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- Alin, Christina Kaijser, et al.
(author)
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Wearing an Activating Spinal Orthosis and Physical Training in Women With Osteoporosis and Back Pain : A Postintervention Follow-Up Study
- 2021
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In: Archives of Rehabilitation Research and Clinical Translation. - : Elsevier Inc.. - 2590-1095. ; 3:4
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Journal article (peer-reviewed)abstract
- Objective: To assess the duration of benefits on back pain and back extensor strength in women with osteoporosis who had previously participated in a randomized controlled trial (RCT) involving either exercise or wearing a spinal orthosis.Design: A 6-month postintervention follow-up of women who were involved in the interventions in the RCT.SettingThe study was conducted in a primary health care center in Stockholm, Sweden.ParticipantsIn this follow-up study 31 women participated in the spinal orthosis group, and 31 women participated in the exercise group, with a median age of 76 years in both groups (N=62). All women were diagnosed as having osteoporosis, had back pain with or without vertebral fracture, and were 60 years or older, which were the inclusion criteria in the RCT.Interventions: The participants received no controlled supervision. The spinal orthosis group was asked to wear the orthosis, and the training group was asked to follow an exercise program for another 6 months voluntarily.Main Outcome Measures: Back extensor strength was measured with a computerized device; back pain was estimated by the visual analog scale and by Borg CR-10.
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- Gonzalez Lindh, Margareta, 1965-, et al.
(author)
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Swallowing function in COVID-19 patients after invasive mechanical ventilation
- 2022
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In: Archives of Rehabilitation Research and Clinical Translation. - : Elsevier. - 2590-1095. ; 4:1
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Journal article (peer-reviewed)abstract
- Objective: To explore swallowing function and risk factors associated with delayed recovery of swallowing in patients with COVID-19 post–invasive mechanical ventilation using the Functional Oral Intake Scale (FOIS).Design: Longitudinal cohort study.Setting: Three secondary-level hospitals.Participants: Invasively ventilated patients (N=28) who were hospitalized with severe COVID-19 and referred to the hospitals’ speech and language pathology (SLP) departments after mechanical ventilation between March 5 and July 5, 2020 for an evaluation of swallowing function before commencing oral diet.Interventions: SLP assessment, advice, and therapy for dysphagia.Main Outcome Measures: Oral intake levels at baseline and hospital discharge according to the FOIS. Patients were stratified according to FOIS (1-5, dysphagia; 6-7, functional oral intake). Data regarding comorbidities, frailty, intubation and tracheostomy, proning, and SLP evaluation were collected.Results: Dysphagia was found in 71% of the patients at baseline (79% men; age, 61±12y; body mass index, 30±8 kg/m2). The median FOIS score at baseline was 2 (interquartile range [IQR], 1) vs 5 (IQR, 2.5) at hospital discharge. Patients with dysphagia were older (64±8.5y vs 53±16y; P=.019), had a higher incidence of hypertension (70% vs 12%; P=.006), and were ventilated invasively longer (16±7d vs 10±2d; P=.017) or had a tracheostomy (9±9d vs 1±2d; P=.03) longer. A negative association was found between swallowing dysfunction at bedside and days hospitalized (r=–0.471, P=.01), and number of days in the intensive care unit (ICU) (r=–0.48, P=.01).Conclusion: Dysphagia is prevalent in COVID-19 patients after invasive mechanical ventilation and is associated with number of days in hospital and number of days in the ICU. Swallowing function and tolerance of oral diet improved at discharge (P<.001).
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- Johansson, Jan, et al.
(author)
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Multiprofessional Neurorehabilitation After COVID-19 Infection Should Include Assessment of Visual Function.
- 2022
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In: Archives of Rehabilitation Research and Clinical Translation. - : Elsevier. - 2590-1095. ; 4:2
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To report vision-related symptoms and neuro-visual clinical signs in patients approximately 4 months after discharge from hospitalization after COVID-19 infection. To report on coexisting functional and activity limitations.DESIGN: The study is part of an ambidirectional population-based cohort study.SETTING: An outpatient setting in a hospital environment.PARTICIPANTS: Patients from a population-based cohort study including all patients with laboratory-confirmed COVID-19 admitted to hospital during a 3-month period in a health care region in Sweden. Among patients who, based on a standardized telephone interview, were identified as having persisting rehabilitation needs 4 months after discharge (n=185), several (n=57) reported vision-related symptoms. All 57 patients were invited to a neuro-visual examination. Six patients declined, 6 were unavailable, and 3 did not fulfil the inclusion criteria. Thus, 42 patients were included in the analysis (N=42).INTERVENTIONS: Not applicable.MAIN OUTCOME MEASURES: Vision-related symptoms, neuro-visual function, and coexisting impairments affecting activities of daily life and participation.RESULTS: A total of 31% of patients with rehabilitation needs after COVID-19 reported vision-related symptoms. Reading-related issues (73.8%), blurry vision (69.0%), and light sensitivity (66.7%) were the most common symptoms. Patients with reading-related issues showed a higher level of eye strain (P<.001). Neuro-visual deficits were found in 83.3% of the patients, mainly concerning eye teaming (23.1%-66.7%) and eye movement (28.6%-30.8%) functions. Patients with vision-related symptoms reported fatigue and 18 other coexisting symptoms to a greater extent (P≤.0001 to .049).CONCLUSIONS: Neuro-visual symptoms and signs should be considered when assessing rehabilitation needs after COVID-19. The association between vision-related issues and coexisting symptoms with an effect on body function and activity and/or participation underlines the need for multiprofessional rehabilitation assessment and intervention.
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- Nilsson, Ellinor, et al.
(author)
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Managing Fatigue: Experiences From a 6-week Course for Adults With Cerebral Palsy
- 2023
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In: Archives of Rehabilitation Research and Clinical Translation. - : ELSEVIER. - 2590-1095. ; 5:4
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Journal article (peer-reviewed)abstract
- Objective: To explore experiences of a 6-week Fatigue Management course (FMC) in adults with cerebral palsy (CP).Design: A qualitative study using semi-structured interviews. The study process followed the Consolidated Criteria for Reporting Qualitative Research (COREQ).Setting: The study was conducted in southeastern Sweden in an out-patient setting.Participants: Adults (N=8) with CP who had participated in FMC. Interventions: Not applicable.Main Outcome Measure: Qualitative content analysis of the transcribed interviews led to identification of a main category, categories, and subcategories, describing the participants' experiences of FMC.Results: The analysis identified 2 categories: Awareness regarding fatigue, with the 2 subcategories: A better understanding, and The feeling of not being alone; and Perceive opportunities for changes, with the 3 subcategories: Understanding the need for changes, Demanding process, and Taking steps toward change. These categories were summed up in the main category describing the participants' experiences of FMC: A challenging and eye-opening course that gave deeper self-understanding and thoughts about making changes.
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- Rich, Timothy J., et al.
(author)
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An international and multidisciplinary consensus on the labeling of spatial neglect using a modified Delphi method
- 2024
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In: Archives of Rehabilitation Research and Clinical Translation. - : Elsevier. - 2590-1095. ; 6:2
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Journal article (peer-reviewed)abstract
- Survivors of neurologic injury (most commonly stroke or traumatic brain injury) frequently experience a disorder in which contralesionally positioned objects or the contralesional features of individual objects are often left unattended or underappreciated. The disorder is known by >200 unique labels in the literature, which potentially causes confusion for patients and their families, complicates literature searches for researchers and clinicians, and promotes a fractionated conceptualization of the disorder. The objective of this Delphi was to determine if consensus (≥75% agreement) could be reached by an international and multidisciplinary panel of researchers and clinicians with expertise on the topic.To accomplish this aim, we used a modified Delphi method in which 66 researchers and/or clinicians with expertise on the topic completed at least 1 of 4 iterative rounds of surveys. Per the Delphi method, panelists were provided with results from each round prior to responding to the survey in the subsequent round with the explicit intention of achieving consensus. The panel ultimately reached consensus that the disorder should be consistently labeled spatial neglect. Based on the consensus reached by our expert panel, we recommend that researchers and clinicians use the label spatial neglect when describing the disorder in general and more specific labels pertaining to subtypes of the disorder when appropriate.
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- Sandberg, Klas, 1961-, et al.
(author)
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Effects of In-Bed Cycle Exercise in Patients With Acute Stroke : A Randomized Controlled Trial
- 2020
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In: Archives of Rehabilitation Research and Clinical Translation. - : Elsevier. - 2590-1095. ; 2:4
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Journal article (peer-reviewed)abstract
- Objective: To investigate the effects of in-bed cycle exercise in addition to usualcare in patients with acute stroke, National Institutes of Health Stroke Scale (NIHSS) 7-42,regarding walking ability, functional outcomes, and inpatient care days.Design: Randomized controlled trial.Setting: Hospital care.Participants: Patients (NZ56) with stroke NIHSS 7-42 were recruited 24-48 hours after strokeonset from 2 stroke units in Sweden.Interventions: Both groups received usual care. The intervention group also received 20 minutes bed cycling 5 days per week with a maximum of 15 sessions.Main Outcome Measures: The primary outcome was median change in walking ability measuredwith the 6-minute walk test (6MWT). Secondary outcome measures included the median change inmodified Rankin Scale (mRS), Barthel Index (BI) for activities of daily living, and inpatient care days.Measurements were performed at baseline, post intervention (3 weeks), and at 3-month follow-up.Results: There was no significant difference in change of walking ability (6MWT) from baseline tofollow-up between the intervention and control groups (median, 105m [interquartile range [IQR,220m] vs 30m [IQR, 118m], respectively, PZ.147, dZ0.401). There were no significant differencesbetween groups regarding mRS, BI, or inpatient care days. Patients with less serious stroke (NIHSS 7-12) seemed to benefit from the intervention.Conclusion: Although this study may have been underpowered, patients with stroke NIHSS 7-42 didnot benefit from in-bed cycle exercise in addition to usual care after acute stroke. A larger study isneeded to confirm our results.
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- Uzunel, Elin, et al.
(author)
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The Effect of Group Training or Spinal Orthosis on Quality of Life and Potential Plasma Markers of Pain in Older Women With Osteoporosis. A Randomized Controlled Trial
- 2023
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In: Archives of Rehabilitation Research and Clinical Translation. - : ELSEVIER. - 2590-1095. ; 5:4
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Journal article (peer-reviewed)abstract
- Objective: Primary purpose was to examine the effects of exercise and use of a spinal orthosis on quality of life (QoL). Secondary, to explore the effects of above-mentioned interventions on plasma levels of potential markers of pain: substance P (SP), calcitonin gene-related peptide (CGRP), and interleukin-6 (IL-6).Design: Randomized controlled trial.Setting: Community-dwelling women in Stockholm.Participants: A total of 113 women aged 60-93 years suffering from back pain and self-reported osteoporosis (n=113).Interventions: The randomized controlled trial was 3-armed: participation in an equipment exercise group, treatment with an activating spinal orthosis or controls. The intervention time was 6 months. Main Outcome Measure(s): QoL (QUALEFFO-41 and SF-36), plasma levels of SP, CGRP, and IL-6 measured at baseline and after 6 months in all 3 arms.Results: No improvement of QoL was found. Comparing change in mobility (QUALEFFO-41), the effect in least squares means was lower in the spinal orthosis group compared with controls. In the exercise group, the role emotional score (SF-36) deteriorated during the intervention. Effect size varied between 0.02 and 0.6. There was no change in the levels of CGRP or SP, while IL-6 levels were lower at 6 months in the spinal orthosis group compared with the other groups. At least 1 previous vertebral fracture was verified by X-ray in 46 women.Conclusion: The interventions showed none or negative effect on QoL, which was unexpected. The modest effect size may prompt a cautious interpretation. We found a lowering of IL-6 levels in the spinal orthosis group, but more studies are needed.(c) 2023 The Authors. Published by Elsevier Inc. on behalf of American Congress of Rehabilitation Medicine.
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- Van Denend, Toni, et al.
(author)
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Adapting the multiple sclerosis functional composite for telehealth administration using videoconference delivery : methodological considerations and interrater reliability
- 2024
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In: Archives of Rehabilitation Research and Clinical Translation. - : Elsevier. - 2590-1095. ; 6:2
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Journal article (peer-reviewed)abstract
- Objective: To describe the adaptations made and to examine interrater reliability and feasibility of administering a telehealth version of the Multiple Sclerosis Functional Composite (tele-MSFC).Design: The Multiple Sclerosis Functional Composite (MSFC) is a commonly used, in-person clinical outcome assessment. It is composed of the timed 25-Foot Walk Test (T25FWT), Nine-Hole Peg Test (NHPT), and Paced Auditory Serial Addition Test (PASAT). The MSFC was adapted for videoconference administration as part of a larger clinical trial. One of the adaptations included administering a timed 12.5-Foot Walk Test (T12.5FWT) for participants who did not have adequate space in their homes for the T25FWT. Participants, examiners, and raters completed surveys online about their satisfaction and experience with tele-MSFC.Setting: Participants underwent the tele-MSFC in their homes using a laptop or smartphone while examiners scored the tele-MSFC in real-time at a remote location.Participants: Community-dwelling adults (n=61) with mild-to-moderate multiple sclerosis (MS) symptoms. Interventions: Not applicable.Main Outcome Measure: Tele-MSFC. Results: Intraclass correlation coefficients (ICC) assessed interrater reliability between the examiner and 2 independent raters who later scored a recording of the tele-MSFC. Interrater reliability was excellent (ICC>0.90) for all tests, including the T12.5FWT. Participants were highly satisfied with tele-MSFC. However, challenges included adequate space for T25FWT, technical difficulties, and safety and privacy considerations of individuals with moderate impairments who were requested to have their caregivers present during testing.Conclusion: The tele-MSFC is reliable and feasible to administer with adaptations for community-dwelling adults with mild to moderate MS symptoms. Further validation of T12.5FWT is needed.
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