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- Carlsson, Håkan, et al.
(författare)
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SENSory re-learning of the UPPer limb after stroke (SENSUPP) : Study protocol for a pilot randomized controlled trial
- 2018
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Ingår i: Trials. - : Springer Science and Business Media LLC. - 1745-6215. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Many stroke survivors suffer from sensory impairments of their affected upper limb (UL). Although such impairments can affect the ability to use the UL in everyday activities, very little attention is paid to sensory impairments in stroke rehabilitation. The purpose of this trial is to investigate if sensory re-learning in combination with task-specific training may prove to be more effective than task-specific training alone to improve sensory function of the hand, dexterity, the ability to use the hand in daily activities, perceived participation, and life satisfaction. Methods/design: This study is a single-blinded pilot randomized controlled trial (RCT) with two treatment arms. The participants will be randomly assigned either to sensory re-learning in combination with task-specific training (sensory group) or to task-specific training only (control group). The training will consist of 2.5 h of group training per session, 2 times per week for 5 weeks. The primary outcome measures to assess sensory function are as follows: Semmes-Weinstein monofilament, Shape/Texture Identification (STI™) test, Fugl-Meyer Assessment-upper extremity (FMA-UE; sensory section), and tactile object identification test. The secondary outcome measures to assess motor function are as follows: Box and Block Test (BBT), mini Sollerman Hand Function Test (mSHFT), Modified Motor Assessment Scale (M-MAS), and Grippit. To assess the ability to use the hand in daily activities, perceived participation, and life satisfaction, the Motor Activity Log (MAL), Canadian Occupational Performance Measure (COPM), Stroke Impact Scale (SIS) participation domain, and Life Satisfaction checklist will be used. Assessments will be performed pre- and post-training and at 3-month follow-up by independent assessors, who are blinded to the participants' group allocation. At the 3-month follow-up, the participants in the sensory group will also be interviewed about their general experience of the training and how effective they perceived the training. Discussion: The results from this study can add new knowledge about the effectiveness of sensory re-learning in combination with task-specific training on UL functioning after stroke. If the new training approach proves efficient, the results can provide information on how to design a larger RCT in the future in persons with sensory impairments of the UL after stroke.
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- Carlstedt, Emma, et al.
(författare)
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BUS TRIPS—A self-management program for people with cognitive impairments after stroke
- 2017
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 14:11
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Tidskriftsartikel (refereegranskat)abstract
- Stroke is a major cause of disability worldwide and different types of impairments can affect the individual’s ability to manage everyday activities such as travel that is essential for participation in society. The purpose of this study was to investigate the feasibility of a new self-management intervention (BUS TRIPS) focusing on travelling by bus, and potential contributions to an improved ability to travel by bus for people with cognitive impairments after stroke. This is a pilot study of five individuals, utilizing a multiple case study design with a mixed methods approach. Assessments (Stroke Impact Scale, General Self-Efficacy Scale and Life Satisfaction Scale-11, Item 1) were performed before, two weeks after, and three months after the program. The data collection also comprised reflection notes from the group leaders (an occupational therapist and a physiotherapist), a semi-structured group interview and an individual phone survey. The feasibility of the intervention was presented in four sub-categories: (1) appreciated group format despite too short sessions, (2) the importance of skilled leaders and motivated participants, (3) session material adequate but needs minor revision to fit the target group, and (4) homework is valuable but reflective group discussions must be supported. The narratives of each case showed that all participants made some progress related to travelling by bus, but the overall positive results could not be verified by all of the quantitative assessments. We conclude that the BUS TRIPS intervention is feasible and can potentially contribute to an improved ability to travel by bus for the target group. Future studies is called for, and should focus on recruitment challenges, to clarify assessments that would be suitable to use in larger scale clinical trials and during subsequent implementation in clinical practice.
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- Carlstedt, Emma, et al.
(författare)
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Psychometric properties of the Swedish version of the General Self-Efficacy Scale in stroke survivors.
- 2015
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Ingår i: International Journal of Rehabilitation Research. - 1473-5660. ; 38:4, s. 333-337
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to assess the psychometric properties of a Swedish version of the General Self-Efficacy Scale (GSE) in stroke survivors. The GSE was administered by the same assessor on two occasions 3 weeks apart with 34 stroke survivors (21 men, 13 women; mean age=68.1 years) 6-10 months after stroke. Psychometric properties including targeting and scaling assumptions, and several reliability indices, were calculated. The mean score was well above the midpoint of the scale and the total scores spanned almost the entire scale range. Floor and ceiling effects were within the limits of 15-20% for total scores (0 and 8.8%, respectively), but not for each item individually. Total skewness was estimated at -1.02 and skewness for individual items was estimated as -1.55 to -0.33. The corrected item-total correlations were all above 0.3, except for one item. Cronbach's α was high (0.92) and the test-retest reliability was acceptable (intraclass correlation coefficient2,1=0.82). The mean difference (đ) was -0.68 (NS). The SEM was 2.97 (SEM%; 9.40). In conclusion, although targeting in relation to skewness and ceiling effects was observed in some items, the GSE was reliable for use in mobile stroke survivors 6-10 months after stroke.
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- Gallo, Valentina, et al.
(författare)
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Physical activity and risk of Amyotrophic Lateral Sclerosis in a prospective cohort study
- 2016
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Ingår i: European Journal of Epidemiology. - : Springer Science and Business Media LLC. - 0393-2990 .- 1573-7284. ; 31:3, s. 255-266
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Tidskriftsartikel (refereegranskat)abstract
- Previous case-control studies have suggested a possible increased risk of Amyotrophic Lateral Sclerosis (ALS) with physical activity (PA), but this association has never been studied in prospective cohort studies. We therefore assessed the association between PA and risk of death from ALS in the European Prospective Investigation into Cancer and Nutrition. A total of 472,100 individuals were included in the analysis, yielding 219 ALS deaths. At recruitment, information on PA was collected through standardised questionnaires. Total PA was expressed by the Cambridge Physical Activity Index (CPAI) and analysed in relation to ALS mortality, using Cox hazard models. Interactions with age, sex, and anthropometric measures were assessed. Total PA was weakly inversely associated with ALS mortality with a borderline statistically significant trend across categories (p = 0.042), with those physically active being 33 % less likely to die from ALS compared to those inactive: HR = 0.67 (95 % CI 0.42-1.06). Anthropometric measures, sex, and age did not modify the association with CPAI. The present study shows a slightly decreased-not increased like in case-control studies-risk of dying from ALS in those with high levels of total PA at enrolment. This association does not appear confounded by age, gender, anthropometry, smoking, and education. Ours was the first prospective cohort study on ALS and physical activity.
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- Gard, Gunvor, et al.
(författare)
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Need for structured healthcare organization and support for return to work after stroke in Sweden : Experiences of stroke survivors
- 2019
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1651-2081 .- 1650-1977. ; 51:10, s. 741-748
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To explore stroke survivors' experiences of healthcare-related facilitators and barriers concerning return to work after stroke. DESIGN: A qualitative study. SETTING: Outpatient stroke rehabilitation unit at a University Hospital in southern Sweden. PARTICIPANTS: A convenient sample of 20 persons admitted to Skåne University Hospital for acute stroke care (median age 52 years), in employment of at least 10 h per week at stroke onset and having been referred to stroke rehabilitation within 180 days. METHODS: The interviews were performed by focus groups, and the data were analysed by content analysis. RESULTS: Facilitating factors were a tailored rehabilitation content with relevant treatments, adequate timing and a structured stepwise return-to-work process. A lack of sufficient early healthcare information, rehabilitation planning and coordination were perceived as barriers. An early rehabilitation plan, a contact person, and improved communication between rehabilitation actors were requested, as well as help with work transport, home care, children and psychosocial support for families. CONCLUSION: Tailored rehabilitation content and a structured stepwise return-to-work process facilitated return to work. Insufficient structure within the healthcare system and lack of support in daily life were perceived barriers to return to work, and need to be improved. These aspects should be considered in the return-to-work process after stroke.
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- Jood, Katarina, 1966, et al.
(författare)
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The psychosocial work environment is associated with risk of stroke at working age
- 2017
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Ingår i: Scandinavian Journal of Work Environment & Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 43:4, s. 367-374
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Tidskriftsartikel (refereegranskat)abstract
- Objective The aim of this study was to explore the relation between the risk of first-ever stroke at working age and psychological work environmental factors. Methods A consecutive multicenter matched 1:2 case control study of acute stroke cases (N=198, age 30-65 years) who had been working full-time at the time of their stroke and 396 sex- and age-matched controls. Stroke cases and controls answered questionnaires on their psychosocial situation during the previous 12 months. The psychosocial work environment was assessed using three different measures: the job control demand model, the effort reward imbalance (ERI) score, and exposures to conflict at work. Results Among 198 stroke cases and 396 controls, job strain [odds ratio (OR) 1.30, 95% confidence interval (95% CI) 1.05-1.62], ERI (OR 1.28, 95% CI 1.01-1.62), and conflict at work (OR 1.75, 95% CI 1.07-2.88) were independent risk factors of stroke in multivariable regression models. Conclusions Adverse psychosocial working conditions during the past 12 months were more frequently observed among stroke cases. Since these factors are presumably modifiable, interventional studies targeting job strain and emotional work environment are warranted.
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