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  • 1.
    Bertilsson, Ann-Sofie
    et al.
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    Ekstam, Lisa
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.; Lund Univ, Dept Hlth Sci, Lund, Sweden.; Karolinska Univ Hosp, Dept Occupat Therapy, Huddinge, Sweden .
    Tham, Kerstin
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.; Karolinska Univ Hosp, Dept Occupat Therapy, Huddinge, Sweden.
    Andersson, Magnus
    Karolinska Inst, Dept Clin Neurosci, Solna, Sweden.; Karolinska Univ Hosp, Dept Neurol, Stockholm, Sweden.
    von Koch, Lena
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.; Karolinska Univ Hosp, Dept Neurol, Stockholm, Sweden.
    Johansson, Ulla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    A cluster randomized controlled trial of a client-centred, activities of daily living intervention for people with stroke: One year follow-up of caregivers2016In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 30, no 8, p. 765-775Article in journal (Refereed)
    Abstract [en]

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

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

    Setting: Inpatient and outpatient rehabilitation.

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

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

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

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

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

  • 2.
    Bertilsson, Ann-Sofie
    et al.
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    Ekstam, Lisa
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.; Lund Univ, Dept Hlth Sci, Lund, Sweden.; Karolinska Univ Hosp, Dept Occupat Therapy, Huddinge, Sweden .
    Tham, Kerstin
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.; Karolinska Univ Hosp, Dept Occupat Therapy, Huddinge, Sweden.
    Andersson, Magnus
    Karolinska Inst, Dept Clin Neurosci, Solna, Sweden.; Karolinska Univ Hosp, Dept Neurol, Stockholm, Sweden.
    von Koch, Lena
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.; Karolinska Univ Hosp, Dept Neurol, Stockholm, Sweden.
    Johansson, Ulla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    A cluster randomized controlled trial of a client-centred, activities of daily living intervention for people with stroke: One year follow-up of caregivers2016In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 30, no 8, p. 765-775Article in journal (Refereed)
    Abstract [en]

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

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

    Setting: Inpatient and outpatient rehabilitation.

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

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

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

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

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

  • 3.
    Bogefeldt, Johan P
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology.
    Grunnesjö, Marie I
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology.
    Svärdsudd, Kurt F
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology.
    Blomberg, Stefan I E
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology.
    Sick leave reductions from a comprehensive manual therapy programme for low back pain: the Gotland Low Back Pain Study2008In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 22, no 6, p. 529-41Article in journal (Refereed)
    Abstract [en]

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

  • 4.
    Bring, Annika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Åsenlöf, Pernilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Söderlund, Anne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    What is the comparative effectiveness of current standard treatment, against an individually tailored behavioural programme delivered either on the Internet or face-to-face for people with acute whiplash associated disorder? A randomized controlled trial2016In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 30, no 5, p. 441-453Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

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

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

  • 5. Denkinger, Michael D.
    et al.
    Igl, Wilmar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Genetics and Pathology.
    Jamour, Michael
    Bader, Anne
    Bailer, Stefanie
    Lukas, Albert
    Nikolaus, Thorsten
    Does functional change predict the course of improvement in geriatric inpatient rehabilitation?2010In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 24, no 5, p. 463-470Article in journal (Refereed)
    Abstract [en]

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

  • 6. Edström Plüss, Cathrine
    et al.
    Billing, Ewa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Held, Claes
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Henriksson, Peter
    Kiessling, Anna
    Rydell Karlsson, Monica
    Wallén, Håkan N.
    Long-term effects of an expanded cardiac rehabilitation programme after myocardial infarction or coronary artery bypass surgery: a five-year follow-up of a randomized controlled study2011In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 25, no 1, p. 79-87Article in journal (Refereed)
    Abstract [en]

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

  • 7.
    Emilson, Christina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Demmelmaier, Ingrid
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    Bergman, Stefan
    Res & Dev Ctr Spenshult, Halmstad, Sweden.; Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden..
    Lindberg, Per
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Denison, Eva
    Malardalen Univ, Sch Hlth Care & Social Welf, Vasteras, Sweden..
    Åsenlöf, Pernilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
    A 10-year follow-up of tailored behavioural medicine treatment and exercise-based physiotherapy in persistent musculoskeletal pain2017In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 31, no 2, p. 186-196Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

  • 8. Franzén-Dahlin, A.
    et al.
    Larson, J.
    Murray, V.
    Wredling, R.
    Billing, Ewa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    A randomized controlled trial evaluating the effect of a support and education programme for spouses of people affected by stroke2008In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 22, no 8, p. 722-730Article in journal (Refereed)
    Abstract [en]

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

  • 9.
    Grunnesjö, Marie I
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Bogefeldt, Johan P
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Blomberg, Stefan I E
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Strender, Lars-Erik
    Karolinska Institutet, Institutionen för neurobiologi, vårdvetenskap och samhälle, Department of Neurobiology, Care Science and Society.
    Svärdsudd, Kurt F
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    A randomized controlled trial of the effects of muscle stretching, manual therapy and steroid injections in addition to 'stay-active' care on health-related quality of life in acute and sub-acute low back pain2011In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 25, no 11, p. 999-1010Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

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

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

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

  • 10. Hammer, Ann
    et al.
    Lindmark, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Is forced use of the paretic upper limb beneficial? - A randomized pilot study during subacute post-stroke recovery2009In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 23, no 5, p. 424-433Article in journal (Refereed)
    Abstract [en]

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

  • 11.
    Hedman, Annicka
    et al.
    Karolinska Inst, Dept Neurobiol Care Sci & Soc NVS, Div Occupat Therapy, Box 23 200, SE-14183 Huddinge, Sweden.
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine. Karolinska Inst, Dept Neurobiol Care Sci & Soc NVS, Div Occupat Therapy, Box 23 200, SE-14183 Huddinge, Sweden.
    von Koch, Lena
    Karolinska Inst, Dept Neurobiol Care Sci & Soc NVS, Div Occupat Therapy, Box 23 200, SE-14183 Huddinge, Sweden;Karolinska Univ Hosp, Neuro, Stockholm, Sweden.
    Guidetti, Susanne
    Karolinska Inst, Dept Neurobiol Care Sci & Soc NVS, Div Occupat Therapy, Box 23 200, SE-14183 Huddinge, Sweden.
    Five-year follow-up of a cluster-randomized controlled trial of a client-centred activities of daily living intervention for people with stroke2019In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 33, no 2, p. 262-276Article in journal (Refereed)
    Abstract [en]

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

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

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

    Participants: People with stroke and significant others.

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

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

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

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

  • 12.
    Hellström, Karin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Vahlberg, Birgit
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Urell, Charlotte
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Emtner, Margareta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Fear of falling, fall-related self-efficacy, anxiety and depression in individuals with chronic obstructive pulmonary disease2009In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 23, no 12, p. 1136-1144Article in journal (Refereed)
    Abstract [en]

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

  • 13. Langhammer, Birgitta
    et al.
    Lindmark, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Stanghelle, Johan K.
    Stroke patients and long-term training: is it worthwhile?: A randomized comparison of two different training strategies after rehabilitation2007In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 21, no 6, p. 495-510Article in journal (Refereed)
    Abstract [en]

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

  • 14.
    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 University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, 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 University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine. 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 study2017In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 31, no 4, p. 555-566Article in journal (Refereed)
    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.

  • 15.
    Nyström, Anna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Hellström, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    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 falls2013In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 27, no 5, p. 473-479Article in journal (Refereed)
    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.

  • 16.
    Peterson, Magnus
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Butler, Stephen
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
    Eriksson, Margaretha
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Svärdsudd, Kurt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    A randomized controlled trial of eccentric vs. concentric graded exercise in chronic tennis elbow (lateral elbow tendinopathy)2014In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 28, no 9, p. 862-872Article in journal (Refereed)
    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.

  • 17. Plüss, Catrine Edström
    et al.
    Karlsson, M. Rydell
    Wallen, N. H.
    Billing, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Held, C.
    Effects of an expanded cardiac rehabilitation programme in patients treated for an acute myocardial infarction or a coronary artery by-pass graft operation2008In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 22, no 4, p. 306-318Article in journal (Refereed)
    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.

  • 18. Raanaas, Ruth Kjaersti
    et al.
    Patil, Grete Grindal
    Hartig, Terry
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Institute for Housing and Urban Research.
    Health benefits of a view of nature through the window: a quasi-experimental study of patients in a residential rehabilitation center2012In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 26, no 1, p. 21-32Article in journal (Refereed)
    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.

  • 19.
    Rodby-Bousquet, Elisabet
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Agustsson, Atli
    Jonsdottir, Gudny
    Czuba, Tomasz
    Johansson, Ann-Christin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    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 positions2014In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 28, no 1, p. 82-90Article in journal (Refereed)
    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.

  • 20.
    Rodby-Bousquet, Elisabet
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. 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 palsy2016In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 30, no 7, p. 697-704Article in journal (Refereed)
    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.

  • 21. Svensson, Elisabeth
    et al.
    Häger-Ross, Charlotte
    Hand function in Charcot Marie Tooth: test retest reliability of some measurements.2006In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 20, no 10Article in journal (Refereed)
    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.

  • 22.
    Åsenlöf, Pernilla
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Söderlund, Anne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    A further investigation of the importance of pain cognition and behaviour in pain rehabilitation: longitudinal data suggest disability and fear of movement are most important2010In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 24, no 5, p. 422-430Article in journal (Refereed)
    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.

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