| 1. |
- Botö, Sara, et al.
(författare)
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Physical inactivity after stroke: Incidence and early predictors based on 190 individuals in a 1-year follow-up of the Fall Study of Gothenburg.
- 2021
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Ingår i: Journal of rehabilitation medicine. - : Medical Journals Sweden AB. - 1651-2081. ; 53:9
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Tidskriftsartikel (refereegranskat)abstract
- To determine the incidence of physical inactivity and factors prior to stroke and in acute stroke that are associated with physical inactivity 1 year after stroke Design: Prospective longitudinal cohort Patients: A total of 190 consecutively included individuals with acute stroke Methods: A follow-up questionnaire, relating to physical activity level using the Saltin-Grimby Physical Activity Scale, was sent to participants in The Fall Study of Gothenburg 1 year after stroke. Predictors of physical inactivity at baseline were identified using univariable and multivariable logistic regression analyses.Physical inactivity 1 year after stroke was reported by 70 (37%) of the 190 patients who answered the questionnaire and was associated with physical inactivity before the stroke, odds ratio (OR) 4.07 (95% confidence interval (95% CI) 1.69-9.80, p=0.002); stroke severity (assessed by National Institutes of Health Stroke Scale (NIHSS), score 1-4), OR 2.65 (95% CI) 1.04-6.80, p=0.042) and fear of falling in acute stroke, OR 2.37 (95% CI 1.01-5.60, p=0.048).Almost 4 in 10 participants reported physical inactivity 1 year after stroke. Physical inactivity before the stroke, stroke severity and fear of falling in acute stroke are the 3 main factors that predict physical inactivity 1 year after stroke.
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| 2. |
- Magnusson, Carl, 1976, et al.
(författare)
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Prehospital recognition of stroke is associated with a lower risk of death
- 2022
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Publishing Corporation. - 0001-6314 .- 1600-0404. ; 146:2, s. 126-136
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Among patients assessed by the emergency medical service (EMS) and hospitalized with a final diagnosis of stroke, to describe delays, patient characteristics, actions taken and outcome in relation to the early recognition of stroke by the EMS clinician.Methods: Patients admitted to any of six stroke units in Region Västra Götaland, Sweden, with a final diagnosis of stroke from 1 January 2013 to 31 December 2015 were included. Data on follow-up were retrieved from the Swedish Stroke Register.Results: In all, 5467 patients were included. Stroke was recognized by the EMS clinician in 4396 cases (80.4%). The mean difference in the time from dialling 112 until arrival at the stroke unit was 556 min shorter when stroke was recognized, while the mean difference in the time from dialling 112 until a preliminary report from a computed tomography (CT) scan was 219 min shorter as compared with the patients in whom stroke was not recognized. After adjustment for age, sex, neurological deficits and coma, a lack of suspicion of stroke on EMS arrival was associated with an increased risk of death during three months of follow-up (odds ratio 1.66; 95% confidence interval 1.19-2.32; p = .003).Conclusion: Among patients with a stroke, more than 80% were recognized by the EMS clinician. Early recognition of stroke was associated with a markedly shorter time until arrival at the stroke unit and until the preliminary report of a CT scan. A lack of early stroke recognition was associated with an increased risk of death.
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| 3. |
- Persson, Carina Ulla, 1970, et al.
(författare)
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A validation study using a modified version of Postural Assessment Scale for Stroke Patients: Postural Stroke Study in Gothenburg (POSTGOT).
- 2011
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Ingår i: Journal of neuroengineering and rehabilitation. - : Springer Science and Business Media LLC. - 1743-0003. ; 8:57
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Tidskriftsartikel (refereegranskat)abstract
- Background A modified version of Postural Assessment Scale for Stroke Patients (PASS) was created with some changes in the description of the items and clarifications in the manual (e.g. much help was defined as support from 2 persons). The aim of this validation study was to assess intrarater and interrater reliability using this modified version of PASS, at a stroke unit, for patients in the acute phase after their first event of stroke. Methods In the intrarater reliability study 114 patients and in the interrater reliability study 15 patients were examined twice with the test within one to 24 hours in the first week after stroke. Spearman's rank correlation, Kappa coefficients, Percentage Agreement and the newer rank-invariant methods; Relative Position, Relative Concentration and Relative rank Variance were used for the statistical analysis. Results For the intrarater reliability Spearman's rank correlations were 0.88-0.98 and k were 0.70-0.93 for the individual items. Small, statistically significant, differences were found for two items regarding Relative Position and for one item regarding Relative Concentration. There was no Relative rank Variance for any single item. For the interrater reliability, Spearman's rank correlations were 0.77-0.99 for individual items. For some items there was a possible, even if not proved, reliability problem regarding Relative Position and Relative Concentration. There was no Relative rank Variance for the single items, except for a small Relative rank Variance for one item. Conclusions The high intrarater and interrater reliability shown for the modified Postural Assessment Scale for Stroke Patients, the Swedish version of Postural Assessment Scale for Stroke Patients, with traditional and newer statistical analyses, particularly for assessments performed by the same rater, support the use of the Swedish version of Postural Assessment Scale for Stroke Patients, in the acute stage after stroke both in clinical and research settings. In addition, the Swedish version of Postural Assessment Scale for Stroke Patients was easy to apply and fast to administer in clinic.
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| 4. |
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| 5. |
- Persson, Carina Ulla, 1970, et al.
(författare)
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Can results from clinical tests for mobility, performed during the first year after stroke, predict the risk of falling the following year?
- 2010
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Ingår i: XIX. European Stroke Conference, Barcelona.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- [284] CAN RESULTS FROM CLINICAL TESTS FOR MOBILITY, PERFORMED DURING THE FIRST WEEK AFTER STROKE, PREDICT THE RISK OF FALLING THE FOLLOWING YEAR? U.C. Persson1, P.O. Hansson2, K. Stibrant Sunnerhagen3. 1The Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburgh, Sweden; 2The Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; 3The Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg University, Gothenburg, Sweden Background: The aim of the study was to examine how well results from clinical assessment scales could predict the risk of falling during the first year after stroke, using data gathered in the acute phase, day 4-7 after first onset of stroke symptoms. Methods: One hundred and sixteen patients, with a first event of an acute stroke, admitted to a stroke unit, were assessed with the 10 Meter Walking Test (10 MWT), the Timed Up & Go (TUG), the Swedish Postural Assessment Scale for Stroke Patients (SwePASS), the Berg Balance Scale (BBS) and the Modified Motor Assessment Scale (M-MAS UAS-95) during the first week after stroke onset. The patients were followed-up at 3, 6 and 12 months with new examinations, and data were collected regarding any event of falling. Results: Forty-six (48%) of the 96 patients who fulfilled the follow-up suffered at least one fall during the first year, most of them during the first 3 months, after stroke. Optimal cut-off levels were obtained by Receiver Operating Characteristic (ROC) curves. The results of all 5 tests were significantly associated with the risk of falling during follow-up. The 10 MWT, cut-off level of 12 seconds or more, seemed to be the best predictor for falling, with a positive predictive value of 64% and a negative predictive value of 76% (area under the curve 0.74, p < 0.001). Conclusions: There is a high risk of falling during the first year after stroke, and ordinary clinical tests for mobility can help us to predict individual risk for the patient. This information can assist us to take important preventive actions to reduce the stroke patients' risk for fractures and other injuries after discharge from hospital. Date: Wednesday, May 26, 2010 Session Info: Poster Session Red: Acute stroke: new treatment concepts - Wednesday, 26 May 2010 Citation: Cerebrovascular Diseases 2010;Vol. 29 (suppl 2)
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| 7. |
- Persson, Carina Ulla, 1970, et al.
(författare)
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Responsiveness of a modified version of the postural assessment scale for stroke patients and longitudinal change in postural control after stroke- Postural Stroke Study in Gothenburg (POSTGOT) -
- 2013
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Ingår i: Journal of neuroengineering and rehabilitation. - : Springer Science and Business Media LLC. - 1743-0003. ; 10:1
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: BACKGROUND: Responsiveness data certify that a change in a measurement output represents a real change, not a measurement error or biological variability. The objective was to evaluate the responsiveness of the modified version of the Postural Assessment Scale for Stroke Patients (SwePASS) in patients with a first event of stroke. An additional aim was to estimate the change in postural control during the first 12 months after stroke onset. METHODS: The SwePASS assessments were conducted during the first week and 3, 6 and 12 months after stroke in 90 patients. Svensson's method, Relative Position (RP), Relative Concentration (RC) and Relative Rank Variance (RV), were used to estimate the scale's responsiveness and the patients' change in postural control over time. RESULTS: From the first week to 3 months after stroke, the patients improved in terms of postural control with 2 to 12 times larger systematic changes in Relative Position (RP), for which 9 items and the total score showed a significant responsiveness to change when compared to the interrater reliability measurement error of the SwePASS reported in a previous study. When SwePASS was used to assess change in postural control between the first week and 3 months, 74% of the patients received higher scores while 10% received lower scores, RP 0.31 (95% CI 0.219-0.402). The corresponding figures between 3 and 6 and between 6 and 12 months were 37% and 16%, RP 0.09 (95% CI 0.030-0.152), and 18% and 26%, RP -0.07 (95% CI -0.134- (-0.010)), respectively. CONCLUSIONS: The SwePASS is responsive to change. Postural control evaluated using the SwePASS showed an improvement during the first 6 months after stroke. The measurement property, in the form of responsiveness, shows that the SwePASS scoring method can be considered for use in rehabilitation when assessing postural control in patients after stroke, especially during the first 3 months.
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| 8. |
- Persson, Carina Ulla, 1970, et al.
(författare)
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Timed Up & Go as a measure for longitudinal change in mobility after stroke - Postural Stroke Study in Gothenburg (POSTGOT)
- 2014
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Ingår i: Journal of NeuroEngineering and Rehabilitation. - : Springer Science and Business Media LLC. - 1743-0003. ; 11:83
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Background A frequently used clinical test to assess mobility after stroke is the Timed Up & Go. Knowledge regarding whether or not the Timed Up & Go is able to detect change over time in patients with stroke, whether improvements in mobility exist after the first three months and whether or not longitudinal change in mobility after stroke depend on the patients’ age, is limited or unclear. The objectives were to investigate the distribution-based responsiveness of the Timed Up & Go (TUG) during the first three months after a first event of stroke, to measure the longitudinal change in TUG time during the first year after stroke and to establish whether recovery in TUG time differs between different age groups. Methods Ninety-one patients with first-ever stroke were assessed using the Timed Up & Go at the 1st week and at 3, 6 and 12 months after stroke. The non-parametric sign-test, the parametric t-test and a mixed model approach to linear regression for repeated measurements (Proc mixed) were used for the statistical analyses. Results The median TUG time was reduced from 17 to 12 seconds (p < 0.001) between the 1st week and 3 months. No further improvement was seen between 3 and 12 months after stroke. In a mixed model approach to linear regression, there was a significant age difference. Patients at age 80 and above tended to deteriorate in terms of TUG time between 3 and 12 months after stroke, while patients < 80 years did not (p = 0.011 for the interaction between age group and time). Conclusion The Timed Up & Go demonstrates ability to detect change in mobility over time in patients with stroke. A significant improvement in TUG time from the 1st week to 3 months after stroke was found, as expected, but thereafter no statistically significant change was detected. After 3 months, patients ≥80 years tended to deteriorate in terms of TUG time, while the younger patients did not.
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