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  • 1.
    Ahlstrand, Inger
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Vaz, Sharmila
    School of Occupational Therapy & Social Work, CHIRI, Curtin University, Perth, WA, Australia.
    Falkmer, Torbjörn
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Thyberg, Ingrid
    Department of Rheumatology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Björk, Mathilda
    Department of Rheumatology and Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden.
    Self-efficacy and pain acceptance as mediators of the relationship between pain and performance of valued life activities in women and men with rheumatoid arthritis2017Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 31, nr 6, s. 824-834Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To study whether personal factors (self-efficacy and pain acceptance) mediate the relationship between pain and performance of valued life activities in persons with rheumatoid arthritis.

    METHODS: Persons with rheumatoid arthritis for at least four years (n = 737; 73% women) answered a questionnaire measuring self-efficacy, pain acceptance, performance of valued life activities, and self-rated pain. Relationships among these constructs were explored using univariate and multivariate analyses. Structural equation modelling was then used to examine the mediational role of personal factors on the relationship between pain and performance of valued life activities.

    RESULTS: A direct negative association between pain and performance of valued life activities was identified (Beta = .34, P < .001). This suggests that people with rheumatoid arthritis who had higher levels of pain has increased difficulties in performing valued life activities. Self-efficacy and activity engagement component of pain acceptance mediated the relationship between pain and performance of valued life activities, however the pain willingness component of pain acceptance did not influence participation in valued life activities.

    CONCLUSION: These findings highlight the importance of considering personal factors, such as pain acceptance and self-efficacy, in facilitating participation in valued life activities.

  • 2.
    Ahlstrand, Inger
    et al.
    School of Health and Welfare, Jönköping University, Jönköping, Sweden.
    Vaz, Sharmila
    School of Occupational Therapy & Social Work, CHIRI, Curtin University, Perth, WA, Australia.
    Falkmer, Torbjörn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum. School of Health and Welfare, Jönköping University, Jönköping, Sweden.
    Thyberg, Ingrid
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Björk, Mathilda
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för arbetsterapi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Self-efficacy and pain acceptance as mediators of the relationship between pain and performance of valued life activities in women and men with rheumatoid arthritis2017Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 31, nr 6, s. 824-834Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To study whether personal factors (self-efficacy and pain acceptance) mediate the relationship between pain and performance of valued life activities in persons with rheumatoid arthritis.

    METHODS: Persons with rheumatoid arthritis for at least four years (n = 737; 73% women) answered a questionnaire measuring self-efficacy, pain acceptance, performance of valued life activities, and self-rated pain. Relationships among these constructs were explored using univariate and multivariate analyses. Structural equation modelling was then used to examine the mediational role of personal factors on the relationship between pain and performance of valued life activities.

    RESULTS: A direct negative association between pain and performance of valued life activities was identified (Beta = .34, P < .001). This suggests that people with rheumatoid arthritis who had higher levels of pain has increased difficulties in performing valued life activities. Self-efficacy and activity engagement component of pain acceptance mediated the relationship between pain and performance of valued life activities, however the pain willingness component of pain acceptance did not influence participation in valued life activities.

    CONCLUSION: These findings highlight the importance of considering personal factors, such as pain acceptance and self-efficacy, in facilitating participation in valued life activities.

  • 3.
    Ahlstrom, G.
    et al.
    Ahlström, G., Department of Health Sciences, University of Örebro, SE-701 82 Örebro, Sweden.
    Lindvall, Björn
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Neurologi. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken.
    Wenneberg, S.
    Department of Health Sciences, University of Örebro, SE-701 82 Örebro, Sweden.
    Gunnarsson, L.G.
    Department of Neurology and Neurophysiology, Örebro University Hospital, Örebro, Sweden.
    A comprehensive rehabilitation programme tailored to the needs of adults with muscular dystrophy2006Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 20, nr 2, s. 132-141Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To assess if activities of daily living (ADL), coping and quality of life could be improved in adults with muscular dystrophy through a comprehensive rehabilitation programme. Design: Quasi-experimental, controlled clinical study comparing patients with similar age and disease aspects. Setting: Two different counties in Sweden, being either study or control setting. Subjects: The study group comprised 37 adults (21 women, 16 men, mean age 50 years), while the control group comprised 39 people (25 women, 14 men, mean age 46 years). Interventions: Four rehabilitation sessions tailored to different medical, physical and psychosocial needs of the patients, comprising a total of 10 days over a period of 18 months. Main measures: ADL, the Mental Adjustment to Cancer Scale measuring coping strategies, the Sickness Impact Profile measuring health-related quality of life, the Hospital Anxiety and Depression Scale, and the Psychosocial Well-being Questionnaire. Results: No significant differences were found between groups with regard to the outcome measures. There was increased dependence on others in ADL after 18 months in both groups, but it was more pronounced in the control group. Furthermore, a clear trend was observed in the data with regard to coping patterns, the control group using more coping strategies such as 'Helplessness/hopelessness' (P = 0.057), 'Anxious preoccupation' (P = 0.085) and 'Fatalistic' (P = 0.073) when being compared to the study group. Conclusions: No apparent effects on ADL were found from the rehabilitation programme, although there was a tendency of reduction of maladaptive coping patterns in the study group. This initial study may provide the rationale and basis for a randomized controlled trial. © 2006 Edward Arnold (Publishers) Ltd.

  • 4. Ahlström, Gerd
    et al.
    Lindvall, B.
    Wenneberg, Stig
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Gunnarsson, Lars-Gunnar
    Örebro universitet, Institutionen för klinisk medicin.
    A comprehensive rehabilitation programme tailored to the needs of adults with muscular dystrophy2006Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 20, nr 2, s. 132-141Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To assess if activities of daily living (ADL), coping and quality of life could be improved in adults with muscular dystrophy through a comprehensive rehabilitation programme. DESIGN: Quasi-experimental, controlled clinical study comparing patients with similar age and disease aspects. SETTING: Two different counties in Sweden, being either study or control setting. SUBJECTS: The study group comprised 37 adults (21 women, 16 men; mean age 50 years), while the control group comprised 39 people (25 women, 14 men; mean age 46 years). INTERVENTIONS: Four rehabilitation sessions tailored to different medical, physical and psychosocial needs of the patients, comprising a total of 10 days over a period of 18 months. MAIN MEASURES: ADL, the Mental Adjustment to Cancer Scale measuring coping strategies, the Sickness Impact Profile measuring health-related quality of life, the Hospital Anxiety and Depression Scale, and the Psychosocial Well-being Questionnaire. RESULTS: No significant differences were found between groups with regard to the outcome measures. There was increased dependence on others in ADL after 18 months in both groups, but it was more pronounced in the control group. Furthermore, a clear trend was observed in the data with regard to coping patterns, the control group using more coping strategies such as 'Helplessness/hopelessness' (P= 0.057), 'Anxious preoccupation' (P = 0.085) and 'Fatalistic' (P= 0.073) when being compared to the study group. CONCLUSIONS: No apparent effects on ADL were found from the rehabilitation programme, although there was a tendency of reduction of maladaptive coping patterns in the study group. This initial study may provide the rationale and basis for a randomized controlled trial.

  • 5.
    Ahlström, Gerd
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
    Lindvall, Björn
    Wenneberg, Stig
    Gunnarsson, Lars-Gunnar
    A comprehensive rehabilitation programme tailored to the needs of adults with muscular dystrophy.2006Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 20, nr 2, s. 132-141Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To assess if activities of daily living (ADL), coping and quality of life could be improved in adults with muscular dystrophy through a comprehensive rehabilitation programme. DESIGN: Quasi-experimental, controlled clinical study comparing patients with similar age and disease aspects. SETTING: Two different counties in Sweden, being either study or control setting. SUBJECTS: The study group comprised 37 adults (21 women, 16 men; mean age 50 years), while the control group comprised 39 people (25 women, 14 men; mean age 46 years). INTERVENTIONS: Four rehabilitation sessions tailored to different medical, physical and psychosocial needs of the patients, comprising a total of 10 days over a period of 18 months. MAIN MEASURES: ADL, the Mental Adjustment to Cancer Scale measuring coping strategies, the Sickness Impact Profile measuring health-related quality of life, the Hospital Anxiety and Depression Scale, and the Psychosocial Well-being Questionnaire. RESULTS: No significant differences were found between groups with regard to the outcome measures. There was increased dependence on others in ADL after 18 months in both groups, but it was more pronounced in the control group. Furthermore, a clear trend was observed in the data with regard to coping patterns, the control group using more coping strategies such as 'Helplessness/hopelessness' (P= 0.057), 'Anxious preoccupation' (P = 0.085) and 'Fatalistic' (P= 0.073) when being compared to the study group. CONCLUSIONS: No apparent effects on ADL were found from the rehabilitation programme, although there was a tendency of reduction of maladaptive coping patterns in the study group. This initial study may provide the rationale and basis for a randomized controlled trial.

  • 6. Baigi, A
    et al.
    Hildingh, C
    Virdhall, H
    Fridlund, Bengt
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
    Sense of coherence as well as social support and network as perceived by patients with a suspected or manifest myocardial infarction: a short-term follow-up study2008Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 22, nr 7, s. 646-652Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To compare sense of coherence as well as social support and network as perceived by ischaemic heart disease patients at baseline and two weeks post-discharge in terms of age, sex, educational and marital status. DESIGN: Multicentre study with a prospective short-term follow-up design. SETTING: A university hospital, a central hospital and a district hospital in southern Sweden. SUBJECTS: Consecutive sample of 246 patients with a suspect or manifest myocardial infarction. MAIN MEASURES: The Lubben Social Network Scale (LSNS-R), the Medical Outcome Study (MOS) Social Support Survey and the Sense of Coherence Scale were included in a self-administered questionnaire and answered twice, together with sociodemographic variables. RESULTS: Bivariate analyses indicated changes in social support (practical support increased in men and decreased in women; both P= 0.003) and social network (family network increased among >65 year olds; P= 0.001, men; P= 0.013, and women; P= 0.033, those with a low; P=0.017, and intermediate; P= 0.033, educational level, as well as those cohabiting; P= 0.0001), but did not reveal any difference in sense of coherence. CONCLUSIONS: Sociodemographic variables have no influence on sense of coherence but do affect social support (i.e. practical support and social network, family). Ischaemic heart disease patients' short stay in hospital implies that the network outside the hospital has to assume responsibility, but at the same time it is important for health care professionals to have sufficient knowledge to be able to support the specific needs of patients and their family members.

  • 7.
    Baigi, Amir
    et al.
    Department of Primary Health Care, Göteborg University, Göteborg.
    Hildingh, Cathrine
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Virdhall, Helen
    Lund University Hospital, Lund, Sweden.
    Fridlund, Bengt
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Sense of coherence as well as social support and network as perceived by patients with a suspected or manifest myocardial infarction: a short-term follow-up study2008Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 22, nr 7, s. 646-652Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective:

    To compare sense of coherence as well as social support and network as perceived by ischaemic heart disease patients at baseline and two weeks post-discharge in terms of age, sex, educational and marital status.

    Design:

    Multicentre study with a prospective short-term follow-up design.

    Setting:

    A university hospital, a central hospital and a district hospital in southern Sweden.

    Subjects:

    Consecutive sample of 246 patients with a suspect or manifest myocardial infarction.

    Main measures:

    The Lubben Social Network Scale (LSNS-R), the Medical Outcome Study (MOS) Social Support Survey and the Sense of Coherence Scale were included in a self-administered questionnaire and answered twice, together with sociodemographic variables.

    Results:

    Bivariate analyses indicated changes in social support (practical support increased in men and decreased in women; both P= 0.003) and social network (family network increased among >65 year olds; P= 0.001, men; P= 0.013, and women; P= 0.033, those with a low; P=0.017, and intermediate; P= 0.033, educational level, as well as those cohabiting; P= 0.0001), but did not reveal any difference in sense of coherence.

    Conclusions:

    Sociodemographic variables have no influence on sense of coherence but do affect social support (i.e. practical support and social network, family). Ischaemic heart disease patients' short stay in hospital implies that the network outside the hospital has to assume responsibility, but at the same time it is important for health care professionals to have sufficient knowledge to be able to support the specific needs of patients and their family members.

  • 8.
    Berggren, Monica
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Karlsson, Åsa
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Lindelöf, Nina
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik. Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Englund, Undis
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Olofsson, Birgitta
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Ortopedi. Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Nordstöm, Peter
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Gustafson, Yngve
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Stenvall, Michael
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Effects of geriatric interdisciplinary home rehabilitation on complications and readmissions after hip fracture: a randomized controlled trial2019Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 33, nr 1, s. 64-73Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: This pre-planned secondary analysis of geriatric interdisciplinary home rehabilitation, which was initially found to shorten the postoperative length of stay in hospital for older individuals following hip fracture, investigated whether such rehabilitation reduced the numbers of complications, readmissions, and total days spent in hospital after discharge during a 12-month follow-up period compared with conventional geriatric care and rehabilitation.

    Design: Randomized controlled trial.

    Setting: Geriatric department, participants' residential care facilities, and ordinary housing.

    Subjects: Individuals aged ⩾70 years with acute hip fracture (n = 205) were included.

    Intervention: Geriatric interdisciplinary home rehabilitation was individually designed and aimed at early discharge with the intention to prevent, detect, and treat complications after discharge.

    Main measures: Complications, readmissions, and days spent in hospital were registered from patients' digital records and interviews conducted during hospitalization and at 3- and 12-month follow-up visits.

    Results: No significant difference in outcomes was observed. Between discharge and the 12-month follow-up, among participants in the geriatric interdisciplinary home rehabilitation group (n = 106) and control group (n = 93), 57 (53.8%) and 44 (47.3%) had complications (P = 0.443), 46 (43.4%) and 38 (40.9%) fell (P = 0.828), and 38 (35.8%) and 27 (29.0%) were readmitted to hospital (P = 0.383); the median total days spent in hospital were 11.5 and 11.0 (P = 0.353), respectively.

    Conclusion: Geriatric interdisciplinary home rehabilitation for older individuals following hip fracture resulted in similar proportions of complications, readmissions, and total days spent in hospital after discharge compared with conventional geriatric care and rehabilitation.

  • 9.
    Bertilsson, Ann-Sofie
    et al.
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    Ekstam, Lisa
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.; Lund Univ, Dept Hlth Sci, Lund, Sweden.; Karolinska Univ Hosp, Dept Occupat Therapy, Huddinge, Sweden .
    Tham, Kerstin
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.; Karolinska Univ Hosp, Dept Occupat Therapy, Huddinge, Sweden.
    Andersson, Magnus
    Karolinska Inst, Dept Clin Neurosci, Solna, Sweden.; Karolinska Univ Hosp, Dept Neurol, Stockholm, Sweden.
    von Koch, Lena
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.; Karolinska Univ Hosp, Dept Neurol, Stockholm, Sweden.
    Johansson, Ulla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    A cluster randomized controlled trial of a client-centred, activities of daily living intervention for people with stroke: One year follow-up of caregivers2016Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 30, nr 8, s. 765-775Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Compare caregiver burden, provision of informal care, participation in everyday occupationsand life satisfaction of caregivers to people with stroke, who either had received a client-centred, activitiesof daily living intervention or usual activities of daily living interventions.

    Design: A multicentre cluster randomized controlled trial in which 16 rehabilitation units were randomlyassigned to deliver a client-centred, activities of daily living intervention or usual activities of daily livinginterventions. Caregiver outcomes were compared cross-sectionally at 12 months and changes inoutcomes between three and 12 months after people with stroke were included in the study.

    Setting: Inpatient and outpatient rehabilitation.

    Participants: Caregivers of people with stroke enrolled in the trial.

    Intervention: A client-centred, activities of daily living intervention aiming to increase agency in dailyactivities and participation in everyday life for people after stroke.

    Main measures: Caregiver Burden Scale, Occupational Gaps Questionnaire, LiSat-11.

    Results: There were no differences in outcomes between caregivers in the client-centred, activities ofdaily living (n = 88) and the usual activities of daily living (n = 95) group at 12 months. The caregiver burdenscore was 42.7 vs. 41.8, p = 0.75, mean occupational gaps were 3.5 vs. 4.0, p = 0.52 and satisfaction with lifewas 53% vs. 50%, p = 0.87. There were no differences in changes between three and 12 months. However,within groups there were significant differences in caregiver burden, factor general strain, for caregivers inthe client-centred, activities of daily living group, and in provision of informal care for the usual activitiesof daily living group.

    Conclusion: The client-centred intervention did not bring about any difference between caregivergroups,but within groups some difference was found for caregiver burden and informal care.

  • 10.
    Bertilsson, Ann-Sofie
    et al.
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    Ekstam, Lisa
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.; Lund Univ, Dept Hlth Sci, Lund, Sweden.; Karolinska Univ Hosp, Dept Occupat Therapy, Huddinge, Sweden .
    Tham, Kerstin
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.; Karolinska Univ Hosp, Dept Occupat Therapy, Huddinge, Sweden.
    Andersson, Magnus
    Karolinska Inst, Dept Clin Neurosci, Solna, Sweden.; Karolinska Univ Hosp, Dept Neurol, Stockholm, Sweden.
    von Koch, Lena
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.; Karolinska Univ Hosp, Dept Neurol, Stockholm, Sweden.
    Johansson, Ulla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    A cluster randomized controlled trial of a client-centred, activities of daily living intervention for people with stroke: One year follow-up of caregivers2016Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 30, nr 8, s. 765-775Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Compare caregiver burden, provision of informal care, participation in everyday occupationsand life satisfaction of caregivers to people with stroke, who either had received a client-centred, activitiesof daily living intervention or usual activities of daily living interventions.

    Design: A multicentre cluster randomized controlled trial in which 16 rehabilitation units were randomlyassigned to deliver a client-centred, activities of daily living intervention or usual activities of daily livinginterventions. Caregiver outcomes were compared cross-sectionally at 12 months and changes inoutcomes between three and 12 months after people with stroke were included in the study.

    Setting: Inpatient and outpatient rehabilitation.

    Participants: Caregivers of people with stroke enrolled in the trial.

    Intervention: A client-centred, activities of daily living intervention aiming to increase agency in dailyactivities and participation in everyday life for people after stroke.

    Main measures: Caregiver Burden Scale, Occupational Gaps Questionnaire, LiSat-11.

    Results: There were no differences in outcomes between caregivers in the client-centred, activities ofdaily living (n = 88) and the usual activities of daily living (n = 95) group at 12 months. The caregiver burdenscore was 42.7 vs. 41.8, p = 0.75, mean occupational gaps were 3.5 vs. 4.0, p = 0.52 and satisfaction with lifewas 53% vs. 50%, p = 0.87. There were no differences in changes between three and 12 months. However,within groups there were significant differences in caregiver burden, factor general strain, for caregivers inthe client-centred, activities of daily living group, and in provision of informal care for the usual activitiesof daily living group.

    Conclusion: The client-centred intervention did not bring about any difference between caregivergroups,but within groups some difference was found for caregiver burden and informal care.

  • 11.
    Björk, Mathilda
    et al.
    Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland. Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för arbetsterapi.
    Thyberg, Mikael
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Valtersson, Eva
    Linköpings universitet, Institutionen för medicin och hälsa. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Rörelse och Hälsa. Linköpings universitet, Medicinska fakulteten.
    Katz, Patricia
    University of California, San Francisco, USA.
    Validation and internal consistency of the Swedish version of the Valued Life Activities scale.2016Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 30, nr 12, s. 1211-1219Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: The objective was to create a linguistically and culturally validated Swedish version of the Valued Life Activities scale. The aim was also to describe its content and concurrent validity and its internal consistency in persons with rheumatoid arthritis.

    METHODS: The Valued Life Activities scale was translated to Swedish and culturally adapted. In order to describe the content validity, both the Swedish and original Valued Life Activities scale were linked to the International Classification of Functioning, Disability and Health. The concurrent validity and internal consistency were evaluated in 737 patients with rheumatoid arthritis. To establish concurrent validity, the scale was correlated to disease activity, activity limitations, and life satisfaction. Internal consistency was assessed with Cronbach's alpha.

    RESULTS: The equivalence of meaning between the Swedish and the original Valued Life Activities scale was ensured by harmonization review. Content validity was high when linked to the International Classification of Functioning, Disability and Health. Concurrent validity showed a strong correlation with the activity limitations (r = 0.87), moderate with life satisfaction (r = -0.61), and weak with disease activity (r = 0.38). Internal consistency was excellent (Cronbach's alpha = 0.97).

    CONCLUSIONS: The Swedish Valued Life Activities scale has been tested in a large and well-characterized sample and found to be a linguistically valid and culturally adapted self-reported measure of participation. Content validity of the Valued Life Activities scale was excellent, concurrent validity strong, and the internal consistency excellent. Since both individual preferences and International Classification of Functioning, Disability and Health concepts of disability are taken into account, the Swedish Valued Life Activities scale appears to be a promising new scale addressing important aspects of participation.

  • 12.
    Björkdahl, Ann
    et al.
    Rehabiliteringsmedicin, Institutionen för neurovetenskap och rehabilitering, Sahlgrenska Akademin, Göteborgs Universitet.
    Lundgren Nilsson, Asa
    Rehabiliteringsmedicin, Institutionen för neurovetenskap och rehabilitering, Sahlgrenska Akademin, Göteborgs Universitet.
    Grimby, Gunnar
    Rehabiliteringsmedicin, Institutionen för neurovetenskap och rehabilitering, Sahlgrenska Akademin, Göteborgs Universitet.
    Stibrant Sunnerhagen, Katharina
    Rehabiliteringsmedicin, Institutionen för neurovetenskap och rehabilitering, Sahlgrenska Akademin, Göteborgs Universitet.
    Does a short period of rehabilitation in the home setting facilitate functioning after stroke?: A randomized controlled trial2006Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 20, nr 12, s. 1038-1049Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To assess the effect of three weeks of rehabilitation in the home setting for younger patients with stroke with the aim of improving activity level.

    DESIGN: A randomized controlled study with blinded evaluations at discharge, three weeks, three months and one year after discharge.

    SETTING: Home of the patient or the ordinary day rehabilitation clinic at the university hospital.

    SUBJECTS: Fifty-eight patients (median age 53 years) consecutively discharged from inpatient rehabilitation with a first occurrence of stroke participated in training directly after discharge. Intervention: Rehabilitation was given for 9 hours/week over three weeks. The home group received individually tailored training, based on the patient's needs and desires, with a focus on activities in their natural context. Support and information were also given. The intervention in the day clinic group was aimed mainly at improved functions.

    MAIN MEASURES: The main outcome was activity, assessed with the Assessment of Motor and Process Skill (AMPS). The impairment level was also evaluated. Costs were estimated.

    RESULT: There were no significant differences between the groups on any of the four assessments. However, there seemed to be an earlier improvement on some measures (including AMPS) for the home group. For both groups there was a greater improvement on the activity level than on the impairment level. the costs of the home group were less than half of the costs of the day clinic group.

    CONCLUSION: With the present results, both rehabilitation programmes could be recommended, however, further studies are needed to define patients who may specifically benefit from the home rehabilitation programme. Costs should be taken into consideration.

  • 13.
    Bogefeldt, Johan P
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och klinisk epidemiologi.
    Grunnesjö, Marie I
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och klinisk epidemiologi.
    Svärdsudd, Kurt F
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och klinisk epidemiologi.
    Blomberg, Stefan I E
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och klinisk epidemiologi.
    Sick leave reductions from a comprehensive manual therapy programme for low back pain: the Gotland Low Back Pain Study2008Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 22, nr 6, s. 529-41Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To evaluate if a comprehensive manual therapy programme reduces sick leave due low back pain and facilitates return to work more than the conventional optimized activating care. DESIGN: A randomized controlled trial over a 10-week period with a two-year follow-up. SETTING: Primary health care and Visby Hospital, Municipality of Gotland, Sweden. SUBJECTS: One hundred and sixty patients (70 women, 90 men, ages 20-55 years) with acute or subacute low back pain with or without pain radiation into the legs. INTERVENTIONS: Standardized optimized activating care (n = 71) versus a comprehensive pragmatic manual therapy programme including specific corticosteroid injections (n = 89). MAIN MEASURES: Sick leave measured as net sick leave volume, point prevalence and return to work. RESULTS: After 10 weeks, significantly more manual therapy patients than reference patients had returned to work (hazards ratio 1.62, 95% confidence interval (CI) 1.006-2.60, P<0.05), and among those on sick leave at baseline, significantly fewer were still on sick leave (8/58 versus 13/40, ratio 0.35, 95% CI 0.13-0.97, P<0.05). For all other measures there were inconclusive differences in favour of the manual therapy group. No significant differences remained after two years. CONCLUSIONS: The manual therapy programme used in this study decreased sick leave and increased return to work more than the standardized optimized activating care only up to 10 weeks but not up to two years.

  • 14.
    Bostrom, Karin
    et al.
    Linköpings universitet, Institutet för handikappvetenskap (IHV). Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten.
    Natterlund, Birgitta Sjöquist
    Örebro University .
    Ahlstrom, Gerd
    Örebro University.
    Sickness impact in people with muscular dystrophy: a longitudinal study over 10 years2005Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 19, nr 6, s. 686-694Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To describe changes of function in terms of sickness impact over 10 years in adult patients with different types of muscular dystrophy. Design: Patients with muscular dystrophy answered the Sickness Impact Profile and Self-report ADL questionnaires in 1991 and 2001. Setting: The study population was identified in a comprehensive prevalence study in the county of Orebro, Sweden. Subjects: The study group comprised 44 people grouped according to whether they had myotonic dystrophy or muscular dystrophy with proximal or distal muscles affected. Main measures: Comparison was made between assessments of sickness impact in terms of function at the two time points. Results: Most obvious deterioration over time was in activities of daily living that require finger and arm strength. Ambulation was significantly decreased in myotonic dystrophy and proximal muscular dystrophy. Those walking without assistive devices decreased from 91% to 52%, and the number with a disability pension increased from 36 to 55%. There was a relatively small influence with regard to psychosocial dysfunction assessed by the Sickness Impact Profile. Conclusions: This longitudinal study shows the deteriorating functions reported by patients with muscular dystrophy. This knowledge could be used to formulate new interventions in order to offer appropriate support and treatment to this patient group.

  • 15. Boström, Katrin
    et al.
    Sjöquist Nätterlund, Birgitta
    Ahlström, Gerd
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
    Sickness impact in people with muscular dystrophy: a longitudinal study over 10 years.2005Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 19, nr 6, s. 686-694Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To describe changes of function in terms of sickness impact over 10 years in adult patients with different types of muscular dystrophy. DESIGN: Patients with muscular dystrophy answered the Sickness Impact Profile and Self-report ADL questionnaires in 1991 and 2001. SETTING: The study population was identified in a comprehensive prevalence study in the county of Orebro, Sweden. SUBJECTS: The study group comprised 44 people grouped according to whether they had myotonic dystrophy or muscular dystrophy with proximal or distal muscles affected. MAIN MEASURES: Comparison was made between assessments of sickness impact in terms of function at the two time points. RESULTS: Most obvious deterioration over time was in activities of daily living that require finger and arm strength. Ambulation was significantly decreased in myotonic dystrophy and proximal muscular dystrophy. Those walking without assistive devices decreased from 91% to 52%, and the number with a disability pension increased from 36 to 55%. There was a relatively small influence with regard to psychosocial dysfunction assessed by the Sickness Impact Profile. CONCLUSIONS: This longitudinal study shows the deteriorating functions reported by patients with muscular dystrophy. This knowledge could be used to formulate new interventions in order to offer appropriate support and treatment to this patient group.

  • 16.
    Boström, Katrin
    et al.
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Sjöquist Nätterlund, Birgitta
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Ahlström, Gerd
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Sickness impact in people with muscular dystrophy: a longitudinal study over 10 years2005Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 19, nr 6, s. 686-694Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To describe changes of function in terms of sickness impact over 10 years in adult patients with different types of muscular dystrophy. DESIGN: Patients with muscular dystrophy answered the Sickness Impact Profile and Self-report ADL questionnaires in 1991 and 2001. SETTING: The study population was identified in a comprehensive prevalence study in the county of Orebro, Sweden. SUBJECTS: The study group comprised 44 people grouped according to whether they had myotonic dystrophy or muscular dystrophy with proximal or distal muscles affected. MAIN MEASURES: Comparison was made between assessments of sickness impact in terms of function at the two time points. RESULTS: Most obvious deterioration over time was in activities of daily living that require finger and arm strength. Ambulation was significantly decreased in myotonic dystrophy and proximal muscular dystrophy. Those walking without assistive devices decreased from 91% to 52%, and the number with a disability pension increased from 36 to 55%. There was a relatively small influence with regard to psychosocial dysfunction assessed by the Sickness Impact Profile. CONCLUSIONS: This longitudinal study shows the deteriorating functions reported by patients with muscular dystrophy. This knowledge could be used to formulate new interventions in order to offer appropriate support and treatment to this patient group.

  • 17.
    Bring, Annika
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Fysioterapi.
    Åsenlöf, Pernilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Fysioterapi.
    Söderlund, Anne
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Fysioterapi.
    What is the comparative effectiveness of current standard treatment, against an individually tailored behavioural programme delivered either on the Internet or face-to-face for people with acute whiplash associated disorder? A randomized controlled trial2016Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 30, nr 5, s. 441-453Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To investigate the comparative effectiveness of current standard treatment, against an individually tailored behavioural programme delivered via the Internet or face-to-face for people with acute whiplash associated disorders.

    DESIGN: A multicentre, randomized, three-group design, with concealed allocation.

    SUBJECTS AND SETTINGS: A total of 55 participants (37 female), age 18-65, with acute Whiplash Associated Disorder (Grade I-II), recruited at two emergency clinics in Sweden.

    INTERVENTIONS: Before randomization all participants received standard self-care instructions. The Internet and face-to-face groups followed a seven-week behavioural programme involving individual tailoring, via email (Internet group), or in sessions at a physical therapy unit (face-to-face group). The control group only received the self-care instructions.

    MAIN MEASURES: Pain-related disability, pain intensity, self-efficacy in daily activities, catastrophizing and fear of movement/(re)injury. Assessments were performed at baseline (2-4 weeks postinjury) and at three, six and 12 months postintervention.

    RESULTS: Both the Internet (n = 16) and face-to-face (n = 14) group showed a larger decrease in pain-related disability than the control group (n = 16); -12 and -11, respectively, compared with -5 in the control group at 12-months follow-up. Significant differences between the groups in overall treatment effect were shown in all outcomes except pain intensity. All groups improved significantly over time in all outcomes, except for fear of movement/(re)injury and catastrophizing in the control group.

    CONCLUSION: An individually tailored behavioural programme improved biopsychosocial factors in patients with whiplash associated disorders up to 12 months after treatment. Internet-delivered intervention was as effective as clinic-based face-to-face therapy sessions.

  • 18.
    Bring, Annika
    et al.
    Uppsala Universitet, Sweden.
    Åsenlöf, Pernilla
    Uppsala Universitet, Sweden.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    What is the comparative effectiveness of current standard treatment, against an individually tailored behavioural programme delivered either on the Internet or face-to-face for people with acute whiplash associated disorder?: A randomized controlled trial2016Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 30, nr 5, s. 441-453Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To investigate the comparative effectiveness of current standard treatment, against an individually tailored behavioural programme delivered via the Internet or face-to-face for people with acute whiplash associated disorders.

    DESIGN: A multicentre, randomized, three-group design, with concealed allocation.

    SUBJECTS AND SETTINGS: A total of 55 participants (37 female), age 18-65, with acute Whiplash Associated Disorder (Grade I-II), recruited at two emergency clinics in Sweden.

    INTERVENTIONS: Before randomization all participants received standard self-care instructions. The Internet and face-to-face groups followed a seven-week behavioural programme involving individual tailoring, via email (Internet group), or in sessions at a physical therapy unit (face-to-face group). The control group only received the self-care instructions.

    MAIN MEASURES: Pain-related disability, pain intensity, self-efficacy in daily activities, catastrophizing and fear of movement/(re)injury. Assessments were performed at baseline (2-4 weeks postinjury) and at three, six and 12 months postintervention.

    RESULTS: Both the Internet (n = 16) and face-to-face (n = 14) group showed a larger decrease in pain-related disability than the control group (n = 16); -12 and -11, respectively, compared with -5 in the control group at 12-months follow-up. Significant differences between the groups in overall treatment effect were shown in all outcomes except pain intensity. All groups improved significantly over time in all outcomes, except for fear of movement/(re)injury and catastrophizing in the control group.

    CONCLUSION: An individually tailored behavioural programme improved biopsychosocial factors in patients with whiplash associated disorders up to 12 months after treatment. Internet-delivered intervention was as effective as clinic-based face-to-face therapy sessions.

  • 19.
    Brogårdh, Christina
    et al.
    Umeå University, Rehabilitation Medicine, Department of Community Medicine and Rehabilitation.
    Flansbjer, Ulla-Britt
    Department of Rehabilitation, Lund University Hospital, Sweden.
    Lexell, Jan
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    What is the long term benefit of constraint induced movement therapy?: a 4-year follow-up2009Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 23, nr 5, s. 418-423Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To evaluate the long-term benefits of constraint-induced movement therapy in chronic stroke.Design: A four-year follow-up after constraint-induced group therapy assessing arm and hand function and self-reported daily hand use.Subjects: Fourteen post-stroke individuals (six women and eight men; mean age 59.6 ± 12.7 years, range 23-75 years) with mild to moderate impairments of hand function.Outcome measures: The Sollerman hand function test and the Motor Activity Log test.Results: Four years after constraint-induced group therapy the participants had maintained their hand function, as measured by the Sollerman hand function test. The self-reported use and quality of movements of the more affected hand, as measured by the Motor Activity Log test, had decreased compared to post-treatment and three months follow-up (P < 0.01), but was still significantly higher than pre-treatment (P < 0.05).Conclusion: There seems to be a long-term benefit of constraint-induced group therapy. Hand function was maintained over time and daily hand use had increased compared to pre-treatment. To provide guidelines about the clinical use of constraint-induced movement therapy further, larger and controlled studies are needed.

  • 20.
    Brogårdh, Christina
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering.
    Sjölund, Bengt H
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering.
    Constraint Induced Movement Therapy in patients with stroke: A pilot study on effects of small group training and of extended mitt use2006Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 20, nr 3, s. 218-227Artikel i tidskrift (Refereegranskat)
  • 21.
    Budh Norrbrink, Cecilia
    et al.
    Spinalis SCI unit, Karolinska Hospital and Faculty of Public Health Sciences, Karolinska Institutet, Stockholm.
    Lund, Irene
    Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm.
    Ertzgaard, Per
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Rehabiliteringsmedicin. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Neurologiska kliniken.
    Hulting, Claes
    Spinalis SCI unit, Karolinska Hospital and Faculty of Public Health Sciences, Karolinska Institutet, Stockholm.
    Holtz, Anders
    Department of Neurosurgery, University Hospital, Uppsala.
    Levi, Richard
    Frösunda Center, Solna and Department of Clinical Neuroscience, Karolinska Institutet, Stockholm.
    Werhagen, Lars
    Spinalis SCI unit, Karolinska Hospital, Stockholm.
    Lundeberg, Thomas
    Spinalis SCI Unit, Karolinska Hospital, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
    Pain in a Swedish spinal cord injury population2003Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 17, nr 6, s. 685-690Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To describe pain and associated variables in a prevalence group of persons with a sustained spinal cord injury (SCI) in the Swedish capital and its surroundings. Setting: Spinalis SCI Unit (outpatient clinic), Stockholm, Sweden. Design: Assessment over a 12-month period in a yearly health control. Subjects: Four hundred and fifty-six SCI patients. Results: Two hundred and ninety-one out of 456 SCI patients (63.7%) suffered from pain, and in 45.7% of these it was classified as being neurogenic. Aching pain was the most used descriptor (38.5%). The onset of pain was commonly within three months (73.5%). In 70.4% of patients pain occurred below the level of the lesion. Most patients identified pain as coming from one (55.0%) or two (28.2%) body regions. Rating of the general pain intensity on a visual analogue scale (VAS) was 46 out of 100 and rating of the worst pain intensity was 78 out of 100. Ninety-four out of 276 patients (32.3%) considered that their quality of life was significantly affected by pain. Conclusion: Pain was most common in patients with incomplete lesions (ASIA impairment grade D) and there was a correlation between pain and higher mean age at injury and between pain and female gender.

  • 22.
    Carling, Anna
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper. University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Department of Physiotherapy, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Forsberg, Anette
    Örebro universitet, Institutionen för hälsovetenskaper. Region Örebro län. Department of Physiotherapy.
    Nilsagård, Ylva
    Örebro universitet, Institutionen för hälsovetenskaper. Region Örebro län.
    Falls in people with multiple sclerosis: experiences of 115 fall situations2018Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 32, nr 4, s. 526-535Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: The aim was to describe falls and the perceived causes, experienced by people with multiple sclerosis shortly after falling.

    Design: A qualitative study using content analysis and quantitative data to illustrate where and why people report falls most commonly. Semi-structured telephone interviews were performed. Interviews were conducted shortly (0–10 days) after a fall.

    Subjects: In all, 67 informants who had reported at least one fall during the previous three-month period and who used a walking aid participated.

    Results: A total of 57 (85%) informants fell at least once during eight months resulting in 115 falls; 90 (78%) falls happened indoors, most commonly in the kitchen (n = 20; 17%) or bathroom (n = 16; 14%). Informants fell during everyday activities and walking aids had been used in more than a third of the reported falls. The falls were influenced of both intrinsic and extrinsic factors. Two categories emerged from the analysis: ‘activities when falling’ and ‘influencing factors’. The category contained three (basic activities of daily living, instrumental activities of daily living and leisure and work) and six (multiple sclerosis–related symptoms, fluctuating body symptoms, being distracted, losing body control, challenging surrounding and involvement of walking aid) subcategories, respectively.

    Conclusion: The majority of falls occurs indoors and in daily activities. Several factors interacted in fall situations and should be monitored and considered to reduce the gap between the person’s capacity and the environmental demands that cause fall risk. Fluctuation of bodily symptoms between and within a day is a variable not earlier targeted in multiple sclerosis fall risk research.

  • 23. Denkinger, Michael D.
    et al.
    Igl, Wilmar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för genetik och patologi.
    Jamour, Michael
    Bader, Anne
    Bailer, Stefanie
    Lukas, Albert
    Nikolaus, Thorsten
    Does functional change predict the course of improvement in geriatric inpatient rehabilitation?2010Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 24, nr 5, s. 463-470Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The evaluation of rehabilitation success as measured by different tools is becoming increasingly important in terms of time and money allocation. We wanted to know whether functional change in the first week predicts subsequent improvement in a geriatric inpatient rehabilitation clinic. Design: Observational longitudinal study. Setting: Geriatric inpatient rehabilitation clinic in Germany. Subjects: One hundred and sixty-one inpatients (117 women) with a median age of 82 years, capable of walking at baseline. Main measures: Weekly assessments of physical function were performed from admission until three weeks later. We used a self-rated tool (the function component of the Short Form - Late Life Function and Disability Index), a proxy-rated tool (the Barthel Index) and a performance-based tool (gait speed). We set up linear regression models to estimate the predictive capacity of change in physical function within the first week on change in physical function within the following two weeks. Results: Positive correlations were found between functional change within the first week and total change within three weeks. However, correlations of the same periods of change with subsequent change were negative. Correlations were highly significant for both analysis with P-values < 0.0001 when the same measures for prediction and outcome were used. Correlations were inconsistent when prediction and outcome were different. Conclusions: Improvement within the first week of inpatient rehabilitation is negatively correlated with subsequent functional change.

  • 24. Edström Plüss, Cathrine
    et al.
    Billing, Ewa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Held, Claes
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Uppsala kliniska forskningscentrum (UCR).
    Henriksson, Peter
    Kiessling, Anna
    Rydell Karlsson, Monica
    Wallén, Håkan N.
    Long-term effects of an expanded cardiac rehabilitation programme after myocardial infarction or coronary artery bypass surgery: a five-year follow-up of a randomized controlled study2011Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 25, nr 1, s. 79-87Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To investigate the long-term effect of expanded cardiac rehabilitation on a composite end-point, consisting of cardiovascular death, myocardial infarction or readmission for cardiovascular disease, in patients with coronary artery disease.Design: Single-centre prospective randomized controlled trial.Setting: University hospital.Subjects: Two hundred and twenty-four patients with acute myocardial infarction or undergoing coronary artery by-pass grafting.Intervention: Patients were randomized to expanded cardiac rehabilitation (a one-year stress management programme, increased physical training, staying at a 'patient hotel' for five days after the event, and cooking sessions), or to standard cardiac rehabilitation. MAIN MEASURES: Data on cardiovascular death, myocardial infarction, readmission for cardiovascular disease and days at hospital for cardiovascular reasons were obtained from national registries of the Swedish National Board of Health and Welfare.Results: The primary end-point occurred in 121 patients altogether (54%). The number of cardiovascular events were reduced in the expanded rehabilitation group compared with the standard cardiac rehabilitation (53 patients (47.7%) versus 68 patients (60.2%); hazard ratio 0.69; P = 0.049). This was mainly because of a reduction of myocardial infarctions in the expanded rehabilitation group. During the five years 12 patients (10.8%) versus 23 patients (20.3%); hazard ratio 0.47; P = 0.047 had a myocardial infarction. Days at hospital for cardiovascular reasons were significantly reduced in patients who received expanded cardiac rehabilitation (median 6 days) compared with standard cardiac rehabilitation (median 10 days; P = 0.02).Conclusion: Expanded cardiac rehabilitation after acute myocardial infarction or coronary artery bypass grafting reduces cardiovascular morbidity and days at hospital for cardiovascular reasons.

  • 25. Edström-Plüss, Catrin
    et al.
    Rydell Karlsson, Monica
    Sophiahemmet Högskola.
    Wallén, Håkan N
    Billing, Ewa
    Held, Claes
    Effects of an expanded cardiac rehabilitation programme in patients treated for an acute myocardial infarction or a coronary artery by-pass graft operation2008Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 22, nr 4, s. 306-18Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To investigate the effects of expanded cardiac rehabilitation with multifactorial interventions on metabolic and inflammatory markers, exercise performance and on established cardiovascular risk factors. DESIGN: Single-centre prospective randomized controlled trial. SETTING: A university hospital. SUBJECTS: Two hundred and twenty-four patients with an acute myocardial infarction or patients undergoing coronary artery by-pass grafting. INTERVENTION: Patients were randomized to expanded cardiac rehabilitation including stress management, increased physical training, staying at a 'patient hotel' and cooking sessions, or to usual cardiac rehabilitation. MAIN MEASURES: Biochemical risk markers and exercise performance; follow-up was one year. RESULTS: There were no significant differences between the two treatment groups in the changes of biochemical risk markers or in exercise performance. Thus, low-density lipoprotein (LDL)-cholesterol levels decreased from 3.00 (0.97) to 2.54 (0.66) mmol/L in the intervention group and from 3.20 (0.85) to 2.54 (0.63) mmol/L in the control group, fibrinogen levels decreased from 5.30 (2.00) to 4.25 (1.01) g/L in the intervention group and from 5.29 (1.89) to 4.33 (0.83) g/L in the control group and C-reactive protein (CRP) levels decreased from 3.04 (2.79) to 2.09 (2.13) mg/L in the intervention group and from 4.01 (3.49) to 2.39 (2.49) mg/L in the control group. Total workload (W) improved from 118 (35) to 136 (34) in the intervention group and from 117 (36) to 133 (39) in the control group. CONCLUSION: There was no further significant benefit in biochemical risk markers or in exercise performance among patients undergoing the expanded rehabilitation as compared to the control group which received usual cardiac rehabilitation.

  • 26.
    Emilson, C.
    et al.
    Department of Psychology, Uppsala University, Uppsala, Sweden.
    Demmelmaier, I.
    Department of Psychology, Uppsala University, Uppsala, Sweden.
    Bergman, S.
    Research and Development Center Spenshult, Halmstad, Sweden.
    Lindberg, P.
    Department of Psychology, Uppsala University, Uppsala, Sweden.
    Denison, Eva
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Åsenlöf, P.
    Department of Public Health, and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    A 10-year follow-up of tailored behavioural treatment and exercise-based physiotherapy for persistent musculoskeletal pain2017Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 31, nr 2, s. 186-196Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To study the long-term outcomes of two interventions targeting patients with sub-acute and persistent pain in a primary care physiotherapy setting. Design: A 10-year follow-up of a two-armed randomised controlled trial, initially including 97 participants. Interventions: Tailored behavioural medicine treatment, applied in a physiotherapy context (experimental condition), and exercise-based physiotherapy (control condition). Main measures: Pain-related disability was the primary outcome. The maximum pain intensity, pain control, fear of movement, sickness-related absence (register data) and perceived benefit and confidence in coping with future pain problems were the secondary outcomes. Results: Forty-three (44%) participants responded to the follow-up survey, 20 in the tailored behavioural medicine treatment group and 23 in the exercise-based physiotherapy group. The groups did not differ in terms of the change in the scores for the primary outcome (p=0.17) of pain-related disability between the experimental group (median: 2.5, Q1-Q3: -2.5-14.25), and the control group (median: 0, Q1-Q3: -5-6). Further, there were also no significant differences found for the secondary outcomes except for sickness-related absence, where the exercise-based physiotherapy group had more days of sickness-related absence three months before treatment (p= 0.02), and at the 10-year follow-up (p=0.03). Discussion: The beneficial effects favouring tailored behavioural medicine treatment that observed post-treatment and at the two-year follow-up were not maintained 10 years after treatment.

  • 27.
    Emilson, Christina
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Fysioterapi.
    Demmelmaier, Ingrid
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Fysioterapi.
    Bergman, Stefan
    Res & Dev Ctr Spenshult, Halmstad, Sweden.; Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden..
    Lindberg, Per
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Denison, Eva
    Malardalen Univ, Sch Hlth Care & Social Welf, Vasteras, Sweden..
    Åsenlöf, Pernilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Fysioterapi.
    A 10-year follow-up of tailored behavioural medicine treatment and exercise-based physiotherapy in persistent musculoskeletal pain2017Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 31, nr 2, s. 186-196Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To study the long-term outcomes of two interventions targeting patients with sub-acute and persistent pain in a primary care physiotherapy setting.

    Design: A 10-year follow-up of a two-armed randomised controlled trial, initially including 97 participants.

    Interventions: Tailored behavioural medicine treatment, applied in a physiotherapy context (experimental condition), and exercise-based physiotherapy (control condition). Main measures: Pain-related disability was the primary outcome. The maximum pain intensity, pain control, fear of movement, sickness-related absence (register data) and perceived benefit and confidence in coping with future pain problems were the secondary outcomes.

    Results: Forty-three (44%) participants responded to the follow-up survey, 20 in the tailored behavioural medicine treatment group and 23 in the exercise-based physiotherapy group. The groups did not differ in terms of the change in the scores for the primary outcome (p=0.17) of pain-related disability between the experimental group (median: 2.5, Q1-Q3: -2.5-14.25), and the control group (median: 0, Q1-Q3: -5-6). Further, there were also no significant differences found for the secondary outcomes except for sickness-related absence, where the exercise-based physiotherapy group had more days of sickness-related absence three months before treatment (p= 0.02), and at the 10-year follow-up (p=0.03).

    Discussion: The beneficial effects favouring tailored behavioural medicine treatment that observed post-treatment and at the two-year follow-up were not maintained 10 years after treatment.

  • 28.
    Emilson, Christina
    et al.
    Department of Neuroscience, Uppsala University, Uppsala, Sweden.
    Demmelmaier, Ingrid
    Department of Neuroscience, Uppsala University, Uppsala, Sweden.
    Bergman, Stefan
    Research and Development Center Spenshult, Halmstad, Sweden & Department of Public Health, and Community medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Lindberg, Per
    Department of Psychology, Uppsala University, Uppsala, Sweden.
    Denison, Eva
    School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
    Åsenlöf, Pernilla
    Department of Neuroscience, Uppsala University, Uppsala, Sweden.
    A 10-year follow-up of tailored behavioural treatment and exercise-based physiotherapy for persistent musculoskeletal pain2017Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 31, nr 2, s. 186-196Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To study the long-term outcomes of two interventions targeting patients with sub-acute and persistent pain in a primary care physiotherapy setting.

    DESIGN: A 10-year follow-up of a two-armed randomised controlled trial, initially including 97 participants.

    INTERVENTIONS: Tailored behavioural medicine treatment, applied in a physiotherapy context (experimental condition), and exercise-based physiotherapy (control condition).

    MAIN MEASURES: Pain-related disability was the primary outcome. The maximum pain intensity, pain control, fear of movement, sickness-related absence (register data) and perceived benefit and confidence in coping with future pain problems were the secondary outcomes.

    RESULTS: Forty-three (44%) participants responded to the follow-up survey, 20 in the tailored behavioural medicine treatment group and 23 in the exercise-based physiotherapy group. The groups did not differ in terms of the change in the scores for the primary outcome (p=0.17) of pain-related disability between the experimental group (median: 2.5, Q1-Q3: -2.5-14.25), and the control group (median: 0, Q1-Q3: -5-6). Further, there were also no significant differences found for the secondary outcomes except for sickness-related absence, where the exercise-based physiotherapy group had more days of sickness-related absence three months before treatment (p= 0.02), and at the 10-year follow-up (p=0.03).

    DISCUSSION: The beneficial effects favouring tailored behavioural medicine treatment that observed post-treatment and at the two-year follow-up were not maintained 10 years after treatment. 

    © The Author(s) 2016

  • 29.
    Forsberg, Anette
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Division of Physiotherapy, Neurotec Department, Karolinska Institutet, Stockholm, sweden.
    Press, Rayomand
    Section of Neurology, Department of Clinical Neuroscience, Karolinska Institutet, Karolinska University Hospital at Huddinge, Stockholm, Sweden.
    Einarsson, Ulrika
    Division of Physiotherapy, Neurotec Department, Karolinska Institutet, Stockholm, Sweden.
    de Pedro-Cuesta, Jesus
    Section of Neurology, Department of Clinical Neuroscience, Karolinska Institutet, Karolinska University Hospital at Huddinge, Stockholm, Sweden; Department of Applied Epidemiology, National Centre for Epidemiology, Carlos IlIl Institute of Health, Madrid, Spain.
    Widén Holmqvist, Lotta
    Division of Physiotherapy, Neurotec Department and Section of Neurology, Department of Clinical Neuroscience, Karolinska Institutet, Karolinska University Hospital at Huddinge, Stockholm, Sweden.
    Disability and health-rated quality of life in Guillain-Barré syndrome during the first two years after onset: a prospective study2005Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 19, nr 8, s. 900-909Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To describe changes in disability and health-related quality of life in patients with Guillain-Barré syndrome in Sweden during the first two years after onset.

    SUBJECTS: Forty-four patients were recruited from eight different hospitals, and 42 of them (mean age 52 years) were followed for two years. Evaluations were performed, primarily as home visits, at two weeks, two months, six months, one year and two years after onset.

    MAIN MEASURES: Disability was measured using the Katz Personal and Extended Activities of Daily Living Indexes, the Barthel Index, the Frenchay Activity Index and assessments of work capacity; health-related quality of life using the Sickness impact Profile.

    RESULTS: At two weeks, one year and two years after onset of Guillain-Barré syndrome, 76%, 14% and 12% of patients were dependent in personal activities of daily life (ADL); and 98%, 28% and 26% were dependent in instrumental ADL. At two weeks, all of the patients that were working before onset were unable to work owing to Guillain-Barré syndrome; at two years, 17% were unable to work. At two weeks, scores on Sickness Impact Profile were elevated in all dimensions; at two years, they remained elevated in the physical dimension and in the categories home management, work and recreation and pastimes.

    CONCLUSIONS: The impact of Guillain-Barré syndrome on ADL, work, social activities and health-related quality is considerable two years after onset and presumably persists beyond this time point.

  • 30.
    Forsberg, Anette
    et al.
    Region Örebro län. Division of Neurology, Karolinska Institutet, Stockholm, Sweden; Family Medicine Research Centre, Örebro County Council, Örebro, Sweden.
    Widén-Holmqvist, Lotta
    Division of Neurology, Karolinska Institutet, Stockholm, Sweden; Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.
    Ahlström, Gerd
    Department of Health Sciences, Lund University, Lund, Sweden.
    Balancing everyday life two years after falling ill with Guillain-Barre syndrome: a qualitative study2015Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 29, nr 6, s. 601-610Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: The aim was to describe experiences of disability in everyday life and managing the recovery process two years after falling ill with Guillain-Barré syndrome.

    Design: Qualitative interview study.

    Methods: Interviews were conducted with 35 persons (22 male, mean age 50 years) two years after the onset of Guillain-Barré syndrome. The interviews were transcribed verbatim and analysed using content analysis.

    Results: The analysis revealed four categories and an overall theme: ‘Striving for balance in everyday life’. The participants described persistent lived body restrictions that affected their arms, legs, and face. Bodily symptoms and loss of energy limited or restricted many everyday activities. In connection with healthcare, both satisfaction and feeling vulnerable in a critical situation were described. Experiences of the recovery process varied. The participants described acceptance and reappraisal of a new life situation despite their limitations, and having gained the knowledge that life can change suddenly. However, they also expressed disappointment following an overly positive prognosis in the early stages, and over a continuous wait for recovery. For some participants life had returned to as before.

    Conclusion: The participants experienced limitations in everyday life and decreased functioning in several parts of the body. The recovery process may still be ongoing two years after onset. Rehabilitation intervention with an extended focus on supporting individualized coping processes could facilitate ways to live with persistent disability.

  • 31. Franzén-Dahlin, A.
    et al.
    Larson, J.
    Murray, V.
    Wredling, R.
    Billing, Ewa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    A randomized controlled trial evaluating the effect of a support and education programme for spouses of people affected by stroke2008Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 22, nr 8, s. 722-730Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To determine whether a nurse-led support and education programme for spouses of patients affected by stroke improved the psychological health of the spouses. Design: A longitudinal, open, randomized controlled trial. Sample: One hundred spouses of stroke patients were randomly assigned to either an intervention or a control group. Setting: The study was conducted in a hospital setting. Intervention: The intervention consisted of six group meetings during six months, with a follow-up after further six months. Comparison between the intervention and the control groups was made at baseline, after six and 12 months using analysis with repeated measures. Main measures: The Comprehensive Psychopathological Rating Scale Self-Affective for psychological health. Results: No significant difference was found between the intervention and control groups concerning overall psychological health. However, a subanalysis revealed that those who participated more frequently in the group meetings (five or six times) had significantly stronger psychological health (P < , 0.05). Knowledge about stroke increased over time in both groups, but participants in the intervention group learned more (P=0.041). Conclusion: Encouraging participation in the group meetings of a support programme might have a positive effect on psychological health.

  • 32. Franzén-Dahlin, Åsa
    et al.
    Larson, Jenny
    Murray, Veronica
    Wredling, Regina
    Sophiahemmet Högskola.
    Billing, Ewa
    A randomized controlled trial evaluating the effect of a support and education programme for spouses of people affected by stroke2008Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 22, nr 8, s. 722-30Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To determine whether a nurse-led support and education programme for spouses of patients affected by stroke improved the psychological health of the spouses. DESIGN: A longitudinal, open, randomized controlled trial. SAMPLE: One hundred spouses of stroke patients were randomly assigned to either an intervention or a control group. SETTING: The study was conducted in a hospital setting. INTERVENTION: The intervention consisted of six group meetings during six months, with a follow-up after further six months. Comparison between the intervention and the control groups was made at baseline, after six and 12 months using analysis with repeated measures. MAIN MEASURES: The Comprehensive Psychopathological Rating Scale--Self-Affective for psychological health. RESULTS: No significant difference was found between the intervention and control groups concerning overall psychological health. However, a subanalysis revealed that those who participated more frequently in the group meetings (five or six times) had significantly stronger psychological health (P<0.05). Knowledge about stroke increased over time in both groups, but participants in the intervention group learned more (P=0.041). CONCLUSION: Encouraging participation in the group meetings of a support programme might have a positive effect on psychological health.

  • 33.
    Franzén-Dahlin, Åsa
    et al.
    Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.
    Larson [Windahl], Jenny
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden; Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Murray, Veronica
    Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.
    Wredling, Regina
    Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden; Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Billing, Ewa
    Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden; Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    A randomized controlled trial evaluating the effect of a support and education programme for spouses of people affected by stroke2008Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 22, nr 8, s. 722-30Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To determine whether a nurse-led support and education programme for spouses of patients affected by stroke improved the psychological health of the spouses.

    DESIGN: A longitudinal, open, randomized controlled trial.

    SAMPLE: One hundred spouses of stroke patients were randomly assigned to either an intervention or a control group.

    SETTING: The study was conducted in a hospital setting.

    INTERVENTION: The intervention consisted of six group meetings during six months, with a follow-up after further six months. Comparison between the intervention and the control groups was made at baseline, after six and 12 months using analysis with repeated measures.

    MAIN MEASURES: The Comprehensive Psychopathological Rating Scale--Self-Affective for psychological health.

    RESULTS: No significant difference was found between the intervention and control groups concerning overall psychological health. However, a subanalysis revealed that those who participated more frequently in the group meetings (five or six times) had significantly stronger psychological health (P<0.05). Knowledge about stroke increased over time in both groups, but participants in the intervention group learned more (P=0.041).

    CONCLUSION: Encouraging participation in the group meetings of a support programme might have a positive effect on psychological health.

  • 34.
    Fridlund, Bengt
    et al.
    Högskolan i Halmstad.
    Hansson, H
    Ysander, L
    Working conditions among men before and after their first myocardial infarction: implications for a rehabilitative care strategy1992Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 6, nr 4, s. 299-304Artikel i tidskrift (Refereegranskat)
  • 35.
    Grunnesjö, Marie I
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    Bogefeldt, Johan P
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    Blomberg, Stefan I E
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    Strender, Lars-Erik
    Karolinska Institutet, Institutionen för neurobiologi, vårdvetenskap och samhälle, Department of Neurobiology, Care Science and Society.
    Svärdsudd, Kurt F
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    A randomized controlled trial of the effects of muscle stretching, manual therapy and steroid injections in addition to 'stay-active' care on health-related quality of life in acute and sub-acute low back pain2011Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 25, nr 11, s. 999-1010Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To evaluate the health-related quality of life effects of muscle stretching, manual therapy and steroid injections in addition to 'stay active' care in acute or subacute low back pain patients.

    Study design: A randomized, controlled trial during 10 weeks with four treatment groups.

    Setting: Nine primary health care and one outpatient orthopaedic hospital department.

    Subjects: One hundred and sixty patients with acute or subacute low back pain.

    Interventions: Ten weeks of 'stay active' care only (group 1), or 'stay active' and muscle stretching (group 2), or 'stay active', muscle stretching and manual therapy (group 3), or 'stay active', muscle stretching, manual therapy and steroid injections (group 4).

    Main measures: The Gothenburg Quality of Life instrument subscales Well-being score and Complaint score.

    Results: In a multivariate analysis adjusted for possible outcome affecting variables other than the treatment given Well-being score was 68.4 (12.5), 72.1 (12.4), 72,3 (12.4) and 72.7 (12.5) in groups 1-4, respectively (P for trend <0.05). There were significant trends for the well-being components patience (P < 0.005), energy (P < 0.05), mood (P < 0.05) and family situation (P < 0.05). The remaining two components and Complaint score showed a non-significant trend towards improvement.

    Conclusion: The effects on health-related quality of life were greater the larger the number of treatment modalities available. The 'stay active' treatment group, with the most restricted number of modalities, had the most modest health-related quality of life improvement, while group 4 with the most generous choice of treatment modalities, had the greatest improvement.

  • 36. Hammer, Ann
    et al.
    Lindmark, Birgitta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.
    Is forced use of the paretic upper limb beneficial? - A randomized pilot study during subacute post-stroke recovery2009Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 23, nr 5, s. 424-433Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To evaluate the effect of two weeks of forced use of the paretic upper limb, as a supplement to the rehabilitation programme in the subacute phase after stroke, on self-rated use of that limb. Design: A randomized, non-blind, parallel group, clinical, before-and-after trial. A forced use group and a conventional group were followed up one and three months after intervention. Setting: In- and outpatient units of rehabilitation at a University   Hospital. Subjects: Thirty patients were allocated to two groups, 15 in each, 1-6 months (mean 2.4) after stroke onset. Twenty-six patients completed the  study. Interventions: The patients of both groups participated in two weeks of  daily training on weekdays. In addition, the forced use group wore a  restraining sling on the non-paretic arm for up to 6 hours per weekday. Main measure: The Motor Activity Log; patients scored 0-5 for 30 daily   tasks concerning both amount of use and quality of movement. Results: The forced use group tended to achieve larger improvements  immediately post-intervention, but this was not clearly demonstrated. The small differences also levelled out up to the three-month   follow-up, with both groups earning an approximately 1.0 score point on both scales of the Motor Activity Log. Conclusions: This pilot study did not reveal any additional benefit of   forced use on self-rated performance in daily use of the paretic upper  limb. Both groups performed fairly extensive, active training with a similar duration, amount and content.

  • 37.
    Hammer, Ann M.
    et al.
    Örebro universitet, Hälsoakademin.
    Lindmark, Birgitta
    Uppsala Universitet.
    Is forced use of the paretic upper limb beneficial?: A randomized pilot study during subacute post-stroke recovery2009Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 23, nr 5, s. 424-433Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To evaluate the effect of two weeks of forced use of the paretic upper limb, as a supplement to the rehabilitation programme in the subacute phase after stroke, on self-rated use of that limb.

    Design: A randomized, non-blind, parallel group, clinical, before-and-after trial. A forced use group and a conventional group were followed up one and three months after intervention.

    Setting: In- and outpatient units of rehabilitation at a University Hospital.Subjects: Thirty patients were allocated to two groups, 15 in each, 1-6 months (mean 2.4) after stroke onset. Twenty-six patients completed the study.

    Interventions: The patients of both groups participated in two weeks of daily training on weekdays. In addition, the forced use group wore a restraining sling on the non-paretic arm for up to 6 hours per weekday.

    Main measure: The Motor Activity Log; patients scored 0-5 for 30 daily tasks concerning both amount of use and quality of movement.

    Results: The forced use group tended to achieve larger improvements immediately post-intervention, but this was not clearly demonstrated. The small differences also levelled out up to the three-month follow-up, with both groups earning an approximately 1.0 score point on both scales of the Motor Activity Log.

    Conclusions: This pilot study did not reveal any additional benefit of forced use on self-rated performance in daily use of the paretic upper limb. Both groups performed fairly extensive, active training with a similar duration, amount and content.

  • 38.
    Hedman, Annicka
    et al.
    Karolinska Inst, Dept Neurobiol Care Sci & Soc NVS, Div Occupat Therapy, Box 23 200, SE-14183 Huddinge, Sweden.
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Karolinska Inst, Dept Neurobiol Care Sci & Soc NVS, Div Occupat Therapy, Box 23 200, SE-14183 Huddinge, Sweden.
    von Koch, Lena
    Karolinska Inst, Dept Neurobiol Care Sci & Soc NVS, Div Occupat Therapy, Box 23 200, SE-14183 Huddinge, Sweden;Karolinska Univ Hosp, Neuro, Stockholm, Sweden.
    Guidetti, Susanne
    Karolinska Inst, Dept Neurobiol Care Sci & Soc NVS, Div Occupat Therapy, Box 23 200, SE-14183 Huddinge, Sweden.
    Five-year follow-up of a cluster-randomized controlled trial of a client-centred activities of daily living intervention for people with stroke2019Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 33, nr 2, s. 262-276Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To compare five-year outcomes and changes over time of a client-centred activities of daily living (ADL) intervention versus usual ADL interventions for people with stroke and their significant others.

    Design: Five-year follow-up of a cluster-randomized controlled trial where a client-centred ADL intervention (n = 129) or usual ADL interventions (n = 151) were delivered to people with stroke.

    Setting: Multicentre study including 16 inpatient or home-based rehabilitation units.

    Participants: People with stroke and significant others.

    Intervention: The client-centred ADL intervention aimed at enabling agency in daily activities and participation in everyday life and at reducing caregiver burden.

    Main measures: For people with stroke, perceived participation (Stroke Impact Scale), independence in ADL, life satisfaction, and use of formal/informal care were measured. For significant others, caregiver burden, life satisfaction, and mood (Hospital Anxiety and Depression Scale) were assessed.

    Results: Five years post-intervention, data were collected from 145 people with stroke (intervention group: n = 71/control group: n = 74) and 75 significant others (intervention group: n = 36/control group: n = 39). For those with stroke, the Participation domain of the Stroke Impact Scale showed no group differences at year five (68.9 vs 75.4, P = 0.062) or in changes over time. At year five, the control group had better outcomes regarding Other help/supervision. Significant others in the control group were more likely to show signs of depression at year five (odds ratio = 22.3; P < 0.001).

    Conclusion: The client-centred ADL intervention appears to render similar long-term effects as usual ADL interventions for people with stroke, but for significant others signs of depression might be reduced.

  • 39.
    Hellström, Karin
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik.
    Vahlberg, Birgit
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik.
    Urell, Charlotte
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik.
    Emtner, Margareta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Lungmedicin och allergologi. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik.
    Fear of falling, fall-related self-efficacy, anxiety and depression in individuals with chronic obstructive pulmonary disease2009Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 23, nr 12, s. 1136-1144Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To examine the risk and frequency of falls, prevalence of fear of falling and activity avoidance, the magnitude of fall-related self-efficacy, and anxiety and depression in patients with chronic obstructive pulmonary disease. DESIGN AND SETTINGS: A cross-sectional study in patients with a diagnosis of chronic obstructive pulmonary disease who visited a lung clinic at a university hospital in Sweden. SUBJECTS: Successive inclusion from autumn 2005 to spring 2006 of 80 patients with a mean age of 65 years. INTERVENTION: Nil. MAIN MEASURES: A questionnaire about fall history and consequences of fall, The Falls Efficacy Scale, Swedish version, and the Hospital Anxiety and Depression Scale were used. RESULTS: Twenty patients (25%) reported at least one fall in the last year and 29% displayed fear of falling. Odds ratio for falling was 4-5 times higher in patients with severe chronic obstructive pulmonary disease. Older patients, women and patients with previous falls had a higher rate of fear of falling, and those with fear of falling had lower fall-related self-efficacy, increased level of anxiety and depression, more activity avoidance and use of assistive device. CONCLUSION: The increased risk of falls in patients with chronic obstructive pulmonary disease warrants attention in order to reduce serious and adverse health consequences of falls.

  • 40.
    Kammerlind, Ann-Sofi
    et al.
    Futurum – the Academy for Healthcare, County Council, Jönköping, Sweden.
    Fristedt, Sofi
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Ernsth Bravell, Marie
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Fransson, Eleonor
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för naturvetenskap och biomedicin. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Test–retest reliability of the Swedish version of the life-space assessment questionnaire among community-dwelling older adults2014Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 28, nr 8, s. 817-823Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To examine the test–retest reliability of the Swedish version of the Life-Space Assessment Questionnaire.

    Design: Test–retest reliability study.

    Subjects: A total of 298 community-dwelling subjects between 75 and 90 years of age.

    Methods: The Life-Space Assessment Questionnaire was translated into Swedish. By personal interviews during home visits and two weeks later by telephone interviews the subjects were asked about their life-space mobility during the past four weeks, and how often and whether they were independent or needed assistance from another person or equipment to reach different life-space levels.

    Results: None of the four scoring methods showed significant difference between test sessions. The mean (SD) total scores were 65 (22) and 65 (23) out of the maximum possible score of 120 at the two sessions. High levels were found for independent, assisted, and maximal life-space at both sessions. Intraclass correlation coefficients and weighted Kappa-values between 0.84–0.94 were found for the total score, the independent, and the assisted life-space levels, indicating good to excellent reliability. A lower Kappa-value was observed for the maximal life-space level, mainly owing to skewed distributions. The method error values showed that a change of 10 in the total score and a change of one level in any of the three life-space levels can be considered to indicate a real change in clinical practice.

    Conclusion: The Swedish version of the Life-Space Assessment Questionnaire can be reliably used among community-dwelling older adults.

  • 41.
    Kammerlind, Ann-Sofi
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för sjukgymnastik. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Öron- näsa- och halskliniken US.
    Fristedt, Sofi
    Jonköping University, Sweden .
    Ernsth Bravell, Marie
    Jonköping University, Sweden .
    Fransson, Eleonor I.
    Jonköping University, Sweden Karolinska Institute, Sweden .
    Test-retest reliability of the Swedish version of the Life-Space Assessment Questionnaire among community-dwelling older adults2014Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 28, nr 8, s. 817-823Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To examine the test-retest reliability of the Swedish version of the Life-Space Assessment Questionnaire. Design: Test-retest reliability study. Subjects: A total of 298 community-dwelling subjects between 75 and 90 years of age. Methods: The Life-Space Assessment Questionnaire was translated into Swedish. By personal interviews during home visits and two weeks later by telephone interviews the subjects were asked about their life-space mobility during the past four weeks, and how often and whether they were independent or needed assistance from another person or equipment to reach different life-space levels. Results: None of the four scoring methods showed significant difference between test sessions. The mean (SD) total scores were 65 (22) and 65 (23) out of the maximum possible score of 120 at the two sessions. High levels were found for independent, assisted, and maximal life-space at both sessions. Intraclass correlation coefficients and weighted Kappa-values between 0.84-0.94 were found for the total score, the independent, and the assisted life-space levels, indicating good to excellent reliability. A lower Kappa-value was observed for the maximal life-space level, mainly owing to skewed distributions. The method error values showed that a change of 10 in the total score and a change of one level in any of the three life-space levels can be considered to indicate a real change in clinical practice. Conclusion: The Swedish version of the Life-Space Assessment Questionnaire can be reliably used among community-dwelling older adults.

  • 42.
    Kammerlind, Ann-Sofi
    et al.
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oto-Rhino-Laryngologi. Linköpings universitet, Hälsouniversitetet.
    Håkansson, Jenny
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oto-Rhino-Laryngologi. Linköpings universitet, Hälsouniversitetet.
    Skogsberg, Maria
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oto-Rhino-Laryngologi. Linköpings universitet, Hälsouniversitetet.
    Effects of balance training in elderly people with nonperipheral vertigo and unsteadiness2001Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 15, nr 5, s. 463-470Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To evaluate the effect of balance training in group in elderly people with nonperipheral vertigo and unsteadiness.

    Design: Randomized controlled study.

    Setting: Ear, nose and throat department, University Hospital, Sweden.

    Subjects: Twenty-three elderly subjects with nonperipheral vertigo and/or unsteadiness randomized into training group and control group.

    Intervention: The training group attended balance training in group twice a week for eight weeks.

    Main outcome measures: Timed static balance tests, walking tests and six sensory organization tests on EquiTest dynamic posturography were performed before and after the training period. Besides, the patients estimated their vertigo and unsteadiness on a visual analogue scale (VAS) before and after the training period.

    Results: The training group improved significantly in standing on one leg with eyes open, walking forward on a line, walking speed, in three out of six tests on dynamic posturography and estimated less vertigo and unsteadiness measured with VAS. No changes were seen in the control group.

    Conclusion: Balance training in elderly people with nonperipheral vertigo and unsteadiness seems to improve both objective and perceived balance.

  • 43.
    Kammerlind, Ann-Sofi
    et al.
    Linköpings universitet, Institutionen för hälsa och samhälle, Sjukgymnastik. Linköpings universitet, Hälsouniversitetet.
    Ledin, Torbjörn
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oto-Rhino-Laryngologi. Linköpings universitet, Hälsouniversitetet.
    Ödkvist, Lars
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oto-Rhino-Laryngologi. Linköpings universitet, Hälsouniversitetet.
    Skargren, Elisabeth
    Linköpings universitet, Institutionen för hälsa och samhälle, Sjukgymnastik. Linköpings universitet, Hälsouniversitetet.
    Effects of home training and additional physical therapy on recovery after acute unilateral vestibular loss: a randomized study2005Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 19, nr 1, s. 54-62Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To evaluate the effects of additional physical therapy on recovery after acute unilateral vestibular loss given to patients receiving home training.

    Design: Randomized controlled trial.

    Setting: Ear, nose and throat departments in three hospitals.

    Subjects: Fifty-four patients (mean age 52 years) with acute unilateral vestibular loss within the last week confirmed with electronystagmography testing were included. Patients with central neurologic or auditory symptoms or other vertigo disease were excluded.

    Interventions: Home training with or without additional physical therapy 12 times during 10 weeks.

    Main measures: Electronystagmography testing was performed before and after the training period. Clinical static (Romberg?s test, sharpened Romberg?s test, standing on foam and standing on one leg) and dynamic (walking forward and backward on a line) balance tests and subjective ratings of vertigo and balance problems on a visual analogue scale were done one week, 10 weeks and six months after the start of training.

    Results: Similar changes were seen in the two training groups.

    Conclusions: No significant differences in outcome regarding balance function or perceived symptoms were found between home training with or without additional physical therapy.

  • 44.
    Kammerlind, Ann-Sofi
    et al.
    Linköpings universitet, Institutionen för hälsa och samhälle, Sjukgymnastik. Linköpings universitet, Hälsouniversitetet.
    Ledin, Torbjörn
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oto-Rhino-Laryngologi. Linköpings universitet, Hälsouniversitetet.
    Ödkvist, Lars
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oto-Rhino-Laryngologi. Linköpings universitet, Hälsouniversitetet.
    Skargren, Elisabeth
    Linköpings universitet, Institutionen för hälsa och samhälle, Sjukgymnastik. Linköpings universitet, Hälsouniversitetet.
    Influence of asymmetry of vestibular caloric response and age on balance and perceived symptoms after acute unilateral vestibular loss2006Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 20, nr 2, s. 142-148Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To evaluate the influence of asymmetry of vestibular caloric response and age on balance and perceived symptoms after acute unilateral vestibular loss.

    Design: Prospective study.

    Setting: Ear, nose and throat departments in three hospitals.

    Subjects: Fifty-four patients (mean age 52 years) with acute unilateral vestibular loss participating in a randomized controlled training study were included.

    Main measures: Electronystagmography testing was performed within one week after onset of symptoms and after 10 weeks. The outcome measures clinical static balance tests (sharpened Romberg's test with eyes closed, standing on foam with eyes closed, and standing on one leg with eyes open and closed) and subjective symptom ratings on a visual analogue scale were done after one week, 10 weeks and six months. The correlation between age and asymmetry of vestibular caloric response, respectively, and the outcome measures were analysed.

    Results: Greater caloric asymmetry correlated with poorer performance at the sharpened Romberg's test and standing on one leg with eyes closed at all three follow-ups (rho=-0.31 to -0.54), and with higher symptom ratings at the 10-week and six-month follow-ups (rho=0.30-0.60). Higher age was associated with poorer performance on the sharpened Romberg's test and standing on one leg at all three follow-ups (rho=0.31-0.64), but did not change over time. Higher age was also associated with higher ratings of vertigo at the six-month follow-up, and less reduction of vertigo between the 10-week and six-month follow-ups (rho=0.29-0.48).

    Conclusions: A higher degree of asymmetry of vestibular caloric response and high age seem to be associated with poor outcome in balance and perceived symptoms after acute unilateral vestibular loss.

  • 45. Langhammer, Birgitta
    et al.
    Lindmark, Birgitta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik.
    Stanghelle, Johan K.
    Stroke patients and long-term training: is it worthwhile?: A randomized comparison of two different training strategies after rehabilitation2007Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 21, nr 6, s. 495-510Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To find out if there were any differences in improvement and maintenance of motor function, activity of daily living and grip strength between patients with first-ever stroke receiving two different strategies of physical exercise during the first year after stroke. Design: A longitudinal randomized controlled stratified trial. Setting: Rehabilitation institutions, community, patients' homes and nursing homes. Subjects: Seventy-five male and female first-time-ever stroke patients: 35 in an intensive exercise group and 40 in a regular exercise group. Intervention: The intensive exercise group received physiotherapy with focus on intensive exercises in four periods during the first year after stroke. The regular exercise group patients were followed up according to their subjective needs during the corresponding year. Main outcome measures: Motor Assessment Scale, Barthel Index of Activities of Daily Living, and grip strength. Results: Both groups improved significantly up to six months when function stabilized. The groups did not differ significantly on any test occasions. The difference of improvement from admission to discharge was significant in favour of the intensive exercise group, in the Motor Assessment Scale total score (intensive exercise group 7.5; regular exercise group 1.7, P = 0.01), and in the Barthel Index of Activities of Daily Living total score (17.4 versus 8.9, P = 0.04). Conclusion: Motor function, activities of daily living functions and grip strength improved initially and were maintained during the first year after stroke in all patients irrespective of exercise regime. This indicates the importance of motivation for regular exercise in the first year following stroke, achieved by regular check-ups.

  • 46. Larsson, PA
    et al.
    Fridlund, Bengt
    Högskolan i Halmstad.
    Aspects of life stress after myocardial infarction: implications for a multifactorial rehabilitation1991Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 5, nr 1, s. 71-76Artikel i tidskrift (Refereegranskat)
  • 47. Lexell, Jan
    et al.
    Flansbjer, Ulla-Britt
    Department of Rehabilitation, Lund University Hospital, Sweden.
    Holmbäck, Anna Maria
    Department of Rehabilitation, Lund University Hospital, Sweden.
    Downham, David
    Department of Rehabilitation, Lund University Hospital, Sweden.
    What change in isokinetic knee muscle strength can be detected in men and women with hemiparesis after stroke?2005Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 19, nr 5, s. 514-22Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To assess the intra-rater (between occasions) test-retest reliability of isokinetic knee muscle strength measurements in subjects with chronic poststroke hemiparesis and to define limits for the smallest change that indicates real (clinical) improvements for stroke patients. SUBJECTS: Fifty men and women (mean age 58 +/- 6.4 years) 6-46 months post stroke, able to walk at least 300 m with or without a unilateral assistive device. METHODS: Maximal concentric knee extension and flexion contractions at 60 degrees/s and 120 degrees/s, and maximal eccentric knee extension contractions at 60 degrees/s, with the paretic and nonparetic limbs, were performed seven days apart using a Biodex dynamometer. MEASURES: Reliability of the maximum peak torque measurements was evaluated with the intraclass correlation coefficient (ICC(2,1)), the Bland and Altman analyses, the standard error of measurement (SEM and SEM%) and the smallest real difference (SRD and SRD%). RESULTS: Test-retest agreements were high (ICC(2,1) 0.89-0.96) with no discernible systematic differences between limbs, angular velocities and modes. The SEM%, representing the smallest change that indicates a real (clinical) improvement for a group of subjects, was relatively small (8-20%). The SRD%, representing the smallest change that indicates a real improvement for a single subject ranged from 26% to 33% for concentric knee extension, from 39% to 55% for concentric knee flexion, and from 22% to 25% for eccentric knee extension. CONCLUSION: Isokinetic knee muscle strength can be reliably measured and used to detect real improvements following an intervention for single subjects as well as for groups of subjects with chronic mild to moderate hemiparesis after stroke.

  • 48.
    Lindgren, Ingrid
    et al.
    Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund; Physiotherapy Research Group, Department of Health Sciences, Lund University, Lund.
    Brogårdh, Christina
    Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund; Physiotherapy Research Group, Department of Health Sciences, Lund University, Lund.
    Gard, Gunvor
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Pain management strategies among persons with long-term shoulder pain after stroke: a qualitative study2019Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 33, nr 2, s. 357-364Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To explore strategies that persons with persistent shoulder pain after stroke use to manage their pain in daily life. Design: A qualitative study using semi-structured face-to-face interviews, analysed by content analysis. Setting: A university hospital. Subjects: Thirteen community-dwelling persons (six women; median age: 65 years; range 57-77) with shoulder pain after stroke were interviewed median two years after the pain onset. Results: An overall theme 'Managing shoulder pain by adopting various practical and cognitive strategies' emerged from the analysis. Three categories were identified: (1) practical modifications to solve daily life problems; (2) changed movement patterns and specific actions to mitigate the pain, by non-painful movements, avoidance of pain-provoking activities and various pain distracting activities and (3) learned how to deal with the pain mentally. Several strategies were used simultaneously and they were experienced successful to various degrees. Conclusion: The findings in the present study indicate that persons with persistent shoulder pain after stroke use both practical and cognitive strategies to manage their pain.

  • 49.
    Lindvall, Mialinn Arvidsson
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Family Medicine Research Centre, Örebro County Council, Örebro, Sweden .
    Forsberg, Anette
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län. Family Medicine Research Centre, Örebro County Council, Örebro, Sweden .
    Body awareness therapy in persons with stroke: a pilot randomised controlled trial2014Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 28, nr 12, s. 1180-1188Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To investigate the effects of body awareness therapy on balance, mobility, balance confidence, and subjective health status in persons with stroke.

    Design: A pilot randomized controlled study with follow-up at one and 4–6 weeks after the intervention period.

    Setting: Four primary healthcare centres in Örebro County Council.

    Subjects: Persons more than six months post stroke, with walking ability of 100 metres.

    Intervention: The experimental intervention was body awareness therapy in groups once a week for eight weeks. The controls were instructed to continue their usual daily activities.

    Main measures: Berg Balance Scale, Timed Up and Go Test, Timed Up and Go Test with a cognitive component, 6-minute walk test, and Timed-Stands Test. Self-rated balance confidence was assessed using the Activities-specific Balance Confidence Scale, and subjective health status using the Short Form 36 (SF-36) questionnaire.

    Results: A total of 46 participants were included (mean age 64 years); 24 in the experimental intervention group and 22 in the control group. No significant differences in changed scores over time were found between the groups. Within the experimental intervention group, significant improvements over time was found for the tests Berg Balance Scale, Timed Up and Go cognitive, and 6-minute walk test. Within the control group, significant improvements over time were found for the Timed Up and Go Cognitive, and the Timed-Stands Test.

    Conclusion: In comparison to no intervention, no effects were seen on balance, mobility, balance confidence, and subjective health status after eight weeks of body awareness therapy.

  • 50. Marklund, Ingela
    et al.
    Klässbo, Maria
    Effects of lower limb intensive mass practice in poststroke patients: single-subject experimental design with long-term follow-up2006Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 20, nr 7, s. 568-576Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To investigate the effects of two weeks of intensive mass practice with a constraint-induced movement therapy approach for the lower extremity in five chronic poststroke patients, and the persistence of effects at three and six months.

    DESIGN: A single-subject experimental design (SSED) was used with an AB design and follow-ups three and six months later.

    SETTING: Outpatient rehabilitation at Torsby Hospital in Sweden.

    MAIN MEASURES: Motor function in lower extremity, mobility, dynamic balance, weight-bearing symmetry and walking ability were measured on six occasions during two weeks (A phase), with the Fugl-Meyer assessment for lower extremity, the Timed Up and Go, the Step Test, the Timed Walking Test and the Six-Minute Walk Test. During the intervention's B phase, six measurements were performed with the same time intervals as in the A phase. There were follow-ups three and six months later.

    INTERVENTION: The intervention (B phase) consisted of bicycling, training in water, strength training, standing weight-bearing, walking up and down stairs, walking indoors and outdoors and flexibility training of the lower extremity, on all weekdays, 6 h a day for two weeks.

    RESULTS: The results showed improvements in 23/30 variables (77%), 12 of them statistically significant (52%). At follow-up, 22/23 improvements persisted. For example, three of five subjects walked significantly further after the intervention and the follow-ups showed that they still walked further than before the intervention.

    CONCLUSION: Intensive mass practice with constraint-induced movement therapy for the lower extremity can improve motor function, mobility, dynamic balance, weight-bearing symmetry and walking ability in chronic poststroke patients. Long-term follow-up showed that the effects persisted for these five subjects.

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