| 1. |
- Persson, Hanna C, 1979, et al.
(författare)
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Consequences and coping strategies six years after a subarachnoid hemorrhage - A qualitative study
- 2017
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Ingår i: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 12:8
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Tidskriftsartikel (refereegranskat)abstract
- Background After a subarachnoid haemorrhage (SAH), continuing impairment is common and may impact the person's life. There is a lack of knowledge regarding long-term consequences experienced. To explore experiences of the care and rehabilitation as well as the consequences and strategies used to cope with everyday life six years post SAH. An explorative interview study with a qualitative design. Individual interviews, with open ended questions, using an interview guide were performed with sixteen participants (mean age 63, 8 men, 8 women) six years post SAH. Data was analyzed according to a descriptive thematic analysis, and themes were discovered inductively. Two major themes from the analysis, both including four sub-themes, were identified; these themes were consequences of the SAH and coping strategies. Participants were grateful to have survived the SAH and most were satisfied with their acute medical care. If discharged directly from the neurosurgical unit participants can feel abandoned. In contrast, participants who were referred to a rehabilitation clinic felt supported and informed. Cognitive problems, such as impaired memory and mental fatigue, were reported as still present six years post SAH. Coping strategies were; receiving support from family, society, employers, or technical equipment. At work, talking to colleagues and to taking breaks were common. Participants described hiding their symptoms from employers and friends, as well as trying to continue doing tasks in the same manner as prior to the SAH. If this was not possible, some refrained from doing these tasks. They went through a mourning process, fear, and worries. Participants reported several long-term consequences which impacted on their daily lives post SAH, and different coping strategies were used to cope with these problems. Participants reported lack of awareness regarding the consequences of SAH and stressed the importance of structured multidisciplinary follow-ups, which mostly is missing.
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| 2. |
- Törnbom, Karin, 1982, et al.
(författare)
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Swedish Citizens with Cerebral Palsy or Spina Bifida – Perceived Experiences of Social Life and Employment
- 2017
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Ingår i: Review of disability studies: an international journal. - 1552-9215. ; 13:1, s. 47-63
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Tidskriftsartikel (refereegranskat)abstract
- This article offers insight into the ways in which people with cerebral palsy and spina bifida reflect upon their experiences of participation in relation to social life and employment. The qualitative method was used to explore experiences of participation among adults with CP or SB, using semi structured interviews. Participants expressed a desire to make a contribution to the labor market, to have sustainable relationships and to be accepted by others.
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| 3. |
- Danielsson, Anna, 1957, et al.
(författare)
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Experience of treadmill walking and audio-visual feedback after brain injury
- 2016
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Ingår i: ACPIN-INPA International Neurophysiotherapy Conference, London UK, 17-18 March 2016.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background People with stroke often have a low physical activity level and finding ways to motivate people to become more physically active is highly important. Using virtual reality in rehabilitation has shown positive effects, however knowledge about patients’ perceptions of this type of training is needed. Purpose To explore mental and physical experiences of treadmill walking and audio – visual (AV) feedback after brain injury. Method Three woman and seven men (median age 51) with stroke/other brain injury were interviewed after walking on a treadmill with and without AV- feedback mediated as follows: the speed of a realistic movie projecting a walking path, with nature sounds and step rhythm sounds, (through earphones) were directed by software connected to movement sensors donned to the legs. Semi structured interviews were audio recorded, transcribed and analysed using qualitative content analysis (QCA). Interviews were read by both authors and a coding scheme based on key concepts related to the research questions was developed. All codes were retrieved in the interviews and grouped into categories. To catch the latent meaning, categories were formulated into themes. Results Themes comprised positive and negative experiences. Participants experienced treadmill walking as enjoyable. The AV- feedback was mainly considered as pleasurable and exiting. Patients with mental weariness were ambivalent and found the AV-feedback more or less disturbing. Therefore, they considered the experience to be too exhausting in this early stage of rehabilitation. No fall incidents occurred but patients with balance problems using hand support reported tiredness in the hand. Conclusions In general, participants liked and found this inexpensive AV –feedback motivating and more enjoyable than ordinary treadmill walking. However, to avoid perceptional overload the amount of stimuli provided should be adjusted to the each individual. Further studies are needed to investigate if AV-feedback can be used to increase exercise intensity.
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| 4. |
- Danielsson, Anna, 1957, et al.
(författare)
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Experiences of treadmill walking and audio-visual feedback after stroke – an interview study
- 2017
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Ingår i: Nordic Stroke 2017. 19th Nordic Congress on Cerebrovascular Diseases, August 23-25, Aarhus, DK.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Walking training after stroke is highly important and a high intensity is recommended. As in-patients rarely reach the recommended physical activity level, finding ways to motivate exercise is therefore a key issue in rehabilitation. Offering a variety of training methods e.g by using virtual reality, could be one option to increase exercise intensity. The purpose of the study was to explore how patients’ with stroke experience treadmill walking with a prototype for audio – visual (AV) feedback. Methods: Three woman and five men, with a median age of 52, undergoing walking training, participated during inpatient rehabilitation 2-10 months after stroke. They walked for two sessions of up to 30 minutes on a treadmill at self-selected speed, with and without AV- feedback, respectively. The AV-feedback was mediated through a realistic movie of a walking path displayed on a TV-screen. Movement sensors donned to the legs connected to software, directed the speed of the movie. In addition, nature sounds and the individual’s step rhythm were mediated through headphones. After the walking session the participants took part in an individual interview regarding their experience walking with and without the AV-feedback. Semi structured interviews were audio recorded, transcribed and analysed using qualitative content analysis. Interviews were read by both authors and a coding scheme based on key concepts related to the research questions was developed. All codes were retrieved in the interviews, grouped into categories and finally formulated into themes. Results: Three main themes; positive, negative and ambivalent experiences, were expressed. The AV- feedback was mainly considered as enjoyable, engaging and made walking on the treadmill more interesting than without. Some participants experienced dizziness and those sensitive to mental overload found parts of the feedback more or less wearing. No fall incidences occurred but patients with more pronounced balance problems reported physical fatigue in their supporting hand. Conclusions: In general, participants liked and found this inexpensive AV –feedback motivating and enjoyable. Yet, the individual’s capacity has to be taken into account when adding perceptional stimuli during treadmill walking. The additional value of virtual feedback aiming to increase exercise intensity ought to be further explored.
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| 5. |
- Danielsson, Anna, 1957, et al.
(författare)
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VIEWS AND EXPERIENCES OF PHYSICAL TRAINING IN PEOPLE WITH STROKE OR OTHER BRAIN INJURY
- 2016
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Ingår i: 20th European Congress of Physical and Rehabilitation Medicine, Estoril Portugal 23-28 April 2016.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction Physical activity after stroke promotes neuroplasticity, physical functions, daily activities, health and well-being. People with stroke are shown to be less active than healthy controls which is a risk for decline in function as well as getting a new cardiovascular event. To improve guidance further knowledge regarding attitudes and factors significant for physical activity is needed. Purpose To explore participants’ experiences of physical activity after stroke or other brain injury. Method Ten semi structured interviews were analysed, using qualitative content analysis. Interviews were read several times by the authors and a coding scheme based on key concepts related to the research questions was developed. All codes retrieved from the interviews were grouped into categories. To catch the latent meaning, categories were formulated into themes. Three woman and seven men with a median age of 51 years undergoing rehabilitation after stroke (n=7) or other brain injury (n=3) were interviewed. Results Three themes were identified: 1.The participants had mixed experiences and views on the significance of physical activity prior to injury. 2. After injury they experienced a new situation and saw exercise as a duty. Physical activity after injury was limited to short walks a few times a week. 3.Factors of importance for executing physical activity: Advice and support from a physiotherapist or other professionals were highlighted as very important. Support from significant others, fellow patients and to see progression towards set goals contributed as motivating factors. Physical and mental factors, especially balance and walking impairments as well as fatigue and lack of motivation were perceived as hindering. Discussion and Conclusions After injury, physical activity was perceived as filled with demands, a necessary evil to achieve as good function as possible. Dependence on security in the training situation, support and push from professionals and relatives were evident.
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| 6. |
- Törnbom, Karin, 1982, et al.
(författare)
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Experiences of treadmill walking with non-immersive virtual reality after stroke or acquired brain injury - A qualitative study.
- 2018
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Ingår i: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 13:12
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Tidskriftsartikel (refereegranskat)abstract
- It is well known that physical activity levels for persons after stroke or acquired brain injuries do not reach existing recommendations. Walking training is highly important since the ability to walk is considered to be a meaningful occupation for most people, and is often reduced after a brain injury. This suggests a need to innovate stroke rehabilitation, so that forms of walking training that are user-friendly and enjoyable can be provided.An interview study was carried out with persons after stroke (n = 8), or acquired brain injury (n = 2) at a rehabilitation unit at Sahlgrenska University Hospital. We used a semi-structured interview guide to investigate experiences and thoughts about walking on a treadmill with non-immersive virtual reality feedback. The contents were analyzed through an inductive approach, using qualitative content analysis.The virtual reality experience was perceived as enjoyable, exciting, and challenging. Participants stressed that the visual and auditory feedback increased their motivation to walk on a treadmill. However, for some participants, the virtual reality experience was too challenging, and extreme tiredness or fatigue were reported after the walking session.Participants' thoughts and experiences indicated that the Virtual Reality walking system could serve as a complement to more traditional forms of walking training. Early after a brain injury, virtual reality could be a way to train the ability to handle individually adapted multisensory input while walking. Obvious benefits were that participants perceived it as engaging and exciting.
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| 7. |
- Törnbom, Karin, 1982, et al.
(författare)
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Long-term participation 7-8 years after stroke: Experiences of people in working-age.
- 2019
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Ingår i: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 14:3
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Tidskriftsartikel (refereegranskat)abstract
- To enhance the understanding of long-term participation in working-aged people 7-8 years after stroke.This study had a qualitative design, using a thematic analysis methodology. Eleven individuals took part in an in depth interview 7-8 years after a first time stroke. They had received care at the Sahlgrenska University Hospital in Gothenburg, and were recruited as a heterogenic sample with respect to age, gender, stroke severity and subtype.From the participants' experiences four themes emerged: "Returning to work after stroke"; "Working life 7-8 years after stroke"; "Social life 7-8 years after stroke"; and "A state of reorientation in life". Quotes about experienced participation in everyday life were summarized and presented as "Participation after stroke narratives". Participants chose to emphasize on work- and social life when describing situations of successful participation. Being included in the wider community and having a sense of purpose, when interacting with others, were factors that these narratives had in common. Participants had gradually become accustomed to a somewhat altered life situation. Some consequences after stroke were still considered frustrating in social or work situations. However, the importance of these issues had reduced and were no longer problematized.Participants felt content with their everyday life in general, which was a principal and positive result of this study. Reaching a stage of acceptance seemed to be a complex and continuous struggle, and an individual approach in long-term rehabilitation would be valuable to support this personal process. More knowledge about what factors that facilitate participation in people of working-age many years after stroke is needed, so that more people can reach a state of positive identity and participation.
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| 8. |
- Törnbom, Karin, 1982, et al.
(författare)
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”My life after stroke through a camera lens” – A Photovoice study on participation in Sweden
- 2019
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 14:9
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Tidskriftsartikel (refereegranskat)abstract
- Background An increasing number of people with stroke live in their communities, yet the understanding of how their reintegration into society can best be facilitated is incomplete. If needs are not sufficiently met and difficulties overcome, it may result in limited participation and decreased life satisfaction for this group. We aimed to understand life after stroke through the lens of participants’ cameras, and hence their views and experiences guided this study. Methods By the means of photovoice, an action research method, this study was conducted in a collaborative format with six women and five men after stroke. Participants photographed in everyday life for up to four weeks and then met to discuss all images in a focus group setting. Subsequently, participants gave feedback on the method and discussed the upcoming photography exhibition. All photos and the three focus group discussions were analyzed using a thematic analysis with an inductive approach. Results In the focus group discussions, life after stroke were conceptualized through five main themes: a driving force to participate in society; managing everyday life through inventiveness and persistent training; insufficient healthcare and rehabilitation in the long-term perspective; finding meaningful relationships and activities in daily life. Participants’ voices are made clear through selected photos, which aim to present each theme and make results easier to understand. Conclusions Participants found new ways to approach everyday life situations and had thereby regained a sense of control in life. However, it was evident that psychological processes towards adaptation were hindered by depression and that some individuals felt alone in an ongoing struggle. Additionally, available interventions a long time after stroke were not flexible enough to address all participants’ needs.
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| 9. |
- Törnbom, Karin, 1982
(författare)
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Participation after stroke in a short- and long-term perspective
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The main scope of this thesis was to study and describe perceived participation among persons with stroke. In doing so, different timepoints were chosen to make a more complete picture of participation after stroke. The two first studies were performed using quantitative methods. The results of study I demonstrated that emotional health, communication skills, and the ability to remember were perceived as quite good one month after stroke. The findings of study II showed that participation scores were widely distributed during the first year after stroke. Associations between perceived physical capacity and participation were found at 1, 6, and 12 months. Findings of study I and II indicate that physical functioning was important for perceived participation during all timepoints that were investigated in the first year after stroke. A continuous focus on physical functioning in rehabilitation should therefore also be beneficial for perceived participation. Study III and IV had qualitative designs and aimed to exemplify, describe and to deepen our understanding of how participation, and life in general, may be experienced in a long term perspective after stroke. Results of study III showed that participants most often emphasized work and social life when describing their participation. They had adapted to a somewhat altered way of living and the importance of consequences after stroke in everyday life had decreased. This result was partly confirmed by the results of study IV, which showed that participants had found new ways to approach difficult situations in everyday life. However, the more multi-dimensional result of study IV showed that several participants still felt depressed many years after onset, and were not content with how life had turned out at all. Findings of both qualitative studies showed a need for more knowledge about how participation can be promoted many years after stroke, so that more persons after stroke may achieve a positive identity and a life which they consider meaningful.
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| 10. |
- Törnbom, Karin, 1982, et al.
(författare)
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Perceptions of physical activity and walking in an early stage after stroke or acquired brain injury.
- 2017
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 12:3
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Tidskriftsartikel (refereegranskat)abstract
- Physical activity has been established as being highly beneficial for health after stroke. There are considerable global efforts to find rehabilitation programs that encourage increased physical activity for persons with stroke. However, many persons with stroke or acquired brain injury do not reach recommended levels of physical activity and increased knowledge about why is needed. We aimed to explore views and experiences of physical activity and walking among persons with stroke or acquired brain injury.A qualitative study was conducted, among persons with stroke (n = 8) or acquired brain injury (n = 2) from a rehabilitation unit at Sahlgrenska University Hospital in Sweden. Semi-structured in-depth interviews were held about perceptions and experiences of walking and physical activity in general. Data were analyzed using qualitative content analysis, with categories that were determined inductively.Physical activity in general and walking ability more specifically were considered very important by the participants. However, physical activity was, regardless of exercising habits pre-injury, associated with different kinds of negative feelings and experiences. Commonly reported internal barriers in the current study were; fatigue, fear of falling or getting hurt in traffic, lack of motivation and depression. Reported external barriers were mostly related to walking, for example; bad weather, uneven ground, lack of company or noisy or too busy surroundings.Persons with stroke or acquired brain injury found it difficult to engage in and sustain an eligible level of physical activity. Understanding individual concerns about motivators and barriers surrounding physical activity may facilitate the work of forming tailor-made rehabilitation for these groups, so that the levels of physical activity and walking can increase.
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| 11. |
- Törnbom, Karin, 1982, et al.
(författare)
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Self-Assessed Physical, Cognitive, and Emotional Impact of Stroke at 1 Month: The Importance of Stroke Severity and Participation
- 2017
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Ingår i: Journal of Stroke & Cerebrovascular Diseases. - : Elsevier BV. - 1052-3057. ; 26:1, s. 57-63
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Tidskriftsartikel (refereegranskat)abstract
- Objectives The aims of this study were to describe the self-assessed physical, emotional, and cognitive impact of stroke and to investigate associations with participation and stroke severity in early stage (1 month) poststroke. Methods Participants (n=104, mean age=68) with reduced upper extremity function assessed at day 3 were included from a Swedish stroke unit. Participants were evaluated with The National Institutes of Health Stroke Scale at arrival, median 7.9 (0-24). The cohort was assessed for their perceived impact of stroke with the Stroke Impact Scale at 1 month poststroke. Results The perceptions of emotional health, communication skills, and ability to remember were perceived as quite good, with a mean score of 83-86. However, nearly 60% reported limitations in participation. This group also evaluated their physical function to be significantly lower compared to participants who did not report limitations in participation. Conclusions One month poststroke, a lower score on self-assessed physical function was associated with both a perceived restriction in participation and a more severe stroke. The association of physical function and perceived participation at 1 month poststroke needs to be taken into account when planning the early rehabilitation.
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| 12. |
- Törnbom, Karin, 1982, et al.
(författare)
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Self-Perceived Participation and Autonomy at 1-Year Post Stroke: A Part of the Stroke Arm Longitudinal Study at the University of Gothenburg (SALGOT Study)
- 2018
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Ingår i: Journal of Stroke & Cerebrovascular Diseases. - : Elsevier BV. - 1052-3057. ; 27:4, s. 1115-1122
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Tidskriftsartikel (refereegranskat)abstract
- Background: Identifying factors predicting the long-term outcome of participation and autonomy after stroke is essential for developing individualized rehabilitation interventions. The aim was to describe self-assessed participation and autonomy and to explore factors associated with the same at 1 year post stroke. Methods: Participants consisted of 79 persons (mean age = 67) with a first-time stroke at the 1-year follow-up. To investigate perceived participation and autonomy at 1 year, a self-assessment questionnaire, the Impact on Participation and Autonomy—English version (IPA-E) was used. Multivariate logistic regression models were performed using age, gender, stroke severity, and functional dependency at discharge as potential contributors to the perceived level of participation and autonomy. Results: A high percentage (70%-88%) evaluated their functions as fair to very good within all domains of the IPA-E at 1 year post stroke. However, around a fifth experienced their Family role as poor to very poor. Participants' functional dependency at discharge significantly influenced the outcome for the domains of Family role (odds ratio [OR] = 5.66, P <.01), Social relations (OR = 3.23, P <.03), and Autonomy indoors (OR = 3.44, P <.04) at 1 year post stroke. Conclusion and Implications: Aspects of the Family role domain deserve further attention in interventions aimed at improving participation and autonomy at 1 year post stroke. The results also indicate that supporting indoor autonomy and social relations of persons with stroke during the acute rehabilitation is important to enhance participation and autonomy at 1 year post stroke.
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| 13. |
- Törnbom, Karin, 1982, et al.
(författare)
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The impact of physical functioning on participation in the first year post-stroke
- 2017
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314. ; 135:6, s. 649-655
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Tidskriftsartikel (refereegranskat)abstract
- Studies have investigated predictors of participation and showed that fewer depressive symptoms, physical independence, and age could predict the level of participation after stroke. Association between self-assessed functions and perceived levels of participation over time is not yet known. The aim of this study was to investigate perceptions of participation and how this related to background characteristics and self-assessed rehabilitation outcomes, at 1, 6, and 12 months post-stroke.
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