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Lexell, Jan
Publications (10 of 10) Show all publications
Jacobsson, L. & Lexell, J. (2020). Functioning and disability from 10 to 16 years after traumatic brain injury. Acta Neurologica Scandinavica, 141(2), 115-122
Open this publication in new window or tab >>Functioning and disability from 10 to 16 years after traumatic brain injury
2020 (English)In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 141, no 2, p. 115-122Article in journal (Refereed) Published
Abstract [en]

Objectives

With increased long-term survival after traumatic brain injury (TBI), there is a need to understand the life situation many years after the injury. In this study, we have assessed persons on average 16 years after their injury and determined changes over 6 years in overall outcome, living condition, marital status and vocational situation, and in their functioning and disability.

Materials & Methods

Individuals (n = 49, mean age 45 years, 28-70 years) who were assessed 6-15 years (average 10 years) post-TBI were reassessed 12-21 years after their injury (average 16 years) using internationally established TBI outcome measures.

Results

From the first to the second assessment, overall outcome using the Glasgow Outcome Scale (GOS) was stable for a large majority and no significant changes in marital status or vocational situation were found. There was some significant, but very small, decline regarding cognitive function, home integration and social integration. In the multiple regression analysis, there was a small significant decline in the Mayo-Portland Adaptability Inventory (MPAI-4) Adjustment subscale score for women with a moderate-to-severe injury.

Conclusions

The very small changes over 6 years imply that persons with a TBI can reach and maintain a stable level of functioning many years post-TBI. Women with a moderate-to-severe TBI seem to be more vulnerable and may experience a small decline in some aspects of their functioning related to anxiety, depression, irritability, pain and headache and fatigue. The relatively small sample requires further studies to confirm these findings.

Keywords
disability evaluation, Glasgow Outcome Scale, outcome, questionnaires, recovery of function, traumatic brain injury
National Category
Neurology
Identifiers
urn:nbn:se:uu:diva-402626 (URN)10.1111/ane.13194 (DOI)000505461300002 ()31705523 (PubMedID)
Available from: 2020-01-17 Created: 2020-01-17 Last updated: 2020-01-17Bibliographically approved
Derman, W., Runciman, P., Jordaan, E., Schwellnus, M., Blauwet, C., Webborn, N., . . . Kim, K.-S. (2020). High incidence of injuries at the Pyeongchang 2018 Paralympic Winter Games: a prospective cohort study of 6804 athlete days. British Journal of Sports Medicine, 54(1), 38-43
Open this publication in new window or tab >>High incidence of injuries at the Pyeongchang 2018 Paralympic Winter Games: a prospective cohort study of 6804 athlete days
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2020 (English)In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 54, no 1, p. 38-43Article in journal (Refereed) Published
Abstract [en]

Objective: To describe the epidemiology of sports injury at the Pyeongchang 2018 Paralympic Winter Games.

Methods: 567 athletes from 49 countries were monitored daily for 12 days over the Pyeongchang 2018 Paralympic Winter Games (6804 athlete days). Injury data were obtained daily from teams with their own medical support (41 teams and 557 athletes) and teams without their own medical support (8 teams and 10 athletes) through two electronic data capturing systems.

Results: 112 of 567 athletes (19.8%) reported a total of 142 injuries, with an injury incidence rate (IR) of 20.9 per 1000 athlete days (95% CI 17.4 to 25.0). The highest IR was reported for para snowboard (IR of 40.5 per 1000 athlete days [95% CI 28.5 to 57.5]; p<0.02), particularly in the lower limb and head/face/neck anatomical areas. Across all sports at the Games, acute traumatic injuries (IR of 16.2 per 1000 athlete days [95% CI 13.2 to 19.8]) and injuries to the shoulder/arm/elbow complex (IR of 5.7 per 1000 athlete days [95% CI 4.2 to 7.8]) were most common. However, most injuries (78.9%) did not require time loss.

Conclusion: The new Paralympic Winter Games sport of Para snowboard requires attention to implement actions that will reduce injury risk. The shoulder was the most injured single joint-a consistent finding in elite para sport.

Place, publisher, year, edition, pages
BMJ PUBLISHING GROUP, 2020
National Category
Sport and Fitness Sciences
Identifiers
urn:nbn:se:uu:diva-403495 (URN)10.1136/bjsports-2018-100170 (DOI)000506224200009 ()30796104 (PubMedID)
Available from: 2020-01-30 Created: 2020-01-30 Last updated: 2020-01-30Bibliographically approved
Jörgensen, S., Svedevall, S., Magnusson, L., Ginis, K. A. M. & Lexell, J. (2019). Associations between leisure time physical activity and cardiovascular risk factors among older adults with long-term spinal cord injury. Spinal Cord, 57(5), 427-433
Open this publication in new window or tab >>Associations between leisure time physical activity and cardiovascular risk factors among older adults with long-term spinal cord injury
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2019 (English)In: Spinal Cord, ISSN 1362-4393, E-ISSN 1476-5624, Vol. 57, no 5, p. 427-433Article in journal (Refereed) Published
Abstract [en]

Study Design: This is a cross-sectional study.

Objectives: To describe the association between cardiovascular risk factors (body mass index (BMI), waist circumference (WC), blood pressure, blood glucose and lipids) and leisure time physical activity (LTPA) in older adults with long-term spinal cord injury (SCI).

Setting: Community settings, southern Sweden.

Methods: Data from the baseline data collection of the Swedish Aging with Spinal Cord Injury Study (SASCIS) (n = 123, 71% men, injury levels C1-L5, American Spinal Injury Association Impairment Scale A-D, mean age 63 years, mean time since injury 24 years). Data were collected through home interviews, assessments and blood samples. The Physical Activity Recall Assessment for People with SCI was used to assess LTPA. Associations were investigated using multivariable linear regression analyses adjusted for age, gender, level and severity of injury, cause of injury, time since injury and tobacco use.

Results: More minutes per day of moderate-to-heavy LTPA were significantly associated with a lower BMI (Beta = -0.31; p = 0.001) and a lower WC (Beta = -0.24; p = 0.009). More minutes per day of total LTPA (mild intensity or greater) were associated with a higher systolic blood pressure (Beta = 0.27; p = 0.041) among participants with tetraplegia. No other significant associations between the cardiovascular risk factors and total LTPA were found.

Conclusion: Participation in daily LTPA is associated with better cardiovascular health with regard to BMI and WC in older adults with long-term SCI. Further studies are needed to establish the specific amount of activity needed to obtain positive health effects in this group and the directional causality of the associations.

Place, publisher, year, edition, pages
NATURE PUBLISHING GROUP, 2019
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-383850 (URN)10.1038/s41393-018-0233-5 (DOI)000466845000012 ()30622291 (PubMedID)
Funder
Swedish Research CouncilForte, Swedish Research Council for Health, Working Life and WelfareGun och Bertil Stohnes Stiftelse
Available from: 2019-05-24 Created: 2019-05-24 Last updated: 2019-05-24Bibliographically approved
Jorgensen, S., Hill, M. & Lexell, J. (2019). Cardiovascular Risk Factors Among Older Adults With Long-Term Spinal Cord Injury. PM&R, 11(1), 8-16
Open this publication in new window or tab >>Cardiovascular Risk Factors Among Older Adults With Long-Term Spinal Cord Injury
2019 (English)In: PM&R, ISSN 1934-1482, E-ISSN 1934-1563, Vol. 11, no 1, p. 8-16Article in journal (Refereed) Published
Abstract [en]

Background: Individuals with spinal cord injury (SCI) now live longer, which increases the risk of cardiovascular disease. Knowledge of cardiovascular risk factors amenable to intervention are therefore needed to support their healthy aging.

Objective: To describe the occurrence of cardiovascular risk factors among older adults with long‐term SCI and investigate the association with sociodemographics and injury characteristics.

Design: Cross‐sectional descriptive cohort study.

Setting: Home settings.

Participants: In total, 123 individuals (71% men, injury levels C1–L5, American Spinal Injury Association Impairment Scale A–D), mean age 63 years, mean time since injury 24 years.

Methods: Data from the Swedish Aging with Spinal Cord Injury Study (SASCIS), collected through interviews and assessments during home visits and from medical records.

Main Outcome Measures: Anthropometric measurements, blood pressure, fasting plasma glucose and blood lipids, and data on cardiovascular comorbidity and tobacco use.

Results: One third had a previous diagnosis of hypertension, and 55% presented with a blood pressure ≥ 140/90 mm Hg at the time of assessment. Sixteen percent had a history of diabetes and in 15% fasting glucose levels were ≥ 7 mmol/L. Dyslipidemia was present in 76%, whereas 16% had prediagnosed dyslipidemia. Mean body mass index (BMI) was 27 kg/m2 and mean waist circumference was 101 cm. When SCI‐adjusted BMI cut‐off values were used, 93% were considered overweight (BMI ≥22 kg/m2), and 60% had a waist circumference associated with cardiometabolic risk. A total of 16% smoked regularly. The median number of cardiovascular risk factors was 3. No significant associations were found between the total number of risk factors and sociodemographics and injury characteristics.

Conclusions: The high occurrence of cardiovascular risk factors among older adults with long‐term SCI can pose additional consequences to their health. Regular assessments and interventions targeting cardiovascular risk in this population are therefore warranted. Further research is needed to identify modifiable factors associated with their risk profile.

Level of Evidence: III

National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:uu:diva-377368 (URN)10.1016/j.pmrj.2018.06.008 (DOI)000457224000002 ()29964213 (PubMedID)
Funder
Swedish Research CouncilForte, Swedish Research Council for Health, Working Life and WelfareGun och Bertil Stohnes Stiftelse
Available from: 2019-02-25 Created: 2019-02-25 Last updated: 2019-02-25Bibliographically approved
Derman, W., Runciman, P., Jordaan, E., Schwellnus, M., Blauwet, C., Webborn, N., . . . Kim, K.-S. (2019). Incidence rate and burden of illness at the Pyeongchang 2018 Paralympic Winter Games. British Journal of Sports Medicine, 53(17), 1099-1104
Open this publication in new window or tab >>Incidence rate and burden of illness at the Pyeongchang 2018 Paralympic Winter Games
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2019 (English)In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 53, no 17, p. 1099-1104Article in journal (Refereed) Published
Abstract [en]

Objective To describe the incidence rate (IR) and illness burden (IB) at the Pyeongchang 2018 Paralympic Winter Games.

Methods A total of 567 athletes from 49 countries were monitored for 12 days over the Pyeongchang 2018 Games (6804 athlete days). Illness data were obtained daily from teams with (41 teams, 557 athletes) and teams without (8 teams, 10 athletes) their own medical support, through electronic data capturing systems.

Results There were 87 illnesses reported, with an illness IR of 12.8 illnesses per 1000 athlete days (95% CI 10.2 to 16.0) and IB of 6.8 days lost per 1000 athlete days (95% CI 3.4 to 13.5). The highest IR was reported for Para snowboard (IR of 19.7 [95% CI 12.0 to 32.2]). Illnesses in the respiratory system (IR of 4.1 [95% CI 2.9 to 5.9]; IB of 1.4 [95% CI 0.6 to 3.0]), skin and subcutaneous system (IR of 2.5 [95% CI 1.5 to 4.1]; IB of 0.6 [95% CI 0.1 to 2.9]), and eye and ocular adnexa (IR of 1.6 [95% CI 0.9 to 3.1]; IB of 0.5 [95% CI 0.1 to 3.3]) were the most common.

Conclusion This is the first study to report both the IR and IB in this setting. There was a high IR of illness in the new sport of Para snowboard. The respiratory system had both the highest IR and IB.

 

National Category
Sport and Fitness Sciences
Identifiers
urn:nbn:se:uu:diva-397649 (URN)10.1136/bjsports-2018-100096 (DOI)000493920700008 ()30636703 (PubMedID)
Available from: 2019-12-03 Created: 2019-12-03 Last updated: 2019-12-03Bibliographically approved
Blauwet, C., Webborn, N., Kissick, J., Lexell, J., Stomphorst, J., van de Vliet, P., . . . Derman, W. (2019). When van Mechelen's sequence of injury prevention model requires pragmatic and accelerated action: the case of para alpine skiing in Pyeong Chang 2018. British Journal of Sports Medicine, 53(22), 1391-1392
Open this publication in new window or tab >>When van Mechelen's sequence of injury prevention model requires pragmatic and accelerated action: the case of para alpine skiing in Pyeong Chang 2018
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2019 (English)In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 53, no 22, p. 1391-1392Article in journal, Editorial material (Other academic) Published
National Category
Sport and Fitness Sciences
Identifiers
urn:nbn:se:uu:diva-399976 (URN)10.1136/bjsports-2018-099997 (DOI)000498577100005 ()30967380 (PubMedID)
Available from: 2019-12-17 Created: 2019-12-17 Last updated: 2019-12-17Bibliographically approved
Goosey-Tolfrey, V. L., van der Scheer, J. W., Lexell, J., Clements, K. & Ginis, K. A. M. (2018). Development of scientific exercise guidelines for adults with spinal cord injury. British Journal of Sports Medicine, 52(18), 1166-1167
Open this publication in new window or tab >>Development of scientific exercise guidelines for adults with spinal cord injury
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2018 (English)In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 52, no 18, p. 1166-1167Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
BMJ PUBLISHING GROUP, 2018
Keywords
physical activity, aerobic fitness, exercise training, rehabilitation, strength
National Category
Sport and Fitness Sciences
Identifiers
urn:nbn:se:uu:diva-364831 (URN)10.1136/bjsports-2018-099202 (DOI)000443599000009 ()29695510 (PubMedID)
Available from: 2018-11-05 Created: 2018-11-05 Last updated: 2018-11-05Bibliographically approved
Lexell, J., Jonasson, S. B. & Brogardh, C. (2018). Psychometric Properties of Three Fatigue Rating Scales in Individuals With Late Effects of Polio. ANNALS OF REHABILITATION MEDICINE-ARM, 42(5), 702-712
Open this publication in new window or tab >>Psychometric Properties of Three Fatigue Rating Scales in Individuals With Late Effects of Polio
2018 (English)In: ANNALS OF REHABILITATION MEDICINE-ARM, ISSN 2234-0645, Vol. 42, no 5, p. 702-712Article in journal (Refereed) Published
Abstract [en]

Objective To evaluate the psychometric properties of the Fatigue Severity Scale (FSS), the Fatigue Impact Scale (FIS), and the Multidimensional Fatigue Inventory (MFI-20) in persons with late effects of polio (LEoP). More specifically, we explored the data completeness, scaling assumptions, targeting, reliability, and convergent validity. Methods A postal survey including FSS, FIS, and MFI-20 was administered to 77 persons with LEoP. Responders received a second survey after 3 weeks to enable test-retest reliability analyses. Results Sixty-one persons (mean age, 68 years; 54% women) responded to the survey (response rate 79%). Data quality of the rating scales was high (with 0%-0.5% missing item responses), the corrected item-total correlations exceeded 0.4 and the scales showed very little floor or ceiling effects (0%-6.6%). All scales had an acceptable reliability (Cronbach's alpha >= 0.95) and test-retest reliability (intraclass correlation coefficient, >= 0.80). The standard error of measurement and the smallest detectable difference were 7%-10% and 20%-28% of the possible scoring range. All three scales were highly correlated (Spearman's correlation coefficient r(s)=0.79-0.80; p<0.001). Conclusion The FSS, FIS, and MFI-20 exhibit sound psychometric properties in terms of data completeness, scaling assumptions, targeting, reliability, and convergent validity, suggesting that these three rating scales can be used to assess fatigue in persons with LEoP. As FSS has fewer items and therefore is less time consuming it may be the preferred scale. However, the choice of scale depends on the research question and the study design.

Place, publisher, year, edition, pages
KOREAN ACAD REHABILITATION MEDICINE, 2018
Keywords
Fatigue, Postpoliomyelitis syndrome, Psychometrics, Rehabilitation, Reliability of results
National Category
Nursing Neurology
Identifiers
urn:nbn:se:uu:diva-369749 (URN)10.5535/arm.2018.42.5.702 (DOI)000449459700007 ()30404419 (PubMedID)
Available from: 2018-12-18 Created: 2018-12-18 Last updated: 2018-12-18Bibliographically approved
Ekstrand, E., Lexell, J. & Brogardh, C. (2018). Test-Retest Reliability Of The Life Satisfaction Questionnaire (LISAT-11) And Association Between Items In Individuals With Chronic Stroke. Journal of Rehabilitation Medicine, 50(8), 713-718
Open this publication in new window or tab >>Test-Retest Reliability Of The Life Satisfaction Questionnaire (LISAT-11) And Association Between Items In Individuals With Chronic Stroke
2018 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 50, no 8, p. 713-718Article in journal (Refereed) Published
Abstract [en]

Objective: To evaluate the test-retest reliability of the Life Satisfaction Questionnaire (LiSat-11) and the association between items in individuals with chronic stroke. Design: Test-retest design. Subjects: Forty-five individuals (mean age 65 years) with mild to moderate disability at least 6 months post-stroke. Methods: LiSat-11, which includes 1 global item "Life as a whole" and 10 domain-specific items, was rated on 2 occasions, one week apart. Test-retest reliability was evaluated by kappa statistics, the percent agreement (PA) and the Svensson rank-invariant method. The association between items was evaluated with the Spearman's rank correlation coefficient (rho). Results: The kappa coefficients showed good to excellent agreement (0.59-0.97) and the PA <= 1 point was high (> 89%) for all items. According to the Svensson method, a small systematic disagreement was found for "Partner relationship". The other items showed no systematic or random disagreements. All domain-specific items, except one ("Sexual life") were significantly correlated with "Life as a whole" (rhos 0.29-0.80). Conclusion: LiSat-11 is considered reliable and can be recommended for assessing life satisfaction after stroke. The association between items indicates that LiSat-11 measures various aspects that can impact on an individual's life satisfaction.

Keywords
outcome assessment, psychometrics, rehabilitation, reproducibility of results, self-report, quality of life, stroke
National Category
Other Medical Sciences not elsewhere specified
Identifiers
urn:nbn:se:uu:diva-362633 (URN)10.2340/16501977-2362 (DOI)000441351600005 ()30080236 (PubMedID)
Available from: 2018-10-09 Created: 2018-10-09 Last updated: 2018-10-09Bibliographically approved
Ekstrand, E., Lexell, J. & Brogårdh, C. (2018). Test-Retest Reliability of The Participation Domain of the Stroke Impact Scale in Persons with Chronic Stroke. Journal of Rehabilitation Medicine, 50(9), 843-846
Open this publication in new window or tab >>Test-Retest Reliability of The Participation Domain of the Stroke Impact Scale in Persons with Chronic Stroke
2018 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 50, no 9, p. 843-846Article in journal (Refereed) Published
Abstract [en]

Objective: To evaluate the test-retest reliability and variability of the Participation domain of the Stroke Impact Scale (SIS Participation) in persons with stroke as it is widely used to assess perceived participation in rehabilitation after stroke.

Design: A test-retest design. Subjects: Forty-five persons (mean age 65 years) with mild to moderate disability at least 6 months post-stroke.

Methods: The SIS Participation domain was rated on 2 occasions, 1 week apart. The test-retest reliability of the total score was evaluated using Kappa statistics. The 8 item scores were evaluated by the proportion of participants who rated the same score (percentage agreement, PA) or +/- 1 point (PA <= 1 point) at T1 and T2. The Svensson method was used to evaluate systematic and random disagreement.

Results: The test-retest reliability of the total score showed excellent agreement (Kappa coefficient = 0.79). The items showed high PA <= 1 point (> 82%). No items, except 2, showed a systematic disagreement, and no items showed a random disagreement according to the Svensson method.

Conclusion: The SIS Participation domain is reliable in persons with chronic stroke and mild to moderate disability and can be used to assess perceived participation in this population.

Place, publisher, year, edition, pages
FOUNDATION REHABILITATION INFORMATION, 2018
Keywords
outcome assessment, psychometrics, rehabilitation, reproducibility of results, self-report, social participation, stroke
National Category
Neurology Physiotherapy Other Medical Sciences not elsewhere specified
Identifiers
urn:nbn:se:uu:diva-369114 (URN)10.2340/16501977-2378 (DOI)000447771700010 ()30132013 (PubMedID)
Available from: 2018-12-11 Created: 2018-12-11 Last updated: 2018-12-11Bibliographically approved
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