| 1. |
- Rajestari, Maryam, 1983, et al.
(author)
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Very necessary: the meaning of non-gradable modal adjectives in discourse contexts
- 2021
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In: Selected contributions from the Eighth Swedish Language Technology Conference (SLTC-2020), 25-27 November 2020 / Peter Ljunglöf, Simon Dobnik and Richard Johansson (editors).. - Linköping, Sweden : Linköping University Electronic Press. - 1650-3686 .- 1650-3740. - 9789179290313
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Conference paper (peer-reviewed)abstract
- In this paper we provide a quantitative and qualitative analysis of meaning of allegedly non-gradable modal adjectives in different discourse contexts. The adjectives studied are essential, necessary, crucial and vital which are compared with a gradable modal adjective important. In our study sentences containing these adjectives were chosen from a large corpus together with their contexts. Then 120 English native speakers evaluated the meaning of these adjectives in a crowd-sourced study. Different types of contexts were chosen for this purpose. In some the adjectives were used as gradable with a modifier very while in others as non-gradable, without a modifier. We also modified the contexts by adding or removing the modifier very. The task for evaluators was to provide a replacement for adjectives for all the resulting contexts. From the replacements we are able to quantitatively evaluate the semantic potential of these contexts and what kind of adjectives they license.
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| 2. |
- Alfonsson, Sven, 1977-, et al.
(author)
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Clinical supervision in cognitive behavior therapy improves therapists' competence : a single-case experimental pilot study
- 2020
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In: Cognitive Behaviour Therapy. - : Informa UK Limited. - 1650-6073 .- 1651-2316. ; 49:5, s. 425-438
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Journal article (peer-reviewed)abstract
- Clinical supervision is a cornerstone in psychotherapists' training but there are few empirical evaluations on the effects of supervision on therapists' competencies. The aim of this study was therefore to evaluate the effects of standardized supervision on rater-assessed competency in Cognitive Behavior Therapy (CBT). Six therapists with basic training in CBT were provided with protocol-based clinical supervision in CBT in a single-case experimental multiple baseline design. The supervision focused on specific CBT competencies and used experiential learning methods such as role-play. Each therapist recorded weekly treatment sessions during phases without and with supervision. The therapists' CBT competence was assessed by third-party raters using the Revised Cognitive Therapy Scale (CTS-R). Statistical analyses showed that the therapists' CTS-R scores increased significantly during the phase with supervision with a mean item increase of M = 0.71 (range = 0.50-1.0) on the supervision focus areas. This is one of the first empirical studies that can confirm that supervision affect CBT competencies. The results also suggest that supervision can be manualized and that supervisees have a positive perception of more active training methods. Further studies are needed to replicate the results and to find ways to improve the impact of supervision.
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| 3. |
- Abzhandadze, Tamar, 1980, et al.
(author)
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DEVELOPMENT OF A SWEDISH SHORT VERSION OF THE MONTREAL COGNITIVE ASSESSMENT FOR COGNITIVE SCREENING IN PATIENTS WITH STROKE
- 2023
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In: Journal of Rehabilitation Medicine. - : Medical Journals Sweden. - 1650-1977 .- 1651-2081. ; 55
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Journal article (peer-reviewed)abstract
- Objective: The primary objective was to develop a Swedish short version of the Montreal Cognitive Assessment (s-MoCA-SWE) for use with patients with stroke. Secondary objectives were to iden-tify an optimal cut-off value for the s-MoCA-SWE to screen for cognitive impairment and to compare its sensitivity with that of previously developed short forms of the Montreal Cognitive Assessment. Design: Cross-sectional study.Subjects/patients: Patients admitted to stroke and rehabilitation units in hospitals across Sweden. Methods: Cognition was screened using the Mont-real Cognitive Assessment. Working versions of the s-MoCA-SWE were developed using supervised and unsupervised algorithms.Results: Data from 3,276 patients were analysed (40% female, mean age 71.5 years, 56% minor stroke at admission). The suggested s-MoCA-SWE compri-sed delayed recall, visuospatial/executive function, serial 7, fluency, and abstraction. The aggregated scores ranged from 0 to 16. A threshold for impai-red cognition & LE; 12 had a sensitivity of 97.41 (95% confidence interval, 96.64-98.03) and positive pre-dictive value of 90.30 (95% confidence interval 89.23-91.27). The s-MoCA-SWE had a higher abso-lute sensitivity than that of other short forms.Conclusion: The s-MoCA-SWE (threshold & LE; 12) can detect post-stroke cognitive issues. The high sensitivity makes it a potentially useful "rule-out" tool that may eliminate severe cognitive impair-ment in people with stoke.
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| 4. |
- Alt Murphy, Margit, 1970, et al.
(author)
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Implementation of evidence-based assessment of upper extremity in stroke rehabilitation: From evidence to clinical practice
- 2021
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In: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 53:1
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Journal article (peer-reviewed)abstract
- Objective: There is an evidence-practice gap in assessment of the upper extremities during acute and subacute stroke rehabilitation. The aim of this study was to target this gap by describing and evaluating the implementation of, and adherence to, an evidence-based clinical practice guideline for occupational therapists and physiotherapists. Methods: The upper extremity assessment implementation process at Sahlgrenska University Hospital comprised 5 stages: mapping clinical practice, identifying evidence-based outcome measures, development of a guideline, implementation, and evaluation. A systematic theoretical framework was used to guide and facilitate the implementation process. A survey, answered by 44 clinicians (23 physiotherapists and 21 occupational therapists), was used for evaluation. Results: The guideline includes 6 primary standardized assessments (Shoulder Abduction, Finger Extension (SAFE), 2 items of the Actions Research Arm Test (ARAT-2), Fugl-Meyer Assessment of Upper Extremity (FMA-UE), Box and Block Test (BBT), 9-Hole Peg Test (9HPT), and grip strength (Jamar hand dynamometer)) performed at specified time-points post-stroke. More than 80% (35 to 42) clinicians reported reported being content with the guideline and the implementation process. Approximately 60-90% of the clinicians reported good adherence to specific assessments, and approximately 50% reported good adherence to the agreed time-points. Comprehensive scales were more difficult to implement compared with the shorter screening scales. High levels of work rotation among staff, and the need to prioritize other assessments during the first week after stroke, hindered to implementation. Conclusion: The robustness of evidence, adequate support and receptive context facilitated the implementation process. The guideline enables a more structured, knowledge-based and consistent assessment, and thereby supports clinical decision-making and patient involvement.
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| 5. |
- Andersson, Jenni, et al.
(author)
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Long-term perceived disabilities up to 10 years after transient ischaemic attack
- 2021
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In: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 53:3
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Journal article (peer-reviewed)abstract
- BACKGROUND: The long-term impact of transient ischaemic attack is largely unknown.OBJECTIVES: To assess the long-term perceived impact of transient ischaemic attack and explore the influence of sex and age on these perceptions; and to evaluate the relationships between activities of daily living, participation and overall recovery, and the other domains of the Stroke Impact Scale 3.0 (SIS).METHODS: A retrospective study among adult community-dwelling individuals from 6 months up to 10 years after onset of transient ischaemic attack. A total of 299 survivors of transient ischaemic attack responded to the SIS.RESULTS: Most self-reported disabilities involved emotion, strength, and participation domains of SIS and remained stable until 10 years post-transient ischaemic attack. Women reported significantly more disabilities for emotion and hand function. Elderly subjects (age > 65 years) reported more disabilities for strength, mobility, hand function, activities of daily living/instrumental activities of daily living, and participation. The activities of daily living/instrumental activities of daily living, participation, and overall recovery demonstrated significant, although low-to-moderate, associations with other SIS domains after transient ischaemic attack.CONCLUSION: The broadly perceived disabilities were demonstrated consistently and played a significant meaningful role in everyday life and recovery among community-dwelling individuals up to 10 years after a transient ischaemic attack. These findings indicate the need for long-term multi-professional follow-up with holistic rehabilitation to improve overall recovery among survivors of transient ischaemic attack.
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| 6. |
- Andersson, Sofi A., 1970, et al.
(author)
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Arm impairment and walking speed explain real-life activity of the affected Arm and leg after stroke
- 2021
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In: Journal of Rehabilitation Medicine. - : Foundation for Rehabilitation Information. - 1650-1977 .- 1651-2081. ; 53:6
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Journal article (peer-reviewed)abstract
- Objective: To determine to what extent accelerometer-based arm, leg and trunk activity is associated with sensorimotor impairments, walking capacity and other factors in subacute stroke. Design: Cross-sectional study. Patients: Twenty-six individuals with stroke (mean age 55.4 years, severe to mild motor impairment). Methods: Data on daytime activity were collected over a period of 4 days from accelerometers placed on the wrists, ankles and trunk. A forward stepwise linear regression was used to determine associations between free-living activity, clinical and demographic variables. Results: Arm motor impairment (Fugl-Meyer Assessment) and walking speed explained more than 60% of the variance in daytime activity of the more-affected arm, while walking speed alone explained 60% of the more-affected leg activity. Activity of the less-affected arm and leg was associated with arm motor impairment (R2=0.40) and independence in walking (R2=0.59). Arm activity ratio was associated with arm impairment (R2=0.63) and leg activity ratio with leg impairment (R2=0.38) and walking speed (R2=0.27). Walking-related variables explained approximately 30% of the variance in trunk activity. Conclusion: Accelerometer-based free-living activity is dependent on motor impairment and walking capacity. The most relevant activity data were obtained from more-affected limbs. Motor impairment and walking speed can provide some information about real-life daytime activity levels.
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| 7. |
- Björkdahl, Ann, 1959, et al.
(author)
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EXPLORING THE IMPACT OF COGNITIVE DYSFUNCTION, FATIGUE, AND SHORTNESS OF BREATH ON ACTIVITIES OF DAILY LIFE AFTER COVID-19 INFECTION, UNTIL 1-YEAR FOLLOW-UP
- 2024
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In: JOURNAL OF REHABILITATION MEDICINE. - 1650-1977 .- 1651-2081. ; 56
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Journal article (peer-reviewed)abstract
- Objective: Despite expanding knowledge on COVID-19, the long-term effects on daily -life activities remain unclear. The prevalence and changes in fatigue, cognitive dysfunction, and activity limitations in the first year after COVID-19 infection in hospitalized and non -hospitalized patients were explored. Subjects: A total of 122 patients were recruited from hospital care and 90 from primary care. Method: Baseline data comprised the Montreal Cognitive Assessment and Trail Making Test. Participants were followed up at 3 and 12 months using these tests and a semi -structured interview to identify symptoms and how they affected participation in daily -life activities. Both within- and betweengroup analyses were performed to explore changes over time and compare groups. Result: High levels of fatigue and cognitive dysfunction were found in both groups, which persisted for 12 months. A significant impact on daily -life activities was also observed, with marginal change at the 12 -month follow-up. The hospital care group performed worse than the primary care group in the cognitive tests, although the primary care group perceived a higher level of fatigue and cognitive dysfunction. Activity limitations were higher in the primary care group than in the hospital care group. Conclusion: These findings highlight the need for long-term follow-up and further investigation of the impact of persistent deficits on rehabilitation.
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| 8. |
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| 9. |
- Brycke, Sara, et al.
(author)
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Implementation of evidence-based interventions according to the Swedish national guidelines for strokecare : a nationwide survey among physiotherapists
- 2024
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In: Journal of Rehabilitation Medicine. - : Medical Journals Sweden. - 1650-1977 .- 1651-2081. ; 56
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Journal article (peer-reviewed)abstract
- Objective: To investigate (i) to what extent physiotherapists (PTs) working in stroke rehabilitation in various parts of the stroke care chain have implemented interventions according to the national guidelines for stroke (NGS), (ii) facilita-ting and hindering factors for the implementation, and (iii) differences between various care settings.Design: A cross-sectional study.Subjects: 148 PTs working in stroke rehabilitation in various parts of the care chain in Sweden.Methods: Data were collected by a web-based survey.Results: Task-specific training for walking (80–98%), impaired motor function (64–100%) and fall prevention (73–92%) were most implemented. Factors that facilitated implementation were: important to comply with the NGS, that PTs had confidence to per-form the interventions, and that interventions were clearly described. Limited time, lack of resources, no clear goals or routines at the workplace hindered the implementation. Significant differences (p < 0.05) between the settings existed. Municipal and primary care reported most challenges in implementing the NGS and providing evidence-based interventions.Conclusion: Most interventions, with high priority according to NGS, are provided by PTs working in stroke rehabilitation, although differences in various parts of the care chain exist. Knowledge, time, education and supportive management are important factors when implementing evidence-based interventions.
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| 10. |
- Chen, Eric, et al.
(author)
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Levels of physical activity in acute stroke patients treated at a stroke unit: A prospective, observational study.
- 2020
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In: Journal of rehabilitation medicine. - : Medical Journals Sweden AB. - 1651-2081 .- 1650-1977. ; 52:4
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Journal article (peer-reviewed)abstract
- A prospective, observational study to describe levels of physical activity in patients with stroke on day 2 and day 5 or 6 after admission to a comprehensive stroke unit in Sweden.The study was performed at the stroke unit at Sahlgrenska University Hospital during a period of 4 months between 2017 and 2018. Consecutive patients with stroke were observed for 1 min every 10 min while the multidisciplinary team was at work. The level of physical activity, location and the people present were noted at each time-point.A total of 46 patients were observed on day 2, of whom 29 were observed a second time on day 5 or 6. Patients were in bed half of the time and engaged in upright activity for less than 10% of day 2. Patients spent 73% of day 2 in the bedroom and 56% of this day alone. Over time, there was a significant shift of 10% from "in bed" activity to "sitting" (p§lt;0.001).Patients are physically inactive, alone and in their rooms for a majority of the time during the first days at a comprehensive stroke unit. There is some increase in physical activity during the first week after admission.
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