| 1. |
- Arvidsson Lindvall, Mialinn, 1977-, et al.
(författare)
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Basic Body Awareness Therapy for patients with stroke : Experiences among participating patients and physiotherapists
- 2016
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Ingår i: Journal of Bodywork & Movement Therapies. - : Elsevier. - 1360-8592 .- 1532-9283. ; 20:1, s. 83-89
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Tidskriftsartikel (refereegranskat)abstract
- Background: After a stroke many patients have muscle weakness, spasticity and compromised sensation leading to decreased postural stability. Basic Body Awareness Therapy includes slow movements that challenge postural control.Aim: The aim was to describe experiences of 8 weeks of Basic Body Awareness Therapy from the perspective of both patients with stroke and physiotherapists.Method: This study had a qualitative design. Twenty-one patients and four physiotherapists were interviewed. The interviews were analysed using manifest and latent content analysis.Results: One overall theme emerged "Simple yet challenging" which was based on six categories: "Facing one's limitations", "Individualized movements", "A feeling of harmony", "Improved balance", "Integrated knowledge" and "Frustration and doubt". The patients described improvement in balance and stability, as well as increased wellbeing.Conclusion: The patients and physiotherapists related that Basic Body Awareness Therapy challenges balance but also provides an opportunity to reflect on the body.
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| 2. |
- Arvidsson Lindvall, Mialinn, 1977-, et al.
(författare)
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Experiences of living with balance limitations after first-ever stroke
- 2023
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Konferensbidrag (refereegranskat)abstract
- Background: Stroke is the leading cause of serious, long-term disability among adults. Balance control after stroke may be affected due to motor impairment such as muscle weakness, spasticity and impaired sensory function and also cognitive deficits may affect balance control. The balance limitations affect walking and independence in activities of daily living. Having good balance has been described as an important factor in outdoor walking and for participation in exercises. Studies in which persons with stroke describe their experience of balance in everyday life are scarce.Purpose: The aim of the present presentation is to describe experiences of living with balance limitations in everyday life after first-ever stroke.Methods: Twenty persons initially agreed to participate; however, one person later declined further participation, thus giving a sample size of 19 participants (10 females and 9 men), aged between 42-92 years. The inclusion criteria were: having had a first-ever stroke and having self-reported impaired balance, unaffected speech, independence in toileting and dressing, and walking ability indoors and outdoors with or without a walking aid. A qualitative data collection through individual interviews was conducted. Data was analysed by means of an inductive content analysis covering both the manifest and the latent content of the transcribed interviews.Results: The participants' experiences of balance and its influence in everyday life, are presented in two themes. The first theme “Feeling dizzy and unstable is a continuous challenge”, revolves around participants' descriptions of balance as a constant feeling of dizziness and unsteadiness. The second theme “Feeling trust and confidence despite dizziness and unsteadiness” is about perceived abilities and feelings of confidence about still being able to do things oneself, despite the dizziness and unsteadiness.Conclusion(s): All participants experienced the balance limitations as a continuous challenge in everyday life, yet they also felt trust and confidence and experienced that they still managed their everyday life. In future research it would be of interest to establish which strategies can make persons with stroke feel in balance in relation to fear of falling.Implications:In physical therapy practice, the experiences of balance limitations after stroke from the person with stroke add valuable information to various assessments. By asking the person about their abilities and challenges in daily living, rehabilitation interventions can be more individualized and based on the person's actual condition and their wishes and needs.
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| 3. |
- Arvidsson Lindvall, Mialinn, 1977-, et al.
(författare)
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"I can manage the challenge" : a qualitative study describing experiences of living with balance limitations after first-ever stroke
- 2021
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Co-Action Publishing. - 1748-2623 .- 1748-2631. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To describe experiences of living with balance limitations after first-ever stroke.Materials and methods: This study has a qualitative design, comprising interviews with 19 persons with first-ever stroke, ten women and nine men. Their mean age was 77 years and the mean time since stroke was 15 months. Stroke survivors who were able to walk outdoors with or without a walking aid and who were independent in toileting and dressing were invited to participate. Semi-structured individual interviews were performed. An inductive qualitative content analysis of the manifest and latent content was conducted.Results: The results are presented in two themes illustrating the latent content of the data, "Feeling dizzy and unstable is a continuous challenge" and "Feeling confidence despite dizziness and unsteadiness", and seven categories illustrating the manifest content: Limitations in daily life; Being emotionally affected; The need for physical support; Everything takes time; I can still manage; Feelings of acceptance; and Finding individual solutions.Conclusions: All participants experienced the balance limitations as a continuous challenge in their everyday life, yet they also felt confidence. They had to some degree adapted their activities and were able to manage their daily life.
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| 4. |
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| 5. |
- Arvidsson Lindvall, Mialinn, 1977-, et al.
(författare)
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LIVING WITH BALANCE LIMITATIONS AFTER FIRST-EVER STROKE
- 2020
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Ingår i: International Journal of Stroke. - : Wiley-Blackwell Publishing Asia. - 1747-4930 .- 1747-4949. ; 15:Suppl. 1, s. 257-257
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: Stroke is the leading cause of serious, long-term disability among adults. Balance can be limited after stroke and the limitations affect walking and independence in activities of daily living. Having good balance has been described as an important factor in outdoor walking and for participation in exercises. Studies in which persons with stroke describe their experience of balance in everyday life are scarce.Aim: To describe experiences of living with balance limitations after first-ever stroke.Methods: A qualitative design, comprising interviews with 19 persons with first-ever stroke, ten women and nine men, aged between 42–92 years. Inclusion criteria were: having had a first-ever stroke and self-reported impaired balance, unaffected speech, independence in toileting and dressing, and walking ability indoors and outdoors with or without a walking aid. Data was analysed by means of an inductive content analysis covering both the manifest and the latent content of the transcribed interviews.Results: The results are presented in two themes illustrating the latent content of the data. “Feeling dizzy and unstable is a continuous challenge” revolves around participants’ descriptions of balance as a constant feeling of dizziness and unsteadiness. “Feeling trust and confidence despite dizziness and unsteadiness” is about perceived abilities and feelings of confidence about still being able to do things oneself, despite the dizziness and unsteadiness.Conclusion: All participants experienced the balance limitations as a continuous challenge in everyday life, yet they also felt trust and confidence and experienced that they still managed their everyday life.
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| 6. |
- Arvidsson Lindvall, Mialinn, 1977-
(författare)
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Physiotherapeutic perspectives on balance control after stroke : exercises, experiences and measures
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to investigate physiotherapeutic perspectives on balance after stroke, in terms of exercises, experiences and measurements. Study I was a pilot randomized controlled trial with 46 persons who had had a stroke, 24 of whom were included in the intervention group and 22 who were included in the control group. The intervention consisted of 8 weeks of body awareness therapy (BAT). There were no significant differences over time between the groups in the outcome measures of balance, walking, self-reported balance confidence and quality of life. Study II had a qualitative design using content analysis. Participants in the intervention group from Study I and the four physiotherapists who had been in charge of the BAT were interviewed. One overall theme emerged: "Simple yet challenging", which was based on six categories. Study III investigated the validity and test-retest reliability of the Six-Spot Step test (SSST), an instrument used to assess the ability to take load on each leg. A cross-sectional design with 81 persons who had had stroke was performed. The convergent validity was strong to moderate, and the test-retest reliability was good. In Study IV a mixed method design including both qualitative and quantitative data collection was used. The participants’ experiences of balance and its influence in everyday life were presented in two themes: "Feeling dizzy and unstable is a continuous challenge" and "Feeling trust and confidence despite dizziness and unsteadiness". Taken together, the different data sets provided complementary and confirmatory information about balance. All participants experienced the balance limitations as a continuous challenge in everyday life, yet they also felt trust and confidence.In summary, BAT can be a complement in physiotherapeutic stroke rehabilitation and the SSST can be used as a measuring instrument of walking balance in persons with stroke. Living with balance limitations was experienced as a challenge but the participants were still able to manage their everyday life and activities.
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| 7. |
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| 8. |
- Arvidsson Lindvall, Mialinn, 1977-, et al.
(författare)
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Validity and test–retest reliability of the six-spot step test in persons after stroke
- 2020
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Ingår i: Physiotherapy Theory and Practice. - : Taylor & Francis. - 0959-3985 .- 1532-5040. ; 36:1, s. 211-218
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Tidskriftsartikel (refereegranskat)abstract
- Background and Purpose: After stroke, asymmetric weight distribution is common with decreased balance control in standing and walking. The six-spot step test (SSST) includes a 5-m walk during which one leg shoves wooden blocks out of circles marked on the floor, thus assessing the ability to take load on each leg. The aim of the present study was to investigate the convergent and discriminant validity and test–retest reliability of the SSST in persons with stroke. Methods: Eighty-one participants were included. A cross-sectional study was performed, in which the SSST was conducted twice, 3–7 days apart. Validity was investigated using measures of dynamic balance and walking. Reliability was assessed using intraclass correlation coefficient, standard error of the measurement (SEM), and smallest real difference (SRD). Results: The convergent validity was strong to moderate, and the test–retest reliability was good. The SEM% was 14.7%, and the SRD% was 40.8% based on the mean of four walks shoving twice with the paretic and twice with the non-paretic leg. Conclusion: Values on random measurement error were high affecting the use of the SSST for follow-up evaluations but the SSST can be a complementary measure of gait and balance.
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| 9. |
- Carling, Anna, 1985-, et al.
(författare)
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Balance exercise facilitates everyday life for people with multiple sclerosis : A qualitative study
- 2018
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Ingår i: Physiotherapy Research International. - : John Wiley & Sons. - 1358-2267 .- 1471-2865. ; 23:4
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aim of this qualitative study was to describe the experience and perceived effects on everyday life for people with multiple sclerosis after participating in a balance exercise programme focusing on core stability, dual tasking, and sensory strategies (the CoDuSe programme).METHODS: A qualitative approach was chosen, using face-to-face interviews analysed with content analysis. Twenty-seven people with multiple sclerosis (20 women, 7 men) who had participated in the CoDuSe programme were included. All could walk 20 m with or without walking aids but could not walk further than 200 m. The CoDuSe programme was given twice weekly during a 7-week period.RESULTS: The analysis revealed five categories. Learning to activate the core muscles described how the participants gained knowledge of using their core muscles and transferred this core muscle activation into everyday life activities. Improved bodily confidence covered narratives of being more certain of the ability to control their bodies. Easier and safer activities showed how they could now perform activities in everyday life more safely and easily. Increased independence and participation involved the participants' improved ability and self-confidence to execute activities by themselves, as well as their increased participation in activities in daily living. Experiences of the balance exercise programme revealed that they found the programme novel and challenging. The overall theme was balance exercise facilitates everyday life.CONCLUSION: Participating in the CoDuSe programme was perceived to facilitate everyday life for people with multiple sclerosis. Taking part in the balance exercise programme taught the participants how to activate and use the core muscles, which increased their bodily confidence. Having increased bodily confidence helped them to perform everyday life activities with more ease and safety, which increased their independence and participation. The participants described the CoDuSe programme as novel and challenging, yet feasible.
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| 10. |
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| 11. |
- Carling, Anna, 1985-, et al.
(författare)
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CoDuSe group exercise programme improves balance and reduces falls in people with multiple sclerosis : A multi-centre, randomized, controlled pilot study
- 2017
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Ingår i: Multiple Sclerosis Journal. - London, United Kingdom : Sage Publications. - 1352-4585 .- 1477-0970. ; 23:10, s. 1394-1404
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Tidskriftsartikel (refereegranskat)abstract
- Background: Imbalance leading to falls is common in people with multiple sclerosis (PwMS).Objective: To evaluate the effects of a balance group exercise programme (CoDuSe) on balance and walking in PwMS (Expanded Disability Status Scale, 4.0-7.5).Methods: A multi-centre, randomized, controlled single-blinded pilot study with random allocation to early or late start of exercise, with the latter group serving as control group for the physical function measures. In total, 14 supervised 60-minute exercise sessions were delivered over 7 weeks. Pretest-posttest analyses were conducted for self-reported near falls and falls in the group starting late. Primary outcome was Berg Balance Scale (BBS). A total of 51 participants were initially enrolled; three were lost to follow-up.Results: Post-intervention, the exercise group showed statistically significant improvement (p = 0.015) in BBS and borderline significant improvement in MS Walking Scale (p = 0.051), both with large effect sizes (3.66; -2.89). No other significant differences were found between groups. In the group starting late, numbers of falls and near falls were statistically significantly reduced after exercise compared to before (p < 0.001; p < 0.004).Conclusion: This pilot study suggests that the CoDuSe exercise improved balance and reduced perceived walking limitations, compared to no exercise. The intervention reduced falls and near falls frequency.
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| 12. |
- Carling, Anna, 1985-, et al.
(författare)
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Fall bland personer med multipel skleros
- 2017
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Ingår i: Best Practice. - Uppsala, Sweden : BestPractice. - 1329-1874. ; :20, s. 24-27
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 13. |
- Carling, Anna, 1985-, et al.
(författare)
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Falls in people with multiple sclerosis : experiences of 115 fall situations
- 2018
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Ingår i: Clinical Rehabilitation. - : Sage Publications. - 0269-2155 .- 1477-0873. ; 32:4, s. 526-535
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim was to describe falls and the perceived causes, experienced by people with multiple sclerosis shortly after falling.Design: A qualitative study using content analysis and quantitative data to illustrate where and why people report falls most commonly. Semi-structured telephone interviews were performed. Interviews were conducted shortly (0–10 days) after a fall.Subjects: In all, 67 informants who had reported at least one fall during the previous three-month period and who used a walking aid participated.Results: A total of 57 (85%) informants fell at least once during eight months resulting in 115 falls; 90 (78%) falls happened indoors, most commonly in the kitchen (n = 20; 17%) or bathroom (n = 16; 14%). Informants fell during everyday activities and walking aids had been used in more than a third of the reported falls. The falls were influenced of both intrinsic and extrinsic factors. Two categories emerged from the analysis: ‘activities when falling’ and ‘influencing factors’. The category contained three (basic activities of daily living, instrumental activities of daily living and leisure and work) and six (multiple sclerosis–related symptoms, fluctuating body symptoms, being distracted, losing body control, challenging surrounding and involvement of walking aid) subcategories, respectively.Conclusion: The majority of falls occurs indoors and in daily activities. Several factors interacted in fall situations and should be monitored and considered to reduce the gap between the person’s capacity and the environmental demands that cause fall risk. Fluctuation of bodily symptoms between and within a day is a variable not earlier targeted in multiple sclerosis fall risk research.
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| 14. |
- Carling, Anna, 1985-
(författare)
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Impaired balance and fall risk in people with multiple sclerosis
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The symptoms from the neurological disease multiple sclerosis vary from person to person and over time. Impaired balance is common in people with multiple sclerosis and can lead to falls. Fall frequency is high in people with multiple sclerosis, above 50%. Multiple sclerosis affects not only the person having the disease but also their next of kin. To be able to reduce fall risk it is important to know when, why and where people with multiple sclerosis fall, and how to improve balance and reduce falls with exercise. It is also important to know how the falls affect the residing next of kin to people with multiple sclerosis.The overall aim of this thesis was to gain enhanced knowledge by investigating when and why people with MS fall and how these falls possibly affect their next of kin, and also to evaluate the effects and perceptions of participating in a specific balance exercise.Data were gathered using four different data collections, and this thesis contains both qualitative and quantitative data.The major finding in this thesis is that people with multiple sclerosis fall in the course of everyday life activities, most often in their own homes due to various intrinsic and extrinsic factors. Balance can be improved and falls reduced and everyday life may be made easier and facilitated after participating in the CoDuSe balance exercise. This is important also for the next of kin, since they are adapting, adjusting and renouncing their activities due to the falls of the PwMS, in order to make it work for the whole family.
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| 15. |
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| 16. |
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| 17. |
- Carling, Anna, 1985-, et al.
(författare)
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Making it work : experience of living with a person who falls due to multiple sclerosis
- 2020
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Ingår i: Disability and Rehabilitation. - : Taylor & Francis. - 0963-8288 .- 1464-5165. ; 42:7, s. 940-947
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The purpose of this study was to describe how everyday life is experienced by next of kin sharing residence with a person who falls due to multiple sclerosis (MS).METHODS: Twenty face-to-face interviews were analysed using a qualitative content analysis.RESULTS: The overall theme "Making it work" represents the next of kin's struggle to make life work. It comprises three themes: "Taking responsibility", "Making adjustments", and "Standing aside for someone else". The two first themes reflect what relatives do to make the situation work, and the last theme represents what they give up.CONCLUSION: Next of kin who share residence and everyday life with a person with MS are affected by that person's occasional falls. They often take on the responsibility of preventing such falls and adapt their lives practically and emotionally. However, adaptation is neither always enough or always possible. In these cases, relatives often deprioritize their own needs and free time to make everyday life in the home work.Implications for rehabilitationBy highlighting that next of kin also are affected by the falls of their cohabiting person with multiple sclerosis enhances the importance of fall prevention activities that should include the next of kin.Next of kin to people who occasionally fall due to multiple sclerosis can be in need of both practical and emotional support from the health care system.Enhanced information from the health care system can empower and help them to take care of themselves while managing to live with, care for, and protect the person with multiple sclerosis from falls.
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| 18. |
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| 19. |
- Cesta, Amedeo, et al.
(författare)
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GiraffPlus : D1.1 User Requirements and Design Principles Report
- 2012
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- This document reports on the work performed in Task 1.1 User requirements analysis and Task 1.2 GiraffPlus Environment Design Principles. Specifically, it describes the results of a deep involvement of users, both primary (elderly living in their apartment), and secondary (health care professional or family members and friends) recruited in our studies. The report details the qualitative and quantitative research carried out in the three countries of Sweden, Spain and Italy, to elicit user requirements and expectations in terms of type of services as well as system design and appearance. Some qualitative cross-cultural analysis has also been performed in order to highlight differences emerged during the studies in the three countries. Result of this effort is list of user requirements and a set of preferences on different mockups of a component of the system that can be both used to influence the future architecture definition and functional specification of the GiraffPlus system. The work described in this deliverable constitutes the starting point of T1.3 Technological Component Assessment and Selection and overall provides useful hints to the whole system development.
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| 20. |
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| 21. |
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| 22. |
- Forsberg, Anette, 1965-, et al.
(författare)
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Balancing everyday life two years after falling ill with Guillain-Barre syndrome : a qualitative study
- 2015
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Ingår i: Clinical Rehabilitation. - London, United Kingdom : Sage Publications. - 0269-2155 .- 1477-0873. ; 29:6, s. 601-610
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim was to describe experiences of disability in everyday life and managing the recovery process two years after falling ill with Guillain-Barré syndrome.Design: Qualitative interview study.Methods: Interviews were conducted with 35 persons (22 male, mean age 50 years) two years after the onset of Guillain-Barré syndrome. The interviews were transcribed verbatim and analysed using content analysis.Results: The analysis revealed four categories and an overall theme: ‘Striving for balance in everyday life’. The participants described persistent lived body restrictions that affected their arms, legs, and face. Bodily symptoms and loss of energy limited or restricted many everyday activities. In connection with healthcare, both satisfaction and feeling vulnerable in a critical situation were described. Experiences of the recovery process varied. The participants described acceptance and reappraisal of a new life situation despite their limitations, and having gained the knowledge that life can change suddenly. However, they also expressed disappointment following an overly positive prognosis in the early stages, and over a continuous wait for recovery. For some participants life had returned to as before.Conclusion: The participants experienced limitations in everyday life and decreased functioning in several parts of the body. The recovery process may still be ongoing two years after onset. Rehabilitation intervention with an extended focus on supporting individualized coping processes could facilitate ways to live with persistent disability.
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| 23. |
- Forsberg, Anette, 1965-, et al.
(författare)
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Disability and health-rated quality of life in Guillain-Barré syndrome during the first two years after onset : a prospective study
- 2005
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Ingår i: Clinical Rehabilitation. - : SAGE Publications. - 0269-2155 .- 1477-0873. ; 19:8, s. 900-909
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To describe changes in disability and health-related quality of life in patients with Guillain-Barré syndrome in Sweden during the first two years after onset.SUBJECTS: Forty-four patients were recruited from eight different hospitals, and 42 of them (mean age 52 years) were followed for two years. Evaluations were performed, primarily as home visits, at two weeks, two months, six months, one year and two years after onset.MAIN MEASURES: Disability was measured using the Katz Personal and Extended Activities of Daily Living Indexes, the Barthel Index, the Frenchay Activity Index and assessments of work capacity; health-related quality of life using the Sickness impact Profile.RESULTS: At two weeks, one year and two years after onset of Guillain-Barré syndrome, 76%, 14% and 12% of patients were dependent in personal activities of daily life (ADL); and 98%, 28% and 26% were dependent in instrumental ADL. At two weeks, all of the patients that were working before onset were unable to work owing to Guillain-Barré syndrome; at two years, 17% were unable to work. At two weeks, scores on Sickness Impact Profile were elevated in all dimensions; at two years, they remained elevated in the physical dimension and in the categories home management, work and recreation and pastimes.CONCLUSIONS: The impact of Guillain-Barré syndrome on ADL, work, social activities and health-related quality is considerable two years after onset and presumably persists beyond this time point.
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| 24. |
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| 25. |
- Forsberg, Anette, 1965-, et al.
(författare)
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Effects on Balance and Walking with the CoDuSe Balance Exercise Program in People with Multiple Sclerosis : A Multicenter Randomized Controlled Trial
- 2016
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Ingår i: Multiple Sclerosis International. - New York, USA : Hindawi Publishing Corporation. - 2090-2654 .- 2090-2662.
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Tidskriftsartikel (refereegranskat)abstract
- Background: Balance and walking impairments are frequent in people with multiple sclerosis (MS).Objective: The aim was to investigate the effects of a group-based balance exercise program targeting core stability, dual tasking, and sensory strategies (CoDuSe) on balance, postural sway, walking, perceived walking limitations, and balance confidence.Design: A single-blinded randomized multicenter trial. No intervention was given to controls. Participants. People with MS able to walk 100 meters but unable to maintain tandem stance >= 30 seconds. Eighty-seven participants were randomized to intervention or control.Intervention: The 60-minute CoDuSe group program, twice weekly for seven weeks, supervised by physical therapists.Measurements: Primary outcome was dynamic balance (Berg Balance Scale (BBS)). Secondary outcomes were postural sway, walking (Timed-Up and Go test; Functional Gait Assessment (FGA)), MS Walking Scale, and Activities-specific Balance Confidence (ABC) Scale. Assessments were performed before and after (week 8) the intervention.Results: 73 participants fulfilled the study. There were significant differences between the intervention and the control groups in change in the BBS and in the secondary measures: postural sway with eyes open, FGA, MS Walking Scale, and ABC scale in favor of the intervention.Conclusions: The seven-week CoDuSe program improved dynamic balance more than no intervention.
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| 26. |
- Forsberg, Anette, 1965-, et al.
(författare)
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Impairment in Guillain-Barré syndrome during the first 2 years after onset : A prospective study
- 2004
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Ingår i: Journal of the Neurological Sciences. - : Elsevier BV. - 0022-510X .- 1878-5883. ; 227:1, s. 131-138
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesTo provide a comprehensive description of impairment in patients with Guillain–Barré syndrome (GBS) in Sweden during the first 2 years after disease onset.MethodsIn this prospective multi-centre study, 42 patients, mean age 52 years, were evaluated at 2 weeks, 2 months, 6 months, 1 year and 2 years. Evaluations made use of validated, reliable measures of muscle strength, grip strength, finger dexterity, balance, facial-muscle function, respiratory function, gait, motor performance and sensory examination, and included patients' owns assessments of pain, fatigue and paraesthesia.ResultsMechanical ventilation was required in 21% of patients. At 2 weeks, 1 year and 2 years after GBS onset: 100%, 62% and 55% of patients had submaximal overall muscle strength; 98%, 38% and 31% subnormal grip strength; and 38%, 14% and 12% affected facial-muscle function. At the same time points, 62%, 10% and 7% of patients were unable to walk 10 m independently; and affected sensation was detected in 93%, 55% and 52%.ConclusionsRecovery occurred mainly during the first year after onset. At 2 years, motor impairment and sensory impairment were each still detectable in more than 50% of patients. We conclude that residual impairment is significant, somatically widespread and, likely, persistent.
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| 27. |
- Forsberg, Anette, 1965-, et al.
(författare)
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Measuring postural sway in people with multiple sclerosis
- 2015
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Ingår i: Multiple Sclerosis Journal. - : SAGE Publications. - 1352-4585 .- 1477-0970. ; 21:4, s. 531-531
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: Many people with multiple sclerosis (MS) have increased postural sway, which is associated with a higher risk of falls. Significantly increased sway has been found in people with slight or no balance impairment. Measuring postural sway is appropriate to perform in clinical settings; however, technical devices can be costly. The Swaymeter is a low-tech cheaper alter-native, considered reliable and valid in both younger and older populations (Sturnieks et al, 2011).Aims: To investigate the feasibility and validity of the Swaymeter in people with MS.Methods: Baseline values in a trial were used, with inclusion cri-teria unable to stand in tandem for 30 seconds; 87 persons with MS were tested in outpatient clinical settings, mean age 54 years (SD 11). Fifteen participants (17%) used an assistive walking device indoors and 52 (59%) outdoors. Assessments of sway were done in the bipedal stance for 30 seconds with no shoes, four con-ditions: floor eyes open (EO); floor eyes closed (EC); foam EO; and foam EC. The Swaymeter recorded displacements of the body in the horizontal plane at waist level. The displacement sway area was calculated in millimetres (anterioposterior × mediolateral). Construct validity was investigated through correlations with the Berg balance scale (BBS), the timed up and go (TUG) test, and the sit-to-stand test.Results: The postural sway displacements were large: floor EO (n=87) mean area 1393 mm (SD 1612); floor EC (n=82) mean area 3041 mm (SD 4447); foam EO (n=83) mean area 4007 mm (SD 3466); foam EC (n=62) mean area 9178 mm (SD 6514). For floor EO and foam EC, there was no significant correlation between the sway area and any of the balance tests. For floor with EC there was a low correlation (r=−0.266, P=0.016) between the sway area and the BBS, but not the other tests. For the condition foam with EO there were significant low–moderate correlation coefficients for the BBS (r=−0.45, P<0.001), the TUG test (r=0.26, P=0.016), and the sit-to-stand test (r=0.33, P=0.003).Conclusions: The Swaymeter was feasible in a clinical setting, but only 62 (71%) participants could stand on foam with EC for 30 seconds. Construct convergent validity with dynamic balance tests could not be established becausee most correlation coeffi-cients were low and non-significant. Further studies are needed to investigate the properties of the Swaymeter in MS.
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| 28. |
- Forsberg, Anette, 1965-, et al.
(författare)
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Perceptions of using videogames in rehabilitation : a dual perspective of people with multiple sclerosis and physiotherapists
- 2014
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Ingår i: Disability and Rehabilitation. - : Informa Healthcare. - 0963-8288 .- 1464-5165. ; 37:4, s. 338-344
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Our aim was to describe experiences of using Nintendo Wii Fit™ for balance exercise, from the perspectives of patients with multiple sclerosis (MS) and their physiotherapists (PT).Methods: Individual interviews with 15 patients with MS were conducted, recruited from a multi-centre study investigating the effects of balance exercising using Wii Fit. We also conducted a single focus group interview with nine PT involved in the study. The interviews were audio-recorded, transcribed, and analysed using content analysis.Results: Both patients and PT said that exercising with Wii Fit games was fun, and that it challenged the patients’ physical and cognitive capacities. The competitive content in the games provided motivation to continue playing. Patients and PT reported improved body control and, more importantly, positive effects on balance and walking in daily life. The PT regarded Wii training as an effective alternative to other balance training, but some felt unsure in how to manage the video game. The patients regarded Wii training as a possible home training solution.Conclusions: Patients with MS and their PT considered Wii Fit exercises to be fun, challenging, and self-motivating. Exercising with Wii games can address balance impairments in MS, and can be performed at home as well as in rehabilitation settings.Implications for RehabilitationNintendo Wii Fit™ can be used as a fun and challenging way to perform balance exercises.The competitive content embedded in the games triggers continued playing and exercising.The positive effect on balance control can improve standing and walking in everyday activities.
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| 29. |
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| 30. |
- Forsberg, Anette, 1965-, et al.
(författare)
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Residual disability 10 years after falling ill in Guillain-Barré syndrome : a prospective follow-up study
- 2012
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Ingår i: Journal of the Neurological Sciences. - Amsterdam, Netherlands : Elsevier. - 0022-510X .- 1878-5883. ; 317:1-2, s. 74-79
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To describe residual disability 10years after onset of Guillain-Barré syndrome (GBS) and longitudinal changes from 2weeks after onset until 10years afterwards. The Erasmus GBS Outcome score (EGOS) was applied for predicting prognosis at 2 and 10years.Methods: Twenty-nine patients, mean age at onset 49years, were followed prospectively from 2weeks to 10years after GBS onset. Measures included; GBS disability score, EGOS, Barthel Index, Frenchay Activity Index, Sickness Impact Profile (SIP), Overall Neuropathy Limitations Scale (ONLS), Walk-12, and Fatigue Severity Scale.Results: At 10years, the facial paralysis found in 5 participants at 2years was still present, 11 participants (38%) experienced paresthesia, 6 (21%) had limitations in their arms, and 15 (52%) had limitations in walking. Decreased health-related quality of life on comparison to the general population was seen in the physical dimension of SIP at 10years. The median EGOS at 2weeks was 4.5, which correlated highly only with the Barthel Index at 2years and the ONLS arm scale at 10years.Conclusion: The residual disabilities at 1-2years comprised mainly of reduced walking ability, and are still persistent 10years after GBS onset. For some individuals, facial paralysis caused major disability. The EGOS only partly predicted residual disability at 2 and 10years after onset.
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| 31. |
- Forsberg, Anette, 1965-, et al.
(författare)
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Use of health-care, patient satisfaction and burden of care in Guillain-Barré syndrome
- 2006
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 38:4, s. 230-236
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of this study was to investigate, in an unselected sample of patients with Guillain-Barré syndrome in Sweden, the utilization of healthcare resources, satisfaction with these resources, informal help and the burden of care on family caregivers during the first 2 years after onset.SUBJECTS: Forty-four patients were enrolled from 8 hospitals, and 42 of them were followed for 2 years.METHODS: Data on the utilization of hospital inpatient and outpatient care, primary care and community-based services were collected via computerized registry information, medical records and a specific protocol. Patient satisfaction and the burden on family caregivers were studied using questionnaires.RESULTS: Forty-one patients required inpatient hospitalization for a mean of 82 days. Patients with persistent dependency during activities of daily living had significantly longer hospital stays and more days of outpatient rehabilitation. The majority of patients were satisfied with their care, but dissatisfaction was found regarding information and finances. At 2 years after onset, 26% of patients still depended on informal help. The spouses expressed increased concern and responsibility for household and family.CONCLUSION: Patients with persistent disability due to Guillain-Barré syndrome were found to have long-term need for services from the healthcare system and informal help.
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| 32. |
- Forsberg, Anette, 1965-, et al.
(författare)
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Validity and reliability of the Swedish version of the activities-specific balance confidence scale in people with chronic stroke
- 2013
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Ingår i: Physiotherapy Canada. - : University of Toronto Press. - 0300-0508 .- 1708-8313. ; 65:2, s. 141-147
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate the validity and reliability of the Swedish version of the Activities-specific Balance Confidence (ABC) scale in people> 1 year after stroke.Method: In a multi-centre study design, using initial cross-sectional data collection with follow-up, the timed up-and-go (TUG) test, 10 m timed walk (10TW), and 6-Minute Walk Test (6MWT) were performed; ABC scale and Short Form 36 Health Survey (SF-36) were completed; and falls history data were collected during one session. One week later, the ABC scale was sent to participants for a second rating. Spearman correlation coefficients were calculated, and reliability was assessed via the intra-class correlation coefficient (ICC) and Cronbach alpha.Results: A convenience sample of 67 people was included (mean age 68 y). The median score for the ABC scale changed from 57 at the first rating to 43 at the second; 19 participants 28%) reported falls during the previous 3 months. Scores on the ABC scale were moderately correlated with the TUG (r¼0.48), 10TW (r¼0.52), 6MWT (r¼ 0.45), and SF-36 physical component summary score (r¼0.43). Internal consistency was high for the ABC scale at test and retest (a¼ 0.95–0.97). The ICC was 0.82 (95% CI, 0.72–0.88).Conclusions: The Swedish version of the ABC scale is a valid and reliable measure for investigating balance confidence in people >1 year after stroke.
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| 33. |
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| 34. |
- Frennert, Susanne, PhD, et al.
(författare)
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Elderly People's Perceptions of a Telehealthcare System : Relative Advantage, Compatibility, Complexity and Observability
- 2013
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Ingår i: Journal of technology in human services. - : Informa UK Limited. - 1522-8835 .- 1522-8991. ; 31:3, s. 218-237
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Tidskriftsartikel (refereegranskat)abstract
- The use of telehealthcare systems to promote independent living for elderly people is growing. The results presented in this article, derived from an initial user lab test of a telecare system-GiraffPlus-indicate that the crucial factor for adoption of telehealthcare systems is not usability but the system's ability to support autonomy in everyday life. Eleven users tested the usability and reported what they perceived as possible benefits of having such a system at home. To support autonomy, customization is crucial for the system to be perceived as meaningful for the individual. Our analysis confirms previous research. © 2013 Copyright Taylor and Francis Group, LLC.
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| 35. |
- Lindvall, Mialinn Arvidsson, 1977-, et al.
(författare)
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Body awareness therapy in persons with stroke : a pilot randomised controlled trial
- 2014
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Ingår i: Clinical Rehabilitation. - : Sage Publications. - 0269-2155 .- 1477-0873. ; 28:12, s. 1180-1188
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the effects of body awareness therapy on balance, mobility, balance confidence, and subjective health status in persons with stroke.Design: A pilot randomized controlled study with follow-up at one and 4–6 weeks after the intervention period.Setting: Four primary healthcare centres in Örebro County Council.Subjects: Persons more than six months post stroke, with walking ability of 100 metres.Intervention: The experimental intervention was body awareness therapy in groups once a week for eight weeks. The controls were instructed to continue their usual daily activities.Main measures: Berg Balance Scale, Timed Up and Go Test, Timed Up and Go Test with a cognitive component, 6-minute walk test, and Timed-Stands Test. Self-rated balance confidence was assessed using the Activities-specific Balance Confidence Scale, and subjective health status using the Short Form 36 (SF-36) questionnaire.Results: A total of 46 participants were included (mean age 64 years); 24 in the experimental intervention group and 22 in the control group. No significant differences in changed scores over time were found between the groups. Within the experimental intervention group, significant improvements over time was found for the tests Berg Balance Scale, Timed Up and Go cognitive, and 6-minute walk test. Within the control group, significant improvements over time were found for the Timed Up and Go Cognitive, and the Timed-Stands Test.Conclusion: In comparison to no intervention, no effects were seen on balance, mobility, balance confidence, and subjective health status after eight weeks of body awareness therapy.
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| 36. |
- Nilsagård, Ylva, 1964-, et al.
(författare)
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Activities-specific balance confidence in people with multiple sclerosis
- 2012
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Ingår i: Multiple Sclerosis International. - New York, USA : Hindawi Publishing Corporation. - 2090-2654 .- 2090-2662. ; 2012
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate the validity of the Activities-specific Balance Confidence scale (ABC) in people with multiple sclerosis (PwMS). Design. A multicentre, crosssectional study. Setting. Six rural and urban Swedish sites, including specialized units at hospitals and primary care centers.Participants: A sample of 84 PwMS with subjective gait and balance impairment but still able to walk 100 m (comparable with EDSS 1–6).Outcome Measures: Timed Up and Go, Timed Up and Gocog, 25-foot Timed Walk Test, Four Square Step Test, Dynamic Gait Index, Chair Stand Test, 12-item MS Walking Scale, selfreported falls, and use of assistive walking device were used for validation. Results. The concurrent convergent validity was moderate to good (0.50 to −0.75) with the highest correlation found for the 12-item MS Walking Scale. The ABC discriminated between multiple fallers and nonfallers but not between men and women. Ecological validity is suggested since ABC discriminated between users of assistive walking device and nonusers. The internal consistency was high at ? = 0 . 9 5 , and interitem correlations were between 0.30 and 0.83.Conclusion: This study supports the validity of the ABC for persons with mild-to-moderate MS. The participants lacked balance confidence in many everyday activities, likely restricting their participation in society.
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| 37. |
- Nilsagård, Ylva, 1964-, et al.
(författare)
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Balance exercise for persons with multiple sclerosis using Wii games : a randomised, controlled multi-centre study
- 2013
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Ingår i: Multiple Sclerosis Journal. - : Sage Publications. - 1352-4585 .- 1477-0970. ; 19:2, s. 209-216
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Tidskriftsartikel (refereegranskat)abstract
- Background: The use of interactive video games is expanding within rehabilitation. The evidence base is, however, limited.Objective: Our aim was to evaluate the effects of a Nintendo Wii Fit® balance exercise programme on balance function and walking ability in people with multiple sclerosis (MS).Methods: A multi-centre, randomised, controlled single-blinded trial with random allocation to exercise or no exercise. The exercise group participated in a programme of 12 supervised 30-min sessions of balance exercises using Wii games, twice a week for 6–7 weeks. Primary outcome was the Timed Up and Go test (TUG). In total, 84 participants were enrolled; four were lost to follow-up.Results: After the intervention, there were no statistically significant differences between groups but effect sizes for the TUG, TUGcognitive and, the Dynamic Gait Index (DGI) were moderate and small for all other measures. Statistically significant improvements within the exercise group were present for all measures (large to moderate effect sizes) except in walking speed and balance confidence. The non-exercise group showed statistically significant improvements for the Four Square Step Test and the DGI.Conclusion: In comparison with no intervention, a programme of supervised balance exercise using Nintendo Wii Fit® did not render statistically significant differences, but presented moderate effect sizes for several measures of balance performance.
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| 38. |
- Nilsagård, Ylva, 1964-, et al.
(författare)
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Balance exercise program reduced falls in people with multiple sclerosis : a single-group, pretest-posttest trial
- 2014
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Ingår i: Archives of Physical Medicine and Rehabilitation. - : Saunders Elsevier. - 0003-9993 .- 1532-821X. ; 95:12, s. 2428-2434
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate the effects of a balance exercise program on falls in people with mild to moderate multiple sclerosis (MS).Design: Multicenter, single-blinded, single-group, pretest-posttest trial.Setting: Seven rehabilitation units within 5 county councils.Participants: Community-dwelling adults with MS (NZ32) able to walk 100m but unable to maintain 30-second tandem stance with armsalongside the body.Intervention: Seven weeks of twice-weekly, physiotherapist-led 60-minute sessions of group-based balance exercise targeting core stability, dualtasking, and sensory strategies (CoDuSe).Main Outcome Measures: Primary outcomes: number of prospectively reported falls and proportion of participants classified as fallers during 7preintervention weeks, intervention period, and 7 postintervention weeks. Secondary outcomes: balance performance on the Berg Balance Scale,Four Square Step Test, sit-to-stand test, timed Up and Go test (alone and with cognitive component), and Functional Gait Assessment Scale;perceived limitations in walking on the 12-item MS Walking Scale; and balance confidence on the Activities-specific Balance Confidence Scalerated 7 weeks before intervention, directly after intervention, and 7 weeks later.Results: Number of falls (166 to 43;P.001) and proportion of fallers (17/32 to 10/32;P.039) decreased significantly between thepreintervention and postintervention periods. Balance performance improved significantly. No significant differences were detected forperceived limitations in walking, balance confidence, the timed Up and Go test, or sit-to-stand test.Conclusions: The CoDuSe program reduced falls and proportion of fallers and improved balance performance in people with mild to moderateMS but did not significantly alter perceived limitations in walking and balance confidence
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| 39. |
- Nilsagård, Ylva, 1964-, et al.
(författare)
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Comparison of trunk impairment scale versions 1.0 and 2.0 in people with multiple sclerosis : A validation study
- 2017
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Ingår i: Physiotherapy Theory and Practice. - : Taylor & Francis. - 0959-3985 .- 1532-5040. ; 33:10, s. 772-779
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Tidskriftsartikel (refereegranskat)abstract
- Background: Trunk control impairment often accompanies multiple sclerosis (MS). Trunk stability is necessary for movements of extremities, as are selective trunk movements for normal gait. Measuring trunk function is thus of interest.Methods: We examined the relationships between the Trunk Impairment Scale (TIS1.0 and TIS2.0) and the Berg Balance Scale (BBS), 5 sit-to-stand test (5STS), Timed Up and Go test (TUG), 10-m timed walk test (10TW), 2-min walk test (2MWT), Falls Efficacy Scale - International, and 12-item MS Walking Scale (MSWS-12) in 47 outpatients. We determined construct validity by calculating the degree to which the TIS versions produced different scores between known groups: use or nonuse of walking aid, MS disability status, and whether participants experienced a fall or not during 14 weeks.Results: TIS correlated moderately with BBS and 5STS; moderately (TIS1.0) or weakly (TIS2.0) with TUG, 10TW, and 2MWT; and weakly to moderately with MSWS-12 in subgroups with Expanded Disability Status Scale (EDSS) > 6.0. No other clear correlation patterns were found. TIS did not discriminate between known groups.Conclusions: TIS1.0 is recommended for individuals with MS (EDSS score 4.0-7.5). Better trunk function correlates with better balance and walking ability. TIS has limited value in fall risk screening.
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| 40. |
- Nilsagård, Ylva, 1964-, et al.
(författare)
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Engagement in performing clinical physiotherapy research : Perspectives from leaders and physiotherapists
- 2019
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Ingår i: Physiotherapy Research International. - : John Wiley & Sons. - 1358-2267 .- 1471-2865. ; 24:2
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The recent increase in physiotherapy research has led to more physiotherapists being involved in research. Consequently, leaders must make a standpoint on whether the department should engage in research, whereas individual physiotherapists have to decide if they want to play an active role in carrying out a research project. The purpose of this study was to explore perceptions and experiences of both participating physiotherapists and their leaders regarding taking part in clinical physiotherapy research projects.METHODS: A qualitative study using face-to-face interviews was conducted. All (n = 8) leaders were interviewed individually. Physiotherapists (n = 18) were interviewed either individually (n = 5) or in small groups including two to three persons (n = 13). The interviews were analysed using inductive conventional content analysis.RESULTS: There was a consensus that engagement of the leaders was a prerequisite for entering research projects and that the research had to be in line with the department's regular assignment. For the physiotherapists, the key factors for success were having designated time and having support from their leader, especially when feelings of responsibility became overwhelming. The leaders stressed the importance of being well informed. Participating in clinical research created value such as personal and professional growth for the physiotherapists, who also inspired their colleagues and thus positively affected the organization. Engaging in research contributed to being an attractive employer and gave a boost to evidence-based practice.CONCLUSION: The study provides perspectives from leaders and physiotherapists on engaging in research. There was a consensus that participating in a research project was beneficial for the organization, the individual physiotherapist, and the patients. However, clinical applicability, support, sufficient time, and early involvement of leaders are significant prerequisites.
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| 41. |
- Nilsagård, Ylva, 1964-, et al.
(författare)
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Functional gait assessment : Reliability and validity in people with peripheral vestibular disorders
- 2014
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Ingår i: International Journal of Therapy and Rehabilitation. - : MA Healthcare Ltd. - 1741-1645 .- 1759-779X. ; 21:8, s. 367-373
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Tidskriftsartikel (refereegranskat)abstract
- Background/aim: Reliable and valid measures evaluating imbalance during walking are important for targeting rehabilitation efforts. This study aimed to investigate the reliability and validity of the Functional Gait Assessment (FGA) in people with peripheral vestibular disorder.Methods: This study used a cross-sectional design and tested the reliability and validity of the FGA in 43 participants with peripheral vestibular disorder. The participants' performance on the FGA was filmed. To test intra-rater reliability, three raters reassessed 39 of these participants using the video uptakes. Interrater reliability was assessed by five raters analysing the video uptakes. Concurrent validity was investigated using timed measures of dynamic balance and the Activities-specific Balance Confidence scale.Results: The intra-rater reliability for the FGA score was high, with a intraclass correlation coefficient (ICC) (model 2,1)=0.94 (95% CI=0.85; 0.97). The intra-rater percentage of agreement for all raters for separate items was moderate to high, and weighted kappa was good to very good, ranging from 0.61 for change in speed to 0.95 for stair climbing. The inter-rater reliability was ICC (model 2,1)=0.73 (95% CI=0.49; 0.86). Agreement for two random raters was 45-92%. Weighted kappa was fair to very good, ranging from 0.27 for change in speed to 0.87 for walking with a narrow base of support. The internal consistency was high (α=0.88). Gait with eyes closed had the lowest item-to-total (0.33) and item-to-item (<0.30) correlation. Concurrent validity was moderate to strong (rho=0.50-0.76) with the highest correlation coefficient for the Timed Up and Go test.Conclusions: The FGA is a reliable and valid measure in people with peripheral vestibular disorder. For improving internal consistency, removal of the item 'gait with eyes closed' may be considered.
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| 42. |
- Nilsagård, Ylva, 1964-, et al.
(författare)
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Practicability and sensitivity to change of the Activities-specific Balance confidence and 12-item Walking scale for stroke
- 2012
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Ingår i: Topics in Stroke Rehabilitation. - Oxfordshire, United Kingdom : Taylor & Francis. - 1074-9357 .- 1945-5119. ; 19:1, s. 13-22
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To investigate the practicability and sensitivity to change of the Activities-specific Balance Confidence Scale (ABC) and the 12-item Walking Scale (WS-12) in persons at different phases after stroke.Method: A longitudinal data collection with repeated measurements at 0 to 14 days and 3 months post stroke combined with a cross-sectional approach for persons more than 1 year post stroke. The participants were 37 persons (median age, 79 years; interquartile range [IQR] 67-86) in the acute phase admitted to the University Hospital of Orebro (sample A) of whom 31 were measured at follow-up, and 67 persons at 4 primary care centers in Orebro County Council (median age, 68 years; IQR, 61-76) who were more than 1 year post stroke (sample B).Results: The ABC registered balance confidence during activities and the WS-12 measured walking limitations as perceived by participants. The observed score range per item and for the total scores covered a wide range with no floor or ceiling effects. For the older persons in sample A, 3 ABC items requiring high balance levels were found difficult even before stroke. The item for running in the WS-12 was also often commented on as being not possible before stroke. The ABC showed moderate ability and the WS-12 showed good ability to measure change.Conclusion: The scales are practical to use and sensitive to change for persons with remaining walking ability at different phases post stroke.
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| 43. |
- Nilsagård, Ylva, 1964-, et al.
(författare)
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Psychometric properties of the Activities-Specific Balance Confidence Scale in persons 0-14 days and 3 months post stroke
- 2012
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Ingår i: Disability and Rehabilitation. - London, United Kingdom : Informa Healthcare. - 0963-8288 .- 1464-5165. ; 34:14, s. 1186-1191
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To test the internal consistency and validity of a Swedish translation of the Activities-specific Balance Confidence Scale (ABC) 0-14 days and 3 months post stroke.Method: 37 persons were tested at 0-14 days (median 5 days) post stroke and 31 were retested 3 months later (median 87 days). In addition to the ABC, the Functional Ambulation Categories, modified Rivermead Mobility Index, timed up and go test, 10-meter timed walk, SF-36 and the 12-item Walking Scale were used.Results: The internal consistency was high at α = 0.94 to 0.97. Kendall correlation-τ coefficients were moderate and varied somewhat depending on time poststroke. At 0-14 days post stroke the highest correlation was found between the ABC and the 12-item Walking Scale (-0.55, p < 0.01). At 3 months poststroke, the correlations with the Functional Ambulation Categories was 0.49 (p < 0.01), timed up and go test -0.43 (p < 0.01), 10-meter timed walk -0.41 (p < 0.01), and modified Rivermead Mobility Index 0.46 (p < 0.01). Divergent validity was established by the non-significant correlation (0.12) between the ABC and SF-36 mental component summary.Conclusions: The Swedish version of ABC has high internal consistency and is valid for measuring balance confidence in the acute and sub acute phases of stroke
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| 44. |
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| 45. |
- Rådman, Lisa, 1983-, et al.
(författare)
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Modified Rivermead Mobility Index : a reliable measure in people within 14 days post-stroke
- 2015
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Ingår i: Physiotherapy Theory and Practice. - : Taylor & Francis. - 0959-3985 .- 1532-5040. ; 31:2, s. 126-129
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The reliability of the Modified Rivermead Mobility Index (MRMI) has not previously been investigated in the very early post-stroke phase. The aim of the study was to evaluate inter-rater and intra-rater reliability and internal consistency in patients, 1-14 d post-stroke.Method: A cohort study with repeated measures within 24 h, on 37 patients, 1-14 d post-stroke was conducted. Inter-rater (two raters) and intra-rater (one rater) reliability was analyzed using weighted kappa (kappa) statistics and internal consistency with Cronbach's alpha and intra-class correlation (ICC), 3.k.Results: Inter-rater and intra-rater reliability was excellent (ICC coefficient 0.97 and 0.99) for MRMI summary score. Intra-rater exact agreement for separate items was between 77% and 97%; kappa between 0.81 and 0.96. Inter-rater exact agreement for separate items was between 68% and 92%; kappa 0.59-0.87. The internal consistency was high (alpha 0.96; ICC 3.k 0.99). Conclusion: The MRMI is a reliable measure of physical mobility in the early post-stroke phase.
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| 46. |
- Tholin, Helena, et al.
(författare)
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Satisfaction with care and rehabilitation among people with stroke, from hospital to community care
- 2014
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley-Blackwell. - 0283-9318 .- 1471-6712. ; 28:4, s. 822-829
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Despite recent improvements in Swedish stroke care some patients still experience a lack of support and follow-up after discharge from hospital. In order to provide good care according to the National Board of Health and Welfare, systematic evaluations of stroke care must be performed. Quality indicators in the national guidelines could be useful when measuring quality of care in all parts of the stroke care chain.AIM: To investigate how people with stroke experienced their care, rehabilitation, support, and participation from hospital to community care.METHOD: Qualitative interviews were performed with 11 people in 2009-2010 covering their experiences of care, rehabilitation, support, and participation. The interviews were analysed with qualitative content analysis.RESULT: The interviewees were satisfied with their hospital care, but reported both positive and negative experiences of the continuing care. Most of them appreciated intense, specific, and professional rehabilitation, and had experienced these qualities in the rehabilitation they received in most parts of the stroke care chain. Those who received support from the community services expressed satisfaction with the staff, but also felt that autonomy was lost. Several did not feel involved in the health care planning, but instead relied on the judgement of the staff.CONCLUSION: To ensure high quality throughout the whole stroke care chain, people with stroke must be invited to participate in the care and the planning of care. To offer evidence-based stroke rehabilitation, it is important that the rehabilitation is specific, intense, and performed by professionals, regardless of where the rehabilitation is performed. A changed view of the patient's autonomy in residential community services should be developed, and this process must start from the staff and residents.
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| 47. |
- W. Thörn, Rose-Marie, 1964-, et al.
(författare)
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Supervised Immediate Postoperative Mobilization After Elective Colorectal Surgery : A Feasibility Study
- 2022
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Ingår i: World Journal of Surgery. - : Springer. - 0364-2313 .- 1432-2323. ; 46:1, s. 34-42
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Early mobilization is a significant part of the ERAS® Society guidelines, in which patients are recommended to spend 2 h out of bed on the day of surgery. However, it is not yet known how early patients can safely be mobilized after completion of colorectal surgery. The aim of this study was to evaluate the feasibility, and safety of providing almost immediate structured supervised mobilization starting 30 min post-surgery at the postoperative anesthesia care unit (PACU), and to describe reactions to this approach.METHODS: This feasibility study includes 42 patients aged ≥18 years who received elective colorectal surgery at Örebro University Hospital. They underwent a structured mobilization performed by a specialized physiotherapist using a modified Surgical ICU Optimal Mobilization Score (SOMS). SOMS determines the level of mobilization at four levels from no activity to ambulating. Mobilization was considered successful at SOMS ≥ 2, corresponding to sitting on the edge of the bed as a proxy of sitting in a chair due to lack of space.RESULTS: In all, 71% (n = 30) of the patients reached their highest level of mobilization between the second and third hour of arrival in the PACU. Before discharge to the ward, 43% (n = 18) could stand at the edge of the bed and 38% (n = 16) could ambulate. Symptoms that delayed advancement of mobilization were pain, somnolence, hypotension, nausea, and patient refusal. No serious adverse events occurred.CONCLUSIONS: Supervised mobilization is feasible and can safely be initiated in the immediate postoperative care after colorectal surgery. Trial registration Clinical trials.gov identifier: NTC03357497.
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| 48. |
- Wilnerzon Thörn, Rose-Marie, 1964-, et al.
(författare)
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Immediate mobilization in post-anesthesia care unit does not increase overall postoperative physical activity after elective colorectal surgery : A randomized, double-blinded controlled trial within an enhanced recovery protocol
- 2024
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Ingår i: World Journal of Surgery. - : Springer. - 0364-2313 .- 1432-2323. ; 48:4, s. 956-966
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The level of post-operative mobilization according to Enhanced Recovery After Surgery (ERAS) guidelines is not always achieved. We investigated whether immediate mobilization increases postoperative physical activity. The objective was to evaluate the effects of immediate postoperative mobilization in the post-anesthesia care unit (PACU) compared to standard care.METHODS: This randomized controlled trial, involved 144 patients, age ≥18 years, undergoing elective colorectal surgery. Patients were randomized to mobilization starting 30 min after arrival in the PACU, or to standard care. Standard care consisted of mobilization a few hours later at the ward according to ERAS guidelines. The primary outcome was physical activity, in terms of number of steps, measured with an accelerometer during postoperative days (PODs) 1-3. Secondary outcomes were physical capacity, functional mobility, time to readiness for discharge, complications, compliance with the ERAS protocol, and physical activity 1 month after surgery.RESULTS: With the intention-to-treat analysis of 144 participants (median age 71, 58% female) 47% underwent laparoscopic-or robotic-assisted surgery. No differences in physical activity during hospital stay were found between the participants in the intervention group compared to the standard care group (adjusted mean ratio 0.97 on POD 1 [95% CI, 0.75-1.27], p = 0.84; 0.89 on POD 2 [95% CI, 0.68-1.16], p = 0.39, and 0.90 on POD 3 [95% CI, 0.69-1.17], p = 0.44); no differences were found in any of the other outcome measures.CONCLUSIONS: Addition of the intervention of immediate mobilization to standard care did not make the patients more physically active during their hospital stay.TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NTC 03357497.
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| 49. |
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