Subjects: Two hundred persons with stroke. Methods: Data from the Occupational Gaps Questionnaire, one year post-stroke, was used as the dependent variable in 3- and 12-month regression analyses. Domains of the Stroke Impact Scale, global life satisfaction, demographic and medical factors were used as independent variables. Results: At 3 months, activities of daily living abilities, social participation and not being born in Sweden predicted occupational gaps at 12 months. Stroke severity and not being born in Sweden and 3 factors at 12 months: social participation, self-rated recovery, and global life satisfaction were associated with occupational gaps. Conclusion: Activities of daily living ability at 3 months predicted occupational gaps after stroke. Thus, it is possible to identify early on, and provide interventions for, those that risk participation restrictions. Not being born in the country might be an indicator of a risk for participation restrictions.
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| 28. |
- Bergström, Aileen L., et al.
(författare)
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Participation in everyday life and life satisfaction in persons with stroke and their caregivers 3–6 months after onset
- 2015
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 47:6, s. 508-515
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To explore and describe persons with stroke and their caregivers' restrictions in participation in everyday occupations, i.e. occupational gaps, 3-6 months post-stroke, in relation to life satisfaction, combined life satisfaction, caregiver burden, perceived impact of stroke, and activities of daily living. Design: Cross-sectional study. Subjects: Persons with stroke and their caregivers (105 dyads). Methods: The Occupational Gaps Questionnaire, Life Satisfaction Checklist, Caregiver Burden Scale, Stroke Impact Scale and Barthel Index were used. Correlations were analysed with Spearman's rank, and regression analyses used life satisfaction as the dependent variable. Results: At least one person in 86% of the dyads perceived restrictions in participation, with the most common gap in travelling for pleasure. Correlations were low between the numbers of occupational gaps and life satisfaction (R=-0.33, R=-0.31); however, life satisfaction accounted for occupational gaps both for persons with stroke and for caregivers. A greater number of occupational gaps were perceived in the dyads with combined low levels of life satisfaction compared with those with combined high levels of life satisfaction. Conclusion: Participation in everyday occupations is related to life satisfaction even for caregivers of persons with stroke. The results of this study add to our knowledge about the stroke-caregiver dyad and will help to inform family-centred approaches within stroke rehabilitation.
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| 29. |
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| 30. |
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| 31. |
- Berzina, Guna, et al.
(författare)
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Exploration of some personal factors with the International Classification of Functioning, Disability and Health Core sets for stroke.
- 2013
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Ingår i: Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1651-2081. ; 45:7, s. 609-615
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to explore the influence of personal factors (i.e. age, gender, place of residence and time since onset of stroke) on self-perceived functioning and environmental factors, using the International Classification of Functioning, Disability and Health (ICF) Core Set for Stroke (extended version) as a framework. Design: Cross-sectional study. Participants: A total of 243 community-dwelling persons (53% men) with prior stroke (6 months to 13 years) with a mean age of 68 years (age range 24-95 years). Methods: Regression analysis of 4 personal factors (age, gender, place of residence, and time since onset of stroke) was used to explore their influence on different components, domains and categories of functioning and environmental factors, evaluated with the extended version of the Comprehensive ICF Core Set for Stroke. Results: The personal factors had statistically significant predictive values for almost all the categories, domains and components of functioning and environmental factors examined in this study. These factors influence self-perceived functional outcome and environmental factors in terms of being barriers or facilitators in various ways. Conclusion: Personal factors, such as age, gender, place of residence and time since onset of stroke, influence self-perceived functioning and environmental factors.
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| 32. |
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| 33. |
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| 34. |
- Bjerkefors, Anna, et al.
(författare)
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Assessment of abdominal muscle function in individuals with motor-complete spinal cord injury above T6 in response to transcranial magnetic stimulation.
- 2015
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 47:2, s. 138-146
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To use transcranial magnetic stimulation and electromyography to assess the potential for preserved function in the abdominal muscles in individuals classified with motor-complete spinal cord injury above T6. Subjects: Five individuals with spinal cord injury (C5-T3) and 5 able-bodied individuals. Methods: Transcranial magnetic stimulation was delivered over the abdominal region of primary motor cortex during resting and sub-maximal (or attempted) contractions. Surface electromyography was used to record motor-evoked potentials as well as maximal voluntary (or attempted) contractions in the abdominal muscles and the diaphragm. Results: Responses to transcranial magnetic stimulation in the abdominal muscles occurred in all spinal cord injury subjects. Latencies of muscle response onsets were similar in both groups; however, peak-to-peak amplitudes were smaller in the spinal cord injury group. During maximal voluntary (or attempted) contractions all spinal cord injury subjects were able to elicit electromyography activity above resting levels in more than one abdominal muscle across tasks. Conclusion: Individuals with motor-complete spinal cord injury above T6 were able to activate abdominal muscles in response to transcranial magnetic stimulation and during maximal voluntary (or attempted) contractions. The activation was induced directly through corticospinal pathways, and not indirectly by stretch reflex activations of the diaphragm. Transcranial magnetic stimulation and electromyography measurements provide a useful method to assess motor preservation of abdominal muscles in persons with spinal cord injury.
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| 35. |
- Bjerkefors, Anna, et al.
(författare)
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Trunk muscle activation in a person with clinically complete thoracic spinal cord injury.
- 2009
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Ingår i: Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1651-2081 .- 1650-1977. ; 41:5, s. 390-2
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of this study was to assess if, and how, upper body muscles are activated in a person with high thoracic spinal cord injury, clinically classified as complete, during maximal voluntary contractions and in response to balance perturbations. METHODS: Data from one person with spinal cord injury (T3 level) and one able-bodied person were recorded with electromyography from 4 abdominal muscles using indwelling fine-wire electrodes and from erector spinae and 3 upper trunk muscles with surface electrodes. Balance perturbations were carried out as forward or backward support surface translations. RESULTS: The person with spinal cord injury was able to activate all trunk muscles, even those below the injury level, both in voluntary efforts and in reaction to balance perturbations. Trunk movements were qualitatively similar in both participants, but the pattern and timing of muscle responses differed: upper trunk muscle involvement and occurrence of co-activation of ventral and dorsal muscles were more frequent in the person with spinal cord injury. CONCLUSION: These findings prompt further investigation into trunk muscle function in paraplegics, and highlight the importance of including motor tests for trunk muscles in persons with thoracic spinal cord injury, in relation to injury classification, prognosis and rehabilitation.
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| 36. |
- Björck van Dijken, Christina, et al.
(författare)
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Low back pain, lifestyle factors and physical activity: a population-based study.
- 2008
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 40:10, s. 864-869
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Tidskriftsartikel (refereegranskat)abstract
- Objective and designThe prevalence of low back pain was assessed in relation to physical activity, for both work and leisure activities, in a randomly selected population in the northern part of Sweden. Additionally, the associations between age, sex, level of education, lifestyle factors, demographic characteristics, and low back pain were evaluated. Subjects: A total of 5798 subjects aged 25–79 years were selected randomly from a geographically well-defined area in northern Sweden. Methods: Additional questions concerning people's experience of low back pain were added to the questionnaire of the World Health Organization MONICA (MONItoring of trends and determinants in CArdiovascular disease) health survey with the aim of investigating prevalence rates and factors associated with low back pain. Results: Forty-one percent of the participants reported having low back pain (of these 55% were women and 45% men). The prevalence rate was highest in the age group 55–64 years. Chronic low back pain was the most frequent occurring problem. Of those with low back pain, 43% of the women and 37% of the men reported having continuous low back pain for more than 6 months. Individuals with low back pain often experienced a more physically heavy workload at work and lower physical activity during leisure time, and they were also more likely to have been smokers, have had higher body mass index, lived in smaller communities, and were less educated than people without low back pain. Conclusion: Low back pain seems to be associated with physical activity at work and in leisure time, certain lifestyle factors and demographic characteristics.
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| 37. |
- Björkdahl, Ann, 1959, et al.
(författare)
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Can rehabilitation in the home setting reduce the burden of care for the next-of-kin of stroke victims?
- 2007
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Ingår i: J Rehabil Med. - : Medical Journals Sweden AB. ; 39:1, s. 27-32
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: More evidence of the efficacy of caregiver interventions is needed. The aim of this study was to evaluate whether counselling in the home setting reduces the caregiver burden. METHODS: Thirty-six patients after stroke, median age 53 years, with a close family member, were selected for an evaluation of the burden of care and 35 participated. They were part of a randomized controlled trial, comparing rehabilitation in the home setting with outpatient rehabilitation. In the home setting, counselling about the stroke and its consequences was included. Assessments with the Caregiver Burden scale were made at 3 weeks, 3 months and one year after discharge. RESULTS: The burden of the 2 groups did not differ. After the intervention, there was a tendency to a lower burden for the home setting. The burden for the home setting was then unchanged from 3 weeks to 1 year, while outpatient rehabilitation showed a reduced burden over time. For the home setting, significant correlations to activity level were seen after the intervention. CONCLUSION: A positive effect of counselling was seen, as the home setting burden tends to be lower after the intervention, while outpatient rehabilitation seems to adjust with time. The results suggest that counselling reduces burden and the remaining burden is associated with the patient's ability.
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| 38. |
- Björkdahl, Ann, 1959, et al.
(författare)
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Effect of very early supported discharge versus usual care on activi-ties of daily living ability after mild stroke: a randomized controlled trial.
- 2023
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Ingår i: Journal of rehabilitation medicine. - 1651-2081. ; 55
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Tidskriftsartikel (refereegranskat)abstract
- To examine the ability to perform basic and instrumental activities of daily life after very early supported discharge vs usual discharge and referral routine during the first year after mild stroke.A secondary analysis of data from the Gothenburg Very Early Supported Discharge randomized controlled trial. Patients: A total of 104 patients (56% men; mean (standard deviation) age 75 (11) years) who had experienced a first stroke classified as mild.The primary outcome was the Activities of Daily Living Taxonomy score. Stroke Impact Scale (activities of daily living, and mobility) scores was a secondary measure. Patients were randomized to either very early supported discharge with 4 weeks of home rehabilitation provided by a multidisciplinary stroke team, or a control group discharged according to usual routine (referral to primary care when needed). Assessments were performed at discharge, 4 weeks post-discharge, and 3 and 12 months post-stroke.Instrumental activities of the Activities of Daily Living Taxonomy scores (the lower the better) in the very early supported discharge and control groups were median 4 and 6 (p=0.039) at 4 weeks post-discharge and 3 and 4.5 (p=0.013 at 3 months post-stroke, respectively. Stroke Impact Scale (Mobility) median scores (the higher the better) in the very early supported discharge and control groups at 3 months were 97 and 86 (p=0.040), respectively. There were no group differences in the 2 outcomes at 12 months post-stroke.Compared with usual discharge routine, team-based rehabilitation during the first month at home is beneficial for instrumental activity in the subacute phase, in patients with mild stroke. One year post-stroke both groups show equal results.
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| 39. |
- Björkman, Anders, et al.
(författare)
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Sensory qualities of the phantom hand map in the residual forearm of amputees
- 2016
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1651-2081 .- 1650-1977. ; 48:4, s. 70-365
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Most amputees experience referred sensations, known as a phantom hand map, on the residual forearm, where touch on specific areas is perceived as touch on the amputated hand. The aim of this study was to evaluate the sensory qualities of the phantom hand map.METHODS: In 10 traumatic forearm-amputees touch thres-holds and discriminative touch of the phantom hand map were assessed and compared with corresponding areas on the contralateral forearm. The study assessed the localization of touch on the phantom hand map, and how distinct and similar to normal touch the referred feeling was.RESULTS: Similar touch thresholds were seen in the phantom hand map and the control site. Tactile discrimination, requiring both detection of stimulus and interpretation, was significantly better in the phantom hand map.CONCLUSION: This explorative study suggests that the phantom hand map and the superior tactile discrimination seen in the phantom hand map are based on adaptations within the brain. Further studies investigating the neural basis for the phantom hand map are needed.
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| 40. |
- Björkman Randström, Kerstin, et al.
(författare)
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Activity and participation in home rehabilitation : Older people's and family members perspectives
- 2013
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 45:2, s. 211-216
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To explore the experiences of older people and their supporting family members in relation to home rehabilitation, with a focus on activity and participation. Methods: Qualitative interviews were carried out with 6 older people and 6 family members at 1 and 6 months after the older person’s discharge to their home. Qualitative content analysis of the data was carried out. The International Classification of Functioning, Disability and Health provides a guiding framework for rehabilitation. Results: Informants’ experiences of home rehabilitation contributed to the formation of 6 categories: (i) living with a frail body; (ii) striving for well-being in daily life; (iii) being close at hand; (iv) feeling dependent in daily life; (v) struggling to carry on; and (vi) striving to be at home. Conclusion: Older people’s goals were to return to daily routines and to perform meaningful activities without feeling dependent on other people. Family members’ participation was crucial. Psychosocial support and autonomy were essential for facilitating activity and participation. Healthcare professionals should consider each individual’s unique experiences along with the significance of being at home.
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| 41. |
- Björnhagen, Viveca, et al.
(författare)
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Burn survivors' pulmonary and muscular impairment, exercise tolerance and return-to-work following medical-vocational rehabilitation : A long-term follow-up
- 2018
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 50:5, s. 465-471
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To follow up the long-term outcome in return-to-work (RTW) rate in burn-injury patients, and to determine the degree of impairment in pulmonary and muscular function and exercise tolerance. Design: A prospective, longitudinal follow-up study without a control group. Patients: Twenty-five burn-injury patients referred for medical-vocational rehabilitation. Methods: Return-to-work rate was followed after completed medical-vocational rehabilitation. Pulmonary function was evaluated with spirometry, diffusing capacity and radio spirometry. Exercise capacity was determined using a bicycle ergometer. Muscle functions evaluated in the arms and legs were: isokinetic torque, isometric strength, endurance and muscular strength utilization. Results: Return-to-work rate was 87%. During bicycle exercise tests the patients, on average, reached their expected workloads. The dominating lung function abnormality observed on lung scintigraphy was delayed wash-out time of inhaled radioactive xenon gas, suggesting airway obstruction. All tests of shoulder-flexor and knee-extensor muscle function showed large minimum-maximum differences. Mean isometric endurance of shoulder flexors was lower than mean of references, and isokinetic knee extensor torques were slightly lower. Conclusion: High return-to-work rates can be achieved after burn injury requiring hospital-ward care. Despite measurable impairments in muscle strength/endurance and pulmonary function in a substantial proportion of these patients, overall normal bicycle exercise capacity was observed except for a few cases.
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| 42. |
- Borg, Jorgen, et al.
(författare)
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RATIONALE AND DESIGN OF A MULTICENTRE, DOUBLE-BLIND, PROSPECTIVE, RANDOMIZED, EUROPEAN AND CANADIAN STUDY: EVALUATING PATIENT OUTCOMES AND COSTS OF MANAGING ADULTS WITH POST-STROKE FOCAL SPASTICITY
- 2011
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Ingår i: JOURNAL OF REHABILITATION MEDICINE. - : Foundation for Rehabilitation Information. - 1650-1977 .- 1651-2081. ; 43:1, s. 15-22
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This report describes the design of a study aiming to provide evidence for the extended use of botulinum toxin A (BOTOX(R), Allergan Inc.) in focal post-stroke upper and lower limb spasticity and to evaluate the impact of incorporating botulinum toxin A treatment into the rehabilitation of patients with spasticity. Design: International, prospective, randomized, double-blind, placebo-controlled study with an open-label extension. Methods: Approximately 300 adults with a stroke occurring 23 months before screening, presenting with symptoms and signs of an upper motor neuron syndrome and focal spasticity-related functional impairment, were randomized to botulinum toxin A+standard care or placebo+standard care. Study medication was administered at baseline and again at Week 12 if required, with follow-up to 52 weeks. The primary endpoint was the number of patients who achieved their investigator-rated principal active functional goal (as measured by Goal Attainment Scaling), at 10 weeks after the second injection (Weeks 22-34) or at the 24-week visit if no second injection was administered. Secondary endpoints included changes from baseline in level of goal achievement, health-related quality of life and resource utilization. Conclusion: The BOTOX(R) Economic Spasticity Trial (BEST) will provide information regarding clinical and cost-effectiveness of botulinum toxin+standard care vs standard care alone in patients with upper and/or lower limb post-stroke spasticity typically seen in clinical practice.
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| 43. |
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| 44. |
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| 45. |
- Botö, Sara, et al.
(författare)
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Physical inactivity after stroke: Incidence and early predictors based on 190 individuals in a 1-year follow-up of the Fall Study of Gothenburg.
- 2021
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Ingår i: Journal of rehabilitation medicine. - : Medical Journals Sweden AB. - 1651-2081. ; 53:9
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Tidskriftsartikel (refereegranskat)abstract
- To determine the incidence of physical inactivity and factors prior to stroke and in acute stroke that are associated with physical inactivity 1 year after stroke Design: Prospective longitudinal cohort Patients: A total of 190 consecutively included individuals with acute stroke Methods: A follow-up questionnaire, relating to physical activity level using the Saltin-Grimby Physical Activity Scale, was sent to participants in The Fall Study of Gothenburg 1 year after stroke. Predictors of physical inactivity at baseline were identified using univariable and multivariable logistic regression analyses.Physical inactivity 1 year after stroke was reported by 70 (37%) of the 190 patients who answered the questionnaire and was associated with physical inactivity before the stroke, odds ratio (OR) 4.07 (95% confidence interval (95% CI) 1.69-9.80, p=0.002); stroke severity (assessed by National Institutes of Health Stroke Scale (NIHSS), score 1-4), OR 2.65 (95% CI) 1.04-6.80, p=0.042) and fear of falling in acute stroke, OR 2.37 (95% CI 1.01-5.60, p=0.048).Almost 4 in 10 participants reported physical inactivity 1 year after stroke. Physical inactivity before the stroke, stroke severity and fear of falling in acute stroke are the 3 main factors that predict physical inactivity 1 year after stroke.
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| 46. |
- Brandt, Ase, et al.
(författare)
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Towards an instrument targeting mobility-related participation: Nordic cross-national reliability
- 2008
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1651-2081 .- 1650-1977. ; 40:9, s. 766-772
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate test-retest reliability and internal consistency of a new instrument for evaluation of mobility device interventions. Material and methods: The instrument comprised 4 scales and one summed index. Two test-retest interviews involved 147 mobility device users (mean age 60 years) with a broad range of functional limitations, living at home. Results: For 2 scales and the summed index the reliability was substantial or almost perfect (K 0.71/ K-W 0.76/intraclass correlation coefficient = 0.93; confidence interval = 0.90-0.95). The reliability of one scale was moderate (K-w 0.4 1), but after reduction of grades and combination with another scale, it was substantial (K-w 0.66). The reliability of the fourth scale was moderate (K-w 0.55). The internal consistency of 3 scales varied from a 0.63 to 0.76. Conclusion: Even thou,,h the test-retest reliability of all but one of the scales of the new instrument was substantial to almost perfect, this study demonstrated that revision is required. The challenges identified were probably due to the highly complex relationship between outdoor participation while using mobility devices and accessibility to the outdoor physical environment. Thus. based on the results of this study the instrument will be revised and subsequently launched as the "Nordic mobility-related participation outcome evaluation of assistive device intervention" (NOMO instrument). More research on the concept of mobility-related participation and the psychometric qualities of the instrument is required.
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| 47. |
- Brandt, Åse, et al.
(författare)
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Older people's use of powered wheelchairs for activity and participation
- 2004
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1651-2081 .- 1650-1977. ; 36:2, s. 70-77
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aims of this study were to investigate outcomes of older people's use of powered wheelchairs and risk factors for negative outcomes. Design: The study was a cross-sectional interview-study including 111 powered wheelchair users over 65 years of age. Results: All participants used their powered wheelchair in the summer; nearly all users regarded it as important and found that it gave them independence. The wheelchair made activity and participation possible for the users. The most frequent activity in the summer was going for a ride, and in the winter it was shopping. However, some could not use the wheelchair for visits, and supplementary travel modes are called for. Users who could not walk at all or who could not transfer without assistance were more likely not to be able to carry out prioritized activities. Furthermore, other risk factors for negative outcomes and need for further research were identified. Conclusion: The use of powered wheelchairs is a relevant societal intervention in relation to older people with limited walking ability in order to make activity and participation possible. It is likely that a larger proportion of older people could benefit from this intervention, in particular if current practices are improved taking activity and participation outcomes into consideration.
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| 48. |
- Brogårdh, Christina, et al.
(författare)
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Experiences of falls and strategies to manage the consequences of falls in persons with late effects of polio : A qualitative study
- 2017
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 49:8, s. 652-658
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To explore how persons with late effects of polio experience falls and what strategies they use to manage the consequences of falls. Design: A qualitative study with face-To-face interviews. Data were analysed by systematic text condensation. Participants: Fourteen ambulatory persons (7 women; mean age 70 years) with late effects of polio. Results: Analysis resulted in one main theme, "Everyday life is a challenge to avoid the consequences of falls", and 3 categories with 7 subcategories. Participants perceived that falls were unpredictable and could occur anywhere. Even slightly uneven surfaces could cause a fall, and increased impairments following late effects of polio led to reduced movement control and an inability to adjust balance quickly. Physical injuries were described after the falls, as well as emotional and psychological reactions, such as embarrassment, frustration and fear of falling. Assistive devices, careful planning and strategic thinking were strategies to prevent falls, together with adaptation and social comparisons to mitigate the emotional reactions. Conclusion: Experiences of falls greatly affect persons with late effects of polio in daily life. To reduce falls and fall-related consequences both problemfocused and emotion-focused strategies are used. In order to increase daily functioning, these findings should be included in a multifaceted falls management programme.
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| 49. |
- Brogårdh, Christina, et al.
(författare)
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Mode of hand training determines cortical reorganisation: A randomized controlled study in healthy adults
- 2010
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1651-2081 .- 1650-1977. ; 42:8, s. 789-794
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate two commonly used forms of hand training with respect to influence on dexterity and cortical reorganization. Subjects: Thirty healthy volunteers (mean age 24.2 years). Methods: The subjects were randomized to 25 min of shaping exercises or general activity training of the non-dominant hand. The dexterity and the cortical motor maps (number of excitable positions) of the abductor pollicis brevis muscle were evaluated pre- and post-training by the Purdue Peg Board test and transcranial magnetic stimulation, respectively. Results: After shaping exercises the dexterity increased significantly (p <= 0.005) for both hands, mostly so in the non-dominant hand. The cortical motor map of the abductor pollicis brevis muscle shifted forwardly into the pre-motor area without expanding. After general activity training, no significant improvements in dexterity were found for the non-dominant hand. The cortical motor map of the non-dominant abductor pollicis brevis muscle expanded significantly (p = 0.03) in the posterior (sensory) direction. Conclusion: These results indicate that shaping exercises, but not general activity training, increase dexterity of the trained non-dominant hand in parallel with a shift of location of active transcranial magnetic stimulation positions. Shifts of active cortical areas might be important for the interpretation of brain plasticity in common behavioural tasks.
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| 50. |
- Brogårdh, Christina, et al.
(författare)
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Shortened constraint-induced movement therapy in subacute stroke - no effect of using a restraint : a randomized controlled study with independent observers
- 2009
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Ingår i: Journal of Rehabilitation Medicine. - : Stiftelsen Rehabiliteringsinformation. - 1650-1977 .- 1651-2081. ; 41:4, s. 231-236
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To examine the effect of using a mitt during shortened constraint-induced movement therapy for patients in the subacute phase after stroke.Subjects: Twenty-four patients with stroke (mean age 57.6 (standard deviation 8.5) years; average 7 weeks post-stroke) with mild to moderate impaired hand function.Methods: The patients were randomized to mitt use or no mitt use on the less affected hand for 90% of waking hours for 12 days. All patients received 3 h of arm and hand training per day for 2 weeks. Assessments were made by blinded observers using the modified Motor Assessment Scale, the Sollerman hand function test, the 2-Point Discrimination test and Motor Activity Log test.Results: Patients in both groups showed significant improvements in arm and hand motor performance and on self-reported motor ability after 2 weeks of therapy and at 3 months follow-up. However, no statistically significant differences between the groups were found in any measures at any point in time.Conclusion: In this study, no effect of using a restraint in patients with subacute stroke was found. Thus, this component in the constraint-induced therapy concept seems to be of minor importance for the outcome.
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