| 1. |
- Jesinkey, Kristina, et al.
(författare)
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Initiation of reaching when standing with and without DAFOs in children with spastic diplegia
- 2005
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Ingår i: Advances in Physiotherapy. - : Informa UK Limited. - 1403-8196 .- 1651-1948. ; 7:4, s. 144-153
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Tidskriftsartikel (refereegranskat)abstract
- We investigated whether the use of dynamic ankle foot orthoses (DAFOs) can improve the coordination between standing posture and a reaching movement. We investigated the temporal sequence between onset of center of pressure (CoP) displacement and onset of hand displacement by means of two AMTI force plates and a two-camera optoelectronic system (ELITE). The task was to reach for a cup. Reflective markers were placed on hand, trunk and the cup. Four children with spastic diplegia and eight control children (aged 5-12) participated. They were tested wearing DAFOs (diplegia) and the results were compared with wearing shoes (diplegia and control). The children with spastic diplegia were able to make use of anticipatory changes in CoP displacement. The results indicated that more trials in children with spastic diplegia had CoP onset preceding hand onset while wearing DAFOs (18/20) than when wearing only shoes. More trials (27/40) during the 20% reaching condition in the control group had CoP onset preceding hand onset than during the 10% reaching condition (18/40). In spite of different amounts of assistance, anticipatory postural adjustments were found in the diplegia group. Use of anticipatory postural adjustments was not consistent in the control group. Practice of reaching during standing can be carried out with DAFOs and/or hand support, and can promote motor learning of anticipatory postural adjustments.
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| 2. |
- Larsson, Annika, et al.
(författare)
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Unwinding fibril formation of medin, the peptide of the most common form of human amyloid.
- 2007
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Ingår i: Biochemical and Biophysical Research Communications - BBRC. - : Elsevier BV. - 0006-291X .- 1090-2104. ; 361:4, s. 822-828
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Tidskriftsartikel (refereegranskat)abstract
- Medin amyloid affects the medial layer of the thoracic aorta of most people above 50 years of age. The consequences of this amyloid are not completely known but the deposits may contribute to diseases such as thoracic aortic aneurysm and dissection or to the general diminished elasticity of blood vessels seen in elderly people. We show that the 50-amino acid residue peptide medin forms amyloid-like fibrils in vitro. With the use of Congo red staining, Thioflavin T fluorescence, electron microscopy, and a solid-phase binding assay on different synthetic peptides, we identified the last 18-19 amino acid residues to constitute the amyloid-promoting region of medin. We also demonstrate that the two C-terminal phenylalanines, previously suggested to be of importance for amyloid formation, are not required for medin amyloid formation.
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| 3. |
- Näslund, Annika
(författare)
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Dynamic ankle-foot orthoses in children with spastic diplegia : interview and experimental studies
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Dynamic ankle-foot orthosis (DAFO) is a thin supra malleolar orthosis used as a compliment to the total treatment program in children with cerebral palsy (CP) in order to facilitate function in sitting, standing and walking. The DAFO keeps the foot in a functional position and is said to provide the child with proprioceptive feedback for balance- and postural control. The aim of the present thesis was to explore how parents of children with spastic diplegia experience the use of DAFOs and to determine the effects of DAFOs in standing during a reaching movement, in relation to postural orientation, anticipatory- and compensatory postural adjustments, and the quality of the reaching movement. The parents of 15 children, aged 4-18 years, who had spastic diplegia and wore DAFOs were interviewed with a broad research question "How do you perceive that DAFO influence your child" and analysed with content analysis. Children with spastic diplegia, aged 5-12 years, (n=6 in studies II and IV and n=4 in study III) classified at level II-IV according to Gross Motor Function Classification System (GMFCS) and typically developing children (controls) (n=8 in study III and n=6 in study IV) in the same age-group performed a voluntary reaching movement towards a target while standing on force plates. This allowed for registration of forces, movement and muscle activity (EMG). Children with spastic diplegia used DAFOs and/or shoes during the experiment while controls used shoes only. The parents experienced that DAFOs with their stabilizing effect on the foot and ankle enabled postural control and alignment, which contributed to functional activities under more favourable physical conditions. Moreover, psychosocial aspects such as a feeling of security, safety and freedom were regarded by the parents as being as important as the physical effects. Our findings showed that children with more severe spastic diplegia applied their body weight in standing more evenly between the legs and improved extension of the knee using DAFOs compared to wearing shoes alone. To initiate the reaching movement, despite different support conditions, children with spastic diplegia wearing DAFOs, as well as the controls make use of anticipatory postural adjustments. Furthermore, during the acceleration and deceleration phase of the reaching movement, children with spastic diplegia make use of compensatory postural adjustments characterized by co-contraction of tibialis anterior (TA) and lateral gastrocnemius (LG) muscles bilaterally. The postural adjustments in the controls were characterized by increased TA activity on the reach side during the acceleration phase and increased LG activity on the non-reach side during the deceleration phase. Movement quality in reaching in children with spastic diplegia showed that coordination between upward and forward reach velocity differed regarding temporal phasing and amplitudes of velocity peaks compared to the controls. According to parents´ perceptions DAFOs can be regarded as a part of treatment that improves stability, balance and functional skills. Children with severe spastic diplegia wearing DAFOs can, in spite of different support conditions, practice standing with a more evenly distributed body weight on the feet. The practice of reaching movements while standing with DAFOs can promote motor learning of postural adjustments and thereby improve the ability to use the hands in daily activities.
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| 4. |
- Näslund, Annika, et al.
(författare)
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Effects of dynamic ankle-foot orthoses on standing in children with severe spastic diplegia
- 2005
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Ingår i: International Journal of Therapy and Rehabilitation. - : Mark Allen Group. - 1741-1645 .- 1759-779X. ; 12:5, s. 200-7
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate whether wearing a dynamic ankle-foot orthosis (DAFO) improved standing posture in six children with severe spastic diplegia Kinematics and ground reaction forces were recorded with a three-dimensional optoelectronic movement analysis system and two force plates. The results revealed that on a group level, DAFOs did not improve standing posture, distribution of body weight or lateral standing stability as reflected in the horizontal ground reaction forces. However, some children could benefit from the use of a DAFO through a more equal weight distribution and improved sagittal position of the knee, compared to wearing shoes alone. According to the heterogeneous clinical signs and symptoms in children with severe spastic diplegia, studies on a group level easily lead to negative findings and therefore individual benefits could be showed by using single case designs
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| 5. |
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| 6. |
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| 7. |
- Näslund, Annika, et al.
(författare)
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Postural adjustments during reaching in children wth severe spastic diplegia wearing Dafos
- 2007
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Ingår i: 15th International Congress of the World Confederation for Physical Therapy. - : WCPT.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- PURPOSE: The aim of this study was to investigate the coordination among reaching kinematics, ground reaction forces and muscle activity in standing in children with severe spastic diplegia wearing dynamic ankle-foot orthoses (DAFOs)and compare the results to age matched non-disabled children. RELEVANCE: Assessment and evaluation are essential because children with spastic diplegia, classified at level III-IV according to GMFCS (Gross Motor Function Classification System), often recieve DAFOs as an adjunct to physiotherapy in order to improve sitting, standing and walking. PARTICIPANTS: All children with spastic diplegia using DAFOs in a county in northern Sweden and had regular follow-ups of their ortohoses, were invited. Six participants at GMFCS level III-IV formed the study group and six age- and sex-matched children with normal motor development served as a control group. METHODS: Bilaterally ground reaction forces and the ankle muscle activity aswell as the reach hand kinematics were investigated by the means of two AMTI forceplates, surface electromyography (EMG)and two-camera optoelectronic system (ELITE). Kinematic, EMG and forceplate signals were recorded simultaniously. The children reached for a cup filled with candy while standing on two forceplates. Reflective markers were placed on the hand and cup. In this study, standing support provided by the parent on the pelvis or by contact of the non-reach hand on the table was necessary during the standing task. ANALYSIS: Because of the small participant number and the heterogeneity of the group with pronounced difficulties in locomotion, the results are presented on group as well as on subject level. RESULTS: Children with severe spastic diplegia, wearing DAFOs, demonstrated that movement quality of upward and forward reach velocity differed regarding temporal phasing and amplitudes of velocity peaks compared to the controls. Furthermore, children with severe spastic diplegia, wearing DAFOs, lacked a coordinated muscle activity pattern and make use of postural adjustments characterized by co-activation of agonist and antagonist muscles. However, the controls demonstrated coordinated muscle activity and an interplay of the ground reaction forces on reach and non-reach side. CONCLUSIONS: In conclusion DAFOs appear to provide some benefit for children with spastic diplegia GMFCS, level III-IV, by the use of postural adjustments for balance control during a reaching movement in standing. An intervention study would be of interest, to assess whether DAFOs could be valuable in the learning of processes considering postural adjustments , since postural control is a result of both maturation and learning. IMPLICATIONS: Children with severe spastic diplegia wearing DAFOs can despite different support conditions practice reaching while standing and thereby promote motor learning of postural adjustments to improve the ability to use the hands in daily standing activities.
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| 8. |
- Näslund, Annika, et al.
(författare)
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Reach performance and postural adjustments during standing in children with severe spastic diplegia using dynamic ankle-foot orthoses
- 2007
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081 .- 0001-5555. ; 39:9, s. 715-23
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate the co-ordination between reaching, ground reaction forces and muscle activity in standing children with severe spastic diplegia wearing dynamic ankle-foot orthoses compared with typically developing children. DESIGN: Clinical experimental study. SUBJECTS: Six children with spastic diplegia (Gross Motor Function Classification System level III-IV) and 6 controls. METHODS: Ground reaction forces (AMTI force plates), ankle muscle activity (electromyography and displacement of the hand (ELITE systems) were investigated while reaching for an object. RESULTS: For the children with severe spastic diplegia who were wearing dynamic ankle-foot orthoses, co-ordination between upward and forward reach velocity differed regarding the temporal sequencing and amplitude of velocity peaks. During reaching, these children lacked interplay of pushing force beneath the reach leg and braking force beneath the non-reach leg and co-ordinated ankle muscle activity, compared with controls. CONCLUSION: The results suggest differences in reach performance and postural adjustments for balance control during a reaching movement in standing between children with spastic diplegia Gross Motor Function Classification System level III-IV, wearing dynamic ankle-foot orthoses compared with typically developing children.
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| 9. |
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| 10. |
- Näslund, Dag, et al.
(författare)
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Operationalizing the concept of value - an action research-based model
- 2006
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Ingår i: Learning Organization. - : Emerald. - 0969-6474. ; 13:3, s. 300-332
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Tidskriftsartikel (refereegranskat)abstract
- Abstract: Purpose – While the importance of measuring customer satisfaction levels is well established, less research exists on how organizations operationalize such knowledge. The purpose of this paper is to describe an action research (AR) case study resulting in a workshop model to operationalize the concept of value. The model facilitates organizational learning and mindset changes in order to remove both cultural and structural barriers to change. Design/methodology/approach – The model is based on AR in three case organizations. The research, over four years in the primary case organization, included phases of planning, action (implementing), observing (evaluating), and analysis and reflection as a basis for new planning and action. By using secondary case organizations the results and methods from the primary case organization were validated and further developed. Findings – The model includes methods to help organizations understand and define what customer value is for any given specific organization, tools to change the employee outlook from a functional/feature oriented mindset into a process/values oriented mindset, and tools to help organizations design and manage the value-adding core processes. The results after implementation clearly indicate that cutting costs and eliminating waste does not necessarily mean that the processes will be less effective. On the contrary, customers are significantly more satisfied than before while the processes cost less and take less time. Furthermore, throughout the project, the employee satisfaction index improved. Originality/value – The model presented expands the steps of understanding, creating and delivering value by changing internal processes and employee mindsets.
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