| 1. |
- Björkdahl, Ann, 1959-, et al.
(författare)
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Decline in cognitive function due to diffuse axonal injury does not necessarily imply a corresponding decline in ability to perform activities
- 2016
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 38:10, s. 1006-1015
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The study explored the direction of change (decline vs. improvement) after diffuse axonal injury (DAI) in the domains of the ICF: body structure, body function, and activity.Methods: Thirteen patients with DAI were assessed by using diffusion tensor imaging (DTI) to measure body structure, the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS) to measure body function, and the Assessment of Motor and Process Skills (AMPS) to measure activity. The DTI, BNIS, and AMPS were applied at the acute phase (A1), and at 6 and 12 months post-injury (A2 and A3). Visual and statistical analyses were conducted to explore time-dependent changes in the ICF domains.Results: Improvements were observed for most patients in all ICF domains from injury until six months. Thereafter, the results diverged, with half of the subjects showing a decline in DTI and BNIS scores between A2–A3, and all but one of the patients exhibiting identical or better A2–A3 AMPS process skill scores.Conclusions: From 6 to 12 months post-injury, some patients underwent an ongoing degenerative process, causing a decline in cognitive function. The same decline was not observed in the activity measure, which might be explained by the use of compensatory strategies.Implications for rehabilitationIn rehabilitation it is essential to be aware that in some cases with TBI, an ongoing degenerative process in the white matter can be expected, causing an adverse late effect on cognitive function.The cognitive decline, caused by DAI, does not necessarily mean a concurrent decrease in activity performance, possibly explained by the use of compensatory strategies. This suggests that, after the post-acute phase, rehabilitation offering strategy training may be beneficial to enhance every-day functioning.Strategy use requires awareness, which imply the need to assess level of awareness in order to guide rehabilitation.
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| 2. |
- Hussain, Netha, et al.
(författare)
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Relationship between self-reported and objectively measured manual ability varies during the first year post-stroke.
- 2020
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Ingår i: Scientific reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 10:1
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Tidskriftsartikel (refereegranskat)abstract
- Self-reported outcomes provide unique insights about an individual's perceived manual ability after stroke. This study aimed at determining how the relationship between objective kinematic variables obtained from the target-to-target pointing task and self-reported manual ability varies during the first year in individuals after stroke. Sixty-six individuals from the Stroke Arm Longitudinal study at the University of Gothenburg (SALGOT) cohort were assessed using ABILHAND questionnaire and kinematic analysis at five timepoints between the 10th day and 12th month after stroke. Kinematic analysis was performed using a target-to-target pointing task in a virtual environment. Spearman's correlation was used to determine the extent of correlation between ABILHAND logits and kinematic variables. The correlations varied with time within the first year after stroke. The correlations were low or very low early after stroke and became moderate to high after 6 months for objective measures of movement time and smoothness, but remained low to moderate for mean velocity and low for peak velocity. Due to this discrepancy between self-perceived and objective assessments of arm function, a combination of self-reported and objective assessments of upper limb should be used as outcome measures, especially in the acute and subacute stages after stroke.
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| 3. |
- Munoz-Novoa, Maria, et al.
(författare)
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Upper Limb Stroke Rehabilitation Using Surface Electromyography: A Systematic Review and Meta-Analysis
- 2022
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Ingår i: Frontiers in Human Neuroscience. - : Frontiers Media SA. - 1662-5161. ; 16
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Forskningsöversikt (refereegranskat)abstract
- Background: Upper limb impairment is common after stroke, and many will not regain full upper limb function. Different technologies based on surface electromyography (sEMG) have been used in stroke rehabilitation, but there is no collated evidence on the different sEMG-driven interventions and their effect on upper limb function in people with stroke. Aim: Synthesize existing evidence and perform a meta-analysis on the effect of different types of sEMG-driven interventions on upper limb function in people with stroke. Methods: PubMed, SCOPUS, and PEDro databases were systematically searched for eligible randomized clinical trials that utilize sEMG-driven interventions to improve upper limb function assessed by Fugl-Meyer Assessment (FMA-UE) in stroke. The PEDro scale was used to evaluate the methodological quality and the risk of bias of the included studies. In addition, a meta-analysis utilizing a random effect model was performed for studies comparing sEMG interventions to non-sEMG interventions and for studies comparing different sEMG interventions protocols. Results: Twenty-four studies comprising 808 participants were included in this review. The methodological quality was good to fair. The meta-analysis showed no differences in the total effect, assessed by total FMA-UE score, comparing sEMG interventions to non-sEMG interventions (14 studies, 509 participants, SMD 0.14, P 0.37, 95% CI –0.18 to 0.46, I2 55%). Similarly, no difference in the overall effect was found for the meta-analysis comparing different types of sEMG interventions (7 studies, 213 participants, SMD 0.42, P 0.23, 95% CI –0.34 to 1.18, I2 73%). Twenty out of the twenty-four studies, including participants with varying impairment levels at all stages of stroke recovery, reported statistically significant improvements in upper limb function at post-sEMG intervention compared to baseline. Conclusion: This review and meta-analysis could not discern the effect of sEMG in comparison to a non-sEMG intervention or the most effective type of sEMG intervention for improving upper limb function in stroke populations. Current evidence suggests that sEMG is a promising tool to further improve functional recovery, but randomized clinical trials with larger sample sizes are needed to verify whether the effect on upper extremity function of a specific sEMG intervention is superior compared to other non-sEMG or other type of sEMG interventions.
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| 4. |
- Rovner, Graciela, 1959, et al.
(författare)
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Chronic pain and sex-differences; women accept and move, while men feel blue.
- 2017
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Ingår i: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 12:4
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study is to explore differences between male and female patients entering a rehabilitation program at a pain clinic in order to gain a greater understanding of different approaches to be used in rehabilitation.1371 patients referred to a specialty pain rehabilitation clinic, completed sociodemographic and pain related questionnaires. They rated their pain acceptance (CPAQ-8), their kinesiophobia (TSK), the impact of pain in their life (MPI), anxiety and depression levels (HAD) and quality of life scales: the SF-36, LiSat-11, and the EQ-5D. Because of the large sample size of the study, the significance level was set at the p ≤.01.Analysis by t-test showed that when both sexes experience the same pain severity, women report significantly higher activity level, pain acceptance and social support while men report higher kinesiophobia, mood disturbances and lower activity level.Pain acceptance (CPAQ-8) and kinesiophobia (TSK) showed the clearest differences between men and women. Pain acceptance and kinesiophobia are behaviorally defined and have the potential to be changed.
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| 5. |
- Stibrant Sunnerhagen, Katharina, 1957, et al.
(författare)
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Webrehab: A Swedish database for quality control in rehabilitation
- 2014
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1651-2081 .- 1650-1977. ; 46:10, s. 958-962
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Tidskriftsartikel (refereegranskat)abstract
- Background: The healthcare sector needs to deliver evidence-based care and be cost-effective. This can be monitored in part via a national quality registry containing individualized data concerning patient problems, medical interventions, outcomes of treatment, and patient-reported outcomes. With this aim, Web Rehab Sweden was launched in 1997 and has been available online since 2007. The aim of this paper is to discuss the design, some results, and possible use of such a registry. Methods: Data entered into the registry online since 2007 were used in this paper. The registry contains information from 7,458 patients. Data from the first 3 years were used to show differences between genders and among diagnostic groups. Non-parametric statistics were used to analyse the differences between groups. Results: The registry coverage of the country is 95%, and completeness is 81%. Data from hospitals/units have been accessible to the general public since 2009, but no data from individuals can be accessed. Length of stay has varied over the years, becoming significantly shorter between 2007 and 2012. Conclusion: A quality registry presents an opportunity to improve rehabilitation processes at participating units, provides data for use in benchmarking between units, and enables hospital management to utilize resources wisely.
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| 6. |
- Thrane, Gyrd, et al.
(författare)
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Recovery of kinematic arm function in well-performing people with subacute stroke: a longitudinal cohort study.
- 2018
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Ingår i: Journal of NeuroEngineering and Rehabilitation. - : Springer Science and Business Media LLC. - 1743-0003. ; 15:1
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Tidskriftsartikel (refereegranskat)abstract
- Most motor function improvements in people who have experienced strokes occur within the first 3 months. However, individuals showing complete or nearly complete arm function recovery, as assessed using clinical scales, still show certain movement kinematic deficits at 3 months, post-stroke. This study evaluated the changes in upper extremity kinematics, in individuals demonstrating minor clinical motor impairments, 3-12 months post-stroke, and also examined the association between kinematics and the subjects's self-perceived hand abilities during the chronic stage, 12 months post-stroke.Forty-two subjects recovering from strokes and having Fugl-Meyer upper extremity motor assessment scores ≥60 were included from the Stroke Arm Longitudinal Study at the University of Gothenburg (SALGOT). Kinematic analyses of a drinking task, performed 3, 6, and 12 months post-stroke, were compared with kinematic analyses performed in 35 healthy controls. The Stroke Impact Scale-Hand domain was evaluated at the 12-month follow-up.There were no significant changes in kinematic performance between 3 and 12 months, post-stroke. The patients recovering from stroke showed lower peak elbow extension velocities, and increased shoulder abduction and trunk displacement during drinking than did healthy controls, at all time points. At 12 months, post-stroke, better self-perceived arm functions correlated with improved trunk displacements, movement times, movement units, and time to peak velocity percentages.Kinematic movement deficits, observed at 3 months post-stroke, remained unchanged at 12 months. Movement kinematics were associated with the patient's self-perceived ability to use their more affected hand.ClinicalTrials: NCT01115348 .
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| 7. |
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| 8. |
- Persson, Hanna C, 1979, et al.
(författare)
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Armfunktion inom 72 timmar efter förstagångsstroke i en oselekterad patientgrupp, samt vårdförlopp och utfall vid utskrivning. En del av SALGOT-studien.
- 2013
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Ingår i: Sjukgymnastdagarna 2013. Göteborg 2-4 oktober 2013..
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund och syfte Nedsatt funktion i övre extremitet efter en stroke har rapporterats förekomma akut hos 70-80%. Akutvården förändras med fler som vårdas på strokeenhet så väl som behandlas med trombolys. Syftet var att i en oselekterad patientgrupp med förstagångsstroke, undersöka vårdförlopp och utskrivningsstatus samt förekomst av nedsatt arm och handfunktion inom 72 timmar efter insjuknande. Ett andra syfte var att undersöka faktorer som associeras med nedsatt övre extremitet och dess påverkan på utfallet. Metoder Inklusionskriterier var: förstagångsstroke, över 18 år, boende i geografiskt upptagningsområde, på strokeenheten inom 72 timmar efter insjuknade, ingen tidigare nedsatt funktion i övre extremitet. Via journalgranskning samlades bakgrundsdata, arm och handfunktion, utfall av stroke och sjukhusvård. Infarkter klassificerades enligt Bamford och med TOAST. Resultat och diskussion Av screenade 969 patienter med förstagångsstroke uppfyllde 642 inklusionskriterierna. Vid ankomst bedömdes patientens funktion med NIHSS, medelvärde 6.0. Förekomst av nedsatt arm och handfunktion inom 72 timmar efter insjuknade var 48%, vilket också samvarierade med ålder (p<0.004), vårdtid (p<0.001) och dödlighet inom akutvården (p<0.001). Det var 89% av patienterna som lades in direkt på strokeenheten och 77% kom till sjukhuset på insjuknadedagen. Medelvårdtiden på strokenheten var 10 dagar och 57% utskrevs till hemmet. Dödligheten inom 72 timmar var 5%. Konklusion Nedsatt arm och handfunktion inom 72 timmar efter insjuknande i förstagångsstroke förekommer hos 48% av patienterna. Nedsatt övre extremitet associerar med högre ålder, längre vårdtider inom strokeenheten och högre dödlighet i akutvården.
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| 9. |
- Persson, Hanna C, 1979, et al.
(författare)
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Patientens skattade arm och handstyrka i korrelation till objektiva mätningar 10 dagar efter en förstagångsstroke; en del av SALGOT-studien.
- 2013
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Ingår i: Sjukgymnastdagarna 2013. Göteborg 2-4 oktober 2013.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund och syfte Kunskap om patientens förståelse av funktionsnedsättning efter stroke är bristfällig. Få studier finns, varav ingen som omfattar akut skede. Syftet med studien var att undersöka patientens upplevad arm och handstyrka 10 dagar efter insjunkande i stroke och hur denna korrelerar till objektiva mätningar. Metoder Etthundra patienter med förstagångsstroke och nedsatt arm och handfunktion 3 dagar efter insjuknade, boende i Göteborgsområdet, undersöktes från studien Stroke Arm Longitudinal Study at the University of Gothenburg (SALGOT). 10 dagar efter insjuknade, skattade patienten sin funktion i övre extremitet på två delmoment av Stroke Impact Scale; styrka i arm respektive i hand i afficierad sida. Övre extremitet bedömdes med greppstryka mätt med JAMAR samt med aktivitetsskalan Action Research Arm Test (ARAT). Korrelationsberäkningar genomfördes. Resultat Hög korrelation visades mellan patientrapporterade styrka i hand och i greppstryka mätt med JAMAR; roh 0.86 and i arm; rho 0.81. Hög korrelation fanns även mellan patientrapporterade styrka i hand och med ARAT; rho 0.83 och i armen; rho 0.79. Samtliga korrelationer med signifikansnivå på p<0.05. Konklusion Denna studie visar att 80% av de patienterna deltog, redan 10 dagar efter stroke klarar att korrekt skatta styrkan i påverkad arm och hand. Detta indikerar på att det finns god överensstämmelse mellan patientens skattade styrka och objektiva mätningar redan tidigt efter stroke.
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| 10. |
- Persson, Hanna C, 1979, et al.
(författare)
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UPPER EXTREMITY TEN DAYS AFTER FIRST OCCASION OF STROKE; PATIENT PERCIEVED STRENGTH CORRELATING TO OBJECTIVE MEASUREMENTS. A PART OF THE SALGOT STUDY.
- 2013
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Ingår i: 7TH ISPRM WORLD CONGRESS. International Society of Physical and Rehabilitation Medicine, June 16-20, 2013, Bejing.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objective To investigate the patient’s perception of arm and hand strength ten days after stroke onset and correlate this to objective measurements. Method One hundred patients with stroke and impaired upper extremity within 3 days after onset were investigated from the Stroke Arm Longitudinal Study at the University of GOThenburg (SALGOT). Ten days after onset, the patients estimated their function in the upper extremity on the Stroke Impact Scale; items regarding the strength of the arm and grip in the hand. Upper extremity function was assessed with grip strength measurement JAMAR and the activity scale Action Research Arm Test (ARAT). The correlations were calculated. Results High correlations were found between patient reported strength in the hand and grip strength (JAMAR); rho 0.86 and in the arm; rho 0.81. High correlation were also found between patient reported strength in the hand and the ARAT; rho 0.83 and in the arm; rho 0.79, all with a significant level of p < 0.01. Implication/Impact on Rehabilitation The results from the present study indicate that only 10 days after stroke over 80% of the participated patients, can correctly evaluate their strength in impaired limb. The patients’ understanding of the capacity is important for the rehabilitation and in planning for the future. Awareness of impaired function in the upper extremity is not previously described in this early stage after a stroke.
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