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| 2. |
- Persson, Carina Ulla, 1970, et al.
(författare)
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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
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Ingår i: Journal of neuroengineering and rehabilitation. - : Springer Science and Business Media LLC. - 1743-0003. ; 10:1
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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.
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| 3. |
- Persson, Carina Ulla, 1970, et al.
(författare)
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Timed Up & Go as a measure for longitudinal change in mobility after stroke - Postural Stroke Study in Gothenburg (POSTGOT)
- 2014
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Ingår i: Journal of NeuroEngineering and Rehabilitation. - : Springer Science and Business Media LLC. - 1743-0003. ; 11:83
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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.
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| 5. |
- Ahlstrand, Christina, et al.
(författare)
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Reliabilitetstestning av Purdue Pegboard® (finmotoriktest)
- 2012
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- För att undersöka hur många upprepade mätningar med Purdue Pegboard som ger tillräckligt bra reliabilitet vid test av finmotorik, genomfördes en pilotstudie på Arbets- och miljömedicin vintern 2010-2011. I studien deltog 28 högerhänta friska personer mellan 20 och 60 år, hälften män och hälften kvinnor. Samtliga försökspersoner gjorde en basmätning och därefter en uppföljande mätning efter en vecka. Höger hand, vänster hand och båda händer testades fem gånger vid varje försökstillfälle som gick ut på att sätta i maximalt antal pinnar på 30 sekunder. Test-retest data för kontinuerliga variabler analyserades med hänsyn till medelvärde av skillnaden mellan basmätning och uppföljning. Resultatet angavs som intervall mellan övre och nedre gräns i ”limits of agreement”( LOA). Efter totalt tio genomförda tester för varje individ (n=28) blev det genomsnittliga antalet isatta pinnar ca 17 för höger hand, 15-16 för vänster hand och ca 13 pinnar för båda händerna. Test nr 1, dvs en enkel test, så som den utförs på AMM (höger + vänster + båda händer), ger ett intervall på 5,6 pinnar för höger hand, 6,4 pinnar för vänster hand och 5,3 pinnar för båda händerna. Medelvärde från tre tester, test nr 1+2+3 ger ett intervall på 4,8 pinnar för höger hand, 4,1 pinnar för vänster hand och 3,5 pinnar för båda händerna. Medelvärde från fem tester, 1+2+3+4+5 ger ett intervall på 4,0 pinnar för höger hand, 2,8 pinnar för vänster hand och 3,8 pinnar för båda händerna. Genom att utöka metoden från en till tre tester uppnås en förbättring av reliabiliteten med närmare två pinnar i genomsnitt vilket ger ett acceptabelt Limits of agreement på mellan tre och en halv pinne (båda händer) till knappt fem pinnar (höger hand). Fyra mätningar ger en ytterligare förbättring av reliabiliteten på ca en halv pinne medan fem mätningar inte ger någon förbättring
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| 6. |
- Feldthusen, Caroline, 1977, et al.
(författare)
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Variations of fatigue in persons with Rheumatoid Arthritis- a 1 year longitudinal study.
- 2014
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Ingår i: DOI: 10.1136/annrheumdis-2014-eular.3502. Ann Rheum Dis. ; 73:Suppl2
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Beside pain, fatigue is expressed as the most prominent symptom in RA [1,2] and has been described as having a greater impact on daily life than pain [2]. Persons with RA experience that their fatigue vary over time concerning duration and frequency [3]. Longitudinal studies assessing change in fatigue after a period of one year have reported relatively stable fatigue [4] or considerable variations of fatigue [5]. More knowledge is needed about how fatigue in persons with RA vary over time. Objectives: To study variations of fatigue during one year in persons with RA of working age. Methods: Sixty-five participants having RA and being of working age (20-65 years) were recruited from a rheumatology clinic in West Sweden. Questionnaires assessing fatigue were given to the participants every other month during 1 year, in total seven times. Fatigue was assessed using both single-item and multidimensional measures: – VAS for global fatigue (0-100 mm) (endpoints no fatigue and worst imaginable fatigue) – The Bristol Rheumatoid Arthritis Fatigue Multidimensional Questionnaire, (BRAF-MDQ) consisting a global score (Total) and four subscales (Physical, Living, Cognition, Emotion) [6-7]. Results: The fatigue showed statistically significant variation over time for the outcome measures VAS fatigue (p<0.01), BRAF-MDQ Total and the subscales Living, Cognition (p<0.001) and Physical (p<0.05), when analyzed by mixed models. For the subscale Emotion (p=0.08) the variation of fatigue over time was not statistically significant. A statistically significant seasonal variation was shown for global fatigue (VAS p<0.01 and BRAF-MDQ Total p<0.001) and physical aspects of fatigue (BRAF-MDQ Physical and Living p<0.01) indicating less physical fatigue in the summer. No statistical differences over time were seen in fatigue between women and men or between age-groups. Conclusions: This study show that fatigue in persons with RA vary significantly during one year and further acknowledges the dynamic nature of fatigue and the complexity of its different facets. References: Wolfe, F., D.J. Hawley, and K. Wilson, The prevalence and meaning of fatigue in rheumatic disease. J Rheumatol, 1996. 23(8): p. 1407-17. Repping-Wuts, H., et al., Fatigue as experienced by patients with rheumatoid arthritis (RA): a qualitative study. Int J Nurs Stud, 2008. 45(7): p. 995-1002. Hewlett, S., et al., Patients' perceptions of fatigue in rheumatoid arthritis: overwhelming, uncontrollable, ignored. Arthritis Rheum, 2005. 53(5): p. 697-702. Mancuso, C.A., et al., Psychosocial variables and fatigue: a longitudinal study comparing individuals with rheumatoid arthritis and healthy controls. J Rheumatol, 2006. 33(8): p. 1496-502. Treharne, G.J., et al., Predictors of fatigue over 1 year among people with rheumatoid arthritis. Psychol Health Med, 2008. 13(4): p. 494-504. Nicklin, J., et al., Measuring fatigue in rheumatoid arthritis: a cross-sectional study to evaluate the Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional questionnaire, visual analog scales, and numerical rating scales. Arthritis Care Res (Hoboken), 2010. 62(11): p. 1559-68. Dures, E.K., et al., Reliability and sensitivity to change of the Bristol Rheumatoid Arthritis Fatigue Scales. Rheumatology (Oxford), 2013.
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| 7. |
- Grimby-Ekman, Anna, 1967
(författare)
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Epidemiological aspects of musculoskeletal pain in the upper body. Analyzing common and recurrent binary outcomes
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis is to gain epidemiological knowledge about musculoskeletal pain in the upper body in light physical work, in relation to gender, psychosocial factors, and computer use; and to compare different methods for analyzing common and recurrent binary outcomes. Two study groups were investigated using questionnaire data: (a) computer users in the Swedish workforce and (b) a cohort of university students. Regression models used were ordinary logistic model, Cox model (for calculating prevalence ratios), marginal logistic model (GEE), random intercept logistic model (GLMM), Markov logistic model and Poisson model. Effect measures used were odds ratio, risk ratio and risk difference. Musculoskeletal pain in the upper body was more prevalent among women than among men, even among young adults. Risk factors among computer users in the workforce were high work demands, and using the computer most of the work-day (women). Protective factors were work control and to learn and develop at work, and for women support from superiors. In the university cohort stress, high work/study demands and computer use break pattern were identified as risk factors for neck pain. Stress was a risk factor associated both with developing and ongoing neck pain, and had an impact on both the group-average risk and the subject-specific risk of neck pain. Computer use break pattern had an impact on the group-average risk for neck pain, but on the subject-specific risk only for women. Among women stress and computer use break pattern interacted. The effect of presence of both factors exceeded the additive effect of each. Simple questions, about present neck pain and neck pain period past year, captured features of pain, such as general health, sleep disturbance, stress, and general performance. Neck pain period past year did not reflect more serious pain compared to present neck pain. The choice of statistical model should be based on whether a group-average risk or a subject-specific risk is of clinical relevance. Women and men differed more in the absolute effect measures than in the relative, regarding neck pain. The causality between risk factors and neck pain may differ between women and men.
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| 8. |
- Grimby-Ekman, Anna, 1967, et al.
(författare)
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Simple neck pain questions used in surveys, evaluated in relation to health outcomes: a cohort study.
- 2012
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Ingår i: BMC research notes. - : Springer Science and Business Media LLC. - 1756-0500. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: BACKGROUND: The high prevalence of pain reported in many epidemiological studies, and the degree to which this prevalence reflects severe pain is under discussion in the literature. The aim of the present study was to evaluate use of the simple neck pain questions commonly included in large epidemiological survey studies with respect to aspects of health. We investigated if and how an increase in number of days with pain is associated with reduction in health outcomes. METHODS: A cohort of university students (baseline age 19-25 years) were recruited in 2002 and followed annually for 4 years. The baseline response rate was 69% which resulted in 1200 respondents (627 women, 573 men). Participants were asked about present and past pain and perceptions of their general health, sleep disturbance, stress and energy levels, and general performance. The data were analyzed using a mixed model for repeated measurements and a random intercept logistic model. RESULTS: When reporting present pain, participants also reported lower prevalence of very good health, higher stress and sleep disturbance scores and lower energy score. Among those with current neck pain, additional questions characterizing the pain such as duration (categorized), additional pain sites and decreased general performance were associated with lower probability of very good health and higher amounts of sleep disturbance. Knowing about the presence or not of pain explains more of the variation in health between individuals, than within individuals. CONCLUSION: This study of young university students has demonstrated that simple neck pain survey questions capture features of pain that affect aspects of health such as perceived general health, sleep disturbance, mood in terms of stress and energy. Simple pain questions are more useful for group descriptions than for describing or following pain in an individual.
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| 9. |
- Lundberg, Mari, 1969, et al.
(författare)
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Pain-related fear: a critical review of the related measures.
- 2011
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Ingår i: Pain research and treatment. - : Hindawi Limited. - 2090-1550 .- 2090-1542. ; 2011
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: In regards to pain-related fear, this study aimed to: (1) identify existing measures and review their measurement properties, and (2) identify the optimum measure for specific constructs of fear-avoidance, pain-related fear, fear of movement, and kinesiophobia. Design: Systematic literature search for instruments designed to measure fear of pain in patients with persistent musculoskeletal pain. Psychometric properties were evaluated by adjusted Wind criteria. Results: Five questionnaires (Fear-Avoidance Beliefs Questionnaire (FABQ), Fear-Avoidance of Pain Scale (FAPS), Fear of Pain Questionnaire (FPQ), Pain and Anxiety Symptoms Scale (PASS), and the Tampa Scale for Kinesiophobia (TSK)) were included in the review. The main findings were that for most questionnaires, there was no underlying conceptual model to support the questionnaire's construct. Psychometric properties were evaluated by diverse methods, which complicated comparisons of different versions of the same questionnaires. Construct validity and responsiveness was generally not supported and/or untested. Conclusion: The weak construct validity implies that no measure can currently identify who is fearful. The lack of evidence for responsiveness restricts the current use of the instruments to identify clinically relevant change from treatment. Finally, more theoretically driven research is needed to support the construct and thus the measurement of pain-related fear.
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