| 1. |
- Algurén, Beatrix, et al.
(författare)
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A Multidisciplinary Cross-Cultural Measurement of Functioning After Stroke : Rasch Analysis of the Brief ICF Core Set for Stroke
- 2011
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Ingår i: Topics in Stroke Rehabilitation. - : Informa UK Limited. - 1074-9357 .- 1945-5119. ; 18:6, s. 573-586
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To investigate the possibility of constructing a multiprofessional cross-cultural measure of functioning after stroke across categories of the International Classification of Functioning, Disability and Health (ICF). Method: Data on 757 stroke survivors from China, Germany, Italy, and Sweden, including ratings of 15 categories from the Brief ICF Core Set for stroke, were analyzed using the Rasch model. Unidimensionality, reliability, fit of the ICF categories to the model, ordering of response options of the ICF qualifier, and presence of differential item functioning (DIF) were studied. Results: Of the 15 ICF categories, response options for 7 categories were collapsed, 5 categories were deleted due to misfit, and 4 ICF categories showed DIF for country and were accordingly split into country-specific categories. The proposed final clinical measure consists of 20 ICF categories (6 categories were country-common) with an overall fit statistic of χ2180 = 184.87, P = .386, and a person separation index of r = 0.72, which indicates good reliability. Based on an individual's functioning after stroke, the ratings across the different ICF categories can be summed on an interval scale ranging from 0 to 100. Conclusion: A construction of a cross-cultural clinical measure after stroke based on ICF categories across body functions, structures, and activities and participation was possible. With this kind of clinical measure, stroke survivors' functional levels can be compared even across countries. Despite the promising results, further studies are necessary to develop definitive measures based on ICF categories.
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| 2. |
- Bergqvist, Gunilla M, et al.
(författare)
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Authors' response.
- 2019
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Ingår i: Topics in stroke rehabilitation. - : Informa UK Limited. - 1945-5119 .- 1074-9357. ; 27:2
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Tidskriftsartikel (refereegranskat)
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| 3. |
- Bergqvist, G. M., et al.
(författare)
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Inter-rater reliability of the Swedish modified version of the Postural Assessment Scale for Stroke Patients (SwePASS) in the acute phase after stroke
- 2019
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Ingår i: Topics in Stroke Rehabilitation. - : Informa UK Limited. - 1074-9357 .- 1945-5119. ; 26:5, s. 366-372
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Tidskriftsartikel (refereegranskat)abstract
- Background: Before implementation of the new scale, the Swedish modified version of the Postural Assessment Scale for Stroke Patients (SwePASS), to clinical practice, it is fundamental to analyze its measurement properties.Objective: To examine the inter-rater reliability of the SwePASS in the acute phase after stroke. Methods: Day 3 to day 7 after admission to a stroke unit, 64 persons with stroke were assessed twice, using the SwePASS, by two physiotherapists. Inter-rater reliability was determined using percentage-agreement and the rank-invariant method: relative position, relative concentration, and relative rank variance. Results: The raters showed a percentage agreement of >= 75% in the assessments using the SwePASS. For 9 of the 12 items, the percentage agreement was >80%. For 8 of the 12 items, there was a statistically significant change in position, revealed in relative position values between 0.08 and 0.15. Three items had statistically significant positive relative concentration values between -0.11 and 0.10. Except for a statistically significant negligible relative variance value of 0.01 for the items 1 and 8, there was no relative variance. Conclusions: The SwePASS shows an acceptable inter-rater reliability, albeit with potential for improvement. The reliability can be improved by a consensus how to interpret the scale between the raters prior to implementation in the clinic.
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| 4. |
- Blane, Alison, et al.
(författare)
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Investigating cognitive ability and self-reported driving performance of post-stroke adults in a driving simulator
- 2018
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Ingår i: Topics in Stroke Rehabilitation. - : Taylor & Francis. - 1074-9357 .- 1945-5119. ; 25:1, s. 44-53
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Tidskriftsartikel (refereegranskat)abstract
- Background: Safe driving is a complex activity that requires calibration. This means the driver can accurately assess the level of task demand required for task completion and can accurately evaluate their driving capability. There is much debate on the calibration ability of post-stroke drivers.Objectives: The aim of this study was to assess the cognition, self-rated performance, and estimation of task demand in a driving simulator with post-stroke drivers and controls.Methods: A between-groups study design was employed, which included a post-stroke driver group and a group of similarly aged older control drivers. Both groups were observed driving in two simulator-based driving scenarios and asked to complete the NASA Task Load Index (TLX) to assess their perceived task demand and self-rate their driving performance. Participants also completed a battery of psychometric tasks to assess attention and executive function, which was used to determine whether post-stroke cognitive impairment impacted on calibration.Results: There was no difference in the amount of perceived task demand required to complete the driving task. Despite impairments in cognition, the post-stroke drivers were not more likely to over-estimate their driving abilities than controls. On average, the post-stroke drivers self-rated themselves more poorly than the controls and this rating was related to cognitive ability.Conclusion: This study suggests that post-stroke drivers may be aware of their deficits and adjust their driving behavior. Furthermore, using self-performance measures alongside a driving simulator and cognitive assessments may provide complementary fitness-to-drive assessments, as well as rehabilitation tools during post-stroke recovery.
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| 5. |
- Bråndal, Anna, 1966-, et al.
(författare)
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Reliability and validity of the Swedish Fatigue Assessment Scale when self-administrered by persons with mild to moderate stroke
- 2016
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Ingår i: Topics in Stroke Rehabilitation. - : Informa UK Limited. - 1074-9357 .- 1945-5119. ; 23:2, s. 90-97
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To examine internal consistency, test-retest reliability, floor/ceiling effects and construct validity of the Fatigue Assessment Scale (FAS), when self-administrated by persons with mild to moderate stroke.Method: The FAS was translated into Swedish and tested for psychometric properties when self-administrated by persons with mild to moderate stroke. Participants, consequently selected from the stroke unit admission register received a letter with three questionnaires: the FAS, Short Form Health Survey (SF-36) subscale for vitality and Geriatric Depression Scale, GDS-15. Within two weeks, a second letter with FAS was sent for re-test.Result: Seventy-tree persons with mild to moderate stroke participated in the study. Internal consistency was good (Cronbach’s alpha 0.82). The test and retest reliability of individual items showed that five items out of 10 items were good (weighted kappa > 0.60), four were moderate (0.40-0.60), and one was fair (0.22). The relative reliability between total scores was good (ICC 3.1 = 0.73) and the absolute reliability was nine points, meaning that a change of at least nine points in total score implies a real change of fatigue level. Correlation analysis showed that the Swedish FAS correlated with the SF-36 subscale for vitality (rs = - 0.73) and GDS-15 (rs = 0.62), suggesting convergent construct validity. There were no floor or ceiling effects.Conclusion: The Swedish translation of the FAS used as a self-administrated questionnaire is reliable and valid for measuring fatigue in persons with mild to moderate stroke.
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| 6. |
- Bunketorp Käll, Lina, 1975, et al.
(författare)
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Multimodal rehabilitation in the late phase after stroke enhances the life situation of informal caregivers
- 2018
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Ingår i: Topics in Stroke Rehabilitation. - : Informa UK Limited. - 1074-9357 .- 1945-5119. ; 25:3, s. 161-167
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The burden of caregiving for stroke survivors is well known, but the effect of late stroke rehabilitation on the life situation of informal caregivers is unknown. Here, we assessed changes in the life situation of informal caregivers of stroke survivors enrolled in a multimodal intervention trial. Methods: This controlled study was a questionnaire-based survey accompanying a three-armed randomized controlled trial of 123 stroke survivors. The care recipients of 106 caregivers who chose to participate were assigned to rhythm-and-music-based therapy (R-MT; n = 37), horse-riding therapy (H-RT; n = 37), or delayed intervention (control group, n = 32). Perceived changes in the life situation of the caregivers were evaluated with the Life Situation among Spouses after the Stroke Event (LISS) questionnaire before randomization, after the 12-week intervention, and 3 and 6 months later. Results: After the intervention, the change in the median LISS score was significantly higher among intervention caregivers (1.5 [interquartile range (IQR) 8.8]) than controls (1.5 [IQR 8.8] vs. 0.0 [IQR 12.0], p = 0.036). The improvement was maintained at 3 months (1.5 [IQR 9.0] vs. 0.0 [IQR 10.5], p = 0.039) but not at 6 months (p = 0.284). Conclusion: Engaging stroke survivors in multimodal interventions late after stroke appears to have potential to produce gains also in the general life situation of informal caregivers.
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| 7. |
- Dalvandi, Asghar, et al.
(författare)
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Rehabilitation Experts' Experience of Community Rehabilitation Services for Stroke Survivors in Iran
- 2012
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Ingår i: Topics in Stroke Rehabilitation. - : Informa UK Limited. - 1074-9357 .- 1945-5119. ; 19:5, s. 395-404
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Successful stroke rehabilitation is a complex process involving teamwork by members of several professions. The aims of this study were to explore the experiences of Iranian rehabilitationexperts concerning community rehabilitation services for stroke survivors and obtain their opinions on how to further develop and improve these services. Method: A qualitative research method with grounded theory was used, including purposive and theoretical sampling. A constant comparative analysis was conducted. Data were gathered from 2 focus group discussions including 10 Iranian rehabilitation experts and 4 in-depth individual interviews. Results: Nonintegrated rehabilitation services emerged as the core concept of the study. The explored concepts were identified as deficiently allocated budget, inadequate public insurance, lack of availability of rehabilitative care, negative public opinion, lack of consistency in care, and split services and professional separation. Areas identified for potential improvement included need to change policymakers' attitudes, need to refine rehabilitation in the health care system, need to establish a registration system, need to provide information and skills, and need to see the family as a whole. Conclusion: Experts should participate in educational rehabilitation programs to become more aware of current rehabilitationservices within the community. Stroke survivors and their families should also participate in the rehabilitation programs as this would allow them to gain knowledge and skills for dealing withstroke management. This can help reduce problems, change public opinion, and eliminate mistrust between health care providers and families.
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| 8. |
- Dias, Caroline Pieta, et al.
(författare)
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Impaired mechanical properties of Achilles tendon in spastic stroke survivors : an observational study.
- 2019
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Ingår i: Topics in Stroke Rehabilitation. - : Taylor & Francis. - 1074-9357 .- 1945-5119. ; 26:4, s. 261-266
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The spasticity could lead to decreased functional capacity and changes in musculoskeletal tissue.OBJECTIVE: To compare the Achilles tendon properties between the affected and contralateral limbs of participants with spasticity due to stroke and the healthy subjects.METHODS: Fifteen individuals with ankle spasticity due to stroke and 15 healthy subjects were recruited. Maximal isometric ankle joint torque was obtained with an isokinetic dynamometer, and an ultrasound was used to determine tendon length, tendon cross-sectional area, and the medial gastrocnemius myotendinous junction displacement. The Achilles tendon strength, displacement, stress, strain, stiffness, and Young's modulus were obtained during a maximum voluntary isometric plantarflexion contraction.RESULTS: There were no differences between Achilles tendon length among participants. Both limbs of participants with stroke showed reduced tendon cross-sectional area (~18%) compared to healthy limb. The affected limb showed decreased tendon strength (686 ± 293.3 N), displacement (10.6 ± 1.7 mm), Young's modulus values (849 ± 235.6 MPa), and lower stiffness (196.6 ± 67.6 N/mm) compared to the contralateral limb (strength, 1357.1 ± 294.8 N; displacement, 15.2 ± 5.5 mm; Young's modulus, 1431.8 ± 301.9 MPa; stiffness, 337.5 ± 98.1 N/mm) and to the healthy limb. The contralateral limb also showed decreased tendon strength (~26.2%) and stiffness (~21.5%) compared to the healthy group.CONCLUSION: There is a decrement in Achilles tendon morphological and mechanical properties of the affected limb in individuals with spasticity due to stroke. The contralateral limb had a thinner tendon more compliant likely to physical activity reduction.
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| 9. |
- Ekstrand, Elisabeth, et al.
(författare)
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Clinical interpretation and cutoff scores for manual ability measured by the ABILHAND questionnaire in people with stroke.
- 2023
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Ingår i: Topics in stroke rehabilitation. - : Informa UK Limited. - 1945-5119 .- 1074-9357. ; 30:1, s. 21-31
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Tidskriftsartikel (refereegranskat)abstract
- The ABILHAND questionnaire is recommended to assess perceived manual ability after stroke; however, more knowledge on interpretability is needed to improve the clinical applicability.To determine clinically meaningful cutoff scores for different levels of perceived manual ability, assessed by ABILHAND, corresponding to established observed and perceived upper extremity assessments post stroke.This cross-sectional study, part of the Stroke Arm Longitudinal Study (SALGOT) at the University of Gothenburg, included 80 participants with upper extremity impairments after stroke. The self-reported upper extremity functioning was assessed with ABILHAND and Stroke Impact Scale Hand (SIS Hand), and the observed functioning was assessed by Fugl-Meyer Assessment for Upper Extremity (FMA-UE) and Action Research Arm Test (ARAT) at 3months after stroke. Receiver operating characteristic curve, sensitivity, and specificity analyses were used to determine the cutoffs.The overall discriminating accuracy was excellent (AUC > 0.90) for most of the cutoffs and sensitivity and specificity values ranged from 0.73 to 1.0. The ABILHAND cutoff score 1.78 discriminated well between low and good functioning resulting in a 95% match with SIS Hand and 87.5% match with ARAT and FMA-UE.The determined cutoff scores of the ABILHAND, validated through established upper extremity assessments, will provide a useful tool to clinicians when interpreting the logit scores and when selecting individualized treatment options. ABILHAND matched well with self-reported SIS Hand, but discrepancies found with observed scales implies that self-perceived assessments should be complemented with observed assessments.
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| 10. |
- Ekstrand, Elisabeth, et al.
(författare)
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Grip strength is a representative measure of muscle weakness in the upper extremity after stroke
- 2016
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Ingår i: Topics in Stroke Rehabilitation. - : Informa UK Limited. - 1074-9357 .- 1945-5119. ; 23:6, s. 400-405
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Muscle weakness is the most common impairment in the upper extremity after stroke, leading to a reduced ability to use the arm and the hand in daily activities. Grip strength is easier to measure than precise, but more time-consuming, isokinetic and isometric arm muscle strength measurements. It would therefore be advantageous in a clinical setting if grip strength could be used as a proxy for muscle strength in the entire upper extremity.OBJECTIVE: To investigate the association between grip strength and isometric and isokinetic arm muscle strength in persons with chronic stroke.METHODS: Forty-five persons with mild-to-moderate paresis in the upper extremity, at least 6 months post-stroke participated. Isometric grip strength was measured with a computerized grip dynamometer and arm strength (isometric shoulder abduction and elbow flexion as well as isokinetic elbow extension and flexion) with an isokinetic dynamometer. Pearson's correlation coefficient was used to determine the association between the muscle strength measurements.RESULTS: There were significant correlations (p < .0001) between grip strength and all arm strength measurements in both the more affected (r = 0.77-0.82) and the less affected upper extremity (r = 0.65-0.82).CONCLUSION: This cross-sectional study showed that grip strength is strongly associated with muscle strength in the arm in persons in the chronic phase after stroke. As grip strength is easy to measure and less time-consuming than arm muscle strength measurements, this implies that grip strength can be a representative measure of muscle weakness of the entire upper extremity in the chronic phase after stroke.
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| 11. |
- Eriksson, Gunilla, et al.
(författare)
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Occupational gaps in everyday life one year after stroke : association with life satisfaction and impact of stroke
- 2012
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Ingår i: Topics in Stroke Rehabilitation. - Birmingham, USA : Thomas Land Publishers Inc. - 1074-9357 .- 1945-5119. ; 19:3, s. 244-255
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To examine the presence, frequency, and distribution of occupational gaps and to explore whether there are associations between occupational gaps and life satisfaction, self-rated recovery, and functioning and participation in activities of daily living (ADLs) 1 year after stroke.Method: Data were collected at onset and at 12 months after stroke from 161 patients admitted to a stroke unit in central Sweden by using Occupational Gaps Questionnaire, LiSat-11, Stroke Impact Scale, Katz ADL Index, and Barthel Index. Spearman rank correlation and Mann Whitney U test were used in the analyses.Results: Occupational gaps were reported by 87% of the participants. The number of occupational gaps was moderately associated with participation and self-rated recovery. There was a significant difference in the number of occupational gaps between the participants who were independent in ADLs and those who were not, both at baseline and at 12 months after stroke. There was, however, no significant association between occupational gaps and life satisfaction.Conclusions: Occupational gaps 1 year after stroke are very common, particularly among individuals experiencing difficulties in ADLs. Increased efforts are vital to enable individuals to do the activities that are important to them, irrespective of whether these are instrumental ADLs or leisure or social activities. Occupational gaps could be reduced by developing rehabilitation interventions that enable desired activities in different contexts that are crucial for individual patients.
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| 12. |
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| 13. |
- Fordell, Helena, et al.
(författare)
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RehAtt – scanning training for neglect enhanced by multi-sensory stimulation in Virtual Reality
- 2016
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Ingår i: Topics in Stroke Rehabilitation. - : Taylor & Francis Group. - 1074-9357 .- 1945-5119. ; 23:3, s. 191-199
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is a lack of effective treatment for neglect. We have developed a new training method, RehAtt (TM). The objective of this study was to determine whether RehAtt (TM) improves spatial attention in chronic neglect after stroke. Methods: RehAtt (TM) consists of a computer with monitor, 3D glasses, and a force feedback interface (Robotic pen) giving sensory motor activation to the contra-lesional arm. The software combines visual scanning training with multi-sensory stimulation in 3D virtual reality (VR) game environment. Fifteen stroke patients with chronic neglect (duration > 6 month) had repeated baseline evaluations to confirm stability of symptoms. There were no test-retest effects for any of the tests. Thereafter, all patients trained 15 h in RehAtt (TM) (3 x 1 h for 5 weeks). A neglect test battery and Catherine Bergego Scale, CBS, were used to assess behavioral outcome after intervention. CBS was also used at a 6-month follow-up. Results: Using repeated measurement analysis improvements due to the training were found for Star cancellation test (p = 0.006), Baking tray task (p < 0.001), and Extinction test (p = 0.05). In the Posner task improvements were seen fewer missed targets (p = 0.024). CBS showed improvements in activities of daily life immediately after training (p < 0.01). After 6 months the patients still reported improvement in CBS. Conclusion: RehAtt (TM) is a new concept for rehabilitation of neglect. Training with the VR-method improved spatial attention and showed transfer to improved spatial attention in activities of daily living in chronic neglect. Our results are promising and merit further studies.
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| 14. |
- Hamre, Charlotta, et al.
(författare)
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Impairments in spatial navigation during walking in patients 70 years or younger with mild stroke
- 2020
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Ingår i: Topics in Stroke Rehabilitation. - : Taylor & Francis. - 1074-9357 .- 1945-5119. ; 27:8, s. 601-609
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Tidskriftsartikel (refereegranskat)abstract
- Background: Spatial navigation, the ability to determine and maintain a route from one place to another, is needed for independence in everyday life. Knowledge about impairments in spatial navigation in people with mild stroke is scarce.Objectives: To explore impairments in spatial navigation in patients ≤70 years after first-ever mild ischemic stroke (NIHSS≤3) and to explore which variables are associated with these impairments 12 months later.Methods: Patients were examined in the acute phase, and after 3 and 12 months. To assess impairments in spatial navigation, we used the Floor Maze Test (FMT), with time and FMT-errors as outcomes. Patients' perceived navigational skills were collected using self-report. Logistic regression was used to explore which variables (sociodemographic data, stroke characteristics, cognition, and mobility) were associated with impaired navigation ability.Results: Ninety-seven patients (20 females) were included. The mean (SD) age was 55.5 (11.4) years. Timed FMT improved significantly from the acute phase to 12 months (p = <.001). At 12 months, 24 (24.7%) of the participants walked through the maze with errors, and 22 (22.7%) reported spatial navigational problems. The Trail Making Test (TMT)-B was the only variable from the acute phase associated with FMT-errors at 12 months, and being female was the only variable associated with self-reported navigational problems at 12 months.Conclusion: Nearly one in four patients experienced spatial navigation problems 12 months after a mild stroke. Executive function (TMT-B), measured in the acute phase, was associated with navigational impairments (FMT-errors) at 12 months, and being female was associated with self-reported navigational problems.
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| 15. |
- Hyden, Lars- Christer
(författare)
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The Importance of Providing Scaffolding to Support Patient Narratives When Brain Damage Impairs Storytelling Ability
- 2011
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Ingår i: TOPICS IN STROKE REHABILITATION. - : Thomas Land Publishers. - 1074-9357 .- 1945-5119. ; 18:1, s. 52-54
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Tidskriftsartikel (refereegranskat)abstract
- Boundaries connected to illness are defined and redefined through new ways of interacting with other people and especially by storytelling and listening to the stories of others. Diseases or traumas that affect the brain can result in memory loss, impaired cognition, and difficulties in expressing oneself clearly, hence making it difficult to present and negotiate identities. In such situations, others often try to remediate the communicative problems by taking over those narrative functions that are lost or impaired and thereby scaffolding the injured persons storytelling capacity. This narrative scaffolding is directed at keeping interpersonal relationships functional and makes it possible for persons with communicative disabilities to continue to be participants in a shared life.
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| 16. |
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| 17. |
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| 18. |
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| 19. |
- Labori, Frida, et al.
(författare)
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The impact of stroke on spousal and family income : a difference-in-difference study from Swedish national registries
- 2024
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Ingår i: Topics in Stroke Rehabilitation. - : Taylor & Francis. - 1074-9357 .- 1945-5119. ; 31:4, s. 381-389
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Tidskriftsartikel (refereegranskat)abstract
- AimTo investigates the financial consequences in the overall population spouses of persons with stroke in Sweden as well as for subgroups based on spouses age, sex and modified Rankin Scale (mRS) of the person with stroke.MethodsThe study population consists of spouses aged <= 60 during the year of their partner's stroke event. Each spouse was matched to four reference individuals. This longitudinal registry data covers spouses and a reference population between 2005 and 2016. We use difference-in-differences to estimate the impact on individual income from paid work, disposable individual income, and disposable family income.ResultsThe primary analysis shows a small and statistically insignificant decrease on spouses' individual income from paid work and disposable individual income. In the subgroup analysis based on mRS, the largest effect is seen in mRS 4-5, where spouses' individual income from paid work and disposable individual income increases after their partner's stroke. Further, younger female spouses' individual income from paid work decreases by 1 614 EUR (p = 0.008) on average.ConclusionThe financial consequences are small in the overall population of spouses. However, for some subgroups, younger women, and spouses of persons with stroke and mRS 4-5, the financial consequences are more prominent.
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| 20. |
- Larén, Amanda, et al.
(författare)
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Fear of falling in acute stroke: The Fall Study of Gothenburg (FallsGOT)
- 2018
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Ingår i: Topics in Stroke Rehabilitation. - : Informa UK Limited. - 1074-9357 .- 1945-5119. ; 25:4, s. 256-260
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Little is known about which factors are associated with a patient’s fear of falling (FoF) after acute stroke. The aim of this study was to investigate baseline variables and their association with FoF during rehabilitation in acute stroke. Patients and methods: The study population consisted of the 462 patients with acute stroke who were admitted to a stroke unit, included in the observational study “The Fall Study in Gothenburg (FallsGOT)” and were able to answer a single question: “Are you afraid of falling?” (Yes/No). To analyze any association between FoF and clinical variables, univariable and multivariable stepwise multiple logistic regression analyses were performed. Results: In the stepwise multivariable regression analysis, only female sex (OR=2.25 [95% confidence interval (CI) 1.46–3.46, p=0.0002]), the use of a walking aid (OR 3.40, [95% CI 2.12–5.43, p<0.0001]), and postural control as assessed with the SwePASS total score were statistically significant associated with FoF. Among patients with a SwePASS score of 24 or less, the OR was 9.41 [95% CI 5.13–17.25, p<0.0001] for FoF compared to patients with a SwePASS score of 31 or above; among the patients with a SwePASS score of 25–30, the OR was 2.29 [95% CI=1.36–3.83, p=0.0017]. Conclusions: Our findings provide valuable insight for those involved in stroke rehabilitation during the acute phase after stroke. FoF is associated with poor postural control, female sex and the use of a walking aid. © 2018 Informa UK Limited, trading as Taylor & Francis Group.
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| 21. |
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| 22. |
- Löfgren, Britta, et al.
(författare)
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Rehabilitation of stroke patients who are older and severely affected: short- and long-term perspectives
- 2000
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Ingår i: Topics in Stroke Rehabilitation. - 1074-9357 .- 1945-5119. ; 6:4, s. 20-29
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Tidskriftsartikel (refereegranskat)abstract
- This review has focused on older and severely affected patients. The following aspects have been studied: the suffering of a stroke, experiences of stroke units, rehabilitation, long-term perspective, and psychological well-being. The conclusion is that older and severely affected patients can make substantial progress during rehabilitation. Most patients can maintain or even improve this progress in the long-term perspective. The review shows that many can stay in independent living with support from home help services and relatives, home adjustments, and assistive devices. In long-term follow-ups, some indications show that stroke patients assess their psychological well-being as good, or fairly good, but detection and treatment of depression are essential
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| 23. |
- Ma, Christina Zong-Hao, et al.
(författare)
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Changes in gait and plantar foot loading upon using vibrotactile wearable biofeedback system in patients with stroke
- 2018
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Ingår i: Topics in Stroke Rehabilitation. - : Taylor & Francis. - 1074-9357 .- 1945-5119. ; 25:1, s. 20-27
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patients with stroke walk with excessive foot inversion at the affected side, which may disturb their balance and gait.Objectives: This study aimed to investigate the effects of instant biofeedback of plantar force at the medial and lateral forefoot regions on gait and plantar foot loading in patients with stroke.Methods: A total of eight patients with hemiplegic stroke, who had flexible rearfoot varus deformity at the affected side, participated in this study. A vibrotactile biofeedback system was developed and evaluated. It analyzed forces at the medial and lateral forefeet, and instantly provided vibration clues when the plantar force at medial forefoot was less than a threshold. Each subject’s three-dimensional gait parameters and plantar-pressure distribution during walking were measured under two experimental conditions (sequence randomized): with and without the device turned on (Trial-registration number: ChiCTR-IPB-15006530 and HKCTR-1853).Results: Providing biofeedback significantly reduced the foot inversion and increased the mid-stance foot–floor contact area and medial midfoot plantar pressure of the affected limb, bringing the values of these parameters closer to those of the unaffected side. The biofeedback also significantly reduced the unaffected side’s excessive knee flexion and hip abduction.Conclusions: There were signs of improved foot loading characteristics and gait upon provision of instant vibrotactile biofeedback of plantar force. The positive results of this study further support the development of wearable biofeedback devices for improving gait of patients with stroke.
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| 24. |
- Miyasaka, Hiroyuki, et al.
(författare)
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The quantification of task-difficulty of upper limb motor function skill based on Rasch analysis
- 2020
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Ingår i: Topics in Stroke Rehabilitation. - : Taylor & Francis. - 1074-9357 .- 1945-5119. ; 27:1, s. 49-56
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Tidskriftsartikel (refereegranskat)abstract
- Background: The degree of difficulty of skills of paretic upper limbs in daily life has not been investigated. Objective: To determine the internal validity and level of difficulty of items of the Functional Skills Measure After Paralysis (FSMAP), which can be used to evaluate the functional skills of daily living for stroke patients. Method: A total of 105 first-stroke patients were assessed using the FSMAP. The evaluation system consists of 65 items in 15 categories. We examined the internal validity and level of difficulty of these items using Rasch analysis. In this study, an item with either infit or outfit of >= 1.5 was defined as underfit. Results: Rasch analysis showed that 8 items were underfit. The highest infit and outfit logits were 2.47 for "Trouser donning/doffing" and 8.44 for "Paper manipulation". "Shirt donning/doffing" was the easiest item and "Coin manipulation" was the most difficult, with difficulty logits of -35.8 and 41.5, respectively. Conclusion: The therapist can confirm items that the patient can or cannot perform. By understanding the level of difficulty of each item, the most appropriate functional skill to focus on acquiring next can be identified.
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| 25. |
- Nilsagård, Ylva, 1964-, et al.
(författare)
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Practicability and sensitivity to change of the Activities-specific Balance confidence and 12-item Walking scale for stroke
- 2012
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Ingår i: Topics in Stroke Rehabilitation. - Oxfordshire, United Kingdom : Taylor & Francis. - 1074-9357 .- 1945-5119. ; 19:1, s. 13-22
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To investigate the practicability and sensitivity to change of the Activities-specific Balance Confidence Scale (ABC) and the 12-item Walking Scale (WS-12) in persons at different phases after stroke.Method: A longitudinal data collection with repeated measurements at 0 to 14 days and 3 months post stroke combined with a cross-sectional approach for persons more than 1 year post stroke. The participants were 37 persons (median age, 79 years; interquartile range [IQR] 67-86) in the acute phase admitted to the University Hospital of Orebro (sample A) of whom 31 were measured at follow-up, and 67 persons at 4 primary care centers in Orebro County Council (median age, 68 years; IQR, 61-76) who were more than 1 year post stroke (sample B).Results: The ABC registered balance confidence during activities and the WS-12 measured walking limitations as perceived by participants. The observed score range per item and for the total scores covered a wide range with no floor or ceiling effects. For the older persons in sample A, 3 ABC items requiring high balance levels were found difficult even before stroke. The item for running in the WS-12 was also often commented on as being not possible before stroke. The ABC showed moderate ability and the WS-12 showed good ability to measure change.Conclusion: The scales are practical to use and sensitive to change for persons with remaining walking ability at different phases post stroke.
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| 26. |
- Persson, Hanna C, 1979, et al.
(författare)
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Transport mobility 5years after stroke in an urban setting.
- 2018
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Ingår i: Topics in stroke rehabilitation. - : Informa UK Limited. - 1945-5119 .- 1074-9357. ; 25:3, s. 180-185
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Tidskriftsartikel (refereegranskat)abstract
- Background People after stroke may have residual problems with mobility that can affect their independence and mode of transport. However, there is limited knowledge about transport mobility several years after stroke. Objective The objective was to survey the outdoor mobility and transportation in an urban setting five years post-stroke. Method This cross-sectional study was based on a mail survey focusing on long-term consequences after stroke. The survey comprises a set of self-evaluated questionnaires and was sent to 457 persons, of whom 281 responded (61.5%). From the survey, items regarding transportation and mobility were selected and analyzed. Results A high level of mobility function was reported with regard to outdoor mobility and different modes of transport. However, one-fifth still reported problems with outdoor mobility and mode of transport. Some perceived barriers were reported, predominantly mobility aspects such as transfer to/from, and getting on/off specific transportation mode/s. The respondents reported some communication problems and cognitive impairments, but these were not reported as prominent barriers when using public transport. A total of 67% were active drivers and were more often men (p=0.002), younger (p≤0.001), and were less dependent at discharge from the acute hospital (p≤0.001). Conclusions Five years post-stroke, mobility problems were the dominant barrier reported when using transport modes. Individualized transport training is needed during rehabilitation to increase possibility to participate. Infrastructure and transportation planning should focus on older, women, and people with impairments to be able to facilitate the use of public transport and mobility.
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| 27. |
- Persson, Josefine, 1981, et al.
(författare)
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All-cause mortality for cohabiting spouses of stroke survivors: Evidence from Swedish national registries.
- 2021
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Ingår i: Topics in stroke rehabilitation. - : Informa UK Limited. - 1945-5119 .- 1074-9357. ; 28:6, s. 432-442
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Tidskriftsartikel (refereegranskat)abstract
- Spousal concordance for cardiovascular risk factors and lifestyle behaviors may affect prevalence rates of diabetes, hypertension, and stroke. Spouses of stroke survivors, therefore, would be expected to have elevated mortality rates, but this has not been established. Thus, the aim of this study was to investigate whether cohabitant spouses of stroke survivors have higher mortality rates compared to a matched reference cohort.Data for this population-based cohort study were extracted from Swedish national registries from 2010 to 2016. The national sample consisted of 13,049 spouses of first ever stroke survivors and a reference cohort of 51,685 cohabitant individuals from the general population matched by age, gender, and place of residence. Effects on mortality were analyzed using Cox proportional hazard survival analyses.Female and male spouses of stroke survivors were found to have 5-year hazard ratios of death of 1.26 (95% confidence interval 1.17, 1.36) and 1.24 (95% confidence interval 1.16, 1.33), respectively, when compared to the reference cohort. Both female and male spouses had higher mortality from diseases in the circulatory system compared to the reference cohort.Spouses of stroke survivors have higher mortality rates than a matched reference population that persist for a minimum of 5years. Policy-makers should acknowledge and address the health status of spouses when evaluating and planning the health and social care of stroke survivors.
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| 28. |
- Rudberg, A. -S, et al.
(författare)
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Stroke survivors’ priorities for research related to life after stroke
- 2020
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Ingår i: Topics in Stroke Rehabilitation. - : Taylor & Francis. - 1074-9357 .- 1945-5119. ; , s. 1-6
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Tidskriftsartikel (refereegranskat)abstract
- Background: Stroke has transitioned from an untreatable, unpreventable disease to a highly treatable and preventable disease over recent decades, and the number of stroke survivors is expected to increase. The number is also foreseen to grow larger as a result of an aging population. With an escalating number of stroke survivors, research on how to improve life after stroke is needed. Aims: The primary aim was to determine which area of research related to life after stroke that stroke patients and their informal carers prioritized as being relevant and valuable. Methods: A cross-sectional study of all patients who had completed the 12 months of follow-up in the EFFECTS trial. In the questionnaire the stroke patients and their informal carers were asked to prioritize areas of research they considered important and valuable with respect to their life after stroke. Results: Of the 731 patients who were still alive after the 12 months-follow-up, 589 responded. The most prioritized areas of research were Balance and walking difficulties (290 (49%) responders) and Post-stroke fatigue (173 (29%) responders). Women answered the undefined alternative “other” more often than men (43 women (11%) versus 11 men (6%), p = .04). Younger patients prioritized Post-stroke fatigue to a higher extent (88 (45%) versus (22%), p < .001), and elderly prioritized Balance and walking difficulties (214 (54%) versus 76 (40%), p = .002) and Speech difficulties (38 (10%) versus 9 (5%), p = .045). Conclusions: Life after stroke is perceived differentely with aging. Future research should address strategies to face challenges such as imbalance and walking difficulties and post-stroke-fatigue.
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| 29. |
- Tistad, Malin, et al.
(författare)
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Shorter length of stay in the stroke unit : comparison between the 1990s and 2000s
- 2012
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Ingår i: Topics in Stroke Rehabilitation. - : Informa UK Limited. - 1074-9357 .- 1945-5119. ; 19:2, s. 172-181
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The process ruling length of stay (LOS) in hospitals is complex, and changes over time in LOS have not been explored. The purpose of the study was to examine differences in LOS, use of and satisfaction with health-related services, and capacity in activities of daily living (ADLs) during the first year post stroke in 2 groups of patients with mild to moderate stroke who received care in the same stroke unit.Method: The patients (1993/96, n=40; 2006/07, n=43) in this study received care in the stroke unit at Karolinska University Hospital, Huddinge, Sweden. Data on LOS and on the use of health-related services were collected from the Stockholm County Council computerized registers. Satisfaction with health-related services was assessed using a questionnaire covering different dimensions of care, while ADLs were assessed using Katz Extended Index of ADL.Results: The LOS in the stroke unit was shorter in the 2006-2007 group (median 8 days) compared to the 1993-1996 group (13 days) (P < .001). Both groups were equally satisfied with health-related services received. A larger proportion of patients were independent in ADLs 3 months post stroke in the 2006-2007 group, but no difference was seen at 6 or 12 months post stroke.Conclusion: It seems possible to reduce the number of days spent in the stroke unit after mild to moderate stroke and instead spend days in a rehabilitation unit, and yet achieve similar patient satisfaction and faster recovery in ADL.
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| 30. |
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| 31. |
- Wagachchige Muthucumarana, Muditha, et al.
(författare)
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Caring for stroke survivors : experiences of family caregivers in Sri Lanka – a qualitative study
- 2018
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Ingår i: Topics in Stroke Rehabilitation. - 1074-9357 .- 1945-5119. ; 25:6, s. 397-402
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Stroke is a life-changing event for both stroke survivors and their family caregivers. After receiving acute care at the hospital, family members are expected to take care of stroke survivors at home and to continue treatment and rehabilitation. The new role of "informal caregiver" is a challenge that creates many difficulties for family caregivers that are not explicit in the Sri Lankan context.OBJECTIVES:This study aimed at exploring family caregivers' experiences of providing informal care for dependent stroke survivors.METHODS:The sample was chosen by purposive sampling with a maximum variation by age, ethnicity, religion, educational level, relationship, and monthly income. Ten informal family caregivers to stroke survivors with hemiplegia who had been treated at the National Hospital of Sri Lanka participated in in-depth interviews analyzed using conventional content analysis.RESULTS:Qualitative content analysis of data resulted in an overriding theme, "Caring with love, against all odds," along with four categories, "Life alterations," "Lack of resources," "Compassionate care," and "Coping strategies." Although the increased workload, restricted social life, physical problems, and knowledge and financial deficits were challenging for the family caregivers, self-strength and supportive social networks helped them to compassionately care for their stroke survivor.CONCLUSIONS:The phenomenon of family caregivers providing informal care for stroke survivors was explicated as compassionate care, notwithstanding numerous difficulties. The findings motivate further research and strategies to minimize family caregivers' burden and facilitate the positive aspects of caregiving to promote the health and well-being of both stroke survivors and their families.
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| 32. |
- Wagachchige Muthucumarana, Muditha, et al.
(författare)
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Caring for stroke survivors : experiences of family caregivers in Sri Lanka – a qualitative study
- 2018
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Ingår i: Topics in Stroke Rehabilitation. - : Taylor and Francis Ltd.. - 1074-9357 .- 1945-5119. ; 25:6, s. 397-402
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Stroke is a life-changing event for both stroke survivors and their family caregivers. After receiving acute care at the hospital, family members are expected to take care of stroke survivors at home and to continue treatment and rehabilitation. The new role of "informal caregiver" is a challenge that creates many difficulties for family caregivers that are not explicit in the Sri Lankan context. OBJECTIVES: This study aimed at exploring family caregivers' experiences of providing informal care for dependent stroke survivors. METHODS: The sample was chosen by purposive sampling with a maximum variation by age, ethnicity, religion, educational level, relationship, and monthly income. Ten informal family caregivers to stroke survivors with hemiplegia who had been treated at the National Hospital of Sri Lanka participated in in-depth interviews analyzed using conventional content analysis. RESULTS: Qualitative content analysis of data resulted in an overriding theme, "Caring with love, againstall odds," along with four categories, "Life alterations," "Lack of resources," "Compassionate care," and "Coping strategies." Although the increased workload, restricted social life, physical problems, and knowledge and financial deficits were challenging for the family caregivers, self-strength and supportive social networks helped them to compassionately care for their stroke survivor. CONCLUSIONS: The phenomenon of family caregivers providing informal care for stroke survivors was explicated as compassionate care, notwithstanding numerous difficulties. The findings motivate further research and strategies to minimize family caregivers' burden and facilitate the positive aspects of caregiving to promote the health and well-being of both stroke survivors and their families.
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| 33. |
- Westerlind, Emma, 1992, et al.
(författare)
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Very early cognitive screening and return to work after stroke
- 2019
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Ingår i: Topics in Stroke Rehabilitation. - : Informa UK Limited. - 1074-9357 .- 1945-5119. ; 26:8, s. 602-607
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Tidskriftsartikel (refereegranskat)abstract
- Background: Stroke is a common cause of long-term disability worldwide, and an increasing number of persons affected by stroke are of working age. In addition to physical impairments, a majority of patients reportedly suffer cognitive impairments after stroke. Reduced cognitive function may hinder poststroke return to work (RTW); however, most studies of this relationship have assessed cognitive function months after the stroke. Objectives: The current study aims to investigate the degree of post-stroke RTW, and whether very early cognitive function screening can predict RTW after a stroke. Methods: This study included 145 persons treated for stroke at 18-63 years of age at a large university hospital in Sweden between 2011 and 2016. Data were retrieved from the GOTVED database. Within 36-48 h after hospital admission, cognitive function was screened using the Montreal Cognitive Assessment (MoCA). Full and partial RTW were assessed based on the Swedish Social Insurance Agency's register. Logistic regression was performed to analyze the potential predictors of RTW at 6 months and 18 months. Results: Neither global cognitive function nor executive function at 36-48 h after stroke predicted any degree of RTW at 6 or 18 months. Male sex, lower stroke severity, and not being on sick leave prior to stroke were significant predictors of RTW. Conclusions: Screening for cognitive impairments at 36-48-h post stroke is apparently too early for predicting RTW, and thus cannot be the sole basis for discharge planning after stroke. Additional research is needed to further analyze cognitive function early after stroke and RTW.
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| 34. |
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| 35. |
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| 36. |
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| 37. |
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| 38. |
- Tibaek, S., et al.
(författare)
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The effect of pelvic floor muscle training on sexual function in men with lower urinary tract symptoms after stroke
- 2015
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Ingår i: Topics in Stroke Rehabilitation. - 1074-9357. ; 22:3, s. 185-193
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Tidskriftsartikel (refereegranskat)abstract
- Background: Erectile dysfunction and lower urinary tract symptoms (LUTS) are common sequelae in men after stroke. Objective: The objective of this study was to evaluate the effect of pelvic floor muscle training (PFMT) on measured erectile function as an indicator of sexuality in men with LUTS after stroke. Method: A sample of 516 men with stroke was invited to participate in this single-blinded, randomized controlled trial according to in- and exclusion criteria. This resulted in 31 participants who were randomized to either a Treatment Group (n=16) or a Control Group (n=15). The intervention included 12weeks of PFMT. The effect was measured on the International Index of Erectile Function (IIEF-5) questionnaire. Results: Thirty participants (median age: 68 years; interquartile range: 60-74 years) completed the study, 15 in each group. The results of the IIEF-5 sum score showed a significant improvement (P<0.04) from pre-test to post-test in the Treatment Group, but not in the Control Group. Within pre-test and 6-month follow-up, the median sum score decreased in both groups, worsened in the Control Group [ Treatment Group, 3 (17%) versus Control Group, 5 (31%)]. There were differences between the groups at post-test and at follow-up, but they were not statistically significant. Conclusion: The results showed that, as measured by erectile function in men with LUTS after stroke, PFMT may have short-term and long-term effect, although no statistically significant effect was demonstrated between the groups.
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| 39. |
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