| 1. |
- Budh Norrbrink, Cecilia, et al.
(författare)
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Pain in a Swedish spinal cord injury population
- 2003
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Ingår i: Clinical Rehabilitation. - : SAGE Publications. - 0269-2155 .- 1477-0873. ; 17:6, s. 685-690
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To describe pain and associated variables in a prevalence group of persons with a sustained spinal cord injury (SCI) in the Swedish capital and its surroundings. Setting: Spinalis SCI Unit (outpatient clinic), Stockholm, Sweden. Design: Assessment over a 12-month period in a yearly health control. Subjects: Four hundred and fifty-six SCI patients. Results: Two hundred and ninety-one out of 456 SCI patients (63.7%) suffered from pain, and in 45.7% of these it was classified as being neurogenic. Aching pain was the most used descriptor (38.5%). The onset of pain was commonly within three months (73.5%). In 70.4% of patients pain occurred below the level of the lesion. Most patients identified pain as coming from one (55.0%) or two (28.2%) body regions. Rating of the general pain intensity on a visual analogue scale (VAS) was 46 out of 100 and rating of the worst pain intensity was 78 out of 100. Ninety-four out of 276 patients (32.3%) considered that their quality of life was significantly affected by pain. Conclusion: Pain was most common in patients with incomplete lesions (ASIA impairment grade D) and there was a correlation between pain and higher mean age at injury and between pain and female gender.
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| 2. |
- Eek, E, et al.
(författare)
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Assessment of the perceptual threshold of touch (PTT) with high-frequency transcutaneous electric nerve stimulation (Hf/TENS) in elderly patients with stroke: a reliability study
- 2003
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Ingår i: Clinical rehabilitation. - : SAGE Publications. - 0269-2155 .- 1477-0873. ; 17:8, s. 825-834
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate the inter-rater reliability and reliability between occasions of assessing the perceptual threshold of touch (PTT) with high-frequency transcutaneous electric nerve stimulation (Hf/TENS) in elderly patients with stroke. Design: A test–retest study of reliability using intraclass correlation coefficient (ICC) and limits of agreement. Setting: Geriatric rehabilitation unit. Subjects: Thirty-two consecutive patients with stroke 3 65 years of age. Main outcome measures: Two-channel current stimulator TENS CEFAR Tempo with four self-adhesive skin electrodes. The stimulator delivered a high-frequency constant current of 40 Hz. The strength of the stimulation was quantifiable and assessed in milliampere (mA). Interventions: The assessments were performed on the hands and feet by two raters. The PTT was identified as the level registered in milliampere (mA) at which the patients perceived a tingling sensation. Results: The ICC values (0.94–0.99) were shown to be good for inter-rater reliability, as well as reliability between occasions. However an additional analysis with limits of agreement showed a high level of agreement for assessment of the hand but a moderate to low agreement for assessment of the foot where some bias was also identified. Clinical acceptable reliability: 3 1 mA for the hand and 3 5 mA for the foot are so far recommended for establishing real differences in clinical measures. Conclusion: Hf/TENS shows an overall high reliability for assessing the PTT of the hand and moderate to low reliability for the foot. Additional research with exclusion of bias is needed to determine the reliability of assessing the foot.
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| 3. |
- Einarsson, U, et al.
(författare)
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Multiple sclerosis in Stockholm County. A pilot study exploring the feasibility of assessment of impairment, disability and handicap by home visits
- 2003
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Ingår i: Clinical rehabilitation. - : SAGE Publications. - 0269-2155 .- 1477-0873. ; 17:3, s. 294-303
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Tidskriftsartikel (refereegranskat)abstract
- Objective: A pilot study performed within Stockholm County to evaluate the feasibility of collecting data using a comprehensive evaluation package administered in the home environment to assess impairment, disability and handicap in order to explore the consequences of multiple sclerosis (MS). Design: Home visits to 26 purposefully selected MS patients with different levels of disability, in both ordinary and sheltered living. The comprehensive evaluation package included: biographical data, Mini-Mental State Examination, Free Recall and Recognition of 12 Random Words Test, Symbol Digit Modalities Test, Beck Depression Index, Lindmark Motor Capacity Assessment, time to walk 10 metres, Nine-hole Peg Test, Barthel ADL Index, Katz Extended ADL Index, Frenchay Activities Index, Sickness Impact Profile and frequency of falls and injurious falls. Results: This pilot study demonstrates that the proposed methods can be used to evaluate MS patients differing in levels of disability and forms of living. The data collection method, based on home visits, was well accepted by the patients, their spouses and salaried personal assistants and could be performed within 2–21/2 hours. Conclusions: The evaluation package used in this pilot study is suitable for use in population-based studies and it should provide comprehensive information on the impact and consequences of MS on patients, and should contribute to the identification of areas in which the provision of rehabilitation and health care services needs to be improved.
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| 4. |
- Ekvall-Hansson, Eva, et al.
(författare)
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Effects of specific rehabilitation for dizziness among patients in primary health care. A randomized controlled trial.
- 2004
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Ingår i: Clinical Rehabilitation. - : SAGE Publications. - 1477-0873 .- 0269-2155. ; 18:5, s. 558-565
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate whether specific rehabilitation for patients with dizziness has any effect on clinical balance measures and/or the apprehension of dizziness measured with a visual analogue scale (VAS). Design: Randomized controlled trial. Subjects: Forty-two patients, 50 years or older with dizziness of central or agerelated origin, identified in primary health care. Method: The patients were randomized to either an intervention or a control group. The intervention included balance training and vestibular rehabilitation in group sessions twice a week for six weeks. All patients were assessed at baseline, after six weeks and after three months with five different balance measures and visual analogue scale. Results: Statistically significant differences were found between the two groups comparing results at baseline and after six weeks regarding standing one leg eyes closed (SOLEC) on right foot (p 0.011). Results of SOLEC right foot after three months differed significantly between the groups (p -0.033) as did SOLEC left foot (p -0.035). No difference between the groups were found in the Romberg test, figure of eight, walking heel to toe, ‘stops walking when talking’, standing one leg eyes open or estimating the experience of dizziness measured with visual analogue scale. Conclusions: Balance training and vestibular rehabilitation improved the ability to stand on one leg with eyes closed in persons with dizziness aged 50 years or over.
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| 5. |
- Forsberg-Wärleby, Gunilla, 1953, et al.
(författare)
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Psychological well-being of spouses of stroke patients during the first year after stroke
- 2004
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Ingår i: Clin Rehabil. - : SAGE Publications. - 0269-2155. ; 18:4, s. 430-7
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate whether spouses' psychological well-being changed between the first weeks after their partner's stroke and four months and one year later, and to study the relationship between spouses' psychological well-being and objective characteristics of the stroke patients. DESIGN: Prospective, longitudinal study. SETTING: Hospital care and follow-ups. SUBJECTS: Sixty-seven consecutively enrolled spouses to first-ever stroke patients < 75 years. MAIN MEASURES: The Psychological General Well-Being (PGWB) Index. Clinical examination of the stroke patients. The Barthel Index. RESULTS: The spouses' psychological well-being was significantly lower in the first weeks after their partner's stroke as compared with norms. At four months, it had increased significantly. Between four months and one year, individual changes were observed in both positive and negative directions; thus, the mean level of the group remained constant. The spouses' psychological well-being in the first weeks was significantly related to the patients' sensorimotor impairments, while it was related at four months to cognitive impairment and the patients' abilities in self-care. At one year, psychological well-being was related to remaining sensorimotor and cognitive impairments. A significant relationship was also seen between the spouses' and the stroke patients' emotional health. CONCLUSIONS: The spouses' psychological well-being increased after the first chaotic weeks. The presence of visible impairments initially seemed to affect spouses' emotional health, while cognitive and emotional impairments became more evident in everyday life. In the long term, however, the spouses' individual life situations and coping abilities seem to be of relatively increasing importance for their continued well-being.
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| 6. |
- Ingemarsson, AH, et al.
(författare)
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Balance function and fall-related efficacy in patients with newly operated hip fracture
- 2000
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Ingår i: Clinical rehabilitation. - : SAGE Publications. - 0269-2155 .- 1477-0873. ; 14:5, s. 497-505
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the relation between fall-related efficacy in daily-life activities and functional as well as instrumental tests of balance in patients with hip fracture. Design: Analysis of different aspects of balance using the Falls Efficacy Scale, Swedish version FES(S), questions on fear of falling, Functional Reach (FR) and tests on a balance platform (Chattanooga). Subjects: Fifty-five elderly inpatients (mean age 82.3) with newly operated hip fracture who were assessed during the last week in hospital before discharge. Results: The results showed a significant relationship between the subjective ability measured with the FES(S) and the objectively measured balance in the Functional Reach test and also between fall-related efficacy measured with FES(S) and fear of falling. Very few significant correlations were found between the results from balance tests on the force platform and those obtained with FES(S) and FR. Conclusions: Both the Falls Efficacy Scale, Swedish version, and the Functional Reach have been shown to be useful in analysing balance function in elderly patients newly operated on for hip fracture. The Falls Efficacy Scale also indicates which of the daily activities the patient perceives as troublesome and thus require further training.
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| 7. |
- Kammerlind, Ann-Sofi, 1969-, et al.
(författare)
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Effects of balance training in elderly people with nonperipheral vertigo and unsteadiness
- 2001
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Ingår i: Clinical Rehabilitation. - : SAGE Publications. - 0269-2155 .- 1477-0873. ; 15:5, s. 463-470
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate the effect of balance training in group in elderly people with nonperipheral vertigo and unsteadiness.Design: Randomized controlled study.Setting: Ear, nose and throat department, University Hospital, Sweden.Subjects: Twenty-three elderly subjects with nonperipheral vertigo and/or unsteadiness randomized into training group and control group.Intervention: The training group attended balance training in group twice a week for eight weeks.Main outcome measures: Timed static balance tests, walking tests and six sensory organization tests on EquiTest dynamic posturography were performed before and after the training period. Besides, the patients estimated their vertigo and unsteadiness on a visual analogue scale (VAS) before and after the training period.Results: The training group improved significantly in standing on one leg with eyes open, walking forward on a line, walking speed, in three out of six tests on dynamic posturography and estimated less vertigo and unsteadiness measured with VAS. No changes were seen in the control group.Conclusion: Balance training in elderly people with nonperipheral vertigo and unsteadiness seems to improve both objective and perceived balance.
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| 8. |
- Lindberg, Lorry, et al.
(författare)
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Subjective quality of life, health, I-ADL ability and adaptation strategies in fibromyalgia
- 2002
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Ingår i: Clinical Rehabilitation. - : SAGE Publications. - 1477-0873 .- 0269-2155. ; 16:6, s. 675-683
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To describe subjective quality of life and health, self-perceived instrumental activities of daily living (I-ADL) ability and adaptation strategies, and to explore possible relationships between these variables in fibromyalgia patients. Design: Two instruments were used with fibromyalgia patients: the Fibrositis Impact Questionnaire and 'Living with fibromyalgia - adaptation to chronic disease and handicap', and correlative analyses were performed. Subjects: A sample of 34 patients undergoing rehabilitation (in a specific programme). Results: The majority of the patients used many adaptation strategies, demonstrating some significant relationships with perceived I-ADL ability and subjective quality of life and health. Different symptoms correlated highly significantly with self-perceived ability in I-ADL. Conclusion: The significant relationships between adaptation strategies and I-ADL ability and health demonstrated deserve clinical awareness and further research efforts.
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| 9. |
- Siggeirsdottir, K, et al.
(författare)
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The timed 'Up & Go' is dependent on chair type
- 2002
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Ingår i: Clinical Rehabilitation. - : SAGE Publications. - 1477-0873 .- 0269-2155. ; 16:6, s. 609-616
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The timed 'Up & Go' (TUG) is a performance test identifying problems in functional mobility. More knowledge on how the type of chair used influences test results is needed. Objective: To investigate inter-rater agreement on the time score and to assess if chair type used influenced the performance of the test. Setting: (1) Inter-rater agreement investigation on the time score was carried out with elderly individuals living in a retirement home (n = 31). (2) Four types of chairs were tested on elderly individuals in three different health care centres (n = 100). Results: The two observers were close in timing (mean difference = 0.04 s). From a reference chair the median time for TUG was 15.7 s compared with 16.9 s from a chair with a low seat (p < 0.001). It was significantly more difficult to stand up from a chair without armrests (p < 0.001), and from the lowest chair (p < 0.001), which was also the only chair difficult to sit down on (p = 0.02). Conclusion: The inter-rater agreement of the time scoring of the TUG has been confirmed. Test performance is dependent on chair type; chairs with armrests and a seating height of 44-47 cm should be used. Clinicians must follow standard procedures and equipment when using the test or else risk invalidating test findings.
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| 10. |
- Sommerfeld, DK, et al.
(författare)
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Disability test 10 days after acute stroke to predict early discharge home in patients 65 years and older
- 2001
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Ingår i: Clinical rehabilitation. - : SAGE Publications. - 0269-2155 .- 1477-0873. ; 15:5, s. 528-534
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To identify prognostic instruments for the planning of care after acute stroke. Design: Prospective study. Setting: Stroke unit and geriatric rehabilitation unit. Subjects: One hundred and fifteen consecutive acute stroke patients ≥65 years old. Main outcome measures: Univariate and multivariate survival analyses. Length of hospital stay and residential form up to three months after onset. Results: The average length of stay was significantly shorter if age <80 years, male, living with another person, normal sensory ability, Barthel Index (BI) score ≥35 and Rivermead Mobility Index (RMI) score ≥4, assessed 10 days after onset. Multivariate analysis, also including BI subtests, showed that RMI score ≥4, which corresponds to the ability to rise from a chair in less than 15 seconds and remain erect for 15 seconds with or without aid, 10 days after onset, had the greatest impact on early discharge home after acute stroke, together with normal bladder function (BI subtest six), normal sensory ability and living with another person. Conclusion: The best predictor of early discharge home, 10 days after stroke onset, was the ability to rise from a chair with or without aid. This simple and quickly conducted test requires no special equipment and in the present study had a very high predictive value.
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| 11. |
- Sommerfeld, DK, et al.
(författare)
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The impact of somatosensory function on activity performance and length of hospital stay in geriatric patients with stroke
- 2004
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Ingår i: Clinical rehabilitation. - : SAGE Publications. - 0269-2155 .- 1477-0873. ; 18:2, s. 149-155
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate in geriatric patients with stroke the relationship between somatosensory function, activity performance and the length of stay (LOS) in either hospital or nursing home. Design: Survey. Setting: Stroke unit and geriatric rehabilitation unit. Subjects: One hundred and fifteen consecutive patients with acute stroke ≥65 years old. Main outcome measures: Clinically assessed somatosensory function, activity of daily living according to the Barthel Index (BI) (0–100 points), mobility according to the Rivermead Mobility Index (RMI) (0–15 points) and LOS. Results: Ten days after stroke onset, the patients with normal ( n = 46), impaired ( n = 31) and nonassessable ( n = 38) somatosensory function scored 85, 40 and 0 points respectively on the BI, and 8.5, 2 and 0 points respectively on the RMI. Forty-one of 46 patients (89%) with normal somatosensory function were discharged home within three months, compared with 10 of 31 patients (32%) with impaired somatosensory function and three of 38 patients (8%) who were nonassessable. These between-group differences were statistically significant ( p < 0.001). Multiple regression, to adjust for the impact of age, social situation and bladder function on outcome still proved a statistically significant ( p < 0.001) predictive value of normal somatosensory function. Conclusions: Normal somatosensory function is related to high activity levels and short LOS more often than somatosensory impairment is related to activity limitations and long LOS.
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| 12. |
- Sonde, L, et al.
(författare)
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Can the site of brain lesion predict improved motor function after low-TENS treatment on the post-stroke paretic arm?
- 2001
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Ingår i: Clinical rehabilitation. - : SAGE Publications. - 0269-2155 .- 1477-0873. ; 15:5, s. 545-551
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Previous reports suggest that afferent stimulation improves arm motor function in patients suffering from stroke. The aim of this pilot study was to test the hypothesis that the brain lesion location determines the response to low-frequency (1.7 Hz) transcutaneous electric nerve stimulation (Low-TENS) therapy. Design: Magnetic resonance imaging (MRI) was performed on 14 patients who had previously received Low-TENS on the paretic arm after stroke. Methods: MR images were classified with two different methods. First, lesions in the cortical and the subcortical areas were registered. Secondly, any change in a described periventricular white matter (PVWM) area was recorded. Interactions between the lesion site, as detected by MRI, and response to Low-TENS treatment were analysed. Results: Arm motor function after Low-TENS treatment in relation to lesion in different brain areas showed that absence of lesions in the PVWM area increased the possibility for improved motor capacity after afferent stimulation. Conclusions: The site of lesion may play a role in prognosis/outcome after Low-TENS treatment but this hypothesis should be further tested in a larger prospective study.
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| 13. |
- Sonde, L, et al.
(författare)
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Low TENS treatment on post-stroke paretic arm: a three-year follow-up
- 2000
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Ingår i: Clinical rehabilitation. - : SAGE Publications. - 0269-2155 .- 1477-0873. ; 14:1, s. 14-19
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To determine whether stroke patients with initial increases in arm motor recovery following low-frequency transcutaneous electrical nerve stimulation (low TENS) treatment go on to show long-term benefits. Also whether the same therapy results in long-term improvements in motor function, spasticity or activities of daily living (ADL). Design: A three-year follow-up study. Subjects: Twenty-eight stroke patients, who had participated in a randomized trial of daily treatment with low-frequency (1.7 Hz) transcutaneous electrical nerve stimulation (low TENS) on the paretic arm for three months starting 6–12 months after stroke. Outcomes: Fugl-Meyer Motor Performance Scale for evaluation of changes in arm motor function. A 6-point Ashworth Scale to measure spasticity. Barthel Index to evaluate performance in ADL. Results: Motor function of the paretic arm had deteriorated in both treatment and control groups. Increased spasticity was seen in both groups. ADL score remained at a similar level in the low TENS group, whereas the control group had deteriorated during the same time period. Conclusions: Low TENS stimulation started 6–12 months after stroke may not have a specific effect on arm motor function years after completion of treatment.
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| 14. |
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| 15. |
- Söderlund, Anne, et al.
(författare)
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Acute whiplash-associated disorders (WAD) : the effects of early mobilization and prognostic factors in long-term symptomatology.
- 2000
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Ingår i: Clinical Rehabilitation. - : SAGE Publications. - 0269-2155 .- 1477-0873. ; 14:5, s. 457-467
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To compare two different home exercise programmes for patients with acute whiplash-associated disorders (WAD). A further aim was to describe the initial prognostic variables related to self-reported pain at six months follow-up. DESIGN: A randomized treatment study with a follow-up period of six months. SETTINGS: The study was undertaken in an orthopaedic clinic at a university hospital. SUBJECTS: A total of 59 symptomatic (neck pain, stiffness, etc.) patients with acute whiplash injury. INTERVENTIONS: Patients were randomized to a regular treatment group (RT group) and an additional-exercise treatment group (AT group). MAIN OUTCOME MEASURES: Pain Disability Index (PDI), Self-Efficacy Scale (SES), Coping Strategies Questionnaire (CSQ), neck range of motion (ROM), head posture, kinaesthetic sensibility, visual analogue scale (VAS). RESULTS: Patients given an additional exercise did not improve more than patients with regular treatment. Only one CSQ item, 'Ability to decrease pain', showed a significant difference between the groups in its pattern of change over time: the AT group had a significant increase between three and six months whilst values in the RT group decreased. Nonsymptomatic patients at six months follow-up were characterized by initially better self-efficacy, lower disability and significantly different patterns in the use of 'behavioural coping strategies' when compared with symptomatic patients. The nonsymptomatic patients also reported more frequent training than symptomatic patients, i.e. they complied better with the treatment regime. CONCLUSION: This home exercise programme, including training of neck and shoulder ROM, relaxation and general advice seems to be sufficient treatment for acute WAD patients when used on a daily basis. Additionally, patients reporting low self-efficacy and high disability levels may profit from more attention initially, as these psychological factors are significant predictors of pain at long-term follow-up.
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| 16. |
- Söderlund, Anne, et al.
(författare)
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Whiplash-associated disorders--predicting disability from a process-oriented perspective of coping
- 2003
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Ingår i: Clinical Rehabilitation. - : SAGE Publications. - 0269-2155 .- 1477-0873. ; 17:1, s. 101-107
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To describe the coping process over time for patients with whiplash-associated disorders (WAD). DESIGN: The study was conducted by following patients prospectively for 12 months. SETTINGS: The orthopaedic clinic at a university hospital. SUBJECTS: Fifty-three patients out of 59 had complete data-sets. MAIN OUTCOME MEASURES: Two measures were used: the Pain Disability Index (PDI) and the Coping Strategies Questionnaire (CSQ). RESULTS: The results showed that the proportion of variance in disability shared with coping increased over time. CONCLUSION: The importance of coping as an explanatory factor for disability increased during the one year follow-up. Thus, coping has a crucial role for disability. The possibility of a positive long-term outcome could therefore be improved by teaching patients to use active and adaptive coping strategies shortly after an accident.
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| 17. |
- von Koch, L, et al.
(författare)
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Rehabilitation at home after stroke: a descriptive study of an individualized intervention
- 2000
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Ingår i: Clinical rehabilitation. - : SAGE Publications. - 0269-2155 .- 1477-0873. ; 14:6, s. 574-583
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To describe the content of a programme involving early hospital discharge and continued rehabilitation at home after stroke. Design: Quantitative and qualitative descriptive study of an intervention within the context of a randomized controlled trial. Setting: Huddinge University Hospital, Stockholm, Sweden. Subjects: Forty-one patients, moderately impaired after stroke, rehabilitated by a team of six occupational, physical, and speech and language therapists. Results: The average duration of the programme was 14 weeks, the mean number of home visits 12, and the median total time consumption 23 hours and 20 minutes, of which face-to-face contact with the patient constituted 54%. The rehabilitation process was pursued by the patient and the therapist in partnership. Supported by the team the therapists incorporated a wider domain of activities than usual and left a considerable amount of the training to self-directed activities. The most common foci of the visits were speech and communication, ADL activities and ambulation. When planning the intervention the therapists paid attention to discrepancies between the desires and abilities of the patient on the one hand and environmental demands on the other – discrepancies detected through observation of the patient in the home environment. Conclusions: The home environment offers therapists working in a team opportunities to adopt a behaviour that enables patients with moderate neurological impairments after stroke to resume responsibility and influence over their rehabilitation process, resulting in an individualized rehabilitation programme that varies in duration, content and frequency of home visits.
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| 18. |
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| 19. |
- Forsberg-Wärleby, Gunilla, 1953, et al.
(författare)
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Spouses of first-ever stroke patients: their view of the future during the first phase after stroke
- 2002
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Ingår i: Clin Rehabil. - 0269-2155. ; 16:5, s. 506-14
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A partner's stroke can be perceived as a critical event by a spouse. Previous studies have focused primarily on the impact of stroke on spouses' psychosocial well-being over the long term. However, the experience of spouses in the first phase after stroke is not well known. AIM: To investigate spouses' perception of their future daily life after stroke and the association between this perception and the objective characteristics of the stroke. METHOD: Eighty-three consecutively enrolled spouses of first-ever stroke patients < 75 years admitted to Sahlgrenska University Hospital in Goteborg, Sweden participated. The mean age of the spouses was 57 years. Sixty-two of the spouses were women and 21 men. Interviews about their experiences 10 days after onset were generally made at the hospital. The interviews were analysed, categorized and combined with statistical analyses of variables such as ages and sex of the spouses, type of lesion and presence of neurological impairments in the stroke patient. RESULTS: Four different categories of the concept 'view of the future' were developed on the basis of the interviews. Of the different characteristics of the stroke, the severity of the sensorimotor impairment seemed to have the greatest impact on the spouses' view of the future. The spouses of stroke patients with pure sensorimotor impairment were more likely to have an optimistic view of the future than when the sensorimotor impairment was combined with cognitive deficits. There was a broad distribution of the different characteristics of stroke between the four categories. CONCLUSIONS: Although the perception of future daily life varied, it was possible to categorize the spouses' cognitive image of future life according to degree of optimism. While the severity of stroke was of importance, the individual perception of the disease, impact on future activities and the spouses' own coping capacity was of great significance for the perception of future daily life.
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| 20. |
- Hansen, R., et al.
(författare)
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Fewer accidents and better maintenance with active wheelchair check-ups: a randomized controlled clinical trial
- 2004
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Ingår i: Clin Rehabil. - 0269-2155 .- 0269-2155. ; 18:6, s. 631-9
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate whether active intervention using a compiled checklist for wheelchair check-ups increases user satisfaction and/or decreases accidents, near accidents and pressure sores. DESIGN: A randomized controlled trial comparing active intervention versus standard intervention for prescribed, manually propelled wheelchairs. SETTING: Patients within primary health care of Boras and Bollebygd municipalities, a mixed urban and rural population. SUBJECTS: Users of manually propelled wheelchairs over 16 years of age. INTERVENTIONS: The accident rate, extent of pressure sores, number and extent of repairs, reconditioning, adjustments as well as user satisfaction were measured initially and at one year. In the standard intervention, the user and carer were encouraged to initiate contact when necessary. In the active intervention, an occupational therapist performed a scheduled, thorough check-up of the wheelchair, following a compiled checklist for safety, comfort and positioning, manoeuvrability and transportation. RESULTS: Of 253 registered wheelchair users, 216 were suitable and randomized. In the active intervention group, 99% (95% confidence interval 96-100%) of the inspected wheelchairs required maintenance. The incidence of accidents was unchanged in the standard intervention group, but decreased to 'no accidents' in the active intervention group (p = 0.03). User satisfaction was not affected by the active intervention. CONCLUSION: Most wheelchair users are unable to determine on their own when adjustments are needed. An active check-up on manually propelled wheelchairs seems to reduce accidents. More information is available at http://www.wheelchair.se
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