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  • 51.
    Muus, Ingrid
    et al.
    Nordiska ministerrådet, Nordic School of Public Health NHV.
    Williams, Linda S
    Ringsberg, Karin C
    Nordiska ministerrådet, Nordic School of Public Health NHV.
    Validation of the Stroke Specific Quality of Life Scale (SS-QOL): test of reliability and validity of the Danish version (SS-QOL-DK).2007Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 21, nr 7, s. 620-7Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To test the reliability and validity of the Danish version of the Stroke Specific Quality of Life Scale version 2.0 (SS-QOL-DK), an instrument for evaluation of health-related quality of life.

    DESIGN: A correlational study.

    SETTING: A stroke unit that provides acute care and rehabilitation for stroke patients in Frederiksborg County, Denmark.

    SUBJECTS: One hundred and fifty-two stroke survivors participated; 24 of these performed test-retest.

    INTERVENTION: Questionnaires were sent out and returned by mail. A subsequent telephone interview assessed functional level and missing items.

    MAIN OUTCOME MEASURES: Test-retest was measured using Spearman's r, internal consistency was estimated using Cronbach's alpha, and evaluation of floor and ceiling values in proportion of minimum and maximum scores. Construct validity was assessed by comparing patients' scores on the SS-QOL-DK with those obtained by other test methods: Beck's Depression Index, the General Health Survey Short Form 36 (SF-36), the Barthel Index and the National Institutes of Health Stroke Scale, evaluating shared variance using coefficient of determination, r2. Comparing groups with known scores assessed known-group validity. Convergent and discriminant validity were assessed.

    RESULTS: Test-retest of SS-QOL-DK showed excellent stability, Spearman's r = 0.65-0.99. Internal consistency for all domains showed Cronbach's alpha = 0.81-0.94. Missing items rate was 1.0%. Most SS-QOL-DK domains showed moderately shared variance with similar domains of other test methods, r2 = 0.03-0.62. Groups with known differences showed statistically significant difference in scores. Item-to-scale correlation coefficients of 0.37-0.88 supported convergent validity.

    CONCLUSIONS: SS-QOL-DK is a reliable and valid instrument for measuring self-reported health-related quality of life on group level among people with mild to moderate stroke.

  • 52.
    Nilsagård, Y
    et al.
    Örebro universitet.
    Lundholm, C
    Karolinska Institutet.
    Denison, Eva
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Gunnarsson, L-G
    Örebro universitetssjukhus.
    Predicting accidental falls in people with multiple sclerosis: a longitudinal study2009Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 23, nr 3, s. 259-269Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To investigate accidental falls and near fall incidents in people with multiple sclerosis with respect to clinical variables and the predictive values of four tests. Design: A longitudinal, multi-centred cohort study with prospectively collected falls. Procedures: Self-reported incidents during the three months following a standardized test procedure. Subjects: Seventy-six people with multiple sclerosis and an Expanded Disability Status Scale score between 3.5 and 6.0. Main outcome measures: Berg Balance Scale, Timed Up and Go cognitive, Four Square Step Test (FSST) and 12-item Multiple Sclerosis Walking Scale. Results: Forty-eight people (63%) registered 270 falls. Most falls occurred indoors during activities of daily life. We found a correlation of r(s) = 0.57 between near falls and falls, and of r(s) = 0.82 between registered and retrospectively recalled falls. Fallers and non-fallers differed significantly regarding Expanded Disability Status Score (odds ratio (OR) 1.99, 95% confidence interval (0) 1.22; 3.40), spasticity (OR 1.14, CI 1.02; 1.31), proprioception (OR 2.50, CI 1.36; 5.12) and use of walking aids (OR 2.27, Cl 1.23; 4.37). Reported use of walking aids both indoors and outdoors increased the odds of falling fivefold while disturbed proprioception increased the odds 2.5-15.6 times depending on severity. The odds of falling were doubled for each degree of increased Expanded Disability Status Score and more than doubled for each degree of increased spasticity. The Berg Balance Scale, use of walking aids and Timed Up and Go cognitive best identified fallers (73-94%) and proprioception, Expanded Disability Status Score, 12-item Multiple Sclerosis Walking Scale and Four Square Step Test best identified non-fallers (75-93%). Conclusions: In clinical practice, looking at the use of walking aids, investigating proprioception and spasticity, rating Expanded Disability Status Score and using Berg Balance Scale or Timed Up and Go cognitive all contribute when identifying fallers

  • 53.
    Nilsagård, Ylva
    et al.
    Örebro universitet, Hälsoakademin.
    Lundholm, Cecilia
    Department of Medical Epidemiology and Biostatistics, Karolinska Institute.
    Denison, E.
    School of Health, Care and Social Welfare, Mälardalen University.
    Gunnarsson, Lars-Gunnar
    Örebro universitet, Hälsoakademin.
    Predicting accidental falls in people with multiple sclerosis: a longitudinal study2009Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 23, nr 3, s. 259-269Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To investigate accidental falls and near fall incidents in people with multiple sclerosis with respect to clinical variables and the predictive values of four tests. Design: A longitudinal, multi-centred cohort study with prospectively collected falls. Procedures: Self-reported incidents during the three months following a standardized test procedure. Subjects: Seventy-six people with multiple sclerosis and an Expanded Disability Status Scale score between 3.5 and 6.0. Main outcome measures: Berg Balance Scale, Timed Up and Go cognitive, Four Square Step Test (FSST) and 12-item Multiple Sclerosis Walking Scale. Results: Forty-eight people (63%) registered 270 falls. Most falls occurred indoors during activities of daily life. We found a correlation of rs=0.57 between near falls and falls, and of rs = 0.82 between registered and retrospectively recalled falls. Fallers and non-fallers differed significantly regarding Expanded Disability Status Score (odds ratio (OR) 1.99, 95% confidence interval (CI) 1.22; 3.40), spasticity (OR 1.14, CI 1.02; 1.31), proprioception (OR 2.50, CI 1.36; 5.12) and use of walking aids (OR 2.27, CI 1.23; 4.37). Reported use of walking aids both indoors and outdoors increased the odds of falling fivefold while disturbed proprioception increased the odds 2.5—15.6 times depending on severity. The odds of falling were doubled for each degree of increased Expanded Disability Status Score and more than doubled for each degree of increased spasticity. The Berg Balance Scale, use of walking aids and Timed Up and Go cognitive best identified fallers (73—94%) and proprioception, Expanded Disability Status Score, 12-item Multiple Sclerosis Walking Scale and Four Square Step Test best identified non-fallers (75—93%). Conclusions: In clinical practice, looking at the use of walking aids, investigating proprioception and spasticity, rating Expanded Disability Status Score and using Berg Balance Scale or Timed Up and Go cognitive all contribute when identifying fallers.

  • 54.
    Nooijen, C. F.
    et al.
    Department of Rehabilitation Medicine, Erasmus MC University Medical Center, Rotterdam.
    Stam, H. J.
    Sluis, T.
    Valent, L.
    Twisk, J.
    van den Berg-Emons, R. J.
    A behavioral intervention promoting physical activity in people with subacute spinal cord injury: secondary effects on health, social participation and quality of life2017Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 31, nr 6, s. 772-780Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To assess, for people with subacute spinal cord injury, if rehabilitation that is reinforced with the addition of a behavioral intervention to promote physical activity leads to a better health, participation and quality of life. DESIGN: Randomized controlled trial. SETTING: Rehabilitation centers. PARTICIPANTS: A total of 39 participants analyzed (45 included), with subacute spinal cord injury in inpatient rehabilitation, dependent on a manual wheelchair (33% tetraplegia, 62% motor complete, 150 +/-74 days postinjury). INTERVENTION: A behavioral intervention promoting physical activity after discharge, involving 13 individual sessions delivered by a coach trained in motivational interviewing, beginning two months before and ending six months after discharge from inpatient rehabilitation. MAIN MEASURES: Physical capacity as determined during a maximal exercise test, body mass index, blood pressure, fasting lipid profile, and social participation (IMPACT-S) and quality of life (SF-36) were determined using questionnaires. Measurements were performed two months before discharge, at discharge, and six and 12 months after discharge from inpatient rehabilitation. B represents the between-group difference. RESULTS: Twelve months after discharge, significant intervention effects were found for diastolic blood pressure (B = -11.35 mmHg, 95% CI = -19.98 to -2.71), total cholesterol (B = -0.89 mmol/L, 95% CI = -1.59 to -0.20), low-density lipoprotein cholesterol (B = -0.63 mmol/L, 95% CI = -1.25 to -0.00) and participation (B = 9.91, 95% CI = 3.34 to 16.48). CONCLUSIONS: A behavioral intervention promoting physical activity after discharge from inpatient rehabilitation improves social participation and seems to reduce risk factors for cardiovascular disease in people with subacute spinal cord injury.

  • 55.
    Norrbrink Budh, Cecilia
    et al.
    Karolinska Institutet, Stockholm.
    Lund, Iréne
    Karolinska Institutet, Stockholm.
    Ertzgaard, Per
    Department of Rehabilitation Medicine, Faculty of Health Sciences, Linköping.
    Holtz, Anders
    Department of Neurosurgery, University Hospital, Uppsala.
    Hultling, Claes
    Karolinska Institutet, Stockholm.
    Richard, Levi
    Karolinska Institutet, Stockholm.
    Werhagen, Lars
    Spinalis SCI unit Karolinska Hospital, Stockholm.
    Lundeberg, Thomas
    Karolinska Institutet, Stockholm.
    Pain in a Swedish spinal cord injury population2003Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 17, nr 6, s. 685-690Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To describe pain and associated variables in a prevalence group of persons with a sustained spinal cord injury (SCI) in the Swedish capital and its surroundings.

    SETTING: Spinalis SCI Unit (outpatient clinic), Stockholm, Sweden.

    DESIGN: Assessment over a 12-month period in a yearly health control.

    SUBJECTS: Four hundred and fifty-six SCI patients.

    RESULTS: Two hundred and ninety-one out of 456 SCI patients (63.7%) suffered from pain, and in 45.7% of these it was classified as being neurogenic. Aching pain was the most used descriptor (38.5%). The onset of pain was commonly within three months (73.5%). In 70.4% of patients pain occurred below the level of the lesion. Most patients identified pain as coming from one (55.0%) or two (28.2%) body regions. Rating of the general pain intensity on a visual analogue scale (VAS) was 46 out of 100 and rating of the worst pain intensity was 78 out of 100. Ninety-four out of 276 patients (32.3%) considered that their quality of life was significantly affected by pain.

    CONCLUSION: Pain was most common in patients with incomplete lesions (ASIA impairment grade D) and there was a correlation between pain and higher mean age at injury and between pain and female gender.

  • 56.
    Nygren DeBoussard, Catharina
    et al.
    Karolinska Inst, Dept Clin Sci, SE-18288 Stockholm, Sweden.;Danderyd Hosp, Univ Dept Rehabil Med Stockholm, SE-18288 Stockholm, Sweden..
    Lannsjö, Marianne
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Sandviken Hosp, Sandviken, Sweden..
    Stenberg, Maud
    Umea Univ, Dept Community Med & Rehabil, Rehabil Med, Umea, Sweden..
    Stalnacke, Britt-Marie
    Umea Univ, Dept Community Med & Rehabil, Rehabil Med, Umea, Sweden..
    Godbolt, Alison K.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Rehabiliteringsmedicin. Karolinska Inst, Dept Clin Sci, SE-18288 Stockholm, Sweden.;Danderyd Hosp, Univ Dept Rehabil Med Stockholm, SE-18288 Stockholm, Sweden..
    Behavioural problems in the first year after Severe traumatic brain injury: a prospective multicentre study2017Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 31, nr 4, s. 555-566Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To investigate the occurrence of behavioural problems in patients with severe traumatic brain injury during the first year after injury and potential associations with outcome. An additional post hoc objective was to analyse the frequency of behaviours with need for intervention from staff.

    Design and setting: In a prospective population based cohort study 114 patients with severe traumatic brain injury were assessed at three weeks, three months and one year after injury.

    Main measures: Assessments included clinical examination and standardised instruments. Agitation was assessed with the Agitated Behaviour Scale, the course of recovery by the Rancho Los Amigo Scale and outcome by Glasgow Outcome Scale Extended.

    Results: Agitation were most common at 3 weeks post injury and 28% (n=68) of the patients showed at least one agitated behaviour requiring intervention from staff. Presence of significant agitation at 3 weeks after injury was not associated with poor outcome. At 3 months agitation was present in 11% (n=90) and apathy in 26 out of 81 assessed patients. At 3 months agitation and apathy were associated with poor outcome at one year.

    Conclusions: Most agitated behaviours in the early phase are transient and are not associated with poor outcome. Agitation and apathy are uncommon at three months but when present are associated with poor outcome at one year after injury. In the early phase after a severe traumatic brain injury agitated behaviour in need of interventions from staff occur in a substantial proportion of patients.

  • 57. Nygren DeBoussard, Catharina
    et al.
    Lannsjö, Marianne
    Stenberg, Maud
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    Stålnacke, Britt-Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    Godbolt, Alison K
    Behavioural problems in the first year after Severe traumatic brain injury: a prospective multicentre study2017Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 31, nr 4, s. 555-566Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To investigate the occurrence of behavioural problems in patients with severe traumatic brain injury during the first year after injury and potential associations with outcome. An additional post hoc objective was to analyse the frequency of behaviours with need for intervention from staff.

    DESIGN AND SETTING: In a prospective population based cohort study 114 patients with severe traumatic brain injury were assessed at three weeks, three months and one year after injury.

    MAIN MEASURES: Assessments included clinical examination and standardised instruments. Agitation was assessed with the Agitated Behaviour Scale, the course of recovery by the Rancho Los Amigo Scale and outcome by Glasgow Outcome Scale Extended.

    RESULTS: Agitation were most common at 3 weeks post injury and 28% (n=68) of the patients showed at least one agitated behaviour requiring intervention from staff. Presence of significant agitation at 3 weeks after injury was not associated with poor outcome. At 3 months agitation was present in 11% (n=90) and apathy in 26 out of 81 assessed patients. At 3 months agitation and apathy were associated with poor outcome at one year.

    CONCLUSIONS: Most agitated behaviours in the early phase are transient and are not associated with poor outcome. Agitation and apathy are uncommon at three months but when present are associated with poor outcome at one year after injury. In the early phase after a severe traumatic brain injury agitated behaviour in need of interventions from staff occur in a substantial proportion of patients.

  • 58.
    Nyström, Anna
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.
    Hellström, Karin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik.
    Fall risk six weeks from onset of stroke and the ability of the Prediction of Falls in Rehabilitation Settings Tool and motor function to predict falls2013Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 27, nr 5, s. 473-479Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective

    To investigate whether the Prediction of Falls in Rehabilitation Settings Tool (Predict FIRST) and motor function could be used to identify people at risk of falling during the first six weeks after stroke, and to compare the risk of falling according to Predict FIRST with real falls frequency.

    Design

    A longitudinal, prospective study.

    Patients

    Sixty-eight people newly diagnosed with stroke admitted to an acute stroke unit.

    Methods

    The participants underwent an assessment of motor ability (Modified Motor Assessment Scale according to Uppsala University Hospital version 99 (M-MAS UAS-99)) and falls risk (Predict FIRST) on the first to fourth day at the acute stroke unit. Falls occurring in the acute stroke unit were recorded and falls occurring after discharge were reported by telephone follow-up. The prediction of falls was analysed with binary logistic regression.

    Results

    Fourteen of the patients (21%) fell at least once during the first six weeks after stroke. The strongest significant predictor for falls was a high score on Predict FIRST (odds ratio 5.21, confidence interval (CI) 1.10–24.78) followed by M-MAS UAS-99 parts C–E (odds ratio 0.65, CI 0.44–0.95). Predict FIRST underestimated the risk of falling as the median fall risk was 9% according to Predict FIRST.

    Conclusion

    Although Predict FIRST has the ability to predict falls in people with recent onset of stroke, there is some underestimation of fall risk.

  • 59. Olofsson, Anna
    et al.
    Andersson, Sven-Olof
    Carlberg, Bo
    'If only I manage to get home I'll get better' - interviews with stroke patients after emergency stay in hospital on their experience and needs2005Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 19, nr 4, s. 433-440Artikel i tidskrift (Refereegranskat)
  • 60.
    Peterson, Magnus
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    Butler, Stephen
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Eriksson, Margaretha
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    Svärdsudd, Kurt
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    A randomized controlled trial of eccentric vs. concentric graded exercise in chronic tennis elbow (lateral elbow tendinopathy)2014Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 28, nr 9, s. 862-872Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective:To analyse treatment effects of eccentric vs. concentric graded exercise in chronic tennis elbow.

    Design:Randomized controlled trial.

    Setting:Primary care in Uppsala County, Sweden.

    Subjects:A total of 120 subjects with tennis elbow lasting more than three months were recruited from primary care and by advertisement.

    Intervention:Eccentric (n = 60) or concentric exercise (n = 60), by lowering or lifting a weight, at home daily, for three months with gradually increasing load.

    Main measures:Pain during muscle contraction and muscle elongation, as well as strength, was assessed at baseline and after one, two, three, six, and 12 months. Function and quality of life was assessed at baseline and after three, six and 12 months.

    Results:The eccentric exercise group had faster regression of pain, with an average of 10% higher responder rate at all levels of pain reduction, both during muscle contraction and elongation, (p < 0.0001 and p = 0.006, respectively). Significant differences were found in Cox's analysis from two months onwards (HR 0.78, 95% confidence interval (CI) 0.63-0.96, p < 0.02). This represents an absolute pain reduction of 10% in the eccentric vs. the concentric group and a number-needed-to-treat of 10. The eccentric group also had a greater increase of muscle strength than the concentric (p < 0.02). The differences persisted throughout the follow-up period. There were no significant differences between the groups regarding function or quality of life measures.

    Conclusion:Eccentric graded exercise reduced pain and increased muscle strength in chronic tennis elbow more effectively than concentric graded exercise.

  • 61. Plüss, Catrine Edström
    et al.
    Karlsson, M. Rydell
    Wallen, N. H.
    Billing, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Held, C.
    Effects of an expanded cardiac rehabilitation programme in patients treated for an acute myocardial infarction or a coronary artery by-pass graft operation2008Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 22, nr 4, s. 306-318Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To investigate the effects of expanded cardiac rehabilitation with multifactorial interventions on metabolic and inflammatory markers, exercise performance and on established cardiovascular risk factors. Design: Single-centre prospective randomized controlled trial. Setting: A university hospital. Subjects: Two hundred and twenty-four patients with an acute myocardial infarction or patients undergoing coronary artery by-pass grafting. Intervention: Patients were randomized to expanded cardiac rehabilitation including stress management, increased physical training, staying at a 'patient hotel' and cooking sessions, or to usual cardiac rehabilitation Main measures: Biochemical risk markers and exercise performance; follow-up was one year. Results: There were no significant differences between the two treatment groups in the changes of biochemical risk markers or in exercise performance. Thus, low-density lipoprotein (LDL)-cholesterol levels decreased from 3.00 (0.97) to 2.54 (0.66) mmol/L in the intervention group and from 3.20 (0.85) to 2.54 (0,63) mmol/L in the control group, fibrinogen levels decreased from 5.30 (2.00) to 4.25 (1.01) g/L in the intervention group and from 5.29 (1.89) to 4.33 (0.83) g/L in the control group and C-reactive protein (CRP) levels decreased from 3.04 (2.79) to 2.09 (2.13) mg/L in the intervention group and from 4.01 (3.49) to 2.39 (2.49) mg/L in the control group. Total workload (W) improved from 118 (35) to 136 (34) in the intervention group and from 117 (36) to 133 (39) in the control group. Conclusion: There was no further significant benefit in biochemical risk markers or in exercise performance among patients undergoing the expanded rehabilitation as compared to the control group which received usual cardiac rehabilitation.

  • 62. Plüss Edström, Catrine
    et al.
    Billing, Ewa
    Held, Claes
    Henriksson, Peter
    Kiessling, Anna
    Rydell Karlsson, Monica
    Sophiahemmet Högskola.
    Wallen, Håkan N
    Long-term effects of an expanded cardiac rehabilitation programme after myocardial infarction or coronary artery bypass surgery: a five-year follow-up of a randomized controlled study2011Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 25, nr 1, s. 79-87Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Expanded cardiac rehabilitation after acute myocardial infarction or coronary artery bypass grafting reduces cardiovascular morbidity and days at hospital for cardiovascular reasons.

  • 63. Porserud, Andrea
    et al.
    Sherif, Amir
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Tollbäck, Anna
    The effects of a physical exercise programme after radical cystectomy for urinary bladder cancer. A pilot randomized controlled trial.2014Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 28, nr 5, s. 451-459Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Assessment of feasibility and effects of an exercise training programme in patients following cystectomy due to urinary bladder cancer.

    Design: Single-blind, pilot, randomized controlled trial.Setting:University hospital, Sweden.

    Subjects: Eighteen patients (64-78 years), of 89 suitable, cystectomized due to urinary bladder cancer, were randomized after hospital discharge to intervention or control.

    Interventions: The 12-week exercise programme included group exercise training twice a week and daily walks. The control group received only standardized information at discharge.

    Main outcome measures: Trial eligibility and compliance to inclusion were registered. Assessments of functional capacity, balance, lower body strength and health-related quality of life (HRQoL) with SF-36.

    Results: Out of 122 patients 89 were eligible, but 64 did not want to participate/were not invited. Twenty-five patients were included, but 7 dropped out before randomization. Eighteen patients were randomized to intervention or control. Thirteen patients completed the training period. The intervention group increased walking distance more than the control group, 109 m (75-177) compared to 62 m (36-119) (P = 0.013), and role physical domain in SF-36 more than the control group (P = 0.031). Ten patients were evaluated one year postoperatively. The intervention group had continued increasing walking distance, 20 m (19-36), whereas the control group had shortened the distance -15.5 m (-43 to -5) (P = 0.010).

    Conclusions: A 12-week group exercise training programme was not feasible for most cystectomy patients. However, functional capacity and the role-physical domain in HRQoL increased in the short and long term for patients in the intervention group compared with controls.

  • 64. Raanaas, Ruth Kjaersti
    et al.
    Patil, Grete Grindal
    Hartig, Terry
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutet för bostads- och urbanforskning (IBF).
    Health benefits of a view of nature through the window: a quasi-experimental study of patients in a residential rehabilitation center2012Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 26, nr 1, s. 21-32Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To examine the health benefits of a bedroom window view to natural surroundings for patients undergoing a residential rehabilitation programme.

    Design: Longitudinal quasi-experiment.

    Setting: A residential rehabilitation centre.

    Subjects: Two-hundred and seventy-eight coronary and pulmonary patients provided data at all measurement points during the programme.

    Intervention: Blind, quasi-random allocation to a private bedroom with a panoramic view to natural surroundings or with a view either partially or entirely blocked by buildings.

    Main measures: Self-reported physical and mental health (SF-12), subjective well-being, emotional states, use of the private bedroom and leisure activities.

    Results: For women, a blocked view appeared to negatively influence change in physical health (time x view x gender interaction, F(4,504)=2.51, P=0.04), whereas for men, a blocked view appeared to negatively influence change in mental health (time x view x gender interaction, F(4,504)=5.67, P<0.01). Pulmonary patients with a panoramic view showed greater improvement in mental health than coronary patients with such a view (time x view x diagnostic group interaction, F(4,504)=2.76, P=0.03). Those with a panoramic view to nature more often chose to stay in their bedroom when they wanted to be alone than those with a blocked view (odds ratio (OR)=2.32, 95% confidence interval (CI) 1.08-5.01).

    Conclusion: An unobstructed bedroom view to natural surroundings appears to have better supported improvement in self-reported physical and mental health during a residential rehabilitation programme, although the degree of change varied with gender and diagnostic group.

  • 65.
    Rodby-Bousquet, Elisabet
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås.
    Agustsson, Atli
    Jonsdottir, Gudny
    Czuba, Tomasz
    Johansson, Ann-Christin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås.
    Hagglund, Gunnar
    Interrater reliability and construct validity of the Posture and Postural Ability Scale in adults with cerebral palsy in supine, prone, sitting and standing positions2014Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 28, nr 1, s. 82-90Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective:To evaluate reliability, internal consistency and construct validity of the Posture and Postural Ability Scale for adults with cerebral palsy. Design:Psychometric evaluation of a clinical assessment tool. Setting:Rehabilitation centres in Sweden and Iceland. Subjects:Thirty adults with cerebral palsy aged 19-22 years, six people at each level I-V of the Gross Motor Function Classification System. Main measures:The Posture and Postural Ability Scale contains a 7-point ordinal scale for postural ability in supine, prone, sitting and standing, and items for assessment of posture. Posture and postural ability was rated from photos and videos by three independent assessors. Interrater reliability was calculated using weighted kappa. Internal consistency was analysed with Cronbach's alpha if item deleted and corrected item-total correlation. Construct validity was evaluated based on known groups, using Jonckheere Terpstra for averaged values of the three raters relative to the Gross Motor Function Classification System. Results:There was an excellent interrater reliability (kappa = 0.85-0.99) and a high internal consistency (alpha = 0.96-0.97, item-total correlation = 0.60-0.91). Median values differed (P < 0.02) between known groups represented by the levels of gross motor function, showing construct validity for all items. Conclusion:The Posture and Postural Ability Scale showed an excellent interrater reliability for experienced raters, a high internal consistency and construct validity. It can detect postural asymmetries in adults with cerebral palsy at all levels of gross motor function.

  • 66.
    Rodby-Bousquet, Elisabet
    et al.
    Lund University.
    Augustson, Atli
    Rehabilitation Centre of Excellence, Kópavogur, Iceland.
    Jonsdottir, Gudny
    Rehabilitation Centre of Excellence, Kópavogur, Iceland.
    Czuba, Tomasz
    Lund university.
    Johansson, Ann-Christin
    Uppsala University.
    Hägglund, Gunnar
    Lund University, Skåne University Hospital, Lund, Sweden.
    Interrater reliability and construct validity of the posture and postural ability scale in adults with cerebral pulsy in supine, prone, siting and standing position2014Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 28, nr 1, s. 82-90Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    Objective To evaluate reliability, internal consistency and construct validity of the Posture and Postural Ability Scale for adults with cerebral palsy. Design Psychometric evaluation of a clinical assessment tool. Setting Rehabilitation Centres in Sweden and Iceland. Subjects Thirty adults with cerebral palsy aged 19-22 years, six people at each level I-V of the Gross Motor Function Classification System. Main measures The Posture and Postural Ability Scale contains a 7-point ordinal scale for postural ability in supine, prone, sitting, and standing and items for assessment of posture. Posture and postural ability was rated from photos and videos by three independent assessors. Interrater reliability was calculated using weighted Kappa. Internal consistency was analysed with Cronbach’s alpha if item deleted and corrected item-total correlation. Construct validity was evaluated based on known groups, using Jonckheere Terpstra for averaged values of the three raters relative to the Gross Motor Function Classification System. Results There was an excellent interrater reliability (kappa=0.85-0.99) and a high internal consistency (alpha=0.96-0.97, item-total correlation=0.60-0.91). Median values differed (p<0.02) between known groups represented by the levels of gross motor function, showing construct validity for all items. Conclusion The Posture and Postural Ability scale showed an excellent interrater reliability for experienced raters, a high internal consistency and construct validity. It can detect postural asymmetries in adults with cerebral palsy at all levels of gross motor function.

  • 67.
    Rodby-Bousquet, Elisabet
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås. Lund Univ, Dept Clin Sci, Lund, Sweden.
    Persson-Bunke, Måns
    Lund Univ, Dept Clin Sci, Lund, Sweden.
    Czuba, Tomasz
    Lund Univ, Natl Musculoskeletal Competence Ctr Qual Register, Lund, Sweden.
    Psychometric evaluation of the Posture and Postural Ability Scale for children with cerebral palsy2016Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 30, nr 7, s. 697-704Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To evaluate construct validity, internal consistency and inter-rater reliability of the Posture and Postural Ability Scale for children with cerebral palsy.

    DESIGN: Evaluation of psychometric properties.

    SETTING: Five child rehabilitation centres in the south of Sweden, in November 2013 to March 2014.

    SUBJECTS: A total of 29 children with cerebral palsy (15 boys, 14 girls), 6-16 years old, classified at Gross Motor Function Classification System (GMFCS) levels II (n = 10), III (n = 7), IV (n = 6) and V (n = 6).

    MAIN MEASURES: Three independent raters (two physiotherapists and one orthopaedic surgeon) assessed posture and postural ability of all children in supine, prone, sitting and standing positions, according to the Posture and Postural Ability Scale. Construct validity was evaluated based on averaged values for the raters relative to known-groups in terms of GMFCS levels. Internal consistency was analysed with Cronbach's alpha and corrected Item-Total correlation. Inter-rater reliability was calculated using weighted kappa scores.

    RESULTS: The Posture and Postural Ability Scale showed construct validity and median values differed between GMFCS levels (p < 0.01). There was a good internal consistency (alpha = 0.95-0.96; item-total correlation = 0.55-0.91), and an excellent inter-rater reliability (kappa score = 0.77-0.99).

    CONCLUSION: The Posture and Postural Ability Scale shows high psychometric properties for children with cerebral palsy, as previously seen when evaluated for adults. It enables detection of postural deficits and asymmetries indicating potential need for support and where it needs to be applied.

  • 68. Rydwik, E.
    et al.
    Karlsson, C.
    Frändin, K.
    Akner, Gunnar
    Örebro universitet, Hälsoakademin.
    Muscle strength testing with one repetition maximum in the arm/shoulder for people aged 75 + - test-retest reliability2007Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 21, nr 3, s. 258-65Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To investigate the reliability of a muscle strength test of the arm/shoulder in elderly people, aged 75 and older, and to compare subjects with and without previous muscle strength training experience.

    DESIGN: Reliability study - test-retest.

    SETTING: Research centre for the elderly.

    MAIN MEASURES: One repetition maximum (1 RM) was measured using an arm/shoulder strength-training device (Pull Down, Norway). Two measurements were conducted, approximately one week apart.

    RESULTS: Forty people were included in the study and 34 completed both sessions. Eleven participants had previous muscle strength training experience on the indicated device. There was a high correlation between the test sessions, r = 0.97 for both groups. The analysis of 95% limits of agreement for the mean difference was -4.3/+6.9 kg for the group without and -3.0/+6.4 kg for the group with previous experience, respectively.

    CONCLUSION: One repetition maximum evaluated by the Pull Down device seems to be a reliable and safe method for dosing and evaluating a muscle strength training programme for elderly people. The observed variation of approximately -4/+7 kg cannot be interpreted as an effect of muscle training, but is more likely an effect of learning, fluctuations in daily condition and/or motivation.

  • 69. Rydwik, Elisabeth
    et al.
    Eliasson, Sara
    Akner, Gunnar
    Örebro universitet, Hälsoakademin.
    The effect of exercise of the affected foot in stroke patients: a randomized controlled pilot trial2006Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 20, nr 8, s. 645-655Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To evaluate the effect of treatment with a portable device called Stimulo on range of motion, muscle strength and spasticity in the ankle joint and its effect on walking ability, balance, activities of daily living (ADL) and health-related quality of life in stroke patients.

    DESIGN: A randomized controlled pilot study.

    SETTING: A research centre.

    SUBJECTS: Ambulatory or partly ambulatory chronic stroke patients with remaining spasticity and/or decreased range of motion in the hemiparetic leg/ankle. Interventions: Standardized and individualized programme including active and passive range of motion of the ankle with a portable device (Stimulo), performed three times a week for 30 min, over a six-week period.

    MAIN MEASURES: Range of motion, muscle strength, spasticity, gait variables, balance, ADL and health-related quality of life.

    RESULTS: Eighteen subjects were included in the study with a mean age of 75 years. The compliance rate was 94-99%. There were no significant differences between the groups.

    CONCLUSION: The study showed no significant effect of an ankle-exercise intervention programme with Stimulo. Further studies with a larger sample size are of importance before any further conclusions can be drawn.

  • 70.
    Sandström, Karin
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Sjukgymnastik. Östergötlands Läns Landsting, Rekonstruktionscentrum, Rehabiliteringsmedicinska kliniken US.
    The lived body: experiences from adults with cerebral palsy2007Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 21, nr 5, s. 432-441Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To get a deeper understanding into how adults with cerebral palsy experience living with a disability and how they manage daily life.

    Design: Interviews with open-ended questions were carried out. They were analysed by one person according to the Empirical Phenomenological Psychological method (EPP).Setting and subjects : Twenty-two community-living adults (35—68 years) with cerebral palsy from five counties in Sweden participated. All had mobility problems and all had cognitive abilities making it possible to carry on a conversation.

    Results: The varied experiences resulted in themes including (1) perceptions of living with a disability and (2) strategies used for managing the described perceptions. The perceptions were: a dys-appearing body, a not-appearing body, difference, being in-between, normality, restricted autonomy and autonomy. The strategies were: to fight one's way, to plan, to get used to it, to hide and to give one's all.

    Conclusion: These interviews expressed heterogeneity in lived experiences showing the importance for professionals to meet people with cerebral palsy as individual subjects in relation to functional problems, self-image and autonomy together with seeing the consequences of different coping strategies.

  • 71.
    Stålnacke, Britt-Marie
    et al.
    Umeå universitet, Institutionen för Rehabiliteringsmedicin.
    Tegner, Yelverton
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Magnusson, Nils-Göran
    Umeå universitet, Institutionen för Rehabiliteringsmedicin.
    Sojka, Peter
    Umeå universitet, Institutionen för Rehabiliteringsmedicin.
    Can the marker of brain damage S-100B be used for prediction of time for return to sport after mild heal injury/concussion2002Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 16, nr 7, s. 803-Artikel i tidskrift (Övrigt vetenskapligt)
  • 72. Svensson, Elisabeth
    et al.
    Häger-Ross, Charlotte
    Hand function in Charcot Marie Tooth: test retest reliability of some measurements.2006Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 20, nr 10Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To evaluate the reliability of some measurements of hand function in people with Charcot Marie Tooth disease.

    DESIGN: Test retest study.

    SETTING: University, hospitals/clinics in northern Sweden.

    SUBJECTS: Twenty people with Charcot Marie Tooth disease.

    MAIN OUTCOME MEASURES: Measures of (1) dexterity; Box and Block Test and Nine-Hole Peg Test, (2) strength; Grippit instrument (grip and pinch), (3) tactile sensation; Shape Texture Identification Test. Statistics used: intraclass correlation (ICC 2.1), limits of agreement, coefficient of repeatability, coefficient of variation, and linear weighted kappa.

    RESULTS: The ICC for the Box and Block Test was very high (0.95). The limits of agreement, coefficient of repeatability (CR) (11.5 blocks/min) and coefficient of variation (CV) (8.4%) were acceptable. There was bias towards a better result on the second occasion. For the Nine-Hole Peg Test, the reliability was good if performance was within 2 min (ICC =0.99, CR = 4.3 s, CV = 3.9%). Grip strength proved to be reliable (ICC = 0.99, CR = 26.7 N, CV = 6.6%), while pinch strength was less reliable. The kappa value of the Shape Texture Identification Test was 0.87, which was considered very good although the test has limitations in terms of how well it can describe patients either performing very well or very poorly.

    CONCLUSIONS: The tested instruments can all be used to evaluate hand function in people with Charcot Marie Tooth. Certain factors, however, like limited time aspects for the Nine-Hole Peg Test and the number of trials used, should be taken into consideration. Pinch strength evaluation should be interpreted with caution.

  • 73.
    Svensson, Elisabeth
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering.
    Häger-Ross, Charlotte
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Hand function in Charcot-Marie-Tooth: test-retest reliability of some measurements2006Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 20, nr 10, s. 896-908Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To evaluate the reliability of some measurements of hand function in people with Charcot Marie Tooth disease.

    DESIGN: Test retest study. SETTING: University, hospitals/clinics in northern Sweden.

    SUBJECTS: Twenty people with Charcot Marie Tooth disease.

    MAIN OUTCOME MEASURES: Measures of (1) dexterity; Box and Block Test and Nine-Hole Peg Test, (2) strength; Grippit instrument (grip and pinch), (3) tactile sensation; Shape Texture Identification Test. Statistics used: intraclass correlation (ICC 2.1), limits of agreement, coefficient of repeatability, coefficient of variation, and linear weighted kappa.

    RESULTS: The ICC for the Box and Block Test was very high (0.95). The limits of agreement, coefficient of repeatability (CR) (11.5 blocks/min) and coefficient of variation (CV) (8.4%) were acceptable. There was bias towards a better result on the second occasion. For the Nine-Hole Peg Test, the reliability was good if performance was within 2 min (ICC =0.99, CR = 4.3 s, CV = 3.9%). Grip strength proved to be reliable (ICC = 0.99, CR = 26.7 N, CV = 6.6%), while pinch strength was less reliable. The kappa value of the Shape Texture Identification Test was 0.87, which was considered very good although the test has limitations in terms of how well it can describe patients either performing very well or very poorly.

    CONCLUSIONS: The tested instruments can all be used to evaluate hand function in people with Charcot Marie Tooth. Certain factors, however, like limited time aspects for the Nine-Hole Peg Test and the number of trials used, should be taken into consideration. Pinch strength evaluation should be interpreted with caution.

  • 74.
    Söderlund, Anne
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Lindberg, Per
    Uppsala University.
    Whiplash-associated disorders--predicting disability from a process-oriented perspective of coping2003Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 17, nr 1, s. 101-107Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To describe the coping process over time for patients with whiplash-associated disorders (WAD). DESIGN: The study was conducted by following patients prospectively for 12 months. SETTINGS: The orthopaedic clinic at a university hospital. SUBJECTS: Fifty-three patients out of 59 had complete data-sets. MAIN OUTCOME MEASURES: Two measures were used: the Pain Disability Index (PDI) and the Coping Strategies Questionnaire (CSQ). RESULTS: The results showed that the proportion of variance in disability shared with coping increased over time. CONCLUSION: The importance of coping as an explanatory factor for disability increased during the one year follow-up. Thus, coping has a crucial role for disability. The possibility of a positive long-term outcome could therefore be improved by teaching patients to use active and adaptive coping strategies shortly after an accident.

  • 75.
    Söderlund, Anne
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Olerud, C
    Uppsala Science Park, Uppsala, Sweden.
    Lindberg, P
    Uppsala Science Park, Uppsala, Sweden.
    Acute whiplash-associated disorders (WAD): the effects of early mobilization and prognostic factors in long-term symptomatology.2000Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 14, nr 5, s. 457-467Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To compare two different home exercise programmes for patients with acute whiplash-associated disorders (WAD). A further aim was to describe the initial prognostic variables related to self-reported pain at six months follow-up. DESIGN: A randomized treatment study with a follow-up period of six months. SETTINGS: The study was undertaken in an orthopaedic clinic at a university hospital. SUBJECTS: A total of 59 symptomatic (neck pain, stiffness, etc.) patients with acute whiplash injury. INTERVENTIONS: Patients were randomized to a regular treatment group (RT group) and an additional-exercise treatment group (AT group). MAIN OUTCOME MEASURES: Pain Disability Index (PDI), Self-Efficacy Scale (SES), Coping Strategies Questionnaire (CSQ), neck range of motion (ROM), head posture, kinaesthetic sensibility, visual analogue scale (VAS). RESULTS: Patients given an additional exercise did not improve more than patients with regular treatment. Only one CSQ item, 'Ability to decrease pain', showed a significant difference between the groups in its pattern of change over time: the AT group had a significant increase between three and six months whilst values in the RT group decreased. Nonsymptomatic patients at six months follow-up were characterized by initially better self-efficacy, lower disability and significantly different patterns in the use of 'behavioural coping strategies' when compared with symptomatic patients. The nonsymptomatic patients also reported more frequent training than symptomatic patients, i.e. they complied better with the treatment regime. CONCLUSION: This home exercise programme, including training of neck and shoulder ROM, relaxation and general advice seems to be sufficient treatment for acute WAD patients when used on a daily basis. Additionally, patients reporting low self-efficacy and high disability levels may profit from more attention initially, as these psychological factors are significant predictors of pain at long-term follow-up.

  • 76.
    Theander, Kersti
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Jakobsson, Per
    Linköpings universitet, Institutionen för medicin och hälsa, Lungmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Kirurgi- och onkologicentrum, Lungmedicinska kliniken US.
    Jorgensen, Nils
    Karlstad Hospital.
    Unosson, Mitra
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Effects of pulmonary rehabilitation on fatigue, functional status and health perceptions in patients with chronic obstructive pulmonary disease: a randomized controlled trial2009Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 23, nr 2, s. 125-136Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To test the effects of pulmonary rehabilitation on fatigue, functional status and health perceptions in patients with chronic obstructive pulmonary disease.

    Design: Randomized controlled trial.

    Setting: Pulmonary outpatient department.

    Subjects: Thirty patients randomly assigned to a rehabilitation (3 men, 9 women, mean age 66 ( 2) years) or a control group (10 men, 4 women, mean age 64 ( 2) years).

    Interventions: The patients in the rehabilitation group participated in a multidisciplinary rehabilitation programme comprising exercise training twice weekly, for a 12-week period, nutritional and self-care advice, and education about disease and energy conservation strategies.

    Main measures: Fatigue, functional limitations due to fatigue, functional performance and satisfaction, six-minute walking distance, hand grip strength and health perception were assessed at baseline and after 12 weeks.

    Results: At baseline there were no significant differences between the groups, except for gender. The six-minute walking distance was 312.6 (+/- 79.3) m for the rehabilitation group and 3603 (+/- 84.7) m for the control group. After 12 weeks, the rehabilitation group improved their walking distance by 40.6 (+/- 27.2) m (P<0.05). The rehabilitation group improved in performance (from 4.8 (12.0) to 6.0 (+/- 1.5) scores, P<0.01) and satisfaction (from 4.6 (+/- 2.2) to 6.0 (+/- 2.1) scores, P<0.001) with regard to own selected daily activities. No statistically significant differences were seen between the changes within the rehabilitation group and changes within the control group at the 12-week follow-up.

    Conclusions: Although the pulmonary rehabilitation programme had an immediate effect, it was not sustained.

  • 77.
    Theander, Kersti
    et al.
    Karlstads universitet, Fakulteten för samhälls- och livsvetenskaper, Avdelningen för omvårdnad.
    Jakobsson, Per
    Jörgensen, Nils
    Unosson, Mitra
    Effects of pulmonary rehabilitation on fatigue, functional status and health perceptions in patients with chronic obstructive pulmonary disease:: a randomized controlled trial2009Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 23, nr 2, s. 125-136Artikel i tidskrift (Refereegranskat)
  • 78.
    Timmer, Amanda J.
    et al.
    School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.
    Unsworth, Carolyn A.
    Högskolan i Jönköping, Hälsohögskolan. School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.
    Taylor, Nicholas F.
    School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.
    Rehabilitation interventions with deconditioned older adults following an acute hospital admission: a systematic review2014Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 28, nr 11, s. 1078-1086Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Objective: To determine effectiveness of inpatient rehabilitation interventions with older deconditioned adults following an acute hospital admission. Data sources: Systematic review of randomised controlled trials (RCTs) from 14 electronic databases from their inception to February 2014. Review methods: Studies selected concerned inpatient rehabilitation, single or multi-factorial interventions, conducted by any discipline, where participants were aged 55 years or older and 50% or more could be classed as deconditioned. Studies were excluded if they focused on acute onset of disability conditions. Data were extracted using the McMaster Quantitative Review Form and appraised using the PEDro Rating Scale. Results: No RCTs were found that specifically addressed the aim. Four studies were reviewed describing multi-disciplinary rehabilitation programs that aimed to reduce functional decline in older adults, with inconsistent findings. However, in two studies participants showed a positive improvement in completing basic activities of daily living (ADL) following multi-disciplinary rehabilitation, one at discharge (median change score Intervention (I)0.23:Control (C)0.15,P=<0.001) and one at 12-months post discharge (I-48.4%: C-25.4% (P 0.001) Relative Risk (RR)1.90 95%CI: 1.15-3.16 (reviewer calculated)). Discharge to home was also measured in two studies with participants in the intervention groups having a higher probability of going home (I-55.6%: C-36.7 %, RR 1.52 95%CI: 1.02-2.26 (reviewer calculated) and I-60%: C-20%, RR 3.00 95%CI: 1.16-7.73(reviewer calculated)). Conclusion: No RCTs have been conducted to examine the effectiveness of specific recondition-ing interventions in rehabilitation, and there is currently insufficient evidence to support the use of geriatric rehabilitation programs to reduce functional decline in older adults who are deconditioned.

  • 79.
    Zidén, Lena
    et al.
    Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg.
    Wenestam, Claes-Göran
    Högskolan Kristianstad, Sektionen för Lärarutbildning.
    Hansson-Scherman, Marianne
    Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg.
    A life-breaking event: early experiences of the consequences of a hip fracture for elderly people2008Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 22, nr 9, s. 801-811Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To explore and describe the consequences of an acute hip fracture as experienced by home-dwelling elderly people shortly after discharge from hospital.Design: Semi-structured interviews using the phenomenographic method.Subjects and setting: Eighteen subjects were interviewed in their own homes one month after discharge.Results: The interviewees described experiences of changes in their relation to the body, themselves, to others and to their whole life situation. These experiences were described as being limited in movement, having lost confidence in the body, becoming humble and grateful, respecting oneself and one's own needs, becoming more dependent on others, gaining more human contact and being treated in a friendly way by others, being secluded and trapped at home, feeling old, closer to death and having lost their zest for life, and taking one day at a time and being uncertain about the future.Conclusion: Experienced consequences of a hip fracture were multidimensional and involved dramatic changes in the interviewees' life situation, including existential thoughts and reappraisal of the years of life that remained. The results indicate that the fracture seemed not only to break the bone but also to cause social and existential cracks, as experienced in the early phase after the injury.

  • 80.
    Åsenlöf, Pernilla
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik.
    Söderlund, Anne
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Sjukgymnastik.
    A further investigation of the importance of pain cognition and behaviour in pain rehabilitation: longitudinal data suggest disability and fear of movement are most important2010Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 24, nr 5, s. 422-430Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

     Tailored treatments are topical in pain rehabilitation. One key issue for correlational studies is the identification of factors having a potential causal impact on essential treatment outcomes.

    Objective

     To study associations between pain beliefs and disability with regard to the amount and time-frame of available data.

    Design

     A prospective, correlational design.

    Subjects and setting

     Ninety-two patients consulting physical therapists in primary care for persistent musculoskeletal pain.

    Main measures

     The Pain Disability Index, the Self-Efficacy Scale and the Tampa Scale of Kinesiophobia.

    Results

     Functional self-efficacy and fear of movement/(re) injury explained variance in pain-related disability pretreatment (adj R-2 = 0.41). Self-efficacy was the most salient predictor. Adding data from immediately post treatment decreased explained variance (adj R-2 = 0.25). Functional self-efficacy and fear of movement/ (re)injury lost their significant contribution in favour of pain-related disability at baseline. Change scores in functional self-efficacy and fear of movement/(re) injury accounted for a modest share of explained variance in change scores of disability (adj R-2 = 0.11). Fear of movement/(re) injury but not functional self-efficacy was related to a reliable change in pain-related disability.

     Conclusions

     Longitudinal data suggest that pretreatment levels of pain-related disability and changes in fear of movement/(re) injury are most important to immediate treatment outcomes and individual reliable change. Disability and elevated fear of movement/(re) injury should therefore be addressed in tailored pain treatments.

  • 81.
    Åsenlöf, Pernilla
    et al.
    Uppsala University, Uppsala, Sweden.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Uppsala University, Uppsala, Sweden.
    A further investigation of the importance of pain cognition and behaviour in pain rehabilitation: longitudinal data suggest disability and fear of movement are most important2010Ingår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 24, nr 5, s. 422-430Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Tailored treatments are topical in pain rehabilitation. One key issue for correlational studies is the identification of factors having a potential causal impact on essential treatment outcomes.

    Objective: To study associations between pain beliefs and disability with regard to the amount and time-frame of available data.

    Design: A prospective, correlational design.

    Subjects and setting: Ninety-two patients consulting physical therapists in primary care for persistent musculoskeletal pain.

    Main measures: The Pain Disability Index, the Self-Efficacy Scale and the Tampa Scale of Kinesiophobia.

    Results: Functional self-efficacy and fear of movement/(re) injury explained variance in pain-related disability pretreatment (adj R(2) = 0.41). Self-efficacy was the most salient predictor. Adding data from immediately post treatment decreased explained variance (adj R(2) = 0.25). Functional self-efficacy and fear of movement/ (re)injury lost their significant contribution in favour of pain-related disability at baseline. Change scores in functional self-efficacy and fear of movement/(re) injury accounted for a modest share of explained variance in change scores of disability (adj R(2) = 0.11). Fear of movement/(re) injury but not functional self-efficacy was related to a reliable change in pain-related disability.

    Conclusions: Longitudinal data suggest that pretreatment levels of pain-related disability and changes in fear of movement/(re) injury are most important to immediate treatment outcomes and individual reliable change. Disability and elevated fear of movement/(re) injury should therefore be addressed in tailored pain treatments. A "

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