| 1. |
- Abbott, Allan, 1978-, et al.
(författare)
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What biopsychosocial factors are associated with work ability in conservatively managed patients with cervical radiculopathy? : A cross-sectional analysis
- 2020
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Ingår i: PM&R. - : John Wiley & Sons. - 1934-1482 .- 1934-1563. ; 12:1, s. 64-72
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundNo previous studies have investigated what biopsychosocial factors are associated with self‐reported work ability in conservatively managed patients with cervical radiculopathy.ObjectiveTo develop a theoretical model of factors and potential processes associated with variation in work ability based on a thorough assessment of biopsychosocial variables in conservatively managed patients with cervical radiculopathy.DesignCross‐sectional observational study.SettingTertiary neurosurgery clinic.PatientsA total of 144 conservatively managed patients with cervical pain and radiculopathy participated in the study.MethodsFrom 64 biopsychosocial candidate variables, significant (P < .05) bivariate correlators with Work Ability Index (WAI) were entered as independent variables in a categorical regression. Elastic net regularization maintained the most parsimonious set of independent variables significantly associated with variation in WAI as the dependent variable. Process analysis of significant independent variable associations with WAI was performed.Main Outcome MeasurementWAI.ResultsFrom 42 bivariate correlates of WAI, multivariate regression displayed a total of seven variables that were significantly (F [25,98] = 5.74, P < .05) associated with 65.8% of the variation in WAI. The Neck Disability Index (NDI) and Fear‐Avoidance Beliefs Questionnaire Work subscale (FABQ‐W) were significant individual factors within the final regression model. Process analysis displayed FABQ‐W having a significant specific indirect association with the direct association between NDI and WAI, with the model associated with 77% of the variability in WAI (F [2,84] = 141.17, P < .001).ConclusionOf 64 candidate biopsychosocial factors, NDI and FABQ‐W were the most significant multivariate correlates with work ability. FABQ‐W has a significant indirect association with baseline NDI scores and perceived work ability. This warrants future research trialing work‐related fear avoidance interventions in conservatively managed patients with cervical radiculopathy.Level of EvidenceIII
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| 2. |
- Andersson, Nilla, et al.
(författare)
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Test-Retest Reliability of the Reintegration to Normal Living Index (RNL-I) to Assess Perceived Participation in Adults With Late Effects of Polio
- 2020
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Ingår i: PM&R. - : WILEY. - 1934-1482 .- 1934-1563. ; 12:2, s. 147-153
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Tidskriftsartikel (refereegranskat)abstract
- Background: Many individuals with late effects of polio have difficulties participating in daily activities. The Reintegration to Normal Living Index (RNL-I) is a self-report questionnaire that evaluates perceived participation, but knowledge of the test-retest reliability and measurement errors in this population is lacking.Objective: To evaluate the test-retest reliability of the RNL-I in adults with late effects of polio.Design: A postal survey with a test-retest design.Setting: University hospital outpatient clinic.Participants: Fifty-one adults (20 women and 31 men; mean age 72 years) with late effects of polio.Main Outcome Measurements: The Reintegration to Normal Living Index (RNL-I).Methods: The participants responded to the RNL-I twice, 3 weeks apart. Data were analyzed with the following statistical methods: percentage agreement (PA), quadratic kappa coefficients, the intraclass correlation coefficient (ICC), mean difference, standard error of measurement (SEM/SEM%), and the smallest real difference (SRD/SRD%).Results: The PA (ie, the same scoring at both test occasions) was >70% for 10 of 11 items. The kappa coefficients showed good test-retest agreement (>0.61) for 7 items. The ICC was 0.88 and the mean difference was -0.74. The SEM (SEM%) was 7.4 (9.7%) and the SRD (SRD%) was 20.5 (27.0%).Conclusion: The RNL-I can be considered reliable for adults with mild to moderate late effects of polio. It can thereby be used to assess changes in perceived participation over time or after rehabilitation interventions, both for a group of individuals and a single individual.
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| 3. |
- Brogårdh, Christina, et al.
(författare)
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Measurement properties of the Falls Efficacy Scale-International (FES-I) in persons with late effects of polio : A cross-sectional study
- 2022
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Ingår i: PM and R. - : Elsevier Inc.. - 1934-1482 .- 1934-1563. ; , s. 1-10
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Tidskriftsartikel (refereegranskat)abstract
- Background : Fear of falling (FoF) is very common in persons with late effects of polio (LEoP). An internationally recognized rating scale to assess FoF is the Falls Efficacy Scale-International (FES-I). Yet, there is limited knowledge about its measurement properties in persons with LEoP. Objective: To investigate the measurement properties of FES-I (16-item version) and short FES-I (7-item version) in persons with LEoP. Design: Explorative factor analysis and Rasch model analysis of cross-sectional data. Setting: University Hospital. Participants : A total of 321 persons with LEoP (mean age 70 ± 10 years, 173 women). Main outcome measurement: The FES-I and short FES-I, comprising four response options about concerns of falling ranging from 1 (not at all concerned) to 4 (very concerned). Methods: Data were collected by a postal survey. First, a factor analysis was performed to investigate unidimensionality of the scale. Thereafter, a Rasch model analysis was used to further analyze the measurement properties of FES-I and short FES-I, such as local dependency, targeting, hierarchical order of items, Differential Item Functioning (DIF), response category functioning and reliability (Person Separation Index, PSI). Raw score transformation to interval measurements was also performed. Results: The factor analysis revealed that FES-I was unidimensional, even though the Rasch analysis showed some misfit to the Rasch model and local dependency. Targeting for FES-I and short FES-I was somewhat suboptimal as the participants on average reported less FoF than expected. A negligible gender DIF was found for two items in FES-I and for one item in short FES-I. Reliability was high (PSI >0.86), and the response category thresholds worked as intended for both FES-I, and short FES-I. Conclusion: The FES-I and the short FES-I have sufficient measurement properties in persons with LEoP. Both versions can be used to assess fear of falling in this population. This article is protected by copyright. All rights reserved.
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| 4. |
- Brogårdh, Christina, et al.
(författare)
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Psychometric properties of the Walking Impact Scale (Walk-12) in persons with late effects of polio
- 2021
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Ingår i: PM&R. - : Wiley-Blackwell. - 1934-1482 .- 1934-1563. ; 13:3, s. 297-306
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Many persons with late effects of polio (LEoP) perceive walking limitations in everyday life. A common rating scale to assess walking limitations is the Walking Impact Scale (Walk-12). However, there is limited knowledge about its psychometric properties.OBJECTIVE: To investigate the psychometric properties of Walk-12 in persons with LEoP.DESIGN: Rasch model analysis of cross-sectional data.SETTING: University Hospital.PARTICIPANTS: A total of 325 persons with LEoP (175 women; mean age 70 ± 10 yr).MAIN OUTCOME MEASUREMENT: The Walk-12, comprising 12 items with five response categories ranging from 1 (not at all) to 5 (extremely).METHODS: Data of Walk-12 were collected by a postal survey. The Rasch model analysis was used to analyze unidimensionality of the scale, local dependency, targeting, hierarchical order of items, Differential Item Functioning (DIF), response category functioning and reliability (Person Separation Index, PSI). Raw score transformation to interval measurements was also performed.RESULTS: The analysis revealed that Walk-12 was multidimensional and suffered from some local dependency. Targeting was compromised among persons with less and worse walking limitations. Hierarchically, the most difficult item to perform was "running" and the easiest was "walking indoors with support". There was a minor DIF for gender in one item ("support when walking outdoors"). Reliability was high (PSI = 0.94). Disordered response category thresholds were found for three items; when merging the middle response categories for these items model fit slightly improved and unidimensionality was achieved.CONCLUSION: The Walk-12, in its current version, does not fully meet the rigorous psychometric Rasch measurement standards in persons with LEoP. Further development of the scale is warranted, including merging response categories and complementing Walk-12 with objective measures of gait in order to improve targeting. As these limitations can be considered minor, the current version of Walk-12 can still be useful for research and clinical practice. This article is protected by copyright. All rights reserved.
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| 5. |
- Brogårdh, Christina, et al.
(författare)
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Psychometric properties of the Walking Impact Scale (Walk-12) in persons with late effects of polio
- 2021
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Ingår i: PM&R. - : Wiley. - 1934-1482 .- 1934-1563. ; 13:3, s. 297-306
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Tidskriftsartikel (refereegranskat)abstract
- Background: Many persons with late effects of polio (LEoP) perceive walking limitations in everyday life. A common rating scale to assess walking limitations is the Walking Impact Scale (Walk-12). However, there is limited knowledge about its psychometric properties. Objective: To investigate the psychometric properties of Walk-12 in persons with LEoP. Design: Rasch model analysis of cross-sectional data. Setting: University hospital. Participants: A total of 325 persons with LEoP (175 women; mean age 70 ± 10 years). Main Outcome Measurement: The Walk-12, comprising 12 items with five response categories ranging from 1 (not at all) to 5 (extremely). Methods: Data of Walk-12 were collected by a postal survey. The Rasch model analysis was used to analyze unidimensionality of the scale, local dependency, targeting, hierarchical order of items, Differential Item Functioning (DIF), response category functioning, and reliability (Person Separation Index, PSI). Raw score transformation to interval measurements was also performed. Results: The analysis revealed that Walk-12 was multidimensional and suffered from some local dependency. Targeting was compromised among persons with less and more walking limitations. Hierarchically, the most difficult item to perform was “running” and the easiest was “walking indoors with support”. There was a minor DIF for gender in one item (“support when walking outdoors”). Reliability was high (PSI = 0.94). Disordered response category thresholds were found for three items; when merging the middle response categories for these items model fit slightly improved and unidimensionality was achieved. Conclusions: The Walk-12, in its current version, does not fully meet the rigorous psychometric Rasch measurement standards in persons with LEoP. Further development of the scale is warranted, including merging response categories and complementing Walk-12 with objective measures of gait in order to improve targeting. As these limitations can be considered minor, the current version of Walk-12 can still be useful for research and clinical practice.
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| 6. |
- Carlsson, Håkan, et al.
(författare)
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Efficacy and feasibility of SENSory relearning of the UPPer limb (SENSUPP) in people with chronic stroke: A pilot randomized controlled trial
- 2022
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Ingår i: PM&R. - : Wiley. - 1934-1482 .- 1934-1563. ; 14:12, s. 1461-1473
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Tidskriftsartikel (refereegranskat)abstract
- Background Sensorimotor impairments of the upper limb (UL) are common after stroke, but there is a lack of evidence-based interventions to improve functioning of UL. Objective To evaluate (1) the efficacy of sensory relearning and task-specific training compared to task-specific training only, and (2) the feasibility of the training in chronic stroke. Design A pilot randomized controlled trial. Setting University hospital outpatient clinic. Participants Twenty-seven participants (median age; 62 years, 20 men) were randomized to an intervention group (IG; n = 15) or to a control group (CG; n = 12). Intervention Both groups received training twice weekly in 2.5-hour sessions for 5 weeks. The training in the IG consisted of sensory relearning, task-specific training, and home training. The training in the CG consisted of task-specific training. Main Outcome Measures Primary outcome was sensory function (touch thresholds, touch discrimination, light touch, and proprioception). Secondary outcomes were dexterity, ability to use the hand in daily activities, and perceived participation. A blinded assessor conducted the assessments at baseline (T1), post intervention (T2), and at 3-month follow-up (T3). Nonparametric analyses and effect-size calculations (r) were performed. Feasibility was evaluated by a questionnaire. Results After the training, only touch thresholds improved significantly from T1 to T2 (p = .007, r = 0.61) in the IG compared to the CG. Within the IG, significant improvements were found from T1 to T2 regarding use of the hand in daily activities (p = .001, r = 0.96) and movement quality (p = .004, r = 0.85) and from T1 to T3 regarding satisfaction with performance in meaningful activities (p = .004, r = 0.94). The CG significantly improved the performance of using the hand in meaningful activities from T1 to T2 (p = .017, r = 0.86). The training was well tolerated by the participants and performed without any adverse events. Conclusions Combined sensory relearning and task-specific training may be a promising and feasible intervention to improve UL sensorimotor function after stroke.
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| 7. |
- Ekstrand, Elisabeth, et al.
(författare)
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Life satisfaction after stroke and the association with upper extremity disability, sociodemographics, and participation
- 2022
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Ingår i: PM and R. - : Wiley. - 1934-1482 .- 1934-1563. ; 14:8, s. 922-930
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Remaining disability after stroke can reduce a person's life satisfaction. Because previous studies of life satisfaction show inconsistent results, there is a need for more knowledge regarding perceived life satisfaction after stroke and associated factors. Objective: To assess perceived life satisfaction after stroke in relation to Swedish reference values; and the association with upper extremity disability, sociodemographics, and participation. Design: Cross-sectional study. Setting: University hospital. Participants: Seventy-five persons (72% male) with mild to moderate disability in a stable phase after stroke. Interventions: Not applicable. Main Outcome Measure: Life satisfaction was assessed with the Life Satisfaction Questionnaire (LiSat-11), which includes one global item Life as a whole and 10 domain-specific items. Global life satisfaction and explanatory factors were evaluated in two multivariate logistic regression models. Results: Fifty-three percent of the participants were satisfied with Life as a whole. Highest satisfaction was found for Family life (78%) and Partner relationship (77%) and lowest satisfaction for Vocational situation (32%), Sexual life (25%), and Physical health (23%). Life as a whole and most domain-specific items showed a significantly lower proportion of satisfied persons compared to Swedish reference values. In the first regression model with factors of upper extremity disability, manual ability was the strongest explanatory variable for Life as a whole (p value =.032, Nagelkerke R Square 0.117). In the second regression model, participation, social, and working status were the final explanatory variables (p value =.006, Nagelkerke R Square = 0.207). Conclusion: Our findings indicate that persons with mild to moderate disability after stroke perceive overall less satisfaction with Life as a whole and domain-specific items than the general Swedish population. To increase a person's life satisfaction after stroke, rehabilitation interventions should target a variety of aspects including enhancing functioning of upper extremity, reducing participation restrictions, and providing support regarding social and vocational situation.
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| 8. |
- Ekstrand, Elisabeth, et al.
(författare)
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Life Satisfaction in Persons With Late Effects of Polio : A Test-Retest Reliability Study
- 2020
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Ingår i: PM and R. - : Wiley. - 1934-1482 .- 1934-1563. ; 12:10, s. 997-1002
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Tidskriftsartikel (refereegranskat)abstract
- Background: The Life Satisfaction Questionnaire (LiSat-11), including one global item and 10 domain-specific items, is used to evaluate life satisfaction in persons with the late effects of polio (LEoPs). However, there is a lack of knowledge about its psychometric properties. Objective: To evaluate the test-retest reliability of the LiSat-11 and the associations between the global and domain-specific items in persons with LEoPs. Design: A test-retest design, where data were collected by a postal survey. Setting: University Hospital, Outpatient Clinic. Participants: A cross-sectional sample of persons (20 women and 31 men; mean age 72 years) with LEoPs. Main Outcome Measurements: LiSat-11, assessing how satisfied a person is with different aspects of life, such as life as a whole, vocation, economy, leisure, contacts with friends and acquaintances, sexual life, activities of daily living (ADLs), family life, partner relationship, somatic health, and psychological health. Methods: LiSat-11 was administered on two occasions, 2 weeks apart. The test-retest reliability was evaluated by Kappa statistics, the percent agreement (PA), and the Svensson rank-invariant method. The association between the items was evaluated with the Spearman rank correlation coefficient (rho). Results: The Kappa coefficients showed good to excellent agreement (0.64-0.90) and the PA ≤1 point was high (>92%) for all items. No items showed any systematic or random disagreements according to the Svensson method. All domain-specific items correlated significantly with the global item “Life as a whole” (P <.01; rhos 0.41 to 0.75). Conclusions: LiSat-11 is reliable for assessing life satisfaction in persons with LEoPs. The global item “Life as a whole” is useful as an overall measure but cannot fully replace the information obtained from the domain-specific items of LiSat-11.
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| 9. |
- Fagher, Kristina, et al.
(författare)
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Mental health, sleep, and pain in elite Para athletes and the association with injury and illness-A prospective study
- 2023
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Ingår i: PM&R. - : WILEY. - 1934-1482 .- 1934-1563. ; 15:9, s. 1130-1139
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionThe interest in the health of Para athletes continues to increase. Still, there are few studies that have evaluated health parameters beyond injury and illness in this athlete population. ObjectiveTo assess (1) the weekly proportion of elite Para athletes reporting anxiety/depression, low sleep levels (<= 7 hours), and pain over 52 weeks; (2) and to explore whether these health parameters are associated with the risk for a sports injury or illness. DesignA 52-week prospective study, part of the Sports-related Injury and Illness in Paralympic Sport Study (SRIIPSS). SettingA total of 107 Swedish elite Para athletes with physical, visual, and intellectual impairment participated. Main outcome measuresData on self-reported anxiety/depression, sleep levels, pain, and injuries/illnesses were collected weekly. Comparisons of these parameters preceding an injury/illness were made using Friedmans analysis of variance (ANOVA). ResultsThe proportion of athletes reporting weekly anxiety/depression was 34.1%; 60.9% of athletes reported sleeping <= 7 hours and 49.9% reported pain. In exploratory analyses, there were no significant differences between weeks before an injury for any of the variables. There were significant differences in levels of sleep over the weeks, where sleep levels were significantly higher (>10 hours) 4 weeks prior to an illness (p = .016). ConclusionThis cohort of elite Para athletes reported relatively high levels of anxiety/depression, low sleep levels, and pain, which is a concern. High sleep levels and the risk for illness might be an indication of overtraining, which commonly leads to persistent fatigue and an increased susceptibility to infections. Monitoring of the health of elite Para athletes is recommended to be able to improve performance and health in this population.
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| 10. |
- Fagher, Kristina, et al.
(författare)
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Prevalence of Sports-Related Injuries and Illnesses in Paralympic Athletes
- 2020
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Ingår i: PM&R. - : WILEY. - 1934-1482 .- 1934-1563. ; 12:3, s. 271-280
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundWith increased participation in Paralympic sports, the burden of sports-related injuries and illnesses may increase. However, there is limited knowledge about the epidemiology of sports-related injuries and illnesses in Paralympic sports (SRIIPS). ObjectiveTo describe among Swedish Paralympic athletes the 1-year retrospective period prevalence of severe SRIIPS and the point prevalence of all SRIIPS and to examine differences in prevalence proportions between athletes with different impairments, behaviors, and sport characteristics. DesignCross-sectional study. SettingSwedish Paralympic Programme. ParticipantsOne hundred and four Paralympic athletes with visual, physical, and intellectual impairment. MethodsAn eHealth application adapted to Paralympic athletes was used to collect self-report data on existing and previous SRIIPS, as well as impairment, behavior, and sport characteristics. Main Outcome MeasurementsOne-year retrospective period prevalence and point prevalence. ResultsThe period prevalence of severe injuries was 31% (95% CI 23-40) and the point prevalence 32% (95% CI 24-41). The period prevalence of severe illnesses was 14% (95% CI 9-23), and 13% of the athletes (95% CI 8-22) reported a current illness. More severe injuries (Pamp;lt;.05) were reported by athletes aged 18 to 25years, not using assistive device, having pain during sport, using analgesics, continuing training injured, and feeling guilt when missing exercise. Athletes who reported a previous severe injury, having pain in daily life and during sport, using analgesics, and being upset when unable to exercise had a higher prevalence of current injuries (Pamp;lt;.05). Being female, reporting previous severe illness, using prescribed medication, and feeling anxious/depressed were features associated with ongoing illnesses (Pamp;lt;.05). ConclusionParalympic athletes report a high prevalence of SRIIPS. Behavioral and psychological aspects as well as pain and use of medication appear to be associated with the occurrence of SRIIPS. The results imply that factors leading to SRIIPS are complex and call for a broad biopsychosocial approach when developing preventive measures. Level of EvidenceIII.
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