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1.	Alt Murphy, Margit, 1970, et al. (författare) Letter by Murphy et al regarding article, "Fugl-Meyer assessment of sensorimotor function after stroke: standardized training procedure for clinical practice and clinical trials". 2011 Ingår i: Stroke; a journal of cerebral circulation. - 1524-4628. ; 42:6 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
2.	Alt Murphy, Margit, 1970, et al. (författare) SALGOT - Stroke Arm Longitudinal study at the University of Gothenburg, prospective cohort study protocol. 2011 Ingår i: BMC neurology. - : Springer Science and Business Media LLC. - 1471-2377. ; 11 Tidskriftsartikel (refereegranskat)abstract BACKGROUND: Recovery patterns of upper extremity motor function have been described in several longitudinal studies, but most of these studies have had selected samples, short follow up times or insufficient outcomes on motor function. The general understanding is that improvements in upper extremity occur mainly during the first month after the stroke incident and little if any, significant recovery can be gained after 3-6 months. The purpose of this study is to describe the recovery of upper extremity function longitudinally in a non-selected sample initially admitted to a stroke unit with first ever stroke, living in Gothenburg urban area. METHODS/DESIGN: A sample of 120 participants with a first-ever stroke and impaired upper extremity function will be consecutively included from an acute stroke unit and followed longitudinally for one year. Assessments are performed at eight occasions: at day 3 and 10, week 3, 4 and 6, month 3, 6 and 12 after onset of stroke. The primary clinical outcome measures are Action Research Arm Test and Fugl-Meyer Assessment for Upper Extremity. As additional measures, two new computer based objective methods with kinematic analysis of arm movements are used. The ABILHAND questionnaire of manual ability, Stroke Impact Scale, grip strength, spasticity, pain, passive range of motion and cognitive function will be assessed as well. At one year follow up, two patient reported outcomes, Impact on Participation and Autonomy and EuroQol Quality of Life Scale, will be added to cover the status of participation and aspects of health related quality of life. DISCUSSION: This study comprises a non-selected population with first ever stroke and impaired arm function. Measurements are performed both using traditional clinical assessments as well as computer based measurement systems providing objective kinematic data. The ICF classification of functioning, disability and health is used as framework for the selection of assessment measures. The study design with several repeated measurements on motor function will give us more confident information about the recovery patterns after stroke. This knowledge is essential both for optimizing rehabilitation planning as well as providing important information to the patient about the recovery perspectives. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01115348.
3.	Bernhardt, Julie, et al. (författare) The International Stroke Recovery and Rehabilitation Alliance 2023 Ingår i: The Lancet Neurology. - 1474-4422 .- 1474-4465. ; 22:4, s. 295-296 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
4.	Björkdahl, Ann, 1959, et al. (författare) Effect of very early supported discharge versus usual care on activi-ties of daily living ability after mild stroke: a randomized controlled trial. 2023 Ingår i: Journal of rehabilitation medicine. - 1651-2081. ; 55 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.
5.	Chen, Eric, et al. (författare) Levels of physical activity in acute stroke patients treated at a stroke unit: A prospective, observational study. 2020 Ingår i: Journal of rehabilitation medicine. - : Medical Journals Sweden AB. - 1651-2081 .- 1650-1977. ; 52:4 Tidskriftsartikel (refereegranskat)abstract A prospective, observational study to describe levels of physical activity in patients with stroke on day 2 and day 5 or 6 after admission to a comprehensive stroke unit in Sweden.The study was performed at the stroke unit at Sahlgrenska University Hospital during a period of 4 months between 2017 and 2018. Consecutive patients with stroke were observed for 1 min every 10 min while the multidisciplinary team was at work. The level of physical activity, location and the people present were noted at each time-point.A total of 46 patients were observed on day 2, of whom 29 were observed a second time on day 5 or 6. Patients were in bed half of the time and engaged in upright activity for less than 10% of day 2. Patients spent 73% of day 2 in the bedroom and 56% of this day alone. Over time, there was a significant shift of 10% from "in bed" activity to "sitting" (p§lt;0.001).Patients are physically inactive, alone and in their rooms for a majority of the time during the first days at a comprehensive stroke unit. There is some increase in physical activity during the first week after admission.
6.	Danielsson, Anna, 1957, et al. (författare) Comparison of energy cost of walking with and without a carbon composite ankle foot orthosis in stroke subjects 2010 Ingår i: 13th ISPO World Congress, 10-15 May 2010, Leipzig, Germany. Konferensbidrag (refereegranskat)abstract 13th ISPO World Congress Poster [3009] Abstract [207] \| Topic: Orthotics Author: Danielsson, Anna (Göteborg SE) Dr. University of Gothenburg, Institute of Neuroscience and Physiology - Clinical Neuroscience and Rehabilitation Title: Comparison of Energy Cost of Walking with and without a Carbon Composite Ankle Foot Orthosis in Stroke Subjects Coauthors: Sunnerhagen KS, Willén C Summary: Oxygen cost, gait speed and perceived exertion was measured in 10 subjects with stroke walking with and without a carbon composite ankle foot orthosis. Walking with ankle foot orthosis was statistically less energy demanding and the speed somewhat higher compared to unbraced walking. Introduction: The opinions on effects of AFOs on functional outcome after stroke are inconsistent and the clinical significance of changes reported has been questioned. The improved walking velocity with an AFO as compared to unbraced walking seen in some studies may involve a reduction in energy cost. To our knowledge, only two studies report reduced energy cost with the use of an AFO. The aim was to measure and compare the energy expenditure and walking speed with and without a carbon composite AFO in stroke subjects. Methods: Ten persons with prior stroke, habituated to a carbon composite AFO were included. First the self-selected speeds on a tredmill without (speed I) and with (speed II) the AFO were determined in randomised order. The energy expenditure and heart rate were estimated with a stationary, computerized system for breath-by-breath analysis. Two measurements of energy expenditure were carried out with and without the AFO in randomized order at speed I. A third measurement was made with the AFO at speed II. Each trial lasted for five minutes. The measurements were repeated in reversed order once within one week. The energy cost per minute was divided by walking speed for estimation of energy cost per distance. Data was analysed with Wilcoxons sign rank test. Results: The mean self-selected walking speed was 20% higher (p = 0.027) with the ankle foot orthosis than without. Walking at speed I with an AFO was 4% less energy demanding (VO2 mL•kg-1•min-1) (p=0.028) than walking without AFO at the same speed. The energy cost (VO2 mL•kg-1•m-1) at speed I was also significantly lower with the AFO (p = 0.037) than without. Heart rate or perceived exertion did not differ between the two conditions. There was no significant difference in energy expenditure (VO2 mL•kg-1•min-1) between walking at speed I without AFO and speed II with AFO. However, the energy cost (VO2 mL•kg-1•m-1), was 12% lower (p=0.024) with the AFO. Heart rate and perceived exertion showed no difference between the two conditions. Conclusion: A carbon composite ankle foot orthosis may decrease energy demands and increase walking speed after stroke. The differences in energy cost seen in this study were small and not clinically significant whereas an increase in walking speed might have some impact on walking capacity. Further studies on the effects of an AFO on walking ability after stroke are wanted. References: Franceschini M, Massucci M, Ferrari L, Agosti M, Paroli C. Effects of an ankle-foot orthosis on spatiotemporal parameters and energy cost of hemiparetic gait. Clin Rehabil 2003;17(4):368-72. Corcoran PJ, Jebsen RH, Brengelmann GL, Simons BC. Effects of plastic and metal leg braces on speed and energy cost of hemiparetic ambulation. Arch Phys Med Rehabil 1970;51(2):69-77. de Wit DC, Buurke JH, Nijlant JM, Ijzerman MJ, Hermens HJ. The effect of an ankle-foot orthosis on walking ability in chronic stroke patients: a randomized controlled trial. Clin Rehabil 2004;18(5):550-7 Leung J, Moseley A. Impact of ankle-foot orthoses on gait and leg muscle activity in adults with hemiplegia: systematic literature review. Physiotherapy 2003;89(1):39-55. Danielsson A, Sunnerhagen KS. Energy expenditure in stroke subjects walking with a carbon composite ankle foot orthosis. J Rehabil Med 2004;36:165-8.
7.	Danielsson, Anna, 1957, et al. (författare) Energikostnad vid gång- en jämförelse av två mätmetoder. 2004 Ingår i: Läkarstämman 2004.. Konferensbidrag (refereegranskat)
8.	Danielsson, Anna, 1957, et al. (författare) Energy cost during walking - a comparison of two measurement methods 2005 Ingår i: European Stroke Conference, Bologna, Italy 25-28 may 2005. Konferensbidrag (refereegranskat)abstract Background and purpose Many persons with stroke walk slowly with increased energy cost. Efficient gait is an important rehabilitation goal. Measurement of energy cost adds valuable information to gait analysis in evaluation of exercise, orthoses and walking aids. Direct measurement of oxygen uptake (VO2) is golden standard, but clinically practicable methods are needed. Physiological Cost Index (PCI)1 is a clinical method based on the relation between VO2 and heart rate. The reliability and validity of PCI in stroke patients has not been investigated. The aim was to compare energy cost measured by VO2 with PCI-value, in persons with stroke and healthy reference persons. Methods 20 persons with stroke and hemiparesis and 16 healthy, reference persons 30-63 years of age were included. Individual, self-selected walking speed on a treadmill was determined. VO2 was measured by breath-by-breath analysis and heart rate by electrocardiography at rest and during 5 minutes of walking on the treadmill at the predetermined self-selected speed. Mean values from two sessions were used. PCI was calculated as the heart rate difference between rest and walking, divided by gait speed. Spearman’s rank correlation between VO2 and PCI was calculated. Results Gait speed on the treadmill was 0,48 and 1,01 m/s, in the stroke and reference group respectively. VO2 was 9,1 and 11,4 ml/kg/min, with an energy cost of 0,41 and 0,19 ml/kg/m, in the stroke and reference group respectively. PCI was 0,76 and 0,30 heartbeats/m, in the stroke and reference group respectively. The correlation coefficient between VO2/m and PCI was ρ = 0,70 for the stroke group and ρ = 0,83 for the reference group. Conclusion Both VO2 and PCI were increased in the stroke group compared to the healthy reference group. VO2 and PCI were correlated in both groups. The stroke group had a large variability, why measurement of VO2 is recommended for research purposes. PCI needs further investigation before conclusions about the applicability for stroke patients can be drawn. 1 MacGregor J. The evaluation of patient performance using long-term ambulatory monitoring technique in the domiciliary environment. Physiotherapy 1981;67(2):30-33.
9.	Danielsson, Anna, 1957, et al. (författare) Energy cost,walking habits and physical activity late after stroke 2008 Ingår i: Neurorehabilitation & Neural repair. ; 22:5 Konferensbidrag (refereegranskat)abstract Background: The aim was to investigate if walking energy cost and walking distance late after stroke were influenced by the physical environment, walking habits, physical activity or perceived difficulties. Methods: Included were 31 subjects with a mean age of 59.7 years and time since stroke 7-10 years. Heart rate and distance were measured during in- and outdoor walking for 6 minutes. The energy cost was assessed by the Physiological Cost Index (PCI). Assessments were made by the Physical Activity Scale for the Elderly, Stroke Impact Scale and a questionnaire on walking habits. Data were analyzed with linear regression. Results: Walking speeds and distances were reduced and the PCI was elevated compared to reference values. There were no differences between in- and outdoor walking. Sex, body mass index and perceived difficulty explained 24% of the variation in PCI (not statistically significant). Body mass index, physical activity level and perceived difficulty explained 48% of the variation in walking distance (p <0.05). Conclusions: Late after stroke, perceived difficulties may influence walking distance and energy cost. In this study the impact of the physical environment was not significant. The level of physical activity was associated with walking distance. Assessment of physical activity may be of importance after stroke and support should be given to increase physical activity when needed.
10.	Danielsson, Anna, 1957, et al. (författare) Energy cost, walking habits and physical activity late after stroke 2008 Ingår i: 5th World Congress in NeuroRehabiliation, Sept 24-27, 2008, Brasilia, Brazil. Konferensbidrag (refereegranskat)
11.	Danielsson, Anna, 1957, et al. (författare) Energy expenditure in stroke subjects walking with a carbon composite ankle foot orthosis. 2004 Ingår i: Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977. ; 36:4, s. 165-8 Tidskriftsartikel (refereegranskat)abstract OBJECTIVE: To measure walking speed and energy cost in patients with prior stroke with and without a carbon composite ankle foot orthosis. DESIGN: Within-group comparisons of 2 walking conditions. PARTICIPANTS: Convenience sample of 10 hemiparetic patients with a stroke at least 6 months earlier (average age 52 years) habituated to a carbon composite ankle foot orthosis. METHODS: Subjects walked on a treadmill at self-selected speed both with and without ankle foot orthosis for 5 minutes on each occasion. Energy expenditure was measured by breath-by-breath analysis and electrocardiography. Main outcome measures were walking speed, oxygen consumption, heart rate and energy cost per metre. RESULTS: Walking speed: without ankle foot orthosis 0.27 (SEM +/- 0.03) m/s, with 0.34 (+/- 0.06) m/s, difference 20%. Oxygen consumption: without ankle foot orthosis 8.6 (+/- 0.4) ml/kg/min, with 8.8 (+/- 0.5) ml/kg/min. Energy cost: without ankle foot orthosis 0.58 (+/- 0.07) ml/kg/m, with 0.51 (+/- 0.06) ml/kg/m, difference 12%. CONCLUSION: Use of a carbon composite ankle foot orthosis in patients with stroke may increase speed and decrease energy cost during walking.
12.	Danielsson, Anna, 1957, et al. (författare) Is walking endurance associated with activity and participation late after stroke? 2011 Ingår i: Disability and rehabilitation. - : Informa UK Limited. - 1464-5165 .- 0963-8288. ; 33:21–22, s. 2053-2057 Tidskriftsartikel (refereegranskat)abstract Purpose.After stroke, impaired walking ability may affect activity and participation. The aim was to investigate whether self-reported activity and participation were associated with walking endurance late after stroke. Method.A non-randomised sample of 31 persons with a mean age of 59.7 years and time since stroke of 7-10 years was studied. Walking endurance was measured by the 6-minute walk test (6MWT). Self-reported activity and participation were measured by the Physical Activity Scale for the Elderly and the Stroke Impact Scale. Relationships were analysed with linear regression. Results.A regression model including activities of daily living and 6MWT explained 44%, mobility and 6MWT explained 25% and a model including physical activity level and 6MWT explained 21% of the variation in activity. Regarding participation, the explanatory level of the model of participation and 6MWT was 30%. Conclusions.Walking distance several years after stroke was partly associated with self-reported difficulties in activity and participation.
13.	Danielsson, Anna, 1957, et al. (författare) Measurement of energy cost by the physiological cost index in walking after stroke. 2007 Ingår i: Archives of physical medicine and rehabilitation. - : Elsevier BV. - 0003-9993. ; 88:10, s. 1298-303 Tidskriftsartikel (refereegranskat)abstract OBJECTIVE: To compare the Physiological Cost Index (PCI) with direct measurement of oxygen consumption (Vo(2)) as an estimate of energy cost in persons with stroke and healthy subjects. DESIGN: Test-retest on separate days. A comparison of 2 methods of measurement. Measurements with and without an orthosis. SETTING: A university hospital. PARTICIPANTS: A convenience sample of 20 persons with hemiparesis more than 6 months after stroke and 16 healthy subjects, ages 30 to 63 years. INTERVENTIONS: Five minutes of treadmill walking at self-selected speeds while recording Vo(2) levels and heart rates. Additional data was recorded for 11 of the stroke subjects with and without an ankle-foot orthosis. MAIN OUTCOME MEASURES: Vo(2) and the PCI. RESULTS: No significant differences were found in the PCI or Vo(2) between test and retest. Both PCI and Vo(2) per distance were higher for the stroke subjects compared with healthy subjects. PCI showed a larger dispersion than Vo(2) between test and retest. The regression analysis for PCI showed that the model including age, sex, group assignment, and Vo(2) could explain 53% of the variation. The PCI did not show a significant difference in walking with or without an orthosis, whereas Vo(2) differed significantly. CONCLUSIONS: The PCI showed limited reliability and validity as a measure of energy cost after stroke due to the extensive variability between test and retest.
14.	Danielsson, Anna, 1957, et al. (författare) Oxygen consumption during treadmill walking with and without body weight support in patients with hemiparesis after stroke and in healthy subjects 2000 Ingår i: Archives of Physical Medicine and Rehabilitation. - 0003-9993 .- 1532-821X. ; 81, s. 953-7 Tidskriftsartikel (refereegranskat)abstract Objective: To compare oxygen consumption during walking with body weight support (BWS) with oxygen consumption during unsupported treadmill walking. Design: Patient and reference group. Comparisons between two walking conditions within each group. Setting: Research laboratory of a university hospital. Participants: Nonrandom convenience sample of 9 hemiparetic and 9 healthy subjects, mean age of 56 and 57 years, respectively. Interventions: The subjects walked on a treadmill with 0% and 30% BWS at their self-selected and maximum walking speeds. The trials were performed twice. Main Outcome Measures: Ventilatory oxygen uptake (VO2) and heart rate were measured by computerized breath-by-breath analysis and electrocardiography. Results: VO2 was lower during walking with 30% BWS than during unsupported walking. At self-selected speed the Wilcoxon's signed rank p values were <.01 for both patients and reference group; at maximum velocity, p values were p <.02 for the patients and p <.05 for the reference group. Patients' heart rates were lower when they walked with 30% BWS than at 0% BWS, at both self-selected and maximum walking speeds (p <.05 and p <.02, respectively). Conclusions: The 30% body weight supported condition requires less oxygen consumption than full weight bearing. Treadmill training with BWS can be tolerated by patients with cardiovascular problems.
15.	Danielsson, Anna, 1957, et al. (författare) Perception of walking and walking capacity late after stroke 2009 Ingår i: 5th World Congress of the International Society of Physical and Rehabilitation Medicine June 13-17 2009, Istanbul, Turkey. Konferensbidrag (refereegranskat)abstract OBJECTIVE: The aim was to investigate the perception of walking ability and compare this to actual walking capacity. MATERIALS-METHODS: Persons who had completed a stroke rehabilitation programme 7-10 years previously were invited to participate. The Modified Rankin Scale was used for classification; Stroke Impact Scale and a Walking Habit Score were used in an interview on walking difficulties and walking habits, respectively. The Six-Minute Walk test (6MW) and the leg section of the Fugl-Meyer Sensorimotor Assessment (FMA, maximum score 34)) were performed in subjects who were able to come to the clinic. The relationships between variables were analysed with Spearman’s Rank correlation (rs) and gamma coefficients. RESULTS: Twelve woman and 24 men with a mean age of 60 years were included. Median time since stroke onset was 9 years.The Modified Rankin Scale scored median 3 (2-4). Three of the subjects used a wheelchair for transport, 19 used a walking aid and 9 wore an ankle foot orthosis. The clinical tests were performed in 31 subjects, their FMA score was median 29 and their mean 6MW distance was 344 m. Seventy percent perceived walking difficulties, 85% answered that they could walk unassisted in the near surroundings and 65% reported that they walked 500m. The 6MW distance was highly associated with the FMA motor score; rs 0.80 (p<0.001). The correlation between 6MW and perceived difficulties was rs 0.65 (p<0.001). There was a moderate correlation, gamma coefficient 0.60 (p<0.01), between 6MW and reported ability to walk 500m. CONCLUSION: The walking capacity may be reduced and stroke subjects perceive walking problems even many years after stroke onset. Persons well adapted to their situation seem to have an adequate opinion on their capacity. The findings support that self-reports on walking ability may be sufficient at follow-up after stroke
16.	Danielsson, Anna, 1957, et al. (författare) Physical activity, ambulation, and motor impairment late after stroke. 2012 Ingår i: Stroke research and treatment. - : Hindawi Limited. - 2042-0056 .- 2090-8105. ; 2012 Tidskriftsartikel (refereegranskat)abstract Objective. To assess walking capacity and physical activity using clinical measures and to explore their relationships with motor impairment late after stroke. Subjects. A nonrandomised sample of 22 men and 9 women with a mean age of 60 years, 7-10 years after stroke. Methods. Fugl-Meyer Assessment, maximum walking speed, 6min walk test, perceived exertion, and heart rate were measured, and the Physiological Cost Index was calculated. Physical activity was reported using The Physical Activity Scale for the Elderly. Results. Mean (SD) 6min walking distance was 352 (±136)m, and Physiological Cost Index was 0.60 (±0.41). Self-reported physical activity was 70% of the reference. Motor impairment correlated with walking capacity but not with the physical activity level. Conclusion. It may be essential to enhance physical activity even late after stroke since in fairly young subjects both walking capacity and the physical activity level were lower than the reference.
17.	Danielsson, Anna, 1957, et al. (författare) Physical activity and walking speed after stroke compared to control values 2012 Ingår i: Neurorehabilitation and neural repair. - : SAGE Publications. - 1545-9683 .- 1552-6844. ; 26:6, s. 695-804 Konferensbidrag (refereegranskat)abstract Background and Aims: Persons with stroke are often less physically active than healthy and it can be hypothesized that activity increases over time and that walking speed is important. The aim was to describe the physical activity level using a questionnaire, compare with normative data and examine relationships between physical activity level, time since stroke and walking speed. Methods: A convenience sample of 70 persons (48 men, 22 woman) with a mean age of 60 (SD 6.8) was examined at a mean of 6 (SD 3) years after first event of stroke. A population based sample of 141 persons (70 men, 71 women) between 40 and 79 years of age from the same geographical area, divided into four cohorts, served as controls. The Physical Activity Scale for the Elderly (PASE) (1) was used to estimate the self-reported physical activity level. The self-selected walking speed was measured on a 30 m track and in stroke persons motor function in the affected leg was assessed according to Fugl-Meyer (maximum score 34). Results: The mean PASE score in the stroke group was 119 (SD 74), corresponding to 72% (SD 31) of the control score. There was no correlation between PASE and time since stroke. The median Fugl-Meyer score was 29 (range 11-34). The mean self-selected walking speed in the stroke group was 1.01 (SD 0.42) m/s which corresponded to 73% of the controls’. In a regression model, the self-selected walking speed could explain the variation in the PASE to 24% (p 0.001) and 6% (p 0.002), in the stroke and control groups, respectively. Conclusions: Persons with stroke reported lower physical activity than controls several years after stroke. Self-selected walking speed could partially explain physical activity level in persons with stroke but not in controls.
18.	Danielsson, Anna, 1957, et al. (författare) PHYSICAL ACTIVITY AND WALKING SPEED AFTER STROKE COMPARED TO CONTROL VALUES 2012 Ingår i: Neurorehabilitation and Neural Repair. - 1545-9683. Konferensbidrag (refereegranskat)
19.	Danielsson, Anna, 1957, et al. (författare) Physical Activity in Community-Dwelling Stroke Survivors and a Healthy Population Is Not Explained byMotor Function Only. 2014 Ingår i: PM & R : the journal of injury, function, and rehabilitation. - : Wiley. - 1934-1563. ; 6:2, s. 139-145 Tidskriftsartikel (refereegranskat)abstract To explore the relationship between self-reporting and physical measures and compare self-reported physical activity (PA) levels in persons who have had a stroke with self-reported PA levels in a control population.
20.	Danielsson, Anna, 1957, et al. (författare) PREVALENCE OF ANXIETY WITHIN THE FIRST YEAR AFTER STROKE: A SYSTEMATIC REVIEW AND METAANALYSIS 2018 Ingår i: European stroke journal. Vol. 3 Issue 1_suppl.. - : SAGE Publications. - 2396-9873 .- 2396-9881. Konferensbidrag (refereegranskat)abstract Background and Aims: Anxiety is associated with decreased quality of life and depression, but gets less attention than other psychological consequences after stroke. The aim was to estimate prevalence of anxiety in the first year after stroke. Method: Searches in EMBASE, MEDLINE, PsycINFO, Cochrane Library, Amed and CINAHL were conducted in May 2015 and April 2017. Included were studies of populations with a hemorrhagic or ischemic stroke or transient ischemic attack, anxiety categorized on a rating scale during the first year after stroke. Two reviewers independently screened and included studies and assessed quality using a checklist. Studies using the Hospital Anxiety and Depression Scale – Anxiety (n 31) were included in a meta- analysis using the random effects model. Heterogeneity was assessed using the Q-test and I2 was used to estimate heterogeneity. Results: Of 4453 titles screened, 37 studies were included comprising 13756 participants with mean ages from 52 to 79 years, assessed within 2 weeks to 1 year after stroke. Most studies were of medium quality. The pooled prevalence of anxiety within the first year was 29.3% [(95% CI 24.8 – 33.8), (I2¼97%, p<0.00001)] which is higher than previously shown. Frequency 0-2 weeks post stroke was 34.8% (95% CI 24.9 – 44.6%), 2 weeks -3 months 23.2 (95% CI 16.3–30.1%) and 3 -12 months 35.6% (95% CI 17.7–54.3. Conclusion: One third of the stroke population may have an anxiety disorder and the prevalence seems to increase, why routine screening may be worth considering in order to provide appropriate interventions.
21.	Danielsson, Anna, 1957, et al. (författare) Reliability and validity of the physiological cost index compared with oxygen consumption for estimation of energy cost after stroke 2007 Ingår i: 4th World Congress of the International Society of Physical and Rehabilitation Medicine, June 10-14, 2007, Seoul, Korea. Konferensbidrag (refereegranskat)abstract The energy cost of walking is often increased after stroke, which might restrict participation in daily activities. Effects of walking aids or orthoses on the energy cost need to be evaluated. Oxygen consumption (VO2) is the standard for measurement of energy cost is, but in clinical practise methods must be simple. The Physiological Cost Index (PCI) based on heart rate and walking speed gives an estimate of energy cost. The reliability and validity of PCI for persons with stroke has not been documented. The aim was to investigate the test retest reliability and validity of PCI in comparison with VO2, in persons with stroke and healthy persons. A convenience sample of 20 persons with hemiparesis > 6 months after stroke and 16 healthy persons were included. VO2 and heart rate were registered during five minutes of treadmill walking at the self-selected speed. Measurements were repeated within one week. Eleven of the stroke participants were measured with and without an ankle foot orthosis. PCI showed a larger dispersion than VO2 of differences between test and retest. Changes in PCI of 74% and 53% in the stroke and healthy groups respectively, were necessary for a “true” difference on retest, compared to 22% and 21% respectively for VO2. The regression analysis for PCI showed that the model including age, sex, group assignment and VO2 could explain 53 % of the variation. PCI did not show any difference between walking with or without an orthosis, whereas VO2 differed significantly. In persons with stroke as well as healthy persons, energy cost measured by the Physiological Cost Index showed limited reliability and validity compared to measurement of oxygen consumption. The Physiological Cost Index might be used as a rough estimate on the individual level, but for study purposes measurement of oxygen consumption seems more accurate.
22.	Danielsson, Anna, 1957, et al. (författare) Self-perceived mobility in the first year after mild stroke – a comparison between Very Early Supported Discharge and ordinary discharge routine 2022 Ingår i: 12th World Congress for Neurorehabilitation, Wien, 14-17 dec 2022. Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract Background: People with mild stroke mostly present with good basic but may experience difficulties with complex ADL activities. Knowledge about effects of common rehabilitation interventions after mild stroke is scarce. Objective: To investigate perceived mobility after Very Early Supported Discharge (VESD) compared to standard discharge. Methods: At an inpatient stroke unit 140 participants (39% women) were included day 2 post stroke. Inclusion criteria: stroke according to WHO criteria, age >18 years, living ≤30 min from the hospital, NIHSS score 0-16, Barthel Index score 50-100 and Montreal Cognitive Assessment <26 if BI=100. Exclusion criteria: life expectancy <1 year, non-communicating in Swedish prior stroke. Patients were randomised to VESD delivered at home by occupational therapist, physiotherapist and nurse from the stroke unit, for 4 weeks or to a control group discharged according to standard routine. VESD was focused on individual goals in personal care, transfers, household and leisure activities. The control group received standard rehabilitation as needed. The Mobility domain (0-100) of the Stroke Impact Scale (SIS) was administered 5 days after onset, 3 and 12 months after discharge. Results: Participants’ mean age was 74 (SD 11) year and NIHSS score median 2 (min-max 0-11). Mean (SD) SIS Mobility was 71.2 (22,7) and 73.6 (23.6) at baseline, in the VESD and control groups respectively. At the 3-month follow up SIS mobility score was significantly higher in the VESD group, 89.6 (15.0) compared to the controls’ 80.9 (21.3), p 0.027. There was no group difference at 12 months after discharge with 85.0 (18.1) and 86.6 (16.8), respectively. We conclude that stroke specialised team rehabilitation at home in the subacute phase may be beneficial for both basic and more demanding mobility situations in the first months, in people with mild stroke.
23.	Danielsson, Anna, 1957, et al. (författare) Self-perceived mobility in the first year after stroke in relation to observer based clinical measures 2020 Ingår i: WFNR & SOFMER congress 7–11 October 2020. Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract Questions: To what extent do people with stroke experience mobility difficulties during the first year after onset? Is self-perceived mobility associated with perceived strength and clinical measures of mobility? Methods: At an inpatient stroke unit 140 participants were recruited. Inclusion criteria were confirmed stroke according to WHO criteria, > 18 years of age, living within 30 min from the hospital, day 2 NIHSS score 0-16, Barthel Index (BI) score 50-100 and MOCA index <26 if BI=100. Exclusion criteria were life expectancy < 1 year and inability to communicate in Swedish prior stroke. Stroke Impact Scale (SIS 3.0) domains for strength and mobility (score 0-100) and Timed Up and Go (TUG, s) at 1 week, 3 months and 1 year after onset were analysed with addition of the motor domain of Fugl-Meyer Assessment (FMA, score 0-100) at week 1 and 1 year. Standard linear regression was carried out with SIS mobility as dependent and SIS strength, TUG and FMA as independent variables. Results: Participants’ mean age was 74 (SD 11) years, 39% were women. Their initial motor function on FMA scored 90. SIS mobility score was 73 (SD 23) at 1 week, 85 (SD 19) at 3 months and 86 (SD 17) at 1 year. At 1 week 28% of the variation in SIS mobility was explained by a model including SIS strength, FMA and TUG with significant contribution from TUG only. At 3 months 40% of the variation in SIS mobility was explained by significant contribution from SIS strength and TUG. At 1 year post stroke, 56% of the variation in perceived mobility was explained by significant contribution from TUG and SIS strength, but not from FMA. Addition of sex and age did not change the explanatory values of the models. Conclusion: People with mildly impaired motor function experienced mobility difficulties that decreased, but still persisted one year after stroke. The pure measure of motor function was not related to self-perceived mobility. Perceived mobility was significantly associated with clinical mobility measures and self-perceived extremity strength. The results highlight the importance of including patient reported outcomes in rehabilitation.
24.	Danielsson, Anna, 1957, et al. (författare) Tematiska rum; strokerummet; rehabilitering och vardag: Muskelfunktion och träning 2007 Ingår i: Vårdalinstutet. Annan publikation (övrigt vetenskapligt/konstnärligt)
25.	Danielsson, Anna, 1957, et al. (författare) Test-retest reliability of two measures of energy cost after stroke 2006 Ingår i: International symposium "Evidence for stroke rehabilitation - bridging into the future", Göteborg, Sweden April 26-28, 2006. Konferensbidrag (refereegranskat)abstract Background: After a stroke, many persons walk slowly with increased energy cost which might restrict daily activities. Measurement of energy cost adds valuable information to gait analysis in the evaluation of exercise, orthoses and walking aids. Direct measurement of oxygen uptake (VO2) is the golden standard, but methods clinically practicable are needed. Physiological Cost Index (PCI) is a clinical method based on the relation between VO2 and heart rate. Regulation of heart rate might be affected after stroke, therefore the reliability of PCI in stroke patients needs to be investigated. The aim was to compare VO2 and PCI with respect to test-retest reliability. Methods: 20 persons with stroke 30-63 years of age were included. VO2 was measured by breath-by-breath analysis and heart rate by electrocardiography at rest and during 5 minutes of walking on a treadmill at the individual's self-selected speed. Two measurement sessions were carried out. PCI was calculated as the heart rate difference between rest and walking, divided by gait speed and expressed as heart beats/m. The differences between sessions were analysed with confidence intervals and Bland-Altman plots. Results: Gait speed on the treadmill was mean 0.48 m/s (CI 95% 0.34 - 0.60). The energy cost was mean 0.41 and 0.40 ml/kg/m at 1st and 2nd session, respectively, with a mean test-retest difference of 0.012 (CI 95% -0.008 - 0.033). PCI was mean 0.76 at both sessions with a mean test-retest difference of 0.009 (95% CI -0.142 - 0.125). Conclusion: The energy cost measured by both VO2 and PCI was increased in the stroke group compared to reference values from the literature. Analysis of mean differences between sessions showed a greater dispersion for the PCI than for the VO2-based values. PCI needs further investigation before conclusions about the applicability for stroke patients can be drawn.
26.	Danielsson, Anna, 1957, et al. (författare) Walking training with virtual reality after stroke: a pilot study 2014 Ingår i: World Congress of Neuro Rehabilitation Istanbul, Turkiet 8-12 april 2014. Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract Background: A prototype for walking training on a treadmill with feedback using virtual reality has been developed at Rehabilitation medicine. It consists of movement sensors and special software directing an application with movie and sound, imaging a walking environment. The aim was to explore the feasibility and possible physical effects of walking training with the system after stroke. Method: Volunteering were one woman and five men with stroke 2-73 months previously. Training was offered 1-2 times/week during 4 weeks. The participants were free to choose treadmill speed, use of handrail and duration of each session. Walking speed, distance and perceived exertion were registered at each session. Balance and walking ability were evaluated prior to and after the training period. Results: Training lasted 2-4 weeks with 5-8 sessions/person. Walking time was 10-23 minutes/session. Walking speeds were 0.4-0.8 m/s and distances 800-2100 m/session. Exertion was perceived as easy or somewhat hard. Training was safe, no falls occurred during 41 sessions in total. All participants felt motivated and some described a “whole experience”. Three reported transient dizziness and other felt coordination problems and tiredness in the supporting hand. A higher technical quality was desired as well as possibility to get a variation in walking environment. The outcome measures showed that balance was slightly improved in four cases and walking speed in one, but no consistent change pattern was seen. Conclusions: This pilot study showed that a system with visual and audio feedback on a treadmill is safe and can be motivating for walking training. Perceptual problems have to be considered and may need further investigation especially in persons with neurological impairments. Technical quality and a possibility to offer various virtual environments are areas for further development. The duration of this study was too short for changes in physical outcomes to be expected.
27.	Israelsson, Johan, et al. (författare) Health status and psychological distress among in-hospital cardiac arrest survivors in relation to gender 2017 Ingår i: Resuscitation. - : Elsevier. - 0300-9572 .- 1873-1570. ; 114, s. 27-33 Tidskriftsartikel (refereegranskat)abstract AIM: To describe health status and psychological distress among in-hospital cardiac arrest (IHCA) survivors in relation to gender.METHODS: This national register study consists of data from follow-up registration of IHCA survivors 3-6 months post cardiac arrest (CA) in Sweden. A questionnaire was sent to the survivors, including measurements of health status (EQ-5D-5L) and psychological distress (HADS).RESULTS: Between 2013 and 2015, 594 IHCA survivors were included in the study. The median values for EQ-5D-5L index and EQ VAS among survivors were 0.78 (q1-q3=0.67-0.86) and 70 (q1-q3=50-80) respectively. The values were significantly lower (p<0.001) in women compared to men. In addition, women reported more problems than men in all dimensions of EQ-5D-5L, except self-care. A majority of the respondents reported no problems with anxiety (85.4%) and/or symptoms of depression (87.0%). Women reported significantly more problems with anxiety (p<0.001) and symptoms of depression (p<0.001) compared to men. Gender was significantly associated with poorer health status and more psychological distress. No interaction effects for gender and age were found.CONCLUSIONS: Although the majority of survivors reported acceptable health status and no psychological distress, a substantial proportion reported severe problems. Women reported worse health status and more psychological distress compared to men. Therefore, a higher proportion of women may be in need of support. Health care professionals should make efforts to identify health problems among survivors and offer individualised support when needed.
28.	Nordin, Åsa, 1975, et al. (författare) Inter- and intra reliability of the action research arm test in patients after stroke 2012 Ingår i: NeuroRehabilitation and Neural Repair. - 1552-6844. ; 26:6, s. 695-804 Konferensbidrag (refereegranskat)
29.	Opheim, Arve, 1962, et al. (författare) Early prediction of long-term upper limb spasticity after stroke: Part of the SALGOT study. 2015 Ingår i: Neurology. - 1526-632X. ; 85:10, s. 873-80 Tidskriftsartikel (refereegranskat)abstract To identify predictors and the optimal time point for the early prediction of the presence and severity of spasticity in the upper limb 12 months poststroke.
30.	Opheim, Arve, 1962, et al. (författare) Is upper-limb sensorimotor function or spasticity the best predictor for spasticity one year poststroke? 2015 Ingår i: World Conference in Physical Therapy, Singapore; 05/2015. Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract ABSTRACT: Background: Clinical assessments of body functions are an important part of physiotherapy practice poststroke. These assessments are used to plan treatments, and may be used to indicate future function. Upper limb spasticity has been found to be associated with poorer motor function and muscle strength, pain and higher dependence in daily life. Therefore, the identification of patients at risk of developing spasticity may be important. Whether sensorimotor function or spasticity during the first month is the better predictor for spasticity after 1 year is unknown. Purpose: The aim was to investigate whether sensorimotor function or spasticity assessed 4 weeks poststroke was the better predictor for spasticity after 1year. Methods: One hundred and seventeen patients in Gothenburg, Sweden, with first ever stroke and impaired upper-limb function on day 3 was included in this study. The clinical assessments were made 4 weeks and 1 year poststroke. Sensorimotor function was assessed with Fugl-Meyer Upper Extremity scale (FMA-UE), and higher score indicate better function (0-66). Spasticity in elbow flexors and extensors, wrist flexors and extensors, was assessed with the modified Ashworth Scale (MAS), with higher score indicating more spasticity (0-5). The MAS score was dichotomized into: 0=no spasticity and ≥1=spasticity present, and spasticity in any of these muscle groups was regarded as spasticity present. Univariate and multivariate logistic regression analysis was used to analyze the predictors, and odds ratio and 95% were calculated. Results: In univariate analysis, both FMA-UE and MAS were significantly associated with spasticity at one year poststroke. I the multivariate analysis, only FMA-UE (OR 0.91, 95%CI: 0.88-0.95) and age (OR 0.94, 95% CI: 0.89-0.99), was significant predictors for spasticity at 1 year post stroke. Conclusion(s): When both MAS and FMA-UE was analyzed together and controlled for in a multivariate regression analysis, only FMA-UE was significantly associated with spasticity after 1 year. Better sensorimotor function was associated with reduced OR for spasticity. Also, higher age had reduced OR for spasticity. This may imply that upper limb spasticity at 4 weeks poststroke may still be an “unstable” impairment, and not yet manifest. Therefore, sensorimotor function seems to be a better predictor than spasticity 4 weeks after for spasticity one year poststroke. Implications: Poorer sensorimotor function was associated with long-term spasticity and therefore important to assess in the first month poststroke. Assessment of spasticity within the first month to predict long-term spasticity poststroke may be limited. Keywords: Stroke, spasticity, sensorimotor function, clinical assessment scales.
31.	Opheim, Arve, 1962, et al. (författare) Spasticitet i övre extremitet under det första året efter stroke: del av SALGOT- studien. 2013 Ingår i: Sjukgymnastikdagarna. Oktober 2013, Göteborg.. Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract BAKGRUND/SYFTE Syftet med studien var att beskriva förekomst av spasticitet, sensomotorisk funktion, smärta och rörelseomfång (ROM) i övre extremitet under första året efter stroke. METODER Konsekutivt inkluderades 117 patienter från Göteborgsområdet, med förstagångs stroke och nedsatt arm och handfunktion tre dagar efter insjuknade. Patienterna bedömdes vid sex tillfällen under det första året: 3, 10 dagar, 4 veckor, 3, 6 och 12 månader efter stroke. Spasticitet i övre extremitet bedömdes med Modifierad Ashworth Skala (MAS), sensomotorisk funktion, smärta vid passiv rörelse och ROM med Fugl-Meyer skala (FMA), Subgruppsanalyser genomfördes. RESULTAT/DISKUSSION Förekomst av spasticitet vid dag 3 var 25% och vid ett år 46%.. Graden av spasticitet ökade över tid bland de som visade spasticitet vid tidigare mättillfällen.Sensomotorisk funktion bedömt med FMA förbättrades fram till 3 månader efter stroke på gruppnivå, men inte därefter. Förekomst av smärta under studieperioden ökade från 20% till 45%. Minskat ROM bedömdes hos 40% vid dag 3 och vecka 4, och ökade till 55% vid 3, 6, 12 månader efter stroke. De med spasticitet hade signifikant lägre poäng på FMA, och högre poäng smärta. KONKLUSSION Spasticitet i övre extremitet är vanligt efter stroke och kan vara associerat med sämre sensomotorisks funktion och ökad smärta. I tillägg till funktionell träning, indikerar denna studie att smärta och spasticitet bör beaktas (behandlas) hos patienter med förstagångsstroke. Smärta och nedsatt rörelseomfång är viktiga aspekter att beakta hos personer med spasticitet efter Denna studie indikerar att smärta och spasticitet bör behandlas (beaktas) i tillägg till funktionell träning.
32.	Opheim, Arve, 1962, et al. (författare) Tidig prediktion av spasticitet i övre extremitet efter stroke. 2016 Ingår i: Neurologi i Sverige. - 2000-8538. ; :1, s. 52-8 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
33.	Opheim, Arve, 1962, et al. (författare) Upper-limb spasticity during the first year after stroke: stroke arm longitudinal study at the University of Gothenburg. 2014 Ingår i: American journal of physical medicine & rehabilitation / Association of Academic Physiatrists. - 1537-7385. ; 93:10, s. 884-96 Tidskriftsartikel (refereegranskat)abstract The aims of this study were to describe the prevalence and the severity of upper-limb spasticity during the first year after stroke and to analyze sensorimotor function, pain, reduced range of motion, and sensibility in persons with and without spasticity.
34.	Opheim, Arve, 1962, et al. (författare) What comes first, spasticity, reduced range of motion or pain in patients after stroke? 2013 Ingår i: Journal of Rehabilitation Medicine. Presented at the 3rd Baltic and North Sea Conference on Physical & Rehabilitation Medicine, the 118th Congress of the German Society for Physical Medicine & Rehabilitation, and the annual Congress for the Austrian Society for Physical Medicine & Rehabilitation. September 2013, Hannover, Germany. - : Medical Journals Sweden AB. - 1650-1977. ; 45 Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract Introduction Pain, reduced range of motion (ROM) and reduced motor function has been found to be associated with spasticity in persons with stroke, but the developments of these impairments over time are less known. The aim of the study was to describe the development of spasticity, pain, ROM, sensibility and sensory motor function in persons with first stroke during the first year after stroke. Method 117 patients with first ever stroke was recruited for the study. No selections apart from reduced arm function on day 3 were made. The patients were assessed six times during the first year, at day 3, 10, week 4, month 3, 6 and 12. Upper limb spasticity was assessed with the modified Ashworth scale (MAS), and a MAS score ≥ 1 was regarded as presence of spasticity. Sensory motor function was assessed with the Fugl-Meyer Upper-Extremity scale (FM-UE). The presence of pain, reduced sensibility and range of motion (ROM) was regarded if lower than maximum scores on the non-motor domains of the FM-UE. Results The proportion of persons with spasticity increased from 0.25 at day 3 to 0.44 at week 4 and was stable up to 12 months. Sensory motor function improved from 28 (SD 25) at day 3 to 47 (SD 23) at 3 months and was stable up to 12 months. The proportion of persons with reduced ROM was 0.45 at day 3, was stable up to 3 months and increased at 6 and 12 months, 0.55 and 0.61, respectively. The proportion of patients with reduced sensibility decreased from 0.55 at day 3 to 0.36 at 12 months. Discussion Pain, spasticity and sensory motor function seemed to develop in about parallel the first 3 months. The proportion of persons with pain continued to increase during the first year. The proportion of patients with reduced ROM was unchanged during the first three months, but increased at 6 and 12 months. Based on this, reduced upper limb ROM seems secondary to pain and spasticity.
35.	Palmcrantz, S., et al. (författare) Impact of Intensive Gait Training With and Without Electromechanical Assistance in the Chronic Phase After Stroke-A Multi-Arm Randomized Controlled Trial With a 6 and 12 Months Follow Up 2021 Ingår i: Frontiers in Neuroscience. - : Frontiers Media SA. - 1662-453X .- 1662-4548. ; 15 Tidskriftsartikel (refereegranskat)abstract Introduction: Movement related impairments and limitations in walking are common long-term after stroke. This multi-arm randomized controlled trial explored the impact of training with an electromechanically assisted gait training (EAGT) system, i.e., the Hybrid Assistive Limb(R) (HAL), when integrated with conventional rehabilitation focused on gait and mobility. Material and Methods: Participants, aged 18-70 years with lower extremity paresis but able to walk with manual support or supervision 1-10 years after stroke, were randomized to (A) HAL-training on a treadmill, combined with conventional rehabilitation interventions (HAL-group), or (B) conventional rehabilitation interventions only (Conventional group), 3 days/week for 6 weeks, or (C) no intervention (Control group). Participants in the Control group were interviewed weekly regarding their scheduled training. Primary outcome was endurance in walking quantified by the 6 Minute Walk Test (6MWT). A rater blinded to treatment allocation performed assessments pre- and post-intervention and at follow-ups at 6 and 12 months. Baseline assessment included the National Institute of Health Stroke Scale (NIHSS) and the Modified Ranking Scale (MRS). Secondary outcomes included the Fugl Meyer Assessment- Lower Extremity, 10 Meter Walk Test, Berg Balance Scale (BBS), Barthel Index (BI) and perceived mobility with the Stroke Impact Scale. Results: A total of 48 participants completed the intervention period. The HAL-group walked twice as far as the Conventional group during the intervention. Post-intervention, both groups exhibited improved 6 MWT results, while the Control group had declined. A significant improvement was only found in the Conventional group and when compared to the Control group (Tukey HSD p = 0.022), and not between the HAL group and Conventional group (Tukey HSD p = 0.258) or the HAL- group and the Control group (Tukey HSD p = 0.447). There was also a significant decline in the Conventional group from post-intervention to 6 months follow up (p = 0.043). The best fitting model to predict outcome included initial balance (BBS), followed by stroke severity (NIHSS), and dependence in activity and participation (BI and MRS). Conclusion: Intensive conventional gait training induced significant improvements long-term after stroke while integrating treadmill based EAGT had no additional value in this study sample. The results may support cost effective evidence-based interventions for gait training long-term after stroke and further development of EAGT.
36.	Parziali, Marina, 1985, et al. (författare) Arm function within 72 hours after first occasion of stroke and stroke outcome in an unselected population 2012 Ingår i: Neurorehabilitation and Neural Repair. - 1552-6844. ; 26:6, s. 695-804 Konferensbidrag (refereegranskat)
37.	Persson, Carina Ulla, 1970, et al. (författare) A validation study using a modified version of Postural Assessment Scale for Stroke Patients: Postural Stroke Study in Gothenburg (POSTGOT). 2011 Ingår i: Journal of neuroengineering and rehabilitation. - : Springer Science and Business Media LLC. - 1743-0003. ; 8:57 Tidskriftsartikel (refereegranskat)abstract Background A modified version of Postural Assessment Scale for Stroke Patients (PASS) was created with some changes in the description of the items and clarifications in the manual (e.g. much help was defined as support from 2 persons). The aim of this validation study was to assess intrarater and interrater reliability using this modified version of PASS, at a stroke unit, for patients in the acute phase after their first event of stroke. Methods In the intrarater reliability study 114 patients and in the interrater reliability study 15 patients were examined twice with the test within one to 24 hours in the first week after stroke. Spearman's rank correlation, Kappa coefficients, Percentage Agreement and the newer rank-invariant methods; Relative Position, Relative Concentration and Relative rank Variance were used for the statistical analysis. Results For the intrarater reliability Spearman's rank correlations were 0.88-0.98 and k were 0.70-0.93 for the individual items. Small, statistically significant, differences were found for two items regarding Relative Position and for one item regarding Relative Concentration. There was no Relative rank Variance for any single item. For the interrater reliability, Spearman's rank correlations were 0.77-0.99 for individual items. For some items there was a possible, even if not proved, reliability problem regarding Relative Position and Relative Concentration. There was no Relative rank Variance for the single items, except for a small Relative rank Variance for one item. Conclusions The high intrarater and interrater reliability shown for the modified Postural Assessment Scale for Stroke Patients, the Swedish version of Postural Assessment Scale for Stroke Patients, with traditional and newer statistical analyses, particularly for assessments performed by the same rater, support the use of the Swedish version of Postural Assessment Scale for Stroke Patients, in the acute stage after stroke both in clinical and research settings. In addition, the Swedish version of Postural Assessment Scale for Stroke Patients was easy to apply and fast to administer in clinic.
38.	Persson, Carina Ulla, 1970, et al. (författare) Responsiveness of a modified version of the postural assessment scale for stroke patients and longitudinal change in postural control after stroke- Postural Stroke Study in Gothenburg (POSTGOT) - 2013 Ingår i: Journal of neuroengineering and rehabilitation. - : Springer Science and Business Media LLC. - 1743-0003. ; 10:1 Tidskriftsartikel (refereegranskat)abstract ABSTRACT: BACKGROUND: Responsiveness data certify that a change in a measurement output represents a real change, not a measurement error or biological variability. The objective was to evaluate the responsiveness of the modified version of the Postural Assessment Scale for Stroke Patients (SwePASS) in patients with a first event of stroke. An additional aim was to estimate the change in postural control during the first 12 months after stroke onset. METHODS: The SwePASS assessments were conducted during the first week and 3, 6 and 12 months after stroke in 90 patients. Svensson's method, Relative Position (RP), Relative Concentration (RC) and Relative Rank Variance (RV), were used to estimate the scale's responsiveness and the patients' change in postural control over time. RESULTS: From the first week to 3 months after stroke, the patients improved in terms of postural control with 2 to 12 times larger systematic changes in Relative Position (RP), for which 9 items and the total score showed a significant responsiveness to change when compared to the interrater reliability measurement error of the SwePASS reported in a previous study. When SwePASS was used to assess change in postural control between the first week and 3 months, 74% of the patients received higher scores while 10% received lower scores, RP 0.31 (95% CI 0.219-0.402). The corresponding figures between 3 and 6 and between 6 and 12 months were 37% and 16%, RP 0.09 (95% CI 0.030-0.152), and 18% and 26%, RP -0.07 (95% CI -0.134- (-0.010)), respectively. CONCLUSIONS: The SwePASS is responsive to change. Postural control evaluated using the SwePASS showed an improvement during the first 6 months after stroke. The measurement property, in the form of responsiveness, shows that the SwePASS scoring method can be considered for use in rehabilitation when assessing postural control in patients after stroke, especially during the first 3 months.
39.	Persson, Carina Ulla, 1970, et al. (författare) Timed Up & Go as a measure for longitudinal change in mobility after stroke - Postural Stroke Study in Gothenburg (POSTGOT) 2014 Ingår i: Journal of NeuroEngineering and Rehabilitation. - : Springer Science and Business Media LLC. - 1743-0003. ; 11:83 Tidskriftsartikel (refereegranskat)abstract Abstract Background A frequently used clinical test to assess mobility after stroke is the Timed Up & Go. Knowledge regarding whether or not the Timed Up & Go is able to detect change over time in patients with stroke, whether improvements in mobility exist after the first three months and whether or not longitudinal change in mobility after stroke depend on the patients’ age, is limited or unclear. The objectives were to investigate the distribution-based responsiveness of the Timed Up & Go (TUG) during the first three months after a first event of stroke, to measure the longitudinal change in TUG time during the first year after stroke and to establish whether recovery in TUG time differs between different age groups. Methods Ninety-one patients with first-ever stroke were assessed using the Timed Up & Go at the 1st week and at 3, 6 and 12 months after stroke. The non-parametric sign-test, the parametric t-test and a mixed model approach to linear regression for repeated measurements (Proc mixed) were used for the statistical analyses. Results The median TUG time was reduced from 17 to 12 seconds (p < 0.001) between the 1st week and 3 months. No further improvement was seen between 3 and 12 months after stroke. In a mixed model approach to linear regression, there was a significant age difference. Patients at age 80 and above tended to deteriorate in terms of TUG time between 3 and 12 months after stroke, while patients < 80 years did not (p = 0.011 for the interaction between age group and time). Conclusion The Timed Up & Go demonstrates ability to detect change in mobility over time in patients with stroke. A significant improvement in TUG time from the 1st week to 3 months after stroke was found, as expected, but thereafter no statistically significant change was detected. After 3 months, patients ≥80 years tended to deteriorate in terms of TUG time, while the younger patients did not.
40.	Persson, Hanna C, 1979, et al. (författare) A cohort study investigating a simple, early assessment to predict upper extremity function after stroke - a part of the SALGOT study 2015 Ingår i: Bmc Neurology. - : Springer Science and Business Media LLC. - 1471-2377. ; 15 Tidskriftsartikel (refereegranskat)abstract Background: For early prediction of upper extremity function, there is a need for short clinical measurements suitable for acute settings. Previous studies demonstrate correct prediction of function, but have ether included a complex assessment procedure or have an outcome that does not automatically correspond to motor function required to be useful in daily activity. The purpose of this study was to investigate whether a sub-set of items from the Action Research Arm Test (ARAT) at 3 days and 1 month post-stroke could predict the level of upper extremity motor function required for a drinking task at three later stages during the first year post-stroke. Methods: The level of motor function required for a drinking task was identified with the Fugl-Meyer Assessment for Upper Extremity (FMA-UE). A structured process was used to select ARAT items not requiring special equipment and to find a cut-off level of the items' sum score. The early prognostic values of the selected items, aimed to determine the level of motor function required for a drinking task at 10 days and 1 and 12 months, were investigated in a cohort of 112 patients. The patients had a first time stroke and impaired upper extremity function at day 3 after stroke onset, were >= 18 years and received care in a stroke unit. Results: Two items, "Pour water from glass to glass" and "Place hand on top of head", called ARAT-2, met the requirements to predict upper extremity motor function. ARAT-2 is a sum score (0-6) with a cut-off at 2 points, where >2 is considered an improvement. At the different time points, the sensitivity varied between 98 % and 100 %, specificity between 73 % and 94 %. Correctly classified patients varied between 81 % and 96 %. Conclusions: Using ARAT-2, 3 days post-stroke could predict the level of motor function (assessed with FMA-UE) required for a drinking task during the first year after a stroke. ARAT-2 demonstrates high predictive values, is easily performed and has the potential to be clinically feasible.
41.	Persson, Hanna C, 1979, et al. (författare) A cross sectional study of upper extremity strength ten days after a stroke; relationship between patient-reported and objective measures 2015 Ingår i: Bmc Neurology. - : Springer Science and Business Media LLC. - 1471-2377. ; 15 Tidskriftsartikel (refereegranskat)abstract Background: Reduced upper extremity function early after a stroke is common, and a combination of strength capacity and patient-reported measures contribute to setting realistic goals. The validity of the patient's perception of upper extremity strength in relation to objective strength assessments early after a stroke needs to be clarified. The objective was to investigate the relationship between perceived upper extremity strength and measured hand strength at ten days post-stroke. Methods: This study of 99 patients with reduced upper extremity function at 3 days post stroke, were consecutively included from a stroke unit to the Stroke Arm Longitudinal Study at the University of Gothenburg, (the SALGOT-study). The correlations between two questions from the Stroke Impact Scale (SIS 1a and 1b), and a dynamometer measure of hand strength values (percentage of normative values) were investigated. In order to explain differences between the two types of measurements, the accordance between perceived strength in a dichotomized SIS and objective measures was explored. In SIS 1a and 1b, 1-3 points correspond to reduced strength (<80 % or normative strength values). In SIS 1a and 1b, 4-5 points correspond to normal strength (>= 80 % of normative strength values). Results: The correlation between the measured strength values and perceived arm strength was rho 0.82 (p = < 0.001) and with perceived grip strength rho 0.87 (p = < 0.001). Using the dichotomized SIS and the 80 % cut-off correctly classified arm strength in 81 % and grip strength in 84 % of the patients, with a sensitivity of 0.86-0.87, a specificity of 0.62-0.77, positive predicted values of 0.87-0.91 and negative predicated values of 0.64-0.67. Discussion: The discrepancy between assessed strength capacity and self-perceived strength highlights the importanceof including self-perceived assessments early after stroke, in order to increase knowledge of a patient'sawareness of functioning or lack thereof. Conclusions: Ten days after stroke in patients without severe cognitive disabilities, this study suggests that despite high correlations between measures, an objective assessment of arm and hand strength does not always reflect the patient's perspective. A combination of self-reported and objective strength assessment is requested to enhance in setting of realistic goals early after stroke.
42.	Persson, Hanna C, 1979, et al. (författare) Armfunktion inom 72 timmar efter förstagångsstroke i en oselekterad patientgrupp, samt vårdförlopp och utfall vid utskrivning. En del av SALGOT-studien. 2013 Ingår i: Sjukgymnastdagarna 2013. Göteborg 2-4 oktober 2013.. Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract Bakgrund och syfte Nedsatt funktion i övre extremitet efter en stroke har rapporterats förekomma akut hos 70-80%. Akutvården förändras med fler som vårdas på strokeenhet så väl som behandlas med trombolys. Syftet var att i en oselekterad patientgrupp med förstagångsstroke, undersöka vårdförlopp och utskrivningsstatus samt förekomst av nedsatt arm och handfunktion inom 72 timmar efter insjuknande. Ett andra syfte var att undersöka faktorer som associeras med nedsatt övre extremitet och dess påverkan på utfallet. Metoder Inklusionskriterier var: förstagångsstroke, över 18 år, boende i geografiskt upptagningsområde, på strokeenheten inom 72 timmar efter insjuknade, ingen tidigare nedsatt funktion i övre extremitet. Via journalgranskning samlades bakgrundsdata, arm och handfunktion, utfall av stroke och sjukhusvård. Infarkter klassificerades enligt Bamford och med TOAST. Resultat och diskussion Av screenade 969 patienter med förstagångsstroke uppfyllde 642 inklusionskriterierna. Vid ankomst bedömdes patientens funktion med NIHSS, medelvärde 6.0. Förekomst av nedsatt arm och handfunktion inom 72 timmar efter insjuknade var 48%, vilket också samvarierade med ålder (p<0.004), vårdtid (p<0.001) och dödlighet inom akutvården (p<0.001). Det var 89% av patienterna som lades in direkt på strokeenheten och 77% kom till sjukhuset på insjuknadedagen. Medelvårdtiden på strokenheten var 10 dagar och 57% utskrevs till hemmet. Dödligheten inom 72 timmar var 5%. Konklusion Nedsatt arm och handfunktion inom 72 timmar efter insjuknande i förstagångsstroke förekommer hos 48% av patienterna. Nedsatt övre extremitet associerar med högre ålder, längre vårdtider inom strokeenheten och högre dödlighet i akutvården.
43.	Persson, Hanna C, 1979, et al. (författare) Differences in recovery of upper extremity functioning after ischemic and hemorrhagic stroke – part of the SALGOT study. 2016 Ingår i: 2nd European Stroke Organisation Conference, 10-12 May, 2016, Barcelona, Spain. Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract Background It is unclear if and how the type of stroke influences the recovery of motor function after stroke. The purpose was to assess if there are differences in extent of change in upper extremity motor function and activity capacity, in persons with ischemic versus hemorrhagic stroke during the first year post stroke. Methods 117 persons with stroke (ischemic n=98, hemorrhagic n=19) and reduced upper extremity function 3 days after onset were consecutively included to the Stroke Arm Longitudinal Study at the University of Gothenburg (SALGOT) from a stroke unit. Upper extremity motor function and activity capacity were assessed at 6 time points during the first year; age and initial stroke severity were recorded. Possible differences between groups in extent of change over time of upper extremity motor function and activity capacity were analyzed with the Mixed models repeated measurements. Results Significant improvements were present in function and activity in both groups within the first month (p= 0.001). Higher age and more severe stroke had a negative impact on recovery in both groups. Larger improvements of function and activity were seen in persons with hemorrhagic stroke, both from 3 days to 3 - and 12 months, and from 1 month to 3 months. Both groups reached similar level of function and activity at 3 months post stroke. Conclusions Poor initial motor function or activity capacity could mislead expertise and exclude persons with hemorrhagic stroke from further intensive rehabilitation.
44.	Persson, Hanna C, 1979, et al. (författare) Motor function in ischemic and hemorrhagic stroke during the first year 2015 Ingår i: the World Confederation for Physical Therapy Congress 2015. Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract Background: Few studies have investigated motor function in the upper extremity in both ischemic or hemorrhagic stroke. Different recovery patterns in upper extremity motor function have clinically been described, but there is a lack of research. Purpose: To investigate differences in recovery of upper extremity motor function after ischemic or hemorrhagic stroke during the first year after a stroke. Methods: From the Stroke Arm Longitudinal Study at the Gothenburg University study, 45 people fulfilled eight assessment occasions during twelve months after a first ever stroke. People who had first ever stroke and reduced upper extremity function at day three post stroke were included in the study. Upper extremity motor function was investigated with the Fugl-Meyer Assessment for Upper Extremity (FMA-UE) at day 3, day 10, at 3, 4 and 6 weeks and at 3, 6 and 12 months. Descriptive statistics was used to present data, to compare differences between ischemic or hemorrhagic stroke, subgroup analyses were performed at every occasion using the Mann-Whitney U-tests. Results: Of 45 people, 33 had ischemic stroke, and twelve had hemorrhagic stroke. There was a crossover in mean level of upper extremity motor function, with lower level of function in people with hemorrhagic stroke compared to ischemic stroke from day three to one month. In one month to one year, the mean level of upper extremity function was higher for people with hemorrhagic stroke. No statistically significant differences in upper extremity motor function between the two groups were seen at any of the eight assessments during the first year after stroke. Conclusion(s): No significant differences were seen in upper extremity motor function between hemorrhage and ischemic stroke. On average those with hemorrhagic stroke seemed to have lower level of upper extremity motor function from day three to one month post stroke, but thereafter have a higher level compared to ischemic stroke. Implications: Based on this study, the implication could be that the rehabilitation of upper extremity motor function during the first year after a stroke, should not be changed due to if the patient have ischemic or hemorrhagic stroke, but should be individual based.
45.	Persson, Hanna C, 1979, et al. (författare) Motor function recovery in patients with ischemic versus hemorrhagic stroke during the first year 2015 Ingår i: Nordic Stroke 2015. 18th Nordic Congress on Cerebrovascular Diseases. 26-28 August 2015, Malmö, Sweden. Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract Background and purpose Few studies have investigated the recovery of motor function in the upper extremity according to the sub types ischemic and hemorrhagic stroke. Different recovery patterns in upper extremity motor function have clinically been described, but there is a lack of research. The purpose of the present study was to investigate possible differences in the recovery of upper extremity motor function in patients with ischemic versus intracerebral hemorrhagic stroke during the first year after a stroke. Materials and methods Patients with a first ever stroke and impaired upper extremity function 3 days after onset were consecutively included in the Stroke Arm Longitudinal Study at the Gothenburg University study during 2009-2011. Upper extremity function was investigated with the Fugl-Meyer Assessment for Upper Extremity (FMA-UE) at 3 and 10 days and at 1, 3, 6 and 12 months, age and initial stroke severity were assessed day 1. To compare changes over time in ischemic and hemorrhagic stroke, the Mixed model repeated measurement was used. A p-value <0.05 at was considered statistically significant. Results Of 117 patients, 98 had ischemic (mean 70 years), and 19 had hemorrhagic stroke (mean 62 years). A wide spread in upper extremity motor function recovery was seen. Statistically significant differences over the first year between ischemic and hemorrhagic stroke (interaction of type of stroke and time since onset, p= 0.001 at 3, 10 days and 1 month) were seen, where patients with ischemic stroke started at a higher FMA-UE level but at 3 months the two groups had approximately same level of motor function. Initial stroke severity and age had a significant impact on the recovery pattern. Conclusion Patients with ischemic stroke has during the first 3 months higher motor function and recover faster compared to hemorrhagic stroke. Thereafter no significant difference was seen. The type of stroke (ischemic or hemorrhagic) is of most relevance for the recovery process in the sub-acute phase, but still, the wide-ranging individual changes emphasizes the importance of individually based rehabilitation. Further studied are needed to confirm these results.
46.	Persson, Hanna C, 1979, et al. (författare) Outcome and upper extremity function within 72 hours after first occasion of stroke in an unselected population at a stroke unit. A part of the SALGOT study. 2012 Ingår i: BMC neurology. - : Springer Science and Business Media LLC. - 1471-2377. ; 12:1 Tidskriftsartikel (refereegranskat)abstract ABSTRACT: BACKGROUND: Reduced upper extremity function is one of the most common impairments after stroke and has previously been reported in approximately 70-80% of patients in the acute stage. Acute care for stroke has changes over the last years, with more people being admitted to a stroke unit as well as use of thrombolysis. The aim of the present study was to describe baseline characteristics, care pathway and discharge status in an unselected group of patients with first occasion of stroke who were at a stroke unit within 72 hours after stroke and also to investigate the frequency of impaired arm and hand function. A second aim was to explore factors associated with impaired upper extremity function and the impact of impairment on the patient's outcome. METHODS: Patients over 18 years of age with first ever stroke, living in a geographical catchment area, being at the stroke unit within 72 hours after onset, with no prior upper extremity impairment were included. Baseline characteristics, arm and hand function within 72 hours, stroke outcome and care pathway in the acute phase were described, by gathering information retrospectively from the patients' charts. Ischemic strokes were categorized according to the Bamford classification and the Trial of Org 10172 in Acute Stroke Treatment criteria. RESULTS: Of the 969 patients with first ever stroke who were screened, 642 patients fulfilled the inclusion criteria. According to the National Institutes of Health Stroke Scale (NIHSS), the patients had a mean score of 5.6, median 3.0, at arrival to the hospital. Ischemic stroke was most frequent in the anterior circulation (87.7%). Within 72 hours after stroke onset 48.0% of the patients had impaired arm and hand function and this was positively associated with higher age (p < 0.004), longer stay in the acute care (p < 0.001) and mortality in acute care (p < 0.001). Directly admitted to the stroke unit were 89.1% of the patients and 77.1% received hospital care on same day as stroke onset. Mean length of stay in the stroke unit was 9.9 days, 56.8% of the patients were discharged directly home from the stroke unit. Mortality within 72 hours after stroke onset was 5.0%. CONCLUSION: Impaired arm and hand function is present in 48% of the patients in a non selected population with first ever stroke, estimated within 72 hours after onset. This is less than previously reported. Impaired arm and hand function early after stroke is associated with higher age, longer stay in the acute care, and higher mortality within the acute hospital care.
47.	Persson, Hanna C, 1979, et al. (författare) Patientens skattade arm och handstyrka i korrelation till objektiva mätningar 10 dagar efter en förstagångsstroke; en del av SALGOT-studien. 2013 Ingår i: Sjukgymnastdagarna 2013. Göteborg 2-4 oktober 2013. Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract Bakgrund och syfte Kunskap om patientens förståelse av funktionsnedsättning efter stroke är bristfällig. Få studier finns, varav ingen som omfattar akut skede. Syftet med studien var att undersöka patientens upplevad arm och handstyrka 10 dagar efter insjunkande i stroke och hur denna korrelerar till objektiva mätningar. Metoder Etthundra patienter med förstagångsstroke och nedsatt arm och handfunktion 3 dagar efter insjuknade, boende i Göteborgsområdet, undersöktes från studien Stroke Arm Longitudinal Study at the University of Gothenburg (SALGOT). 10 dagar efter insjuknade, skattade patienten sin funktion i övre extremitet på två delmoment av Stroke Impact Scale; styrka i arm respektive i hand i afficierad sida. Övre extremitet bedömdes med greppstryka mätt med JAMAR samt med aktivitetsskalan Action Research Arm Test (ARAT). Korrelationsberäkningar genomfördes. Resultat Hög korrelation visades mellan patientrapporterade styrka i hand och i greppstryka mätt med JAMAR; roh 0.86 and i arm; rho 0.81. Hög korrelation fanns även mellan patientrapporterade styrka i hand och med ARAT; rho 0.83 och i armen; rho 0.79. Samtliga korrelationer med signifikansnivå på p<0.05. Konklusion Denna studie visar att 80% av de patienterna deltog, redan 10 dagar efter stroke klarar att korrekt skatta styrkan i påverkad arm och hand. Detta indikerar på att det finns god överensstämmelse mellan patientens skattade styrka och objektiva mätningar redan tidigt efter stroke.
48.	Persson, Hanna C, 1979, et al. (författare) PREDICTION OF ARM FUNCTION WITHIN ONE YEAR AFTER STROKE USING A SHORT ASSESSMENT 2014 Ingår i: The 8th World Congress for NeuroRehabilitation. ; Ref no 319:PP-156 Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract Background: A clinical test is needed, with the possibility through an early assessment to correctly predict clinical relevant arm function in patients with stroke, which would be appropriate for the patient, staff and when planning for future care and rehabilitation. Aims: There are two purposes of the present study. First; investigate if items from the Action Research Arm Test (ARAT) can be extracted to create a diagnostic test easy to perform in the clinic during the acute stage of stroke with the possibility to predict upper limb function and activity, second; assess the new test’s possibility to predict sufficient motor function ability to drink from a glass with the impaired arm. Methods: In the study 112 patients were assessed at day 3, day 10, week 4 and month 12 after stroke onset. Clinically feasible items from the ARAT able to detect sufficient motor function ability to drink from a glass with the impaired arm during the first year after stroke were selected in a structure process. An appropriate cut-off for the diagnostic test was chosen with Receiver Operation Characteristic (ROC) curves. In the second step the chosen items’ possibility to predict upper extremity function and activity were tested with 2-way contingency table. Results: Two items from ARAT; “Pour water from glass to glass” and “Place hand on top of head” were structured selected to a diagnostic test with a total sum of 0-6 p. A cut-off level of 0-1/2-6 p was identified, having an Area Under the Curve (AUC) of 0.91-0.99 presented in the ROC-curves. The percent of correctly predicted patients over all were between 80.8% and 96.4% in the different test occasions. The diagnostic test had the ability to correctly predict motor function of patients having some dexterity at day 3, Negative Predictive Value (NPV) day 10, 0.98, week 4 and month 12 1.0. The Positive Predictive Value (PPV) was high day 10, 0.95, but lower thereafter; week 4, 0.77, month 12, 0.61. From assessments week 4, the PPV/NPV in month 12 were 0.79/1.0. Conclusions: It is possible to, from a short assessment (two items from ARAT) at day 3 post stroke predict sufficient motor function ability to drink from a glass with the paretic arm during the first year. The percentage of correct over all prediction varies between 81 -94%. Keywords: prognosis, stroke, upper extremity
49.	Persson, Hanna C, 1979, et al. (författare) Upper extremity recovery after ischaemic and haemorrhagic stroke: Part of the SALGOT study 2016 Ingår i: European Stroke Journal. - : SAGE Publications. - 2396-9873 .- 2396-9881. ; 1:4, s. 310-19 Tidskriftsartikel (refereegranskat)abstract Introduction The purpose was to explore if there are differences in extent of change in upper extremity motor function and activity capacity, in persons with ischaemic versus haemorrhagic stroke, during the first year post stroke. Patients and methods One hundred seventeen persons with stroke (ischaemic n=98, haemorrhagic n=19) and reduced upper extremity function 3 days after onset were consecutively included to the Stroke Arm Longitudinal Study at the University of Gothenburg (SALGOT) from a stroke unit. Upper extremity motor function (Fugl-Meyer Assessment Scale for Upper Extremity (FMA-UE)) and activity capacity (Action Research Arm Test (ARAT)) were assessed at 6 assessments during the first year; age and initial stroke severity were recorded. Differences between groups in extent of change over time of upper extremity motor function and activity capacity were analysed with mixed models repeated measurements method. Results Significant improvements were found in function and activity in both groups within the first month (p=0.001). Higher age and more severe stroke had a negative impact on recovery in both groups. Larger improvements of function and activity were seen in haemorrhagic stroke compared to ischaemic, both from 3 days to 3- and 12 months, and from 1 month to 3 months. Both groups reached similar levels of function and activity at 3 months post stroke. Conclusion Although persons with haemorrhagic stroke had initially lower scores than those with ischaemic stroke, they had a larger improvement within the first 3 months, and thereafter both groups had similar function and activity.
50.	Persson, Hanna C, 1979, et al. (författare) UPPER EXTREMITY TEN DAYS AFTER FIRST OCCASION OF STROKE; PATIENT PERCIEVED STRENGTH CORRELATING TO OBJECTIVE MEASUREMENTS. A PART OF THE SALGOT STUDY. 2013 Ingår i: 7TH ISPRM WORLD CONGRESS. International Society of Physical and Rehabilitation Medicine, June 16-20, 2013, Bejing. Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract Objective To investigate the patient’s perception of arm and hand strength ten days after stroke onset and correlate this to objective measurements. Method One hundred patients with stroke and impaired upper extremity within 3 days after onset were investigated from the Stroke Arm Longitudinal Study at the University of GOThenburg (SALGOT). Ten days after onset, the patients estimated their function in the upper extremity on the Stroke Impact Scale; items regarding the strength of the arm and grip in the hand. Upper extremity function was assessed with grip strength measurement JAMAR and the activity scale Action Research Arm Test (ARAT). The correlations were calculated. Results High correlations were found between patient reported strength in the hand and grip strength (JAMAR); rho 0.86 and in the arm; rho 0.81. High correlation were also found between patient reported strength in the hand and the ARAT; rho 0.83 and in the arm; rho 0.79, all with a significant level of p < 0.01. Implication/Impact on Rehabilitation The results from the present study indicate that only 10 days after stroke over 80% of the participated patients, can correctly evaluate their strength in impaired limb. The patients’ understanding of the capacity is important for the rehabilitation and in planning for the future. Awareness of impaired function in the upper extremity is not previously described in this early stage after a stroke.

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