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  • 251.
    Stålnacke, Britt-Marie
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering.
    Björnstig, Ulf
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Karlsson, Kurt
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Klinisk kemi.
    Sojka, Peter
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Klinisk fysiologi. Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    One-year follow-up of patients with mild traumatic brain injury: post-concussion symptoms, disabilities and life satisfaction at follow-up in relation to serum levels of S-100B and neuron-specific enolase in acute phase2005Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 37, nr 5, s. 300-305Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To investigate, in patients with mild traumatic brain injury, serum concentrations of S-100B and neurone-specific enolase in acute phase and post-concussion symptoms, disabilities and life satisfaction 1 year after the trauma.

    DESIGN: Prospective study.

    PATIENTS: Eighty-eight patients (age range 18-87 years).

    METHODS: Blood samples were taken on admission and about 7 hours later. At follow-up 15 +/- 4 months later, the patients filled in questionnaires about symptoms (Rivermead Post Concussion Symptoms), disability (Rivermead Head Injury Follow-up) and life satisfaction (LiSat-11).

    RESULTS: Concentrations of S-100B and neurone-specific enolase were regularly increased in the first blood sample. Of the 69 patients participating in the follow-up, 45% reported post-concussion symptom, 48% exhibited disability and 55% were satisfied with "life as a whole". In comparison with the "sick-leave" situation on admission to hospital, 3 patients were on sick-leave at the time of follow-up because of the head trauma. Stepwise forward logistic regression analysis revealed a statistically significant association (p<0.05) between disability and S-100B and dizziness.

    CONCLUSION: In spite of frequent persistent symptoms, disabilities and low levels of life satisfaction, the sick-leave frequency was low at follow-up. The association between S-100B and disability supports the notion that long-term consequences of a mild brain injury may partly be a result of brain tissue injury.

  • 252.
    Stålnacke, Britt-Marie
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    Elgh, Eva
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Sojka, Peter
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering.
    One-year follow-up of mild traumatic brain injury: cognition, disability and life satisfaction of patients seeking consultation.2007Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 39, nr 5, s. 405-11Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To investigate cognitive function, symptoms, disabilities and life satisfaction of patients with mild traumatic brain injury who accepted consultation one year post-trauma. Design: Prospective study. Patients: Sixty-nine patients (16 accepted the consultation offered, 53 declined). Methods: At follow-up, the patients answered questionnaires about symptoms, disabilities (RHFUQ) and life satisfaction (LiSat-11). The patients who underwent consultation and their healthy control subjects were administered a neuropsychological evaluation. Results: In the group undergoing consultation, the number of cognitive tests with outcomes below cut-off limits (–1.5 SD) was statistically significantly higher compared with a control group (21 tests in 11 patients vs 8 tests in 7 control subjects; p = 0.025). The number of patients with one or more disability was statistically significantly higher among patients with consultation than without (94% and 34%, respectively; p < 0.001). Total RHFUQ score was statistically significantly higher for the group with consultation than without (5.9 ± 3.7 and 1.1 ± 2.3, respectively, p < 0.001). The group with consultation exhibited a lower level of life satisfaction (41.5 ± 10.4 vs 45.8 ± 13.8 for the non-consulting group; p = 0.057). Conclusion: The high frequency of occurrence of disabilities and lower cognitive functioning, together with the lower level of life satisfaction, appear to characterize patients choosing consultation 1 year post-injury. This highlights the importance of offering consultation for persons suffering mild head injuries.

  • 253.
    Stålnacke, Britt-Marie
    et al.
    Umeå universitet, Rehabiliteringsmedicin.
    Haukenes, Inger
    Umeå universitet, Institutionen för folkhälsa och klinisk medicin.
    Lehti, Arja
    Umeå universitet, Institutionen för folkhälsa och klinisk medicin.
    Wiklund, Anncristine Fjellman
    Umeå universitet, Fysioterapi.
    Wiklund, Maria
    Umeå universitet, Fysioterapi.
    Hammarström, Anne
    Umeå universitet, Socialmedicin.
    Is there a gender bias in recommendations for further rehabilitation in primary care of patients with chronic pain after an interdisciplinary team assessment?2015Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 47, nr 4, s. 365-371Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To examine potential gender bias in recommendations of further examination and rehabilitation in primary care for patients with chronic musculoskeletal pain after an interdisciplinary team assessment. Methods: The population consisted of consecutive patients (n=589 women, 262 men) referred during a 3-year period from primary healthcare for assessment by interdisciplinary teams at a pain specialist rehabilitation clinic. Patient data were collected from the Swedish Quality Registry for Pain Rehabilitation. The outcome was defined as the examination or rehabilitation that was specified in the patient's record. Results: Men had a significantly higher likelihood than women of being recommended physiotherapy and radiological examination, and the gender difference was not explained by confounding variables and covariates (age, marital status, ethnicity, education, working status, pain severity, pain interference, pain sites, anxiety and depression). There was no significant gender difference in recommendations to treatment by specialist physician, occupational therapist, psychologist or social worker. Conclusion: Our findings indicate that the interdisciplinary teams in specialist healthcare may discriminate against women with chronic pain when physiotherapy and radiological investigation are recommended. The team's choice of recommendations might be influenced by gendered attitudes, but this field of research needs to be studied further.

  • 254.
    Stålnacke, Britt-Marie
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    Haukenes, Inger
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin. Bergen, Norway.
    Lehti, Arja
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin. Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Professionell utveckling.
    Wiklund, Anncristine Fjellman
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Wiklund, Maria
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Hammarström, Anne
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Socialmedicin. Umeå universitet, Samhällsvetenskapliga fakulteten, Umeå centrum för genusstudier (UCGS).
    Is there a gender bias in recommendations for further rehabilitation in primary care of patients with chronic pain after an interdisciplinary team assessment?2015Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 47, nr 4, s. 365-371Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To examine potential gender bias in recommendations of further examination and rehabilitation in primary care for patients with chronic musculoskeletal pain after an interdisciplinary team assessment. Methods: The population consisted of consecutive patients (n=589 women, 262 men) referred during a 3-year period from primary healthcare for assessment by interdisciplinary teams at a pain specialist rehabilitation clinic. Patient data were collected from the Swedish Quality Registry for Pain Rehabilitation. The outcome was defined as the examination or rehabilitation that was specified in the patient's record. Results: Men had a significantly higher likelihood than women of being recommended physiotherapy and radiological examination, and the gender difference was not explained by confounding variables and covariates (age, marital status, ethnicity, education, working status, pain severity, pain interference, pain sites, anxiety and depression). There was no significant gender difference in recommendations to treatment by specialist physician, occupational therapist, psychologist or social worker. Conclusion: Our findings indicate that the interdisciplinary teams in specialist healthcare may discriminate against women with chronic pain when physiotherapy and radiological investigation are recommended. The team's choice of recommendations might be influenced by gendered attitudes, but this field of research needs to be studied further.

  • 255.
    Stålnacke, Britt-Marie
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    Nygren-Deboussard, Catharina
    Godbolt, Alison
    af Geijerstam, Jean-Luc
    Holm, Lena
    Borg, Jörgen
    Mild traumatic brain injuries and their sequelae. II: at risk of clinical neglect?2012Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 44, nr 11, s. 989-990Artikkel i tidsskrift (Fagfellevurdert)
  • 256.
    Suarez, NC
    et al.
    Dept. of Clinical Sciences, Umeå University, Umeå, Sweden. Dept. of Clinical Sciences, Umeå University, Umeå, Sweden..
    Levi, Richard
    Dept. of Clinical Sciences, Umeå University, Umeå, Sweden. Dept. of Clinical Sciences, Umeå University, Umeå, Sweden..
    Bullington, J
    Dept. of Clinical Sciences, Umeå University, Umeå, Sweden. Dept. of Clinical Sciences, Umeå University, Umeå, Sweden..
    Regaining health and wellbeing after traumatic spinal cord injury.2013Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 45, nr 10, s. 1023-1027Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: Traumatic spinal cord injury is typically a devastating event, leading to permanent physical disability. Despite the severity of the condition, many persons with traumatic spinal cord injury manage to lead both active and independent lives. The aim of this study was to investigate the experience of health and wellbeing of persons living with a traumatic spinal cord injury for at least 20 years.andlt;br /andgt;Design and Methods: A qualitative design was used. Data was analysed using a phenomenological-hermeneutical method. Rich narratives were obtained from 14 persons with paraplegia due to traumatic spinal cord injury sustained at least 20 years ago.andlt;br /andgt;Results: The key finding was that health and wellbeing were attained when persons were able to perceive themselves as being "normal" in everyday relationships and circumstances. The normalization process involved learning to negotiate and/or prevent potentially embarrassing situations by acting in a "parallel world", covertly "behind the scenes".andlt;br /andgt;Conclusion: The subjective experience of wellbeing and health after traumatic spinal cord injury depends upon the ability to prevent or resolve potentially embarrassing situations without this being noticed by others. Performing this work "behind the scenes", enables persons with traumatic spinal cord injury to interact smoothly with others and thereby be perceived as normal, despite substantial disability.

  • 257.
    Suarez, Nivia Carballeira
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Barn- och ungdomspsykiatri.
    Levi, Richard
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    Bullington, Jennifer
    Regaining health and wellbeing after traumatic spinal cord injury2013Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 45, nr 10, s. 1023-1027Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: Traumatic spinal cord injury is typically a devastating event, leading to permanent physical disability. Despite the severity of the condition, many persons with traumatic spinal cord injury manage to lead both active and independent lives. The aim of this study was to investigate the experience of health and wellbeing of persons living with a traumatic spinal cord injury for at least 20 years.

    Design and methods: A qualitative design was used. Data was analysed using a phenomenological-hermeneutical method. Rich narratives were obtained from 14 persons with paraplegia due to traumatic spinal cord injury sustained at least 20 years ago.

    Results: The key finding was that health and wellbeing were attained when persons were able to perceive themselves as being "normal" in everyday relationships and circumstances. The normalization process involved learning to negotiate and/or prevent potentially embarrassing situations by acting in a "parallel world", covertly "behind the scenes".

    Conclusion: The subjective experience of wellbeing and health after traumatic spinal cord injury depends upon the ability to prevent or resolve potentially embarrassing situations without this being noticed by others. Performing this work "behind the scenes", enables persons with traumatic spinal cord injury to interact smoothly with others and thereby be perceived as normal, despite substantial disability.

  • 258.
    Svanberg, Mikael
    et al.
    Psychosomat Medical Clin, Västerås, Sweden; University of Örebro, Sweden.
    Stålnacke, Britt-Marie
    Umeå University, Sweden; Danderyd Hospital, Sweden.
    Enthoven, Paul
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Brodda-Jansen, Gunilla
    Gerdle, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum. Danderyd Hospital, Sweden; Institute Psychophysiol Behav Med, Sweden.
    Boersma, Katja
    University of Örebro, Sweden.
    IMPACT OF EMOTIONAL DISTRESS AND PAIN-RELATED FEAR ON PATIENTS WITH CHRONIC PAIN: SUBGROUP ANALYSIS OF PATIENTS REFERRED TO MULTIMODAL REHABILITATION2017Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 49, nr 4, s. 354-361Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: Multimodal rehabilitation programmes (MMRP) for chronic pain could be improved by determining which patients do not benefit fully. General distress and pain-related fear may explain variations in the treatment effects of MMRP. Design: Cohort study with a cross-sectional, prospective part. Patients: Chronic musculoskeletal pain patients referred to 2 hospital-based pain rehabilitation clinics. Methods: The cross-sectional part of this study cluster analyses patients (n = 1,218) with regard to distress and pain-related fear at first consultation in clinical pain rehabilitation and describes differences in external variables between clusters. The prospective part follows the subsample of patients (n = 260) participating in MMRP and describes outcome post-treatment. Results: Four distinct subgroups were found: (i) those with low levels of distress and pain-related fear; (ii) those with high levels of pain-related fear; (iii) those with high levels of distress; and (iv) those with high levels of distress and pain-related fear. These subgroups showed differences in demographics, pain characteristics, quality of life, and acceptance, as well as the degree of MMRP participation and MMRP outcome. Conclusion: Among patients with chronic pain referred to MMRP there are subgroups with different profiles of distress and pain-related fear, which are relevant to understanding the adaptation to pain and MMRP outcome. This knowledge may help us to select patients and tailor treatment for better results.

  • 259. Svanberg, Mikael
    et al.
    Stålnacke, Britt-Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin. Department of Clinical Sciences, Danderyd Hospital, Division of Rehabilitation Medicine.
    Enthoven, Paul
    Brodda-Jansen, Gunilla
    Gerdle, Björn
    Boersma, Katja
    Impact of emotional distress and pain-related fear on patients with chronic pain: subgroup analysis of patients referred to multimodal rehabilitation2017Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 49, nr 4, s. 354-361Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: Multimodal rehabilitation programmes (MMRP) for chronic pain could be improved by determining which patients do not benefit fully. General distress and pain-related fear may explain variations in the treatment effects of MMRP.

    DESIGN: Cohort study with a cross-sectional, prospective part.

    PATIENTS: Chronic musculoskeletal pain patients referred to 2 hospital-based pain rehabilitation clinics.

    METHODS: The cross-sectional part of this study cluster analyses patients (n = 1,218) with regard to distress and pain-related fear at first consultation in clinical pain rehabilitation and describes differences in external variables between clusters. The prospective part follows the subsample of patients (n = 260) participating in MMRP and describes outcome post-treatment.

    RESULTS: Four distinct subgroups were found: (i) those with low levels of distress and pain-related fear; (ii) those with high levels of pain-related fear; (iii) those with high levels of distress; and (iv) those with high levels of distress and pain-related fear. These subgroups showed differences in demogra-phics, pain characteristics, quality of life, and acceptance, as well as the degree of MMRP participation and MMRP outcome.

    CONCLUSION: Among patients with chronic pain referred to MMRP there are subgroups with different profiles of distress and pain-related fear, which are relevant to understanding the adaptation to pain and MMRP outcome. This knowledge may help us to select patients and tailor treatment for better results.

  • 260.
    Svanberg, Mikael
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper. Psychosomatic Medicine Clinic, Västerås County Council, Västerås, Sweden.
    Stålnacke, Britt-Marie
    Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, Umeå, Sweden; Department of Clinical Sciences, Division of Rehabilitation Medicine, Danderyd Hospital, Stockholm, Sweden.
    Enthoven, Paul
    Department of Medical and Health Sciences, Physiotherapy, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden; Pain and Rehabilitation Centre, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Brodda-Jansen, Gunilla
    Department of Clinical Sciences, Division of Rehabilitation Medicine, Danderyd Hospital, Stockholm, Sweden; Institute for Psychophysiological Behavioral Medicine, Stockholm, Sweden.
    Gerdle, Björn
    Pain and Rehabilitation Centre, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Boersma, Katja
    Örebro universitet, Institutionen för juridik, psykologi och socialt arbete.
    Impact of emotional distress and pain-related fear on patients with chronic pain: Subgroup analysis of patients referred to multimodal rehabilitation2017Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 49, nr 4, s. 354-361Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: Multimodal rehabilitation programmes (MMRP) for chronic pain could be improved by determining which patients do not benefit fully. General distress and pain-related fear may explain variations in the treatment effects of MMRP.

    Design: Cohort study with a cross-sectional, prospective part.

    Patients: Chronic musculoskeletal pain patients referred to 2 hospital-based pain rehabilitation clinics.

    Methods: The cross-sectional part of this study cluster analyses patients (n = 1,218) with regard to distress and pain-related fear at first consultation in clinical pain rehabilitation and describes differences in external variables between clusters. The prospective part follows the subsample of patients (n = 260) participating in MMRP and describes outcome post-treatment.

    Results: Four distinct subgroups were found: (i) those with low levels of distress and pain-related fear; (ii) those with high levels of pain-related fear; (iii) those with high levels of distress; and (iv) those with high levels of distress and pain-related fear. These subgroups showed differences in demographics, pain characteristics, quality of life, and acceptance, as well as the degree of MMRP participation and MMRP outcome.

    Conclusion: Among patients with chronic pain referred to MMRP there are subgroups with different profiles of distress and pain-related fear, which are relevant to understanding the adaptation to pain and MMRP outcome. This knowledge may help us to select patients and tailor treatment for better results.

  • 261.
    Svensson, G. L.
    et al.
    Department of Orthopaedics, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden .
    Wendt, G. K.
    Department of Orthopaedics, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden .
    Thomeé, R.
    Department of Orthopaedics, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden .
    Danielson, Ella
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Patients' experience of health three years after structured physiotherapy or surgery for lumbar disc herniation2013Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 45, nr 3, s. 293-299Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To describe the experience of health among patients 3 years after treatment with a structured physiotherapy model or surgery for lumbar disc herniation. Design: A qualitative research study. Subjects/patients: Patients were referred to the orthopaedic clinic at Sahlgrenska University Hospital with sciatica due to lumbar disc herniation. Twenty patients who were eligible for surgery were treated either with a structured physiotherapy model or with surgery. Methods: Open-ended interviews were conducted and analysed using content analysis. Results: Findings were grouped into two themes: feeling of well-being and feeling of ill-being. In the group treated with structured physiotherapy there were a high number of codes in the feeling of well-being theme. In the group treated with surgery there were a high number of codes in the feeling of ill-being theme. Conclusion: Patients treated with structured physiotherapy or surgery experienced feelings of well-being and ill-being 3 years after treatment. Patients treated with physiotherapy and surgery described varying experiences of health 3 years after treatment for lumbar disc herniation. It can be speculated that the experience of well-being may be explained by the ability of structured physiotherapy treatments to empower patients.

  • 262.
    Söderman, Eva
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för samhällsvetenskap.
    Lisspers, Jan
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för samhällsvetenskap.
    Sundin, Örjan
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för samhällsvetenskap. Karolinska Institute, Stockholm.
    Impact of Depressive Mood on Lifestyle Changes in Patients with Coronary Artery Disease2007Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 39, nr 5, s. 412-417Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: The aims of this study were to investigate the time-course of depressive mood in patients with coronary artery disease during a secondary prevention rehabilitation program, and to analyse how different pre-treatment levels of depressive mood during a treatment phase were related to the degree of lifestyle change at 36 months follow-up. SUBJECTS: The study group comprised 109 of the original 183 consecutive coronary artery disease patients (91 male and 18 female) of whom 48 recently had experienced an acute myocardial infarction, 36 had been treated with coronary bypass surgery, 13 with percutaneous transluminal coronary angioplasty, and 12 had angina pectoris that had not been invasively treated. The subjects were divided into 3 subgroups based on their pre-treatment level of depressive mood. METHODS: Depressive mood was assessed at baseline, after 4 weeks and 12 months, using the depression subscale of the Hospital Anxiety and Depression scale. Lifestyle changes analysed included diet, smoking, relaxation (stress management) and exercise. RESULTS: Overall depressive mood ratings were significantly lower, both at the 4-week and 12-month assessments, compared with baseline, with the greatest improvements in patients with higher Hospital Anxiety and Depression measured depression. Original levels of depressive mood were not found to influence change of lifestyle habits during a 36-month follow-up period. CONCLUSION: Depressive mood might not be an obstacle to lifestyle changes when participating in a behaviourally oriented rehabilitation program including exercise-training, which might be a component important for improved depressive mood.

  • 263.
    Thelin, A.
    et al.
    Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology Sections, Uppsala University, Uppsala, Sweden, .
    Holmberg, S.
    Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology Sections, Uppsala University, Uppsala, Sweden, Research and Development Centre, Kronoberg County Council, Växjö, Sweden.
    Thelin, Nils
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan.
    Functioning in neck and low back pain from a 12-year perspective: A prospective population-based study2008Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 40, nr 7, s. 555-561Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: The aim of this study was to evaluate the effects of unspecific neck pain and low back pain at a given time (1990-91) with respect to physical and social functioning and role limitations due to emotional problems 12 years later. Methods: A rural male study population (2351 individuals) was established in 1989 and a first survey conducted in 1990-91. A follow-up survey was performed in 2002-03. A total of 1405 persons participated in both surveys. Functioning and role limitations in 2002-03 were evaluated using the SF-36 instrument. Several possible confounders were included in the analyses. Results: Unspecific neck pain or low back pain in 1990-91 was shown in a multivariate longitudinal regression model to be significantly related to limited physical (odds ratio (OR) = 2.08, 95% confidence interval (CI) 1.51-2.87) and social (OR= 1.92, 95% CI 1.33-2.75) functioning 12 years later. The effects were only slightly modified by the confounders analysed. However, higher education independently and significantly predicted a low risk for functional limitations. Conclusion: Non-specific neck pain and low back pain at a given time impacted on the risk of limited physical and social functioning many years later. Current symptoms of depression and anxiety at the time for the second survey had a high impact on functional limitations. © 2008 Foundation of Rehabilitation Information.

  • 264. Thelin, Anders
    et al.
    Holmberg, Sara
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och klinisk epidemiologi.
    Thelin, Nils
    Functioning in neck and low back pain from a 12-year perspective: a prospective population-based study.2008Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 40, nr 7, s. 555-561Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: The aim of this study was to evaluate the effects of unspecific neck pain and low back pain at a given time (1990-91) with respect to physical and social functioning and role limitations due to emotional problems 12 years later. METHODS: A rural male study population (2351 individuals) was established in 1989 and a first survey conducted in 1990-91. A follow-up survey was performed in 2002-03. A total of 1405 persons participated in both surveys. Functioning and role limitations in 2002-03 were evaluated using the SF-36 instrument. Several possible confounders were included in the analyses. RESULTS: Unspecific neck pain or low back pain in 1990-91 was shown in a multivariate longitudinal regression model to be significantly related to limited physical (odds ratio (OR)=2.08; 95% confidence interval (CI) 1.51-2.87) and social (OR=1.92; 95% CI 1.33-2.75) functioning 12 years later. The effects were only slightly modified by the confounders analysed. However, higher education independently and significantly predicted a low risk for functional limitations. CONCLUSION: Non-specific neck pain and low back pain at a given time impacted on the risk of limited physical and social functioning many years later. Current symptoms of depression and anxiety at the time for the second survey had a high impact on functional limitations.

  • 265.
    Thyberg, Ingrid
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Dahlström, Örjan
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutet för handikappvetenskap (IHV).
    Thyberg, Mikael
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutet för handikappvetenskap (IHV).
    Factors related to fatigue in women and men with early rheumatoid arthritis: The Swedish TIRA study2009Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 41, nr 11, s. 904-912Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To study whether there are differences between women and men, with regard to the reported level of fatigue, and to explore the strength of the relations between fatigue and disease activity, pain, sleep disturbance, mental health, and activity limitation in early rheumatoid arthritis, and also to explore the consistency of such findings.

    Design: Analyses and comparisons of cross-sectional data.

    Subjects. 276 patients, 191 women and 85 men, with early rheumatoid arthritis were included.

    Method: Patients were examined with respect to 28-joint count disease activity score, and disability variables reflecting pain, sleep disturbance, fatigue, mental health, and activity limitation, at follow-ups at one, two and three years after diagnosis.

    Results: Women reported somewhat more fatigue than men. Fatigue was closely and rather consistently related to disease activity, pain and activity limitation, and also to mental health and sleep disturbance.

    Conclusion: Although this study does not permit conclusions about causal directions, statistical relationships may be related to clinical conceptions about causation: When disease activity can be significantly reduced by pharmacological treatment, this may have a positive effect on fatigue. Specific treatment with respect to the mentioned disability aspects that are related to fatigue is also a clinically reasonable strategy.

  • 266.
    Thyberg, Ingrid
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin. Linköpings universitet, Hälsouniversitetet.
    Skogh, Thomas
    Linköpings universitet, Institutionen för molekylär och klinisk medicin. Linköpings universitet, Hälsouniversitetet.
    Hass, Ursula A. M.
    Linköpings universitet, Institutionen för hälsa och samhälle. Linköpings universitet, Filosofiska fakulteten.
    Gerdle, Björn
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan. Linköpings universitet, Hälsouniversitetet.
    Recent-onset rheumatoid arthritis: A 1-year observational study of correlations between health‐related quality of life and clinical/laboratory data2005Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 37, nr 3, s. 159-165Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To analyse correlations within and between clinical/laboratory assessments and health-related quality of life variables for recent-onset rheumatoid arthritis at the time of diagnosis and 12 months later.

    Methods: A total of 297 patients with recent-onset (?12 months) rheumatoid arthritis were included at diagnosis and followed up for 12 months. Clinical/laboratory assessment was performed by erythrocyte sedimentation rate, C-reactive protein, 28-joint count of tender/swollen joints, physician's global assessment, grip force, grip ability, functional impairment and walking speed. The self-reported health-related quality of life included symptoms (pain, morning stiffness), patients estimated general health, Health Assessment Questionnaire and SF-36.

    Results: All tested variables improved within 6 months of diagnosis and then remained stable but still affected at the 12-month follow-up. Multivariate correlations between clinical/laboratory variables and health-related quality of life were weak. At inclusion, clinical/laboratory assessments explained 18% of health-related quality of life at the same time-point and predicted 7% of the variation in health-related quality of life after 12 months.

    Conclusion: The time-course followed similar patterns for most variables, but only a small part of the variation in health-related quality of life was explained or predicted by the clinical/laboratory variables. This implies that health-related quality of life adds important information to clinical/laboratory assessments in clinical practice and should be considered in goal setting together with clinical/laboratory assessment in order to optimize healthcare and outcome.

  • 267.
    Thyberg, Mikael
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Institutet för handikappvetenskap (IHV). Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Nelson, Marie Clark
    Linköpings universitet, Institutionen för studier av samhällsutveckling och kultur, Enheten för historia. Linköpings universitet, Institutet för handikappvetenskap (IHV). Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten.
    Thyberg, Ingrid
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    A definition of disability emphasizing the interaction between individual and social aspects that existed among Scandinavian precursors of rehabilitation medicine as early as 19122010Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 42, nr 2, s. 182-183Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [en]

    This article suggests that definitions of disability exphasizing individuals and social context existed much earlier than is most often claimed

  • 268.
    van der Werff, Ross
    et al.
    University of Queensland, Brisbane, Australia.
    O'Leary, Shaun
    University of Queensland, Brisbane, Australia.
    Jull, Gwendolen
    University of Queensland, Brisbane. Australia.
    Peolsson, Michael
    Umeå University, Sweden.
    Trygg, Johan
    Umeå University, Sweden.
    Peolsson, Anneli
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för sjukgymnastik. Linköpings universitet, Hälsouniversitetet.
    A speckle tracking application of ultrasound to evaluate activity of multilayered cervical muscles2014Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 46, nr 7, s. 662-667Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To evaluate the capacity of the ultrasound-based method of speckle tracking analysis to detect changes in multilayered dorsal neck muscle activity induced by performing a lifting task.

    Subjects: Twenty-one healthy individuals.

    Design: Participants performed a loaded lifting task in 3 different postural orientations of the neck (neutral, flexed and forward head posture). Ultrasound images were recorded and speckle tracking analysis was used to quantify muscle deformation and deformation rate over 3 equal time-periods during the lifting sequence (rest, mid-lift and end-lift).

    Results: Significant main effects of postural orientation for the deformation measure (p < 0.05) and time for the deformation rate measure (p < 0.05) were observed in all dorsal muscles examined. Significant time by postural interactions for the deformation measure were observed in the trapezius, semispinalis cervicis and multifidus (p < 0.05) and in the semispinalis cervicis (p < 0.05) for the deformation rate measure.

    Conclusion: Speckle tracking analysis ultrasound measurements can detect differences in multilayered muscle activity of the dorsal neck induced by postural variations during a lifting task. Findings for the deformation and the deformation rate measures suggest that they quantify a different, albeit related, mechanical event during muscle contraction in a functional task such as lifting.

  • 269. van der Werff, Ross
    et al.
    O'Leary, Shaun
    Jull, Gwendolen
    Peolsson, Michael
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Kemiska institutionen.
    Trygg, Johan
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Kemiska institutionen.
    Peolsson, Anneli
    A speckle tracking application of ultrasound to evaluate activity of multilayered cervical muscles2014Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 46, nr 7, s. 662-667Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To evaluate the capacity of the ultrasound-based method of speckle tracking analysis to detect changes in multilayered dorsal neck muscle activity induced by performing a lifting task. Subjects: Twenty-one healthy individuals. Design: Participants performed a loaded lifting task in 3 different postural orientations of the neck (neutral, flexed and forward head posture). Ultrasound images were recorded and speckle tracking analysis was used to quantify muscle deformation and deformation rate over 3 equal time-periods during the lifting sequence (rest, mid-lift and end-lift). Results: Significant main effects of postural orientation for the deformation measure (p<0.05) and time for the deformation rate measure (p<0.05) were observed in all dorsal muscles examined. Significant time by postural interactions for the deformation measure were observed in the trapezius, semispinalis cervicis and multifidus (p<0.05) and in the semispinalis cervicis (p<0.05) for the deformation rate measure. Conclusion: Speckle tracking analysis ultrasound measurements can detect differences in multilayered muscle activity of the dorsal neck induced by postural variations during a lifting task. Findings for the deformation and the deformation rate measures suggest that they quantify a different, albeit related, mechanical event during muscle contraction in a functional task such as lifting.

  • 270.
    von Holst, Hans
    et al.
    KTH.
    Cassidy, J. David
    Mandate of the who collaborating centre task force on mild traumatic brain injury2004Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 36, s. 8-10Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In collaboration with outside experts, the WHO Collaborating Centre for Neurotrauma at the Karolinska Institute, Stockholm, Sweden, has assembled a task force to undertake a best-evidence synthesis of the literature on mild traumatic brain injury. The task force has addressed the epidemiology, diagnosis, prognosis, treatment and economic costs of mild traumatic brain injury in order to make recommendations to reduce the medical as well as the social consequences of mild traumatic brain injury.

  • 271.
    Wadell, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering.
    Henriksson-Larsén, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Lundgren, Rune
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Lungmedicin.
    Physical training with and without oxygen in patients with chronic obstructive pulmonary disease and exerciseinduced hypoxaemia2001Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 33, nr 5, s. 200-205Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A randomized, controlled, single-blind study was performed on 20 patients with chronic obstructive pulmonary disease and exercise-induced hypoxaemia. Ten patients each were randomly assigned to one of two groups, one training with air and the other training with oxygen. There were no significant differences between the groups regarding values measured prior to the study. The patients trained 3 times per week for 30 minutes each time for a duration of 8 weeks. The training consisted of interval walking on a treadmill (intensity set according to Borg ratings) with either air or oxygen administered through a nasal cannula at a rate of 5 l/min. Training significantly improved the 6-minute walking distance by 20% and 14% in the air and oxygen group, respectively, when the patients were tested on air. In the same test the air group significantly decreased Borg ratings for perceived exertion. Borg ratings for dyspnoea and perceived exertion significantly decreased in the oxygen group when they were tested on oxygen. It was concluded that oxygen supplementation did not further improve the training effect, compared with training with air, in patients with chronic obstructive pulmonary disease and exercise-induced hypoxaemia.

  • 272.
    Wahman, K
    et al.
    Department of Neurobiology, Care Sciences and Society (NVS), Division of Neurorehabilitation, Karolinska Institutet, SE-141 83 Huddinge, Sweden..
    Nash, MS
    Department of Neurobiology, Care Sciences and Society (NVS), Division of Neurorehabilitation, Karolinska Institutet, SE-141 83 Huddinge, Sweden.
    Lewis, JE
    Department of Neurobiology, Care Sciences and Society (NVS), Division of Neurorehabilitation, Karolinska Institutet, SE-141 83 Huddinge, Sweden.
    Seiger, A
    Department of Neurobiology, Care Sciences and Society (NVS), Division of Neurorehabilitation, Karolinska Institutet, SE-141 83 Huddinge, Sweden.
    Levi, Richard
    Department of Neurobiology, Care Sciences and Society (NVS), Division of Neurorehabilitation, Karolinska Institutet, SE-141 83 Huddinge, Sweden.
    Cardiovascular disease risk and the need for prevention after paraplegia determined by conventional multifactorial risk models: the Stockholm spinal cord injury study.2011Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 43, nr 3, s. 237-242Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To assess the need for intervention on cardio-vascular disease risks in persons with paraplegia according to: (i) two multifactorial risk models; and (ii) these models in combination with the additional risk of overweight/obesity.andlt;br /andgt;Design: Cross-sectional.andlt;br /andgt;Subjects: A total of 134 out of 153 persons, comprising more than 80% of a regional prevalence population with traumatic paraplegia (American Spinal Injury Association Impairment Scale A-C) of minimum one year duration.andlt;br /andgt;Methods: Participants were screened for cardiovascular disease risk using two multifactorial risk models: the Systematic Coronary Risk Evaluation and the Framingham Risk Equation. Risk factors included were: age, gender, systolic blood pressure, antihypertensive medication, smoking, total cholesterol, high-density lipoprotein cholesterol, and total cholesterol/total cholesterol ratio. In addition, overweight/obesity was assessed by body mass index.andlt;br /andgt;Results: Twenty-seven percent to 36% of the cohort was eligible for cardiovascular disease risk intervention, depending on the risk model used. When overweight/obesity (spinal cord injury adjusted cut-score body mass index ≥ 22) was also considered, over 80% of the participants qualified for intervention.andlt;br /andgt;Conclusion: Almost one-third of persons with paraplegia were eligible for cardiovascular disease risk intervention according to authoritative assessment tools. The number in need of intervention was dramatically increased when overweight/obesity as a cardiovascular disease risk was considered.

  • 273.
    Wahman, K
    et al.
    Department of Neurobiology, Care Sciences and Society (NVS), Division of neurorehabilitation, Karolinska Institutet, 139 89 Stockholm, Sweden..
    Nash, MS
    Department of Neurobiology, Care Sciences and Society (NVS), Division of neurorehabilitation, Karolinska Institutet, 139 89 Stockholm, Sweden.
    Lewis, JE
    Department of Neurobiology, Care Sciences and Society (NVS), Division of neurorehabilitation, Karolinska Institutet, 139 89 Stockholm, Sweden.
    Seiger, A
    Department of Neurobiology, Care Sciences and Society (NVS), Division of neurorehabilitation, Karolinska Institutet, 139 89 Stockholm, Sweden.
    Levi, Richard
    Department of Neurobiology, Care Sciences and Society (NVS), Division of neurorehabilitation, Karolinska Institutet, 139 89 Stockholm, Sweden.
    Increased cardiovascular disease risk in Swedish persons with paraplegia: The Stockholm spinal cord injury study.2010Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 42, nr 5, s. 489-492Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: Comparison of prevalence of cardiovascular disease risks in persons with chronic traumatic paraplegia with those in the general population.andlt;br /andgt;Design: Cross-sectional comparative study.andlt;br /andgt;Subjects: A total of 135 individuals, age range 18-79 years, with chronic (andgt; or = 1 year) traumatic paraplegia.andlt;br /andgt;Methods: The prevalences of diabetes mellitus, dyslipidaemia, hypertension, overweight, and smoking, were assessed in the study population and were compared with an age- and gender-matched sample of the general population in the region under study. History of myocardial infarction and medication for dyslipidaemia, hypertension, and diabetes mellitus were also recorded. chi2 tests were used to compare the paraplegic cohort with the general population sample.andlt;br /andgt;Results: Significantly more persons with paraplegia reported a history of myocardial infarction (5.9%) than those in the comparison group (0.7%). The prevalences of diabetes mellitus (5.9%), dyslipidaemia (11.1%), and hypertension (14.1%) were also significantly higher in the paraplegic group, as were drug treatment for these disorders.andlt;br /andgt;Conclusion: Persons with paraplegia report increased prevalences of diabetes mellitus, hypertension, and dyslipidaemia, in particular, compared with the general population. Population-based screening and therapeutic counter-measures for these conditions may therefore be particularly indicated for this patient group.

  • 274. Wahman, Kerstin
    et al.
    Nash, Mark S
    Lewis, John E
    Seiger, Åke
    Levi, Richard
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    Increased cardiovascular disease risk in Swedish persons with paraplegia: the Stockholm spinal cord injury study2010Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 42, nr 5, s. 489-492Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: Comparison of prevalence of cardiovascular disease risks in persons with chronic traumatic paraplegia with those in the general population.

    DESIGN: Cross-sectional comparative study.

    SUBJECTS: A total of 135 individuals, age range 18-79 years, with chronic (> or = 1 year) traumatic paraplegia.

    METHODS: The prevalences of diabetes mellitus, dyslipidaemia, hypertension, overweight, and smoking, were assessed in the study population and were compared with an age- and gender-matched sample of the general population in the region under study. History of myocardial infarction and medication for dyslipidaemia, hypertension, and diabetes mellitus were also recorded. chi2 tests were used to compare the paraplegic cohort with the general population sample.

    RESULTS: Significantly more persons with paraplegia reported a history of myocardial infarction (5.9%) than those in the comparison group (0.7%). The prevalences of diabetes mellitus (5.9%), dyslipidaemia (11.1%), and hypertension (14.1%) were also significantly higher in the paraplegic group, as were drug treatment for these disorders.

    CONCLUSION: Persons with paraplegia report increased prevalences of diabetes mellitus, hypertension, and dyslipidaemia, in particular, compared with the general population. Population-based screening and therapeutic counter-measures for these conditions may therefore be particularly indicated for this patient group.

  • 275.
    Wahman, Kerstin
    et al.
    Department of Neurobiology, Care Sciences and Society, Division of Neurorehabilitation, Karolinska Institutet.
    Nash, Mark S
    University of Miami Miller School of Medicine, Miami, Florida, USA.
    Westgren, Ninni
    Spinalis Spinal Cord Injury Rehabilitation Unit, Karolinska University Hospital, Stockholm, Sweden.
    Lewis, John E
    University of Miami Miller School of Medicine, Miami, Florida, USA.
    Seiger, Ake
    Department of Neurobiology, Care Sciences and Society, Division of Neurorehabilitation, Karolinska Institutet.
    Levi, Richard
    Department of Neurobiology, Care Sciences and Society, Division of Neurorehabilitation, Karolinska Institutet.
    Cardiovascular disease risk factors in persons with paraplegia: the Stockholm spinal cord injury study.2010Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 42, nr 3, s. 272-278Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To examine cardiovascular disease risk factors and risk clusters in Swedish persons with traumatic wheelchair-dependent paraplegia.

    DESIGN: Prospective examination.

    SUBJECTS: A total of 135 individuals aged 18-79 years with chronic (>or= 1 year) post-traumatic paraplegia.

    METHODS: Cardiovascular disease risk factors; dyslipidemia, impaired fasting glucose, hypertension, overweight, smoking, and medication usage for dyslipidemia, hypertension, and diabetes mellitus, were analyzed according to authoritative guidelines. Stepwise regression tested the effects of age, gender, and injury characteristics on cardiovascular disease risks.

    RESULTS: High-prevalence risk factors were dyslipidemia (83.1%), hypertension (39.3%), and overweight (42.2%) with pervasive clustering of these risks. Being older was related to increased cardiovascular disease risk, except for dyslipidemia. Hypertension was more common in low-level paraplegia. Prevalence of impaired fasting glucose was lower than previously reported after paraplegia. A high percentage of persons being prescribed drug treatment for dyslipidemia and hypertension failed to reach authoritative targets for cardiovascular disease risk reduction.

    CONCLUSION: Swedish persons with paraplegia are at high risk for dyslipidemia, hypertension, and overweight. Impaired fasting glucose was not as common as reported in some previous studies. Pharmacotherapy for dyslipidemia and hypertension often failed to achieve recommended targets. Population-based screening and therapeutic countermeasures to these cardiovascular disease risks are indicated.

  • 276. Wahman, Kerstin
    et al.
    Nash, Mark S
    Westgren, Ninni
    Lewis, John E
    Seiger, Åke
    Levi, Richard
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    Cardiovascular disease risk factors in persons with paraplegia: the Stockholm spinal cord injury study2010Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 42, nr 3, s. 272-278Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To examine cardiovascular disease risk factors and risk clusters in Swedish persons with traumatic wheelchair-dependent paraplegia.

    DESIGN: Prospective examination.

    SUBJECTS: A total of 135 individuals aged 18-79 years with chronic (>or= 1 year) post-traumatic paraplegia.

    METHODS: Cardiovascular disease risk factors; dyslipidemia, impaired fasting glucose, hypertension, overweight, smoking, and medication usage for dyslipidemia, hypertension, and diabetes mellitus, were analyzed according to authoritative guidelines. Stepwise regression tested the effects of age, gender, and injury characteristics on cardiovascular disease risks.

    RESULTS: High-prevalence risk factors were dyslipidemia (83.1%), hypertension (39.3%), and overweight (42.2%) with pervasive clustering of these risks. Being older was related to increased cardiovascular disease risk, except for dyslipidemia. Hypertension was more common in low-level paraplegia. Prevalence of impaired fasting glucose was lower than previously reported after paraplegia. A high percentage of persons being prescribed drug treatment for dyslipidemia and hypertension failed to reach authoritative targets for cardiovascular disease risk reduction.

    CONCLUSION: Swedish persons with paraplegia are at high risk for dyslipidemia, hypertension, and overweight. Impaired fasting glucose was not as common as reported in some previous studies. Pharmacotherapy for dyslipidemia and hypertension often failed to achieve recommended targets. Population-based screening and therapeutic countermeasures to these cardiovascular disease risks are indicated.

  • 277.
    Wallmark, Svante
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Neurologi.
    Ronne-Engström, Elisabeth
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Neurokirurgi.
    Lundström, Erik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.
    Prevalence of spasticity after aneurysmal subarachnoid haemorrhage2014Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 46, nr 1, s. 23-27Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: The prevalence of spasticity after stroke is approximately 20%. There is, so far, little information in the literature on the development of spasticity after aneurysmal subarachnoid haemorrhage. The objectives of this study were to estimate the prevalence of spasticity after aneurysmal subarachnoid haemorrhage and to identify possible risk factors in the acute phase. Methods: A total of 87 patients were assessed for spasticity with the Modified Ashworth Scale after 6 months. A multivariate logistic regression model was used to evaluate risk factors. Results: Spasticity was present after 6 months in 19 (22%) of the patients, but was treated pharmacologically in only 1 case. Worse clinical status at admission carried a high risk for spasticity (odds ratio (OR) 10.2; 95% confidence interval (CI) 2.4-43.2), followed by the presence of infection (OR 7.4; 95% CI 1.6-33.8) and vasospasm (OR 4.8; 95% CI 1.2-19.0) during the intensive care phase. Conclusion: Spasticity after aneurysmal subarachnoid haemorrhage occurred with the same prevalence as after other stroke. Risk factors for spasticity were worse clinical condition at admission and the occurrence of infection and vasospasm during the intensive care period. Pharmacological treatment was not commonly used.

  • 278.
    Ward, Anthony B.
    et al.
    Haywood Hospital, Burslem, Stoke on Trent, UK.
    Wissel, Jörg
    Vivantes Klinikum Spandau, Berlin, Germany.
    Borg, Jörgen
    Danderyd Hospital, Stockholm, Sweden .
    Ertzgaard, Per
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Rehabiliteringsmedicinska kliniken.
    Herrmann, Christoph
    Asklepios Clinics Schildautal, Seesen, Germany.
    Kulkarni, Jai
    Manchester Royal Infirmary, UK.
    Lindgren, Kristina
    Central Hospital, Karlstad, Sweden .
    Reuter, Iris
    Justus-Liebig University, Giessen, Germany.
    Sakel, Mohamed
    Kent and Canterbury Hospital, UK.
    Säterö, Patrik
    Sahlgrenska University Hospital, Gothenburg, Sweden .
    Sharma, Satyendra
    Sunnybrook Health Science Centre,Toronto, Canada .
    Wein, Theodore
    Montreal General Hospital, Canada .
    Wright, Nicola
    Allergan Ltd, Marlow International, Buckinghamshire, UK.
    Fulford-Smith, Antony
    Allergan Ltd, Marlow International, Buckinghamshire, UK.
    Functional goal achievement in post-stroke spasticity patients: The BOTOX® Economic Spasticity Trial (BEST)2014Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 46, nr 6, s. 504-513Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE:

    Evaluate changes in active and passive function with onabotulinumtoxinA + standard of care within goal-oriented rehabilitation programmes in adults with focal post-stroke spasticity.

    METHODS:

    Prospective, 24-week double-blind study with an open-label extension. Subjects were randomized to onabotulinumtoxinA + standard of care or placebo + standard of care, at baseline and at 12 weeks, if judged appropriate, with follow-up to 52 weeks. The primary endpoint was the number of patients achieving their principal active functional goal at 24 weeks (or 10 weeks after an optional second injection). Secondary endpoints included achievement of a different active or a passive goal at this timepoint.

    RESULTS:

    The intent-to-treat population comprised 273 patients. The proportion of patients achieving their principal active functional goal and secondary active functional goal with onabotulinumtoxinA + standard of care was not statistically different from placebo + standard of care. Significantly more patients achieved their secondary passive goal with onabotulinumtoxinA + standard of care (60.0%) vs. placebo + standard of care (38.6%) (odds ratio, 2.46; 95% confidence interval, 1.18-5.14) as well as higher Goal Attainment Scaling levels for upper limb and ankle flexor subgroups.

    CONCLUSIONS:

    Addition of onabotulinumtoxinA to standard of care as part of goal-oriented rehabilitation in post-stroke spasticity patients significantly increased passive goal achievement and was associated with higher levels of active function.

  • 279.
    Westerdahl, Elisabeth
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Department of Physiotherapy, Örebro Medical Centre Hospital, Örebro, Sweden .
    Lindmark, Birgitta
    Department of Neuroscience, Section of Physiotherapy, University Hospital, Uppsala, Sweden .
    Almgren, Stig-Olof
    Department of Thoracic Surgery, Örebro Medical Centre Hospital, Örebro, Sweden .
    Tenling, Arne
    Department of Thoracic Anaesthesia and Clinical Psychology, Section of Physiotherapy, University Hospital, Uppsala, Sweden .
    Chest physiotherapy after coronary artery bypass graft surgery: a comparison of three different deep breathing techniques2001Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 33, nr 2, s. 79-84Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The effectiveness of three deep breathing techniques was evaluated in 98 male patients after coronary artery bypass graft surgery in a randomized trial. The techniques examined were deep breathing with a blow bottle-device, an inspiratory resistance-positive expiratory pressure mask (IR-PEP) and performed with no mechanical device. Pulmonary function and roentgenological changes were evaluated. Four days post-operatively there were significantly decreased vital capacity, inspiratory capacity, forced expiratory volume in 1 second, functional residual capacity, total lung capacity and single-breath carbon monoxide diffusing capacity in all three groups (p < 0.0001). No major differences between the treatment groups were found, but the impairment in pulmonary function tended to be less marked using the blow bottle technique. The Blow bottle group had significantly less reduction in total lung capacity (p = 0.01) compared to the Deep breathing group, while the IR-PEP group did not significantly differ from the other two groups.

  • 280.
    Westerdahl, Elisabeth
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Lindmark, Birgitta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik.
    Almgren, Stig-Olof
    Tenling, Arne
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Thoraxkirurgi.
    Chest physiotherapy after coronary artery bypass graft surgery: a comparison of three different deep breathing techniques2001Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 33, nr 2, s. 79-84Artikkel i tidsskrift (Fagfellevurdert)
  • 281. Widar, Marita
    et al.
    Samuelsson, Lars
    Karlsson-Tivenius, Susanne
    Ahlström, Gerd
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
    Long-term pain conditions after a stroke2002Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 34, nr 4, s. 165-170Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to classify and describe the characteristics of different long-term pain conditions after a stroke by clinical examination and pain assessment using the Pain-O-Meter and a Pain questionnaire. Pain was classified as central post-stroke pain (n = 15), nociceptive pain (n = 18), and tension-type headache (n = 10). In 65%, pain onset was within 1-6 months and the pain intensity revealed individual differences. Many pain descriptors was common, some were discriminating as burning in central and cramping in nociceptive pain, and pressing and worrying in headache. More than half with central or nociceptive pain had continuous or almost continuous pain. Cold was the factor mostly increasing the pain in central, physical movements in nociceptive pain, and stress and anxiety in headache. More than one-third had no pain treatment and two-thirds of those with central pain had no or inadequate prescribed pain treatment. The clinical findings support the classification of pain and describe discriminating and common pain characteristics in pain conditions after a stroke.

  • 282.
    Widar, Marita
    et al.
    Linköpings universitet, Institutionen för medicin och vård.
    Samuelsson, Lars
    Department of Orthopaedics, Örebro University Hospital, Örebro, Sweden.
    Karlsson-Tivenius, Susanne
    Department of Neurology & Clinical Neurophysiology, Örebro University Hospital, Örebro, Sweden.
    Ahlström, Gerd
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Long-term pain conditions after a stroke2002Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 34, nr 4, s. 165-170Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to classify and describe the characteristics of different long-term pain conditions after a stroke by clinical examination and pain assessment using the Pain-O-Meter and a Pain questionnaire. Pain was classified as central post-stroke pain (n = 15), nociceptive pain (n = 18), and tension-type headache (n = 10). In 65%, pain onset was within 1-6 months and the pain intensity revealed individual differences. Many pain descriptors was common, some were discriminating as burning in central and cramping in nociceptive pain, and pressing and worrying in headache. More than half with central or nociceptive pain had continuous or almost continuous pain. Cold was the factor mostly increasing the pain in central, physical movements in nociceptive pain, and stress and anxiety in headache. More than one-third had no pain treatment and two-thirds of those with central pain had no or inadequate prescribed pain treatment. The clinical findings support the classification of pain and describe discriminating and common pain characteristics in pain conditions after a stroke.

  • 283.
    Widar, Marita
    et al.
    Örebro universitet, Hälsoakademin.
    Samuelsson, Lars
    Karlsson-Tivenius, Susanne
    Ahlström, Gerd
    Long-term pain conditions after a stroke2002Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 34, nr 4, s. 165-170Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to classify and describe the characteristics of different long-term pain conditions after a stroke by clinical examination and pain assessment using the Pain-O-Meter and a Pain questionnaire. Pain was classified as central post-stroke pain (n = 15), nociceptive pain (n = 18), and tension-type headache (n = 10). In 65%, pain onset was within 1-6 months and the pain intensity revealed individual differences. Many pain descriptors was common, some were discriminating as burning in central and cramping in nociceptive pain, and pressing and worrying in headache. More than half with central or nociceptive pain had continuous or almost continuous pain. Cold was the factor mostly increasing the pain in central, physical movements in nociceptive pain, and stress and anxiety in headache. More than one-third had no pain treatment and two-thirds of those with central pain had no or inadequate prescribed pain treatment. The clinical findings support the classification of pain and describe discriminating and common pain characteristics in pain conditions after a stroke.

  • 284.
    Wikström, Madeleine
    et al.
    Region Östergötland, Sinnescentrum, Rehabiliteringsmedicinska kliniken.
    Levi, Richard
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Rehabiliteringsmedicinska kliniken.
    Antepohl, Wolfram
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Rehabiliteringsmedicinska kliniken.
    BLADDER IRRIGATION WITH CHLORHEXIDINE REDUCES BACTERIURIA IN PERSONS WITH SPINAL CORD INJURY2018Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 50, nr 2, s. 181-184Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To explore whether bladder irrigation with chlorhexidine: (i) can reduce bacteriuria, and (ii) is a practically feasible option in subjects with spinal cord injury practicing intermittent self-catheterization. Design: A prospective, non-controlled, open, multicentre study. Methods: Fifty patients with spinal cord injury, practicing intermittent self-catheterization, with a history of recurrent urinary tract infections were screened for bacteriuria at follow-up visits to 4 spinal cord injury centres in Sweden. Twenty-three patients had a positive urine culture (amp;gt; 105 CFU/ml of amp;gt; 1 bacterial species), of which 19 completed the study. Subjects proceeded with bladder irrigation, using 120 ml of 0.2% chlorhexidine solution twice daily for up to 7 days. Urine samples were taken twice daily. Response to treatment was defined as reduction in bacterial counts to amp;lt; 103 CFU/ml. Results: Fourteen of 19 subjects reduced their bacterial counts to or below the set limit. Subsequent return of above-endpoint bacteriuria was seen in most of the subjects. However, there were significantly fewer subjects with bacteriuria after treatment (p amp;lt; 0.005). Conclusion: Bladder irrigation with chlorhexidine, using intermittent self-catheterization, reduced bacteriuria in the majority of subjects with spinal cord injury and bacteriuria. The addition of bladder irrigation was practically feasible in the short time-frame of this study.

  • 285.
    Wolf, Olof
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Ortopedi.
    Mattsson, Per
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Ortopedi.
    Milbrink, Jan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Ortopedi.
    Larsson, Sune
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Ortopedi.
    Mallmin, Hans
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Ortopedi.
    Effects of postoperative weight-bearing on body composition and bone mineral density after uncemented total hip arthroplasty2013Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 45, nr 5, s. 498-503Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective:

    To investigate whether a postoperative weight-bearing regimen affects changes in bone mineral density and body composition after uncemented total hip arthroplasty, and to investigate the changes over a 5-year period after the surgical procedure.

    Design:

    Secondary analysis of a previous randomized controlled trial.

    Methods:

    A total of 39 patients were randomized to immediate full weight-bearing or partial weight-bearing for 3 months. Dual-energy X-ray absorptiometry was used to measure bone mineral density of the contralateral hip and both heels and to measure body composition.

    Results:

    The weight-bearing regimen had no effect on change in bone mineral density or body composition after 3 and 12 months. At 5 years, there was a decrease in bone mineral density of 3% in the total body and 2-3% in the contralateral hip regions. At 5 years we found a decrease in total body bone mineral content of 5%, but no changes in fat mass or lean mass compared with preoperative values.

    Conclusion:

    The postoperative weight-bearing regimen had no effect on changes in body composition or bone mineral density. Five years after total hip arthroplasty there was a decrease in bone mineral content and bone mineral density, but no changes in lean mass or fat mass.

  • 286.
    Wåhlin, Charlotte
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Sjukgymnastik. Linköpings universitet, Hälsouniversitetet.
    Ekberg, Kerstin
    Linköpings universitet, Institutionen för medicin och hälsa, Arbetslivsinriktad rehabilitering. Linköpings universitet, HELIX Vinn Excellence Centre. Linköpings universitet, Hälsouniversitetet.
    Persson, Jan
    Linköpings universitet, Institutionen för medicin och hälsa, Medicinsk teknologiutvärdering. Linköpings universitet, Hälsouniversitetet.
    Bernfort, Lars
    Linköpings universitet, Institutionen för medicin och hälsa, Medicinsk teknologiutvärdering. Linköpings universitet, Hälsouniversitetet.
    Öberg, Birgitta
    Linköpings universitet, Institutionen för medicin och hälsa, Sjukgymnastik. Linköpings universitet, Hälsouniversitetet.
    Association between clinical and work-related interventions and return to work for patients with musculoskeletal or mental disorders2012Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 44, nr 4, s. 355-362Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: The aim of this study was to explore what characterizes patients receiving clinical interventions vs combined clinical and work-related interventions in a cohort of sick-listed subjects with musculoskeletal or mental disorders. Factors associated with return-to-work were also analysed.

    Design: A prospective cohort study.

    Methods: A total of 699 newly sick-listed patients responded to a questionnaire on sociodemographics, measures of health, functioning, work ability, self-efficacy, social support, work conditions, and expectations. The 3-month follow-up questionnaire included patients' self-reported measures of return-to-work, work ability and type of interventions. The most frequent International Classification of Diseases-10 diagnoses for patients' musculoskeletal disorders were dorsopathies (M50-54) and soft tissue disorders (M70-79), and for patients with mental disorders, depression (F32-39) and stress reactions (F43).

    Results: Patients with mental disorders who received combined interventions returned to work to a higher degree than those who received only clinical intervention. The prevalence of work-related interventions was higher for those who were younger and more highly educated. For patients with musculoskeletal disorders better health, work ability and positive expectations of return-to-work were associated with return-to-work. However, combined interventions did not affect return-to-work in this group.

    Conclusion: Receiving combined interventions increased the probability of return-to-work for patients with mental disorders, but not for patients with musculoskeletal disorders. Better health, positive expectations of return-to-work and better work ability were associated with return-to-work for patients with musculoskeletal disorders.

  • 287.
    Ytterberg, Charlotte
    et al.
    Karolinska Inst, Huddinge, Sweden.
    Dyback, Malin
    Vasternorrland Cty Council, Sundsvall, Sweden.
    Bergstrom, Aileen
    Karolinska Inst, Huddinge, Sweden.
    Guidetti, Susanne
    Karolinska Inst, Huddinge, Sweden.
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Karolinska Inst, Huddinge, Sweden.
    Perceived impact of stroke six years after onset, and changes in impact between one and six years2017Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 49, nr 8, s. 637-643Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To examine the perceived impact of stroke between 1 and 6 years after stroke using the Stroke Impact Scale 3.0 (SIS). Design: A prospective longitudinal study.

    Methods: A total of 100 individuals were assessed using the SIS 3.0 at 1 and 6 years after onset of stroke and clinically meaningful changes were explored. Changes in domain scores were calculated over time in relation to age, sex and stroke severity.

    Results: The most impacted SIS domains after 6 years were Participation, Strength, Hand function, and Stroke recovery. Participants with moderate/severe stroke experienced a higher impact in all domains except Hand function and Stroke recovery, indicating more problems in everyday life, compared with those with mild stroke. Almost half of the participants had a clinically meaningful change in the domain Participation between 1 and 6 years. Those with moderate/severe stroke and the older age group experienced more negative clinically meaningful changes in several domains in comparison with those with mild stroke and the younger age group.

    Conclusion: The long-term perceived impact of stroke highlights the importance of appropriate rehabilitation interventions within several areas to reduce the long-term negative impact in everyday life.

  • 288.
    Ytterberg, Charlotte
    et al.
    Karolinska Inst, Huddinge, Sweden.
    Dyback, Malin
    Vasternorrland Cty Council, Sundsvall, Sweden.
    Bergstrom, Aileen
    Karolinska Inst, Huddinge, Sweden.
    Guidetti, Susanne
    Karolinska Inst, Huddinge, Sweden.
    Eriksson, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Karolinska Inst, Huddinge, Sweden.
    Perceived impact of stroke six years after onset, and changes in impact between one and six years2017Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 49, nr 8, s. 637-643Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To examine the perceived impact of stroke between 1 and 6 years after stroke using the Stroke Impact Scale 3.0 (SIS). Design: A prospective longitudinal study.

    Methods: A total of 100 individuals were assessed using the SIS 3.0 at 1 and 6 years after onset of stroke and clinically meaningful changes were explored. Changes in domain scores were calculated over time in relation to age, sex and stroke severity.

    Results: The most impacted SIS domains after 6 years were Participation, Strength, Hand function, and Stroke recovery. Participants with moderate/severe stroke experienced a higher impact in all domains except Hand function and Stroke recovery, indicating more problems in everyday life, compared with those with mild stroke. Almost half of the participants had a clinically meaningful change in the domain Participation between 1 and 6 years. Those with moderate/severe stroke and the older age group experienced more negative clinically meaningful changes in several domains in comparison with those with mild stroke and the younger age group.

    Conclusion: The long-term perceived impact of stroke highlights the importance of appropriate rehabilitation interventions within several areas to reduce the long-term negative impact in everyday life.

  • 289.
    Zetterberg, Lena
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik.
    Lindmark, Birgitta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik.
    Söderlund, Anne
    Åsenlöf, Pernilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik.
    Self-perceived non-motor aspects of cervical dystonia and their association with disability2012Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 44, nr 11, s. 950-954Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To examine the multivariate association between a model of self-perceived non-motor aspects and disability in cervical dystonia. Design: A prospective and correlational design with two points of assessment. Subjects: All 273 members with cervical dystonia from the Swedish Dystonia Patient Association were invited to participate. Methods: Data were collected with one self-reported questionnaire. The questionnaire was sent by post on two separate occasions. Disability was the primary outcome variable measured by the Functional Disability Questionnaire. Results: The questionnaire was completed by 180 individuals (66%) on both occasions. The multivariate association between the non-motor model and disability was statistically significant (adjusted R-2 0.46, F(7, 149)=19.76, p = 0.001). This indicated that 46% of the variance in disability was explained by the non-motor model. Self-efficacy appeared to be the most salient predictor of disability. Conclusion: The results of this study highlight the need for increasing awareness of self-perceived non-motor aspects among care providers treating patients with cervical dystonia. This presents opportunities for new rehabilitation possibilities that apply a behavioural medicine perspective.

  • 290.
    Zetterberg, Lena
    et al.
    Uppsala University.
    Lindmark, Birgitta
    Uppsala University.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Åsenlöf, Pernilla
    Uppsala University.
    Self-perceived non-motor aspects of cervical dystonia and their association with disability2012Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 44, nr 11, s. 950-954Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To examine the multivariate association between a model of self-perceived non-motor aspects and disability in cervical dystonia.DESIGN: A prospective and correlational design with two points of assessment. SUBJECTS: All 273 members with cervical dystonia from the Swedish Dystonia Patient Association were invited to participate. METHODS: Data were collected with one self-reported questionnaire. The questionnaire was sent by post on two separate occasions. Disability was the primary outcome variable measured by the Functional Disability Questionnaire. RESULTS: The questionnaire was completed by 180 individuals (66%) on both occasions. The multivariate association between the non-motor model and disability was statistically significant (adjusted R2 0.46, F(7, 149) = 19.76, p = 0.001). This indicated that 46% of the variance in disability was explained by the non-motor model. Self-efficacy appeared to be the most salient predictor of disability.CONCLUSION: The results of this study highlight the need for increasing awareness of self-perceived non-motor aspects among care providers treating patients with cervical dystonia. This presents opportunities for new rehabilitation possibilities that apply a behavioural medicine perspective.

  • 291.
    Árnadóttir, Guðrún
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Arbetsterapi. 1Occupational Therapy Unit, Grensás, Landspítali University Hospital, Reykjavík; 2Division of Occupational Therapy, Faculty of Health, University of Akureyri, Akureyri, Iceland.
    Löfgren, Britta
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Arbetsterapi.
    Fisher, Anne G
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Arbetsterapi.
    Difference in impact of neurobehavioural dysfunction on Activities of Daily Living performance between right and left hemispheric stroke2010Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 42, nr 10, s. 903-907Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To explore whether persons with right- and left-sided cerebrovascular accidents differ significantly in mean impact of neurobehavioural impairments on ability to perform activities of daily living. Design and subjects: Retrospective study of data from 215 persons (103 right-sided, 112 left-sided cerebrovascular accident). The Activities of daily living-focused Occupation-based Neurobehavioral Evaluation was used to evaluate ability on an activities of daily living scale and the impact of neurobehavioural impairment on ability on another scale. Methods: To control for possible differences in activities of daily living ability between groups, analysis of covariance, with activities of daily living ability as a covariate, was used to test for a significant difference in impact of neurobehavioural impairments on activities of daily living ability between groups. Results: Expected moderate correlation (r=-0.57) was obtained between activities of daily living ability and neurobehavioural impact measures, and there was no difference in mean neurobehavioural impact measures between groups (F [1, 212] = 2.910,p = 0.090). Conclusion: This study is the first: to explore directly the impact of neurobehavioural impairment on activities of daily living ability. While persons with right-sided and left-sided cerebrovascular accidents may differ in type of neurobehavioural impairments, direct evaluation of the impact of such impairments on activities of daily living ability reveals no difference between groups.

  • 292.
    Åberg, Anna Christina
    et al.
    Department of Public Health and Caring Sciences/Geriatrics, Uppsala University.
    Lundin-Olsson, Lillemor
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University.
    Rosendahl, Erik
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Implementation of evidence-based prevention of falls in rehabilitation units: A staff's interactive approach2009Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 41, nr 13, s. 1034-1040Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To provide strategies to assist healthcare professionals in the area of rehabilitation to improve prevention of falls. Design: A conceptual framework is described as a foundation for the proposal of 2 intertwined strategies, of intervention and implementation, which target the questions: Which strategies for intervention represent the current best evidence? and: How can these strategies be implemented and continuously developed? Results: Strategies for multifactorial and multiprofessional fall preventive interventions are presented in terms of a "fall prevention pyramid model", including general, individualized, and acute interventions. A systematic global fall risk rating by the staff is recommended as an initial procedure. Fall event recording and follow-up are stressed as important components of local learning and safety improvement. Development of implementation strategies in 3 phases, focusing on interaction, facilitation and organizational culture, is described Conclusion: A well-developed patient safety culture focusing on prevention of falls will, when successfully achieved, be seen by staff, patients and their significant others as being characteristic of the organization, and will be evident in attitudes, routines and actions. Moreover, it provides potential for positive side-effects concerning organizational and clinical improvements in additional areas

  • 293.
    Åberg, Anna Cristina
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap.
    Gender comparisons of function-related dependence pain and insecurity in geriatric rehabilitation.2006Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 38, nr 1, s. 73-9Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To evaluate possible gender differences regarding the effect of intervention in geriatric rehabilitation, expressed in terms of change in function-related dependence, pain and insecurity. DESIGN: Comparative study. PARTICIPANTS: A total of 110 women and 44 men undergoing geriatric rehabilitation. METHODS: Performance-based assessments with use of the General Motor Function assessment scale. Non-parametric statistics were mainly used. RESULTS: The women showed higher degrees of function-related dependence, pain and insecurity on admission than the men. Both women and men displayed significant improvement in all 3 variables during the rehabilitation period. However, the positive changes regarding pain and insecurity were according to the analyses of systematic group changes, at a low degree among the men, probably because of the low levels on admission. Gender comparisons of proportions with positive intervention outcome indicated that a significantly larger proportion of the women showed a positive treatment effect after intervention, with a difference in recovery of 19% in dependence, 23% in pain and 33% in insecurity (p<0.05). CONCLUSIONS: Gender differences in disability, with higher degrees of function-related dependence, pain and insecurity among women on admission for geriatric rehabilitation, can be diminished during the rehabilitation period. These promising results may have relevance for the public health of the elderly population.

  • 294.
    Åberg, Anna Cristina
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Geriatrik.
    Gender comparisons of function-related dependence pain and insecurity in geriatric rehabilitation2006Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 38, nr 1, s. 73-79Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To evaluate possible gender differences regarding the effect of intervention in geriatric rehabilitation, expressed in terms of change in function-related dependence, pain and insecurity. DESIGN: Comparative study. PARTICIPANTS: A total of 110 women and 44 men undergoing geriatric rehabilitation. METHODS: Performance-based assessments with use of the General Motor Function assessment scale. Non-parametric statistics were mainly used. RESULTS: The women showed higher degrees of function-related dependence, pain and insecurity on admission than the men. Both women and men displayed significant improvement in all 3 variables during the rehabilitation period. However, the positive changes regarding pain and insecurity were according to the analyses of systematic group changes, at a low degree among the men, probably because of the low levels on admission. Gender comparisons of proportions with positive intervention outcome indicated that a significantly larger proportion of the women showed a positive treatment effect after intervention, with a difference in recovery of 19% in dependence, 23% in pain and 33% in insecurity (p<0.05). CONCLUSIONS: Gender differences in disability, with higher degrees of function-related dependence, pain and insecurity among women on admission for geriatric rehabilitation, can be diminished during the rehabilitation period. These promising results may have relevance for the public health of the elderly population.

  • 295.
    Åberg, Anna Cristina
    et al.
    Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala ; The Swedish School of Sport and Health Sciences, Stockholm.
    Lundin-Olsson, Lillemor
    Department of Community Medicine and Rehabilitation/Physiotherapy, Umeå University, Umeå.
    Rosendahl, Erik
    Department of Health Science/Health and Rehabilitation, Luleå University of Technology, Luleå, Sweden.
    Implementation of evidence-based prevention of falls in rehabilitation units: a staff's interactive approach2009Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 41, nr 13, s. 1034-1040Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To provide strategies to assist healthcare professionals in the area of rehabilitation to improve prevention of falls. DESIGN: A conceptual framework is described as a foundation for the proposal of 2 intertwined strategies, of intervention and implementation, which target the questions: Which strategies for intervention represent the current best evidence? and: How can these strategies be implemented and continuously developed? RESULTS: Strategies for multifactorial and multiprofessional fall preventive interventions are presented in terms of a "fall prevention pyramid model", including general, individualized, and acute interventions. A systematic global fall risk rating by the staff is recommended as an initial procedure. Fall event recording and follow-up are stressed as important components of local learning and safety improvement. Development of implementation strategies in 3 phases, focusing on interaction, facilitation and organizational culture, is described. CONCLUSION: A well-developed patient safety culture focusing on prevention of falls will, when successfully achieved, be seen by staff, patients and their significant others as being characteristic of the organization, and will be evident in attitudes, routines and actions. Moreover, it provides potential for positive side-effects concerning organizational and clinical improvements in additional areas.

  • 296.
    Åberg, Anna Cristina
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Geriatrik.
    Lundin-Olsson, Lillemor
    Rosendahl, Erik
    Implementation of evidence-based prevention of falls in rehabilitation units: a staff's interactive approach2009Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 41, nr 13, s. 1034-1040Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To provide strategies to assist healthcare professionals in the area of rehabilitation to improve prevention of falls. DESIGN: A conceptual framework is described as a foundation for the proposal of 2 intertwined strategies, of intervention and implementation, which target the questions: Which strategies for intervention represent the current best evidence? and: How can these strategies be implemented and continuously developed? RESULTS: Strategies for multifactorial and multiprofessional fall preventive interventions are presented in terms of a "fall prevention pyramid model", including general, individualized, and acute interventions. A systematic global fall risk rating by the staff is recommended as an initial procedure. Fall event recording and follow-up are stressed as important components of local learning and safety improvement. Development of implementation strategies in 3 phases, focusing on interaction, facilitation and organizational culture, is described. CONCLUSION: A well-developed patient safety culture focusing on prevention of falls will, when successfully achieved, be seen by staff, patients and their significant others as being characteristic of the organization, and will be evident in attitudes, routines and actions. Moreover, it provides potential for positive side-effects concerning organizational and clinical improvements in additional areas.

  • 297.
    Åhman, Sara
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    Saveman, Britt-Inger
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Styrke, Johan
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Björnstig, Ulf
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Stålnacke, Britt-Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    Long-term follow-up of patients with mild traumatic brain injury: a mixed-methods study2013Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 45, nr 8, s. 758-764Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To characterize the long-term consequences of mild traumatic brain injury regarding post-concussion symptoms, post-traumatic stress, and quality of life; and to investigate differences between men and women.

    DESIGN: Retrospective mixed-methods study.Subjects/patients and methods: Of 214 patients with mild traumatic brain injury seeking acute care, 163 answered questionnaires concerning post-concussion symptoms (Rivermead Post-Concussion Symptoms Questionnaire; RPQ), post-traumatic stress (Impact of Event Scale; IES), and quality of life (Short Form Health Survey; SF-36) 3 years post-injury. A total of 21 patients underwent a medical examination in connection with the survey. The patients were contacted 11 years later, and 10 were interviewed. Interview data were analysed with content analysis.

    RESULTS: The mean total RPQ score was 12.7 (standard deviation; SD 12.9); 10.5 (SD 11.9) for men and 15.9 (SD 13.8) for women (p = 0.006). The 5 most common symptoms were fatigue (53.4%), poor memory (52.5%), headache (50.9%), frustration (47.9%) and depression (47.2%). The mean total IES score was 9.6 (SD 12.9) 7.1 (SD 10.3) for men and 13.0 (SD 15.2) for women (p = 0.004). In general, the studied population had low scores on the Short Form Health Survey (SF-36). The interviews revealed that some patients still had disabling post-concussion symptoms and consequences in many areas of life 11 years after the injury event.

    CONCLUSION: Long-term consequences were present for approximately 50% of the patients 3 years after mild traumatic brain injury and were also reported 11 years after mild traumatic brain injury. This needs to be taken into account by healthcare professionals and society in general when dealing with people who have undergone mild traumatic brain injury.

  • 298.
    Ödman, Pia
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Sjukgymnastik. Linköpings universitet, Hälsouniversitetet.
    Öberg, Brigitta
    Linköpings universitet, Institutionen för medicin och hälsa, Sjukgymnastik. Linköpings universitet, Hälsouniversitetet.
    Effectiveness of intensive training for children with Cerebral Palsy: a comparison between child and youth rehabilitation and conductive education2005Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 37, nr 4, s. 263-270Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: To compare the short-term effectiveness of 1 intensive training period in child and youth rehabilitation with Move&Walk conductive education and describe the effects of 1 intensive training period in terms of changes at 1 year. The amount and influence of additional consumption of training during the 1-year follow-up was also analysed.

    Design: Quasi-experimental with 2 groups: Lemo (n=23) and Move&Walk (n=29).

    Patients: A total of 52 children with cerebral palsy, age range 3–16 years.

    Methods: Data included repeated measures with Gross Motor Function Measure (GMFM) and Pediatric Evaluation of Disability Inventory–Functional Skills (PEDI-FS). Data on additional consumption of training was collected at the 1-year follow-up.

    Results: There was no difference in proportion of change on the clinical measures between the training programmes, except for a higher proportion of improvement on the GMFM total score in Lemo. At the group level, small improvements were shown on GMFM and PEDI FS in the short-term and on PEDI FS only at 1 year. A higher proportion of children who participated in repeated intensive training periods showed improved social functioning.

    Conclusion: No major differences were shown between the 2 training programmes. One intensive training period facilitated small improvements in gross motor function. The majority of children had a high consumption of training during the 1-year follow-up and the added value of repeated intensive training periods was limited.

  • 299. Östlund, Gunilla
    et al.
    Wahlin, Åke
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen.
    Sunnerhagen, Katharina S.
    Borg, Kristian
    Post polio syndrome: Fatigued patients a specific subgroup?2011Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 43, nr 1, s. 39-45Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aims: To examine characteristics of fatigued and non-fatigued post-polio patients and, to define potential subgroups across the fatigue continuum. Design: Multi-center study. Subjects: 143 post-polio patients were, by using the Multi Fatigue Inventory 20 General fatigue ratings, subdivided on the basis of percentile distribution into a fatigue, reference, and non-fatigue group. Methods: Data on background, quality of life, fatigue and pain were collected. Descriptive statistics and correlations in each group and Analysis of Variance and Chi2 for group comparisons were performed. To evaluate differences in the strength of associations between physical and mental fatigue, on the one hand, and vitality on the other, non-linear regressions were employed. Results: The fatigued group was younger, had shorter polio duration, more pain, higher Body Mass Index, lower quality of life and were more physically and mentally fatigued. More had contracted polio after 1956 and were under 65 years of age. Mental fatigue had a relatively higher explanatory value than physical fatigue for differences in vitality in the fatigued group, reversed patterns were seen in the other groups. Conclusions: It may be clamed that the fatigued PPS patients may be considered as a subgroup.

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