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  • 1.
    Adolfsson, Margareta
    et al.
    Högskolan för lärande och kommunikation, Högskolan i Jönköping.
    Granlund, Mats
    Hälsohögskolan, Högskolan i Jönköping.
    Björck-Åkesson, Eva
    Högskolan för lärande och kommunikation, Högskolan i Jönköping.
    Ibragimova, Nina
    Akademin för utbildning, kultur och kommunikation, Mälardalens högskola.
    Pless, Mia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Exploring changes over time in habilitation professionals' perceptions and applications of the International Classification of Functioning, Disability and Health, version for Children and Youth (ICF-CY).2010In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 42, no 7, p. 670-678Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE

    This study explored how professionals in inter-disciplinary teams perceived the implementation of the World Health Organization's International Classification of Functioning, Disability and Health, version for Children and Youth (ICF-CY) in Swedish habilitation services.

    DESIGN

    Descriptive longitudinal mixed-methods design.

    METHODS

    Following participation in a 2-day in-service training on the ICF-CY, 113 professionals from 14 interdisciplinary teams described their perceptions of the implementation of the ICF-CY at 3 consecutive time-points: during in-service training, after 1 year, and after 2.5 years.

    RESULTS

    Implementation of the ICF-CY in daily work focused on assessment and habilitation planning and required adaptations of routines and materials. The ICF-CY was perceived as useful in supporting analyses and in communication about children's needs. Professionals also perceived it as contributing to new perspectives on problems and a sharpened focus on participation.

    CONCLUSION

    Professionals indicated that the ICF-CY enhanced their awareness of families' views of child participation, which corresponded to organizational goals for habilitation services. An implementation finding was a lack of tools fitting the comprehensive ICF-CY perspective. The study points to the need for ICF-CY-based assessment and intervention methods focusing on child participation

  • 2. Agnew, Louise
    et al.
    Johnston, Venerina
    Ludvigsson, Maria Landen
    Peterson, Gunnel
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Overmeer, Thomas
    Johansson, Gun
    Peolsson, Anneli
    Factors associated with work ability in patients with chronic whiplash-associated disorder grade II-III: A cross-sectional analysis2015In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 47, no 6, p. 546-551Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate the factors related to self-perceived work ability in patients with chronic whiplash-associated disorder grades II-III. Design: Cross-sectional analysis. Patients: A total of 166 working age patients with chronic whiplash-associated disorder. Methods: A comprehensive survey collected data on work ability (using the Work Ability Index); demographic, psychosocial, personal, work- and condition-related factors. Forward, stepwise regression modelling was used to assess the factors related to work ability. Results: The proportion of patients in each work ability category were as follows: poor (12.7%); moderate (39.8%); good (38.5%); excellent (9%). Seven factors explained 65% (adjusted R-2 = 0.65, p < 0.01) of the variance in work ability. In descending order of strength of association, these factors are: greater neck disability due to pain; reduced self-rated health status and health-related quality of life; increased frequency of concentration problems; poor workplace satisfaction; lower self-efficacy for performing daily tasks; and greater work-related stress. Conclusion: Condition-specific and psychosocial factors are associated with self-perceived work ability of individuals with chronic whiplash-associated disorder.

  • 3.
    Baunsgaard, Carsten Bach
    et al.
    Univ Copenhagen, Rigshosp, Clin Spinal Cord Injuries, Havnevej 25, DK-3100 Hornbaek, Denmark.
    Nissen, Ulla Vig
    Univ Copenhagen, Rigshosp, Clin Spinal Cord Injuries, Havnevej 25, DK-3100 Hornbaek, Denmark.
    Brust, Anne Katrin
    SPC, Nottwil, Switzerland.
    Frotzler, Angela
    SPC, Nottwil, Switzerland.
    Ribeill, Cornelia
    Ulm Univ, SCI Ctr Orthopaed Dept, Ulm, Germany.
    Kalke, Yorck-Bernhard
    Ulm Univ, SCI Ctr Orthopaed Dept, Ulm, Germany.
    Leon, Natacha
    FLM, Madrid, Spain.
    Gomez, Belen
    FLM, Madrid, Spain.
    Samuelsson, Kersti
    Linkoping Univ, Dept Rehabil Med, Linkoping, Sweden;Linkoping Univ, Dept Med & Hlth Sci, Linkoping, Sweden.
    Antepohl, Wolfram
    Linkoping Univ, Dept Rehabil Med, Linkoping, Sweden;Linkoping Univ, Dept Med & Hlth Sci, Linkoping, Sweden.
    Holmstrom, Ulrika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurosurgery. Uppsala Univ Hosp, Spinal Cord Rehabil Unit, Uppsala, Sweden.
    Marklund, Niklas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurosurgery. Uppsala Univ Hosp, Spinal Cord Rehabil Unit, Uppsala, Sweden.
    Glott, Thomas
    Sunnaas Rehabil Hosp, Nesoddtangen, Norway.
    Opheim, Arve
    Sunnaas Rehabil Hosp, Nesoddtangen, Norway;Univ Gothenburg, Sahlgrenska Acad, Inst Neurosci & Physiol, Rehabil Med, Gothenburg, Sweden;Reg Vastra Gotaland, Habilitat & Hlth, Gothenburg, Sweden.
    Benito Penalva, Jesus
    Neurorehabil Hosp, Inst Guttmann, Barcelona, Spain.
    Murillo, Narda
    Neurorehabil Hosp, Inst Guttmann, Barcelona, Spain.
    Nachtegaal, Janneke
    Heliomare Rehabil Ctr, Wijk Aan Zee, Netherlands.
    Faber, Willemijn
    Heliomare Rehabil Ctr, Wijk Aan Zee, Netherlands.
    Biering-Sorensen, Fin
    Univ Copenhagen, Rigshosp, Clin Spinal Cord Injuries, Havnevej 25, DK-3100 Hornbaek, Denmark.
    Exoskeleton Gait Training After Spinal Cord Injury: An Exploratory Study on Secondary Health Conditions2018In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 50, no 9, p. 806-813Article in journal (Refereed)
    Abstract [en]

    Objective: To explore changes in pain, spasticity, range of motion, activities of daily living, bowel and lower urinary tract function and quality of life of individuals with spinal cord injury following robotic exoskeleton gait training.

    Design: Prospective, observational, open-label multicentre study. Methods: Three training sessions per week for 8 weeks using an Ekso GT robotic exoskeleton (Ekso Bionics). Included were individuals with recent (<1 year) or chronic (>1 year) injury, paraplegia and tetraplegia, complete and incomplete injury, men and women.

    Results: Fifty-two participants completed the training protocol. Pain was reported by 52% of participants during the week prior to training and 17% during training, but no change occurred longitudinally. Spasticity decreased after a training session compared with before the training session (p< 0.001), but not longitudinally. Chronically injured participants increased Spinal Cord Independence Measure (SCIM III) from 73 to 74 (p= 0.008) and improved life satisfaction (p= 0.036) over 8 weeks of training. Recently injured participants increased SCIM III from 62 to 70 (p<0.001), but no significant change occurred in life satisfaction. Range of motion, bowel and lower urinary function did not change over time.

    Conclusion: Training seemed not to provoke new pain. Spasticity decreased after a single training session. SCIM III and quality of life increased longitudinally for subsets of participants.

  • 4. Bergstrom, Aileen L.
    et al.
    Guidetti, Susanne
    Tistad, Malin
    Tham, Kerstin
    von Koch, Lena
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Perceived occupational gaps one year after stroke: An explorative study2012In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 44, no 1, p. 36-42Article in journal (Refereed)
    Abstract [en]

    Objective: To explore and describe factors associated with occupational gaps and to identify factors at 3 months that predict occupational gaps one year post-stroke. A gap, a restriction in participation, is considered to be present when there is a discrepancy between what the individual wants to do and what they actually do in everyday life. Design: Prospective longitudinal study. Subjects: Two hundred persons with stroke. Methods: Data from the Occupational Gaps Questionnaire, one year post-stroke, was used as the dependent variable in 3- and 12-month regression analyses. Domains of the Stroke Impact Scale, global life satisfaction, demographic and medical factors were used as independent variables. Results: At 3 months, activities of daily living abilities, social participation and not being born in Sweden predicted occupational gaps at 12 months. Stroke severity and not being born in Sweden and 3 factors at 12 months: social participation, self-rated recovery, and global life satisfaction were associated with occupational gaps. Conclusion: Activities of daily living ability at 3 months predicted occupational gaps after stroke. Thus, it is possible to identify early on, and provide interventions for, those that risk participation restrictions. Not being born in the country might be an indicator of a risk for participation restrictions.

  • 5.
    Bergström, Aileen L.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    von Koch, Lena
    Andersson, Magnus
    Tham, Kerstin
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Participation in everyday life and life satisfaction in persons with stroke and their caregivers 3–6 months after onset2015In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 47, no 6, p. 508-515Article in journal (Refereed)
    Abstract [en]

    Objective: To explore and describe persons with stroke and their caregivers' restrictions in participation in everyday occupations, i.e. occupational gaps, 3-6 months post-stroke, in relation to life satisfaction, combined life satisfaction, caregiver burden, perceived impact of stroke, and activities of daily living. Design: Cross-sectional study. Subjects: Persons with stroke and their caregivers (105 dyads). Methods: The Occupational Gaps Questionnaire, Life Satisfaction Checklist, Caregiver Burden Scale, Stroke Impact Scale and Barthel Index were used. Correlations were analysed with Spearman's rank, and regression analyses used life satisfaction as the dependent variable. Results: At least one person in 86% of the dyads perceived restrictions in participation, with the most common gap in travelling for pleasure. Correlations were low between the numbers of occupational gaps and life satisfaction (R=-0.33, R=-0.31); however, life satisfaction accounted for occupational gaps both for persons with stroke and for caregivers. A greater number of occupational gaps were perceived in the dyads with combined low levels of life satisfaction compared with those with combined high levels of life satisfaction. Conclusion: Participation in everyday occupations is related to life satisfaction even for caregivers of persons with stroke. The results of this study add to our knowledge about the stroke-caregiver dyad and will help to inform family-centred approaches within stroke rehabilitation.

  • 6.
    Bergström, Aileen L.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    von Koch, Lena
    Andersson, Magnus
    Tham, Kerstin
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Participation in everyday life and life satisfaction in persons with stroke and their caregivers 3–6 months after onset2015In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 47, no 6, p. 508-515Article in journal (Refereed)
    Abstract [en]

    Objective: To explore and describe persons with stroke and their caregivers' restrictions in participation in everyday occupations, i.e. occupational gaps, 3-6 months post-stroke, in relation to life satisfaction, combined life satisfaction, caregiver burden, perceived impact of stroke, and activities of daily living. Design: Cross-sectional study. Subjects: Persons with stroke and their caregivers (105 dyads). Methods: The Occupational Gaps Questionnaire, Life Satisfaction Checklist, Caregiver Burden Scale, Stroke Impact Scale and Barthel Index were used. Correlations were analysed with Spearman's rank, and regression analyses used life satisfaction as the dependent variable. Results: At least one person in 86% of the dyads perceived restrictions in participation, with the most common gap in travelling for pleasure. Correlations were low between the numbers of occupational gaps and life satisfaction (R=-0.33, R=-0.31); however, life satisfaction accounted for occupational gaps both for persons with stroke and for caregivers. A greater number of occupational gaps were perceived in the dyads with combined low levels of life satisfaction compared with those with combined high levels of life satisfaction. Conclusion: Participation in everyday occupations is related to life satisfaction even for caregivers of persons with stroke. The results of this study add to our knowledge about the stroke-caregiver dyad and will help to inform family-centred approaches within stroke rehabilitation.

  • 7.
    Buhrman, Monica
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Nilsson-Ihrfelt, Elisabeth
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Jannert, Maria
    Ström, Lars
    Andersson, Gerhard
    Guided internet-based cognitive behavioural treatment for chronic back pain reduces pain catastrophizing: a randomized controlled trial2011In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 43, no 6, p. 500-505Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study was to investigate whether an Internet-based cognitive behavioural intervention would have an effect on the symptoms of chronic back pain. Design: Experimental design with a treatment group and a control group measured before and after a treatment period. Subjects: Participants who met the criteria for chronic back pain (n = 54). Methods: All participants were screened in a live, structured interview before inclusion. The study period was 12 weeks and the treatment consisted of education, cognitive skills acquisition, behavioural rehearsal, generalization and maintenance. The main outcome of interest was the catastrophizing subscale of the Coping Strategies Questionnaire. Results: There were statistically significant reductions from pre- to post-treatment in catastrophizing in the treatment group, and an improvement in quality of life for the treatment group. However, most outcome measures did not indicate a positive treatment outcome. On a scale measuring pain catastrophizing, 58% (15/26) of the treated participants showed reliable improvement, compared with 18% (5/28) of the control group. Conclusion: Internet-based cognitive behavioural therapy can serve as a complement for individuals with chronic pain who prefer this treatment and have difficulties accessing specialist treatment facilities.

  • 8.
    Dyster-Aas, Johan
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Kildal, Morten
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Willebrand, Mimmie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Return to work and health-related quality of life after burn injury2007In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 39, no 1, p. 49-55Article in journal (Refereed)
    Abstract [en]

    Objective: Although severe burn injury is associated with long-term rehabilitation and disability, research on returning to work in burn patients is limited. The aims of this study were: (i) to explore injury- and personality-related predictors of returning to work, and (ii) to compare health-related quality of life and health outcome in working versus non-working individuals.Design: Cross-sectional study.Subjects: Forty-eight former patients with pre-burn employment were evaluated on average 3.8 years after the burn.Methods: Data were collected from medical records and by a questionnaire in which the patients were asked about their main activity status described in the terms: work, studies, pension, disability pension, sick leave or unemployment. It also contained the Swedish universities Scales of Personality, SF-36, Burn Specific Health Scale-Brief, items assessing fear-avoidance, Impact of Event Scale-Revised and Hospital Anxiety and Depression Scale.Results: Thirty-one percent had not returned to work. In logistic regression, returning to work was associated with time since injury, the extent of full-thickness injuries, and the personality trait embitterment. Those who did not work had lower health-related quality of life, poorer burn-specific health, more fear-avoidance and more symptoms of post-traumatic stress disorder, but they did not differ from those who were working regarding general mood.Conclusion: Returning to work was explained by both injury severity and personality characteristics. Those who did not work were characterized by low health-related quality of life and poorer trauma-related physical and psychological health.

  • 9.
    Ekstrand, Elisabeth
    et al.
    Lund Univ, Dept Hlth Sci, Lund, Sweden;Skane Univ Hosp, Dept Hand Surg, Malmo, Sweden.
    Lexell, Jan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine. Lulea Univ Technol, Dept Hlth Sci, Lulea, Sweden;Lund Univ, Dept Hlth Sci, Lund, Sweden.
    Brogardh, Christina
    Skane Univ Hosp, Dept Neurol & Rehabil Med, Lund, Sweden;Lund Univ, Dept Hlth Sci, Lund, Sweden.
    Test-Retest Reliability Of The Life Satisfaction Questionnaire (LISAT-11) And Association Between Items In Individuals With Chronic Stroke2018In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 50, no 8, p. 713-718Article in journal (Refereed)
    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.

  • 10.
    Ekstrand, Elisabeth
    et al.
    Lund Univ, Dept Hlth Sci, Lund, Sweden;Skane Univ Hosp, Dept Hand Surg, Malmo, Sweden.
    Lexell, Jan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine. Lund Univ, Dept Hlth Sci, Lund, Sweden.
    Brogårdh, Christina
    Lund Univ, Dept Hlth Sci, Lund, Sweden;Skane Univ Hosp, Dept Neurol & Rehabil Med, Lund, Sweden.
    Test-Retest Reliability of The Participation Domain of the Stroke Impact Scale in Persons with Chronic Stroke2018In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 50, no 9, p. 843-846Article in journal (Refereed)
    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.

  • 11.
    Elmgren Frykberg, Gunilla
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Lindmark, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Lanshammar, Håkan
    Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Automatic control.
    Borg, Jörgen
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Correlation between clinical assessment and force plate measurement of postural control after stroke2007In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 39, no 6, p. 448-453Article in journal (Refereed)
    Abstract [en]

    Objectives: To explore the correlation between clinical assessmentand force plate measurement of postural control after stroke when selected balance tasks are performed under similar spatial and temporal conditions, and to examine the inter-rater agreement of assessment of weight distribution during quiet stance in subjects with stroke.

    Design: A descriptive and correlational study.

    Methods: Clinical assessment of postural control using Berg Balance Scale, video recording for rating of weight distribution, and force plate measurement with the Vifor-system, were performed in 20 subjects with stroke.

    Results: Mean velocity of displacement of the centre of pressure in the anterior-posterior direction correlated moderately with scores from the Berg Balance Scale items “maintaining a position” in the whole sample (rs = –0.50, p <0.05) as well as in a subgroup of subjects with stroke with submaximal Berg Balance Scale scores (rs = –0.62, p < 0.05). Moderate correlation was found between ratings of each of 3 physiotherapistsand centre of pressure’s mean position in the frontal plane on the force plate, while the inter-rater agreement was poor.

    Conclusion: Clinical assessment of postural control and weight distribution showed moderate correlation with force plate measurement when the assessments were performed under similar conditions. The data suggest that the reliability of observational postural analysis needs to be improved.

  • 12.
    Eriksson, Gunilla
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Kottorp, Anders
    Borg, Jörgen
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Tham, Kerstin
    Relationship between occupational gaps in everyday life, depressive mood and life satisfaction after acquired brain injury2009In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 41, no 3, p. 187-194Article in journal (Refereed)
    Abstract [en]

    Objective: To explore the relationship between occupational gaps, depressive mood and life satisfaction in persons who have acquired a brain injury during the past 1-4 years and to test the Occupational Gaps Questionnaire. Design: A cross-sectional study. Subjects: A total of 116 persons with traumatic brain injury or subarachnoid haemorrhage acquired 1-4 years previously. Methods: A postal survey with questions on occupational gaps, focusing on the domains instrumental activities of daily living, social life, leisure and work (Occupational Gaps Questionnaire), life satisfaction (LiSat-11 checklist) and depressive mood (Hospital Anxiety and Depression Scale). Rasch analyses and principal component analyses were performed to ensure that data from the LiSat-11 and Occupational Gaps Questionnaire could be used subsequently as valid unidimensional measures in regression and correlational analyses. Results: Calibration of the Occupational Gaps Questionnaire and the LiSat-11 revealed that the items and persons demonstrated acceptable goodness-of-fit to the Rasch models respectively, supporting internal scale validity and person-response validity. In addition, principal component analyses revealed that the measures could be used as valid uni-dimensional estimations of occupational gaps and life satisfaction. There was a strong relationship between the extent of occupational gaps and perceived life satisfaction, a weaker relationship with depressive mood and a non-significant relationship with the aetiological diagnoses and life satisfaction. The factors explained 32% (occupational gaps), 6% (depressive mood), and 2% (diagnosis), respectively, of the total explained variance (40%). Conclusion: There was a strong correlation between participation in desired everyday occupations and life satisfaction 1-4 years after an acquired brain injury. This indicates that individually perceived occupational gaps, as recorded by the for tailored interventions in order to improve life satisfaction among clients with acquired brain injuries.

  • 13.
    Eriksson, Gunilla
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Tham, Kerstin
    Borg, Jörgen
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Occupational gaps in everyday life 1-4 years after aquired brain injury2006In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 38, no 3, p. 159-65Article in journal (Refereed)
    Abstract [en]

    Objective: To explore adaptation, by examining the occupational gaps occurring between what individuals want to do and what they actually do in terms of their everyday activities before and after brain injury. In addition, the relationships between occupational gaps and impairment/activity limitations and the time lapse since the brain injury were explored. Design: A cross-sectional study. Subjects: A total of 187 persons, affected by traumatic brain injury or subarachnoid haemorrhage 1–4 years previously. Methods: A postal questionnaire encompassing questions concerning gaps in the performance of activities in everyday life before and after the brain injury and perceived impairment/activity limitations. Results: The numbers of occupational gaps increased after the injury, with the number of gaps having increased from 46% to 71%. The number of occupational gaps was significantly related to executive impairment/activity limitations, and motor impairment/activity limitations and other somatic impairments, such as headache, also had an impact. The time lapse since the brain injury had no significant effect on the number of occupational gaps. Conclusion: The results suggests that there is a need for adaptation in everyday activities, even several years after a brain injury, which indicates that follow-up and access to individualized rehabilitation interventions in the long-term are required.

  • 14.
    Godbolt, Alison K.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    DeBoussard, Catharine Nygren
    Stenberg, Maud
    Lindgren, Marie
    Ulfarsson, Trandur
    Borg, Jorgen
    Disorders of consciousness after severe traumatic brain injury: a Swedish-Icelandic study of incidence, outcomes and implications for optimizing care pathways2013In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 45, no 8, p. 741-748Article in journal (Refereed)
    Abstract [en]

    Background: Very severe traumatic brain injury may cause disorders of consciousness in the form of coma, unresponsive wakefulness syndrome (also known as vegetative state) or minimally conscious state. Previous studies of outcome for these patients largely pre-date the 2002 definition of minimally conscious state. Objectives: To establish the numbers of patients with disorder of consciousness at 3 weeks, 3 months and 1 year after severe traumatic brain injury, and to relate conscious state 3 weeks after injury to outcomes at 1 year. Design: Multi-centre, prospective, observational study of severe traumatic brain injury. Inclusion criteria: lowest (non-sedated) Glasgow Coma Scale 3-8 during the first 24 h; requirement for neurosurgical intensive care; age 18-65 years; alive 3 weeks after injury. Diagnosis of coma, unresponsive wakefulness syndrome, minimally conscious state or emerged from minimally conscious state was based on clinical and Coma Recovery Scale Revised assessments 3 weeks, 3 months and 1 year after injury. One-year outcome was measured with Glasgow Outcome Scale Extended (GOSE). Results: A total of 103 patients was included in the study. Of these, 81% were followed up to 1 year (76% alive, 5% dead). Three weeks after injury 36 were in coma, unresponsive wakefulness syndrome or minimally conscious state and 11 were anaesthetized. Numbers of patients who had emerged from minimally conscious state 1 year after injury, according to status at 3 weeks were: coma (0/6), unresponsive wakefulness syndrome (9/17), minimally conscious state (13/13), anaesthetized (9/11). Outcome at 1 year was good (GOSE>4) for half of patients in minimally conscious state or anaesthetized at 3 weeks, but for none of the patients in coma or unresponsive wakefulness syndrome. These differences in outcome were not revealed by prognostic predictions based on acute data. Conclusion: Patients in minimally conscious state or anaesthetized 3 weeks after injury have a better prognosis than patients in coma or unresponsive wakefulness syndrome, which could not be explained by acute prognostic models.

  • 15. Grimby, Gunnar
    et al.
    Smedby, Björn
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    ICF approved as the successor of ICIDH2001In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 33, no 5, p. 193-94Article in journal (Refereed)
  • 16. Guidetti, Susanne
    et al.
    Ytterberg, Charlotte
    Ekstam, Lisa
    Johansson, Ulla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Disability and Habilitation.
    Changes in the impact of stroke between 3 and 12 months post-stroke, assessed with the Stroke Impact Scale2014In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 46, no 10, p. 963-968Article in journal (Refereed)
    Abstract [en]

    Objective: To examine data collected using the Stroke Impact Scale 3.0 (SIS) at 3 and 12 months post-stroke, and to explore any clinically meaningful changes in everyday life in relation to age, gender and stroke severity. Design: Prospective longitudinal study. Methods: A total of 204 persons were assessed using the SIS at 3 and 12 months after onset of stroke. Changes in domain scores were calculated over time and in relation to age, gender and stroke severity. Results: The Strength, Hand Function and Participation domains had the highest perceived impact at 3 and 12 months, indicating problems in everyday life. Stroke recovery was perceived to be significantly higher at 12 than at 3 months irrespective of stroke severity, age or gender. The impact on the Strength and Emotion domains was significantly lower at 12 months than at 3 months. Most clinically meaningful changes, both positive and negative ( 15 points), were seen in the Participation domain and in Stroke recovery. Few changes were associated with age, gender or stroke severity. Conclusion: Both positive and negative clinically meaningful changes related to impact of stroke were found between 3 and 12 months post-stroke. Therefore it is important to pay close attention to patients' perceptions of their everyday life situation during rehabilitation and at discharge.

  • 17. Guidetti, Susanne
    et al.
    Ytterberg, Charlotte
    Ekstam, Lisa
    Johansson, Ulla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Disability and Habilitation.
    Changes in the impact of stroke between 3 and 12 months post-stroke, assessed with the Stroke Impact Scale2014In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 46, no 10, p. 963-968Article in journal (Refereed)
    Abstract [en]

    Objective: To examine data collected using the Stroke Impact Scale 3.0 (SIS) at 3 and 12 months post-stroke, and to explore any clinically meaningful changes in everyday life in relation to age, gender and stroke severity. Design: Prospective longitudinal study. Methods: A total of 204 persons were assessed using the SIS at 3 and 12 months after onset of stroke. Changes in domain scores were calculated over time and in relation to age, gender and stroke severity. Results: The Strength, Hand Function and Participation domains had the highest perceived impact at 3 and 12 months, indicating problems in everyday life. Stroke recovery was perceived to be significantly higher at 12 than at 3 months irrespective of stroke severity, age or gender. The impact on the Strength and Emotion domains was significantly lower at 12 months than at 3 months. Most clinically meaningful changes, both positive and negative ( 15 points), were seen in the Participation domain and in Stroke recovery. Few changes were associated with age, gender or stroke severity. Conclusion: Both positive and negative clinically meaningful changes related to impact of stroke were found between 3 and 12 months post-stroke. Therefore it is important to pay close attention to patients' perceptions of their everyday life situation during rehabilitation and at discharge.

  • 18.
    Gustavsson, Catharina
    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.
    Bergstrom, Jakob
    Denison, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    von Koch, Lena
    Predictive factors for disability outcome at twenty weeks AND two years following a pain self-management group intervention in patients with persistent neck pain in primary health care2013In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 45, no 2, p. 170-176Article in journal (Refereed)
    Abstract [en]

    Objective: To explore possible predictors associated with short-term (post-treatment) and long-term (2 years) treatment success in terms of pain-related disability for patients with persistent neck pain following a pain and stress self-management intervention (PASS). Methods: Data from 77 participants assigned to PASS in a randomized controlled trial were explored to identify possible predictors of favourable outcome regarding pain-related disability as measured by the Neck Disability Index (NDI), by use of Pearson correlation analysis, partial least squares (PLS) and ordinary least squares (OLS) regression analyses. Data from self-assessment questionnaires completed by the participants before, post-treatment (i.e. 20 weeks after inclusion) and 2 years after inclusion in the study, were used. Results: Multivariate PLS regression analysis showed that baseline scores in NDI, the Self-Efficacy Scale. (SES) and pain intensity explained 31% of the variance in disability (NDI) post-treatment. Multivariate PLS regression analysis showed that post-treatment scores in NDI, SES and pain intensity explained 68% of the variance in disability (NDI) at 2 years. Conclusion: Treatment gains, as measured by post-treatment scores at 20-week follow-up, in disability, self-efficacy and pain intensity were associated with long-term outcome in pain-related disability at 2 years, in patients with persistent neck pain participating in a self-management group intervention in primary health care.

  • 19.
    Gustavsson, Martha
    et al.
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Huddinge, Sweden.
    Guidetti, Susanne
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, 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, Div Occupat Therapy, Huddinge, Sweden.
    von Koch, Lena
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Huddinge, Sweden;Karolinska Univ Hosp, Theme Neuro, Stockholm, Sweden.
    Ytterberg, Charlotte
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Physiotherapy, Huddinge, Sweden;Karolinska Univ Hosp, Funct Area Occupat Therapy & Physiotherapy, Huddinge, Sweden.
    Factors affecting outcome in participation one year after stroke: a secondary analysis of a randomized controlled trial2019In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 51, no 3, p. 160-166Article in journal (Refereed)
    Abstract [en]

    Objective:

    To explore the importance of client characteristics (age, sex, stroke severity and participation before stroke), rehabilitation context (in-patient or client's home) and approach (enhanced client-centeredness or not) on participation in everyday life after stroke.

    Methods:

    A secondary analysis of data on 237 participants from a previous randomized controlled trial evaluating an enhanced client-centred intervention after stroke. Plausible associations between client characteristics, context and rehabilitation approach, and a positive outcome regarding participation were explored. Three different outcome measures for participation were used: Stroke Impact Scale 3.0, domain participation; Frenchay Activities Index; and Occupational Gaps Questionnaire.

    Results:

    For all participants there was a significant association between mild stroke and a positive outcome using the Frenchay Activities Index. Among participants who had not received the enhanced client-centred approach, there was a significant association between mild stroke and a positive outcome using the Stroke Impact Scale. The context of rehabilitation, i.e. receiving home rehabilitation, was also associated with a positive outcome in the Frenchay Activities Index for the control group.

    Conclusion:

    In order to increase participation in everyday life for people after stroke it appears to be important to use an enhanced client-centred approach, particularly when working within in-patient rehabilitation and with people with moderate or severe stroke.

  • 20.
    Hellström, Karin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Lindmark, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Wahlberg, Birgit
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Fugl-Meyer, Axel R
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Self-efficacy in relation to impairments and ADL disability in elderly stroke patients: A prospective investigation2003In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 35, no 5, p. 202-207Article in journal (Refereed)
    Abstract [en]

    Objectives: The objectives of this prospective study, under-taken in elderly patients with stroke undergoing rehabilita-tion, were to determine to what extent fall-related self-efficacy changes over time, its relationships to objectivelyassessed functions and activities, and the predictive capacityof self-efficacy at discharge for activities of daily living 10months after stroke.

    Methods: The study comprised 37 patients, aged 66–89 years.Main outcome measurement instruments were the FallsEfficacy Scale (Swedish version), Berg Balance Scale andFunctional Independence Measure.

    Results: Significant improvements occurred in all thesemeasures from admission to discharge, but patients with lowself-efficacy at discharge showed less pronounced improve-ments than those with high self-efficacy. Falls Efficacy Scale(Swedish version) was closely associated with all othermeasures and was a more powerful predictor of activities ofdaily living than the observer-based measures of balance.

    Conclusion: To minimize dependence in activities of dailyliving, rehabilitation interventions should incorporate self-efficacy enhancement.

  • 21. Ibragimova, Nina Klang
    et al.
    Pless, Mia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Adolfsson, Margareta
    Granlund, Mats
    Björck-Åkesson, Eva
    Using content analysis to link texts on assessment and intervention to the International Classification of Functioning, Disability and Health: version for Children and Youth (ICF-CY)2011In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 43, no 8, p. 728-733Article in journal (Refereed)
    Abstract [en]

    Objective: To explore how content analysis can be used together with linking rules to link texts on assessment and intervention to the International Classification of Functioning, Disability and Health version for children and youth (ICF-CY). Methods: Individual habilitation plans containing texts on assessment and intervention for children with disabilities and their families were linked to the ICF-CY using content analysis. Texts were first divided into meaning units in order to extract meaningful concepts. Meaningful concepts that were difficult to link to ICF-CY codes were grouped, and coding schemes with critical attributes were developed. Meaningful concepts that could not be linked to the ICF-CY were assigned to the categories "not-definable" and "not-covered", using coding schemes with mutually exclusive categories. Results: The size of the meaning units selected resulted in different numbers and contents of meaningful concepts. Coding schemes with critical attributes of ICF-CY codes facilitated the linking of meaningful concepts to the most appropriate ICF-CY codes. Coding schemes with mutually exclusive categories facilitated the classification of meaningful concepts that could or could not be linked to the ICF-CY. Conclusion: Content analysis techniques can be applied together with linking rules in order to link texts on assessment and intervention to the ICF-CY.

  • 22. Ibragimova, Nina Klang
    et al.
    Pless, Mia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Adolfsson, Margareta
    Granlund, Mats
    Björck-Åkesson, Eva
    Using content analysis to link texts on assessment and intervention to the International Classification of Functioning, Disability and Health: version for Children and Youth (ICF-CY)2011In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 43, no 8, p. 728-733Article in journal (Refereed)
    Abstract [en]

    Objective: To explore how content analysis can be used together with linking rules to link texts on assessment and intervention to the International Classification of Functioning, Disability and Health version for children and youth (ICF-CY). Methods: Individual habilitation plans containing texts on assessment and intervention for children with disabilities and their families were linked to the ICF-CY using content analysis. Texts were first divided into meaning units in order to extract meaningful concepts. Meaningful concepts that were difficult to link to ICF-CY codes were grouped, and coding schemes with critical attributes were developed. Meaningful concepts that could not be linked to the ICF-CY were assigned to the categories "not-definable" and "not-covered", using coding schemes with mutually exclusive categories. Results: The size of the meaning units selected resulted in different numbers and contents of meaningful concepts. Coding schemes with critical attributes of ICF-CY codes facilitated the linking of meaningful concepts to the most appropriate ICF-CY codes. Coding schemes with mutually exclusive categories facilitated the classification of meaningful concepts that could or could not be linked to the ICF-CY. Conclusion: Content analysis techniques can be applied together with linking rules in order to link texts on assessment and intervention to the ICF-CY.

  • 23.
    Jacobson, Dan N. O.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Dept Womens & Childrens Hlth, Neuropediat Unit, Stockholm, Sweden.
    Lowing, Kristina
    Karolinska Inst, Dept Womens & Childrens Hlth, Neuropediat Unit, Stockholm, Sweden;Karolinska Univ Hosp, Stockholm, Sweden.
    Hjelmarsson, Emma
    Karolinska Univ Hosp, Stockholm, Sweden.
    Tedroff, Krishna
    Karolinska Inst, Dept Womens & Childrens Hlth, Neuropediat Unit, Stockholm, Sweden.
    Exploring social participation in young adults with cerebral palsy2019In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 51, no 3, p. 167-174Article in journal (Refereed)
    Abstract [en]

    Objectives:

    To describe social outcomes for young adults with cerebral palsy, and to explore associations of social outcomes with their classification levels within the Gross Motor Function, Manual Ability and Communication Function Classification Systems, and with the presence of intellectual disability.

    Design:

    A cross-sectional study with a population-based inclusion approach at a neuropaediatric referral centre in Sweden.

    Subjects:

    Sixty-one young adults with cerebral palsy, age 20-22 years.

    Methods:

    Physical examination and questionnaires on social outcomes including living arrangements, relationships, occupation, personal finances, extent of family support with personal care, and physical examination.

    Results:

    Twenty percent of the young adults with cerebral palsy had moved out of the parental home. Forty-three percent were dependent on family support for basic activities of daily living. Seventy-nine percent of those without intellectual disability were employed or studying. The Communication Function Classification Systems, and presence of intellectual disability, demonstrated associations with most social outcomes, followed in significance by Manual Ability Classification System.

    Conclusion:

    In this study young adults with cerebral palsy to a high extent lived in the parental home, and more often without employment, compared with their peers. Many were dependent on parental support, financially, and with activities of daily living. Intellectual disability and communication function were important determinants of social participation. Interventions aimed at alleviating the impact of these particular disabilities should be prioritized.

  • 24.
    Lannsjö, Marianne
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Borg, Jörgen
    Björklund, Gunilla
    Af Geijerstam, Jean-Luc
    Lundgren-Nilsson, Asa
    Internal construct validity of the Rivermead Post-Concussion Symptoms Questionnaire2011In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 43, no 11, p. 997-1002Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate the internal construct validity of the Rivermead Post-Concussion Symptoms Questionnaire (RPQ) by Rasch analysis of data from a national cohort of patients with mild traumatic brain injury.

    METHODS: Data collected at 3 months after mild traumatic brain injury from 2,523 patients were analysed using the partial credit model, describing rating scale structure, local dependency, age and gender differential functioning, dimensionality and model fit.

    RESULTS: Categories did not work in a consistent manner; however, collapsing of Categories 1 and 2 yielded ordered thresholds. Local dependency of items was present and 2 item pairs were combined. There was no differential item functioning by gender or age. The Rasch factor explained 47.7% of the variance and the first contrast explained 12.4% of the unexplained variance (eigenvalue 1.9). Further analysis indicated 3 or more dimensions. Person measure had a mean of -2.16, showing poor targeting of persons to items. Person reliability was 0.71 and person separation index was 1.56.

    CONCLUSION: According to this Rasch analysis of data from a representative sample of mild traumatic brain injury, the RPQ may not be optimal for this population. Even after reducing the number of categories and collapsing items with local dependency, unidimensionality was not reached, which argues against summation of a total score. However, the scale is unbiased for gender and age.

  • 25.
    Lannsjö, Marianne
    et al.
    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.
    Raininko, Raili
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Radiology, Oncology and Radiation Science, Radiology.
    Bustamante, Mariana
    Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Division of Visual Information and Interaction. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis and Human-Computer Interaction.
    von Seth, Charlotta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Borg, Jörgen
    Brain pathology after mild traumatic brain injury: An exploratory study by repeated magnetic resonance examination2013In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 45, no 8, p. 721-728Article in journal (Refereed)
    Abstract [en]

    Objective:

    To explore brain pathology after mild traumatic brain injury by repeated magnetic resonance examination.

    Design:

    A prospective follow-up study.

    Subjects:

    Nineteen patients with mild traumatic brain injury presenting with Glasgow Coma Scale (GCS) 14-15.

    Methods:

    The patients were examined on day 2 or 3 and 3-7 months after the injury. The magnetic resonance protocol comprised conventional T1- and T2-weighted sequences including fluid attenuated inversion recovery (FLAIR), two susceptibility-weighted sequences to reveal haemorrhages, and diffusion-weighted sequences. Computer-aided volume comparison was performed. Clinical outcome was assessed by the Rivermead Post-Concussion Symptoms Questionnaire (RPQ), Hospital Anxiety and Depression Scale (HADS) and Glasgow Outcome Scale Extended (GOSE).

    Results:

    At follow-up, 7 patients (37%) reported ≥  3 symptoms in RPQ, 5 reported some anxiety and 1 reported mild depression. Fifteen patients reported upper level of good recovery and 4 patients lower level of good recovery (GOSE 8 and 7, respectively). Magnetic resonance pathology was found in 1 patient at the first examination, but 4 patients (21%) showed volume loss at the second examination, at which 3 of them reported < 3 symptoms and 1 ≥ 3 symptoms, all exhibiting GOSE scores of 8.

    Conclusion:

    Loss of brain volume, demonstrated by computer-aided magnetic resonance imaging volumetry, may be a feasible marker of brain pathology after mild traumatic brain injury.

  • 26.
    Lo, Hiu Kwan
    et al.
    Univ Queensland, Div Physiotherapy, Sch Hlth & Rehabil Sci, Brisbane, Qld, Australia.
    Johnston, Venerina
    Univ Queensland, Div Physiotherapy, Sch Hlth & Rehabil Sci, Brisbane, Qld, Australia; Univ Queensland, Recover Injury Res Ctr, Brisbane, Qld, Australia.
    Landén Ludvigsson, Maria
    Linköping Univ, Dept Med & Hlth Sci, Div Physiotherapy, Linköping, Sweden; Cty Council Östergötland, Rehab Vast, Motala, Sweden; Linköping Univ, Dept Rehabil, Linköping, Sweden; Linköping Univ, Dept Med & Hlth Sci, Linköping, Sweden.
    Peterson, Gunnel
    Linköping Univ, Dept Med & Hlth Sci, Div Physiotherapy, Linköping, Sweden.
    Overmeer, Thomas
    Mälardalen Univ, Sch Hlth Care & Social Welf, Physiotherapy Dept, Västerås, Sweden; Örebro Univ, Ctr Hlth & Med Psychol, Örebro, Sweden.
    David, Michael
    Univ Queensland, Sch Publ Hlth, Brisbane, Qld, Australia; Univ Newcastle, Sch Med & Publ Hlth, Newcastle, NSW, Australia.
    Peolsson, Anneli
    Linköping Univ, Dept Med & Hlth Sci, Div Physiotherapy, Linköping, Sweden.
    Factors associated with work ability following exercise interventions for people with chronic whiplash-associated disorders: Secondary analysis of a randomized controlled trial2018In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 50, no 9, p. 828-836Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate the efficacy of exercise interventions and factors associated with changes in work ability for people with chronic whiplash-associated disorders.

    Design: Secondary analysis of a single-blind, randomized multi-centre controlled trial.

    Setting: Interventions were conducted in Swedish primary care settings.

    Patients: A total of 165 individuals with chronic whiplash-associated disorders grade II–III.

    Methods: Participants were randomly allocated to neck-specific exercise, neck-specific exercise with a behavioural approach, or prescribed physical activity interventions. Work ability was evaluated with the Work Ability Index at baseline, 3, 6 and 12 months.

    Results: The neck-specific exercise with a behavioural approach intervention significantly improved work ability compared with the prescribed physical activity intervention (3 months, p = 0.03; 6 months, p = 0.01; 12 months, p = 0.01), and neck-specific exercise at 12 months (p = 0.01). Neck-specific exercise was better than the prescribed physical activity intervention at 6 months (p = 0.05). An increase in work ability from baseline to one year for the neck-specific exercise with a behavioural approach group (p < 0.01) was the only significant within-group difference. Higher self-rated physical demands at work, greater disability, greater depression and poorer financial situation were associated with poorer work ability (p < 0.01).

    Conclusion: This study found that neck-specific exercise with a behavioural approach intervention was better at improving self-reported work ability than neck-specific exercise or prescribed physical activity. Improvement in work ability is associated with a variety of factors.

  • 27.
    Ludvigsson, Maria Landen
    et al.
    Linkoping Univ, Div Physiotherapy, Dept Med & Hlth Sci, SE-58183 Linkoping, Sweden.;Cty Council Ostergotland, Rehab Vast, Motala, Sweden..
    Peterson, Gunnel
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Linkoping Univ, Div Physiotherapy, Dept Med & Hlth Sci, SE-58183 Linkoping, Sweden.;Cty Council Sormland, Katrineholm, Sweden..
    Dedering, Asa
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Physiotherapy, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Phys Therapy, Stockholm, Sweden..
    Peolsson, Anneli
    Linkoping Univ, Div Physiotherapy, Dept Med & Hlth Sci, SE-58183 Linkoping, Sweden..
    One- And Two-Year Follow-Up Of A Randomized Trial Of Neck Specific Exercise With Or Without A Behavioural Approach Compared With Prescription Of Physical Activity In Chronic Whiplash Disorder2016In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 48, no 1, p. 56-64Article in journal (Refereed)
    Abstract [en]

    Objective: To explore whether neck-specific exercise, with or without a behavioural approach, has benefits after 1 and 2 years compared with prescribed physical activity regarding pain, self-rated functioning/disability, and self-efficacy in management of chronic whiplash. Design: Follow-up of a randomized, assessor blinded, clinical trial. Patients: A total of 216 volunteers with chronic whiplash associated disorders, grades 2 or 3. Methods: Participants were randomized to 1 of 3 exercise interventions: neck-specific exercise with or without a behavioural approach, or physical activity prescription. Self-rated pain (visual analogue scale), disability/functioning (Neck Disability Index/Patient Specific Functional Scale) and self-efficacy (Self-Efficacy Scale) were evaluated after 1 and 2 years. Results: Both neck-specific exercise groups maintained more improvement regarding disability/functioning than the prescribed physical activity group at both time-points (p <= 0.02). At 1 year, 61% of subjects in the neck-specific group reported at least 50% pain reduction, compared with 26% of those in the physical activity prescription group (p < 0.001), but at 2 years the difference was not significant. Conclusion: After 1-2 years, participants with chronic whiplash who were randomized to neck-specific exercise, with or without a behavioural approach, remained more improved than participants who were prescribed general physical activity.

  • 28.
    Lundström, Erik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurology.
    Smits, Anja
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurology.
    Terént, Andreas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Borg, Jörgen
    Time-course and determinants of spasticity during the first six months following first-ever stroke2010In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 42, no 4, p. 296-301Article in journal (Refereed)
    Abstract [en]

    Purpose:

    To explore the occurrence of and risk factors for spasticity until six months after first-ever stroke.

    Methods:

    Forty-nine patients were examined at day 2-10, at one month, and at six months. The Modified Ashworth Scale (MAS) was used to assess resistance to passive movements. A comprehensive clinical examination was performed to identify other positive signs of the upper motor neuron syndrome, in accordance with a broader definition of spasticity, and to evaluate if spasticity was disabling. Neurological impairments were determined by use of the National Institutes of Health Stroke Scale and global disability by use of the modified Rankin Scale.

    Results:

    Spasticity was present in two patients (4%) at day 2-10, in 13 patients (27%) at one month, and in 11 patients (23%) at six months. Severe paresis at day 2-10 was associated with a 10-fold higher risk for spasticity at one month (OR=10, 95% CI 2-48). Disabling spasticity was present  in one patient at one month and in 6 patients (13%) at six months.

    Conclusions:

    Spasticity according to MAS usually occurs within one month and disabling spasticity later in a subgroup. Severe paresis of the arm is a risk factor for spasticity.

  • 29.
    Lytsy, Per
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine. Centre for Clinical Research Dalarna, Uppsala University, Falun, Sweden.
    Carlsson, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine. Centre for Clinical Research Dalarna, Uppsala University, Falun, Sweden.
    Anderzén, Ingrid
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Effectiveness of two vocational rehabilitation programmes in women with long-term sick leave due to pain syndrome or mental illness: 1-year follow-up of a randomized controlled trial2017In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 49, no 2, p. 170-177Article in journal (Refereed)
    Abstract [en]

    Objective: Mental illness and chronic pain are common reasons for long-term sick leave, typically more so for women. This study investigated the effects on return to work of 2 vocational rehabilitation programmes. Methods: In this randomized controlled study, 308 women were allocated to treatment with acceptance and commitment therapy, to multidisciplinary assessment and individualized rehabilitation interventions, or to a control group. Return-to-work at 12 months was assessed as: (i) returning to health insurance; (ii) number of reimbursed health insurance days during follow-up; (iii) self-reported change in working hours; (iv) a composite measure of self-reported change in work-related engagement. Results: The mean age of the Swedish study population was 48.5 years (standard deviation (SD) 6.3 years) and the mean time on sick leave 7.5 years (SD 3.2 years). There were no significant differences in reimbursed days or returning to the health insurance at 12 months. The multidisciplinary assessment and individualized rehabilitation interventions group, compared with control, reported a significant increase in working hours per week, as well as a significant increase in work-related engagement. Conclusion: Multidisciplinary assessments and individual rehabilitation interventions may improve the chance of return-to-work in women with long-term sick leave due to pain condition or mental illness.

  • 30.
    Matuseviciene, Giedre
    et al.
    Karolininska Institutet.
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine. Karolininska Institutet.
    Nygen DeBoussard, Catharina
    Karolininska Institutet.
    No effect of an early intervention after mild traumatic brain injury on activity and participation: A randomized controlled trial.2016In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 48, no 1, p. 19-26Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate measures of activity, participation and quality of life 3 months after mild traumatic brain injury and the effect of an early intervention for patients with an estimated high risk for problems after mild traumatic brain injury.

    PATIENTS: Consecutive patients attending the emergency room with mild traumatic brain injury.

    DESIGN: Randomized controlled trial.

    METHODS: Patients reporting < 3 symptoms after 10 days were considered to have a low risk for prolonged problems. Patients with ≥ 3 symptoms (high-risk patients) were randomized to a visit to a physician or treatment-as-usual. Data on self-reported limitations in activity, restrictions in participation, and quality of life were collected for all patients at 3 months.

    RESULTS: At 3 months post-injury, low-risk patients reported good quality of life and significantly fewer problems in everyday life compared with high-risk patients. The intervention had no effect on activity, participation or quality of life.

    CONCLUSION: Patients who report few symptoms early after mild traumatic brain injury are likely to have a good outcome regarding activity and participation. The intervention offered in this study, focusing on reassurance of a good outcome and treatment of comorbidities, had no effect.

  • 31.
    Matuseviciene, Giedre
    et al.
    Karolininska Institutet.
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine. Karolininska Institutet.
    Nygen DeBoussard, Catharina
    Karolininska Institutet.
    No effect of an early intervention after mild traumatic brain injury on activity and participation: A randomized controlled trial.2016In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 48, no 1, p. 19-26Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate measures of activity, participation and quality of life 3 months after mild traumatic brain injury and the effect of an early intervention for patients with an estimated high risk for problems after mild traumatic brain injury.

    PATIENTS: Consecutive patients attending the emergency room with mild traumatic brain injury.

    DESIGN: Randomized controlled trial.

    METHODS: Patients reporting < 3 symptoms after 10 days were considered to have a low risk for prolonged problems. Patients with ≥ 3 symptoms (high-risk patients) were randomized to a visit to a physician or treatment-as-usual. Data on self-reported limitations in activity, restrictions in participation, and quality of life were collected for all patients at 3 months.

    RESULTS: At 3 months post-injury, low-risk patients reported good quality of life and significantly fewer problems in everyday life compared with high-risk patients. The intervention had no effect on activity, participation or quality of life.

    CONCLUSION: Patients who report few symptoms early after mild traumatic brain injury are likely to have a good outcome regarding activity and participation. The intervention offered in this study, focusing on reassurance of a good outcome and treatment of comorbidities, had no effect.

  • 32.
    Melin, Roland
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Fugl-Meyer, Axel R
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    On prediction of vocational rehabilitation outcome at a Swedish employability institute2003In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 35, no 6, p. 284-289Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The main objective of this investigation was to identify a set of variables usable in early outcome prediction of vocational rehabilitation.

    DESIGN: On commencement of rehabilitation at an employability institute, data were sampled using structured interviews and checklists. Two years later the subjects were followed up by telephone interviews.

    SUBJECTS: The study sample was all unemployed with a somatic disorder as the cause of vocational disability, admitted from October 1995 to December 1996 (n = 149). Of these 109 (73%) agreed to participate.

    METHODS: Initially, data on demography, symptoms, expectations/beliefs about future capacity for gainful employment and sense of coherence (as an indicator of coping resources) were sampled. At follow-up the subjects' vocational situations were recorded.

    RESULTS: At follow-up, 40% were working or employable. Among the about 30 variables included, logistic regression showed that having a relatively high belief in vocational return (odds ratio, OR: 4.6, CI: 1.4-15.4), having a relatively high sense of coherence (OR: 3.5, CI: 1.5-8.4) and having a relatively high educational level (OR: 2.6, CI: 1.1-6.3) were significant predictors of positive outcome.

    CONCLUSION: In this sample, socio-psychological and educational aspects were far more predictive of outcome than were medical circumstances.

  • 33.
    Pless, Mia
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Ibragimova, Nina
    Akademin för utbildning, kultur och kommunikation, Mälardalens högskola.
    Adolfsson, Margareta
    Högskolan för lärande och kommunikation, Högskolan i Jönköping.
    Björck-Åkesson, Eva
    Högskolan för lärande och kommunikation. Högskolan i Jönköping.
    Granlund, Mats
    Hälsohögskolan, Högskolan i Jönköping.
    Evaluation of in-service training in using the ICF and ICF version for children and youth2009In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 41, no 6, p. 451-458Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To study the effects of in-service training on staff's self-reported knowledge, understanding use of the International Classification of Functioning, Disability and Health (ICF) and ICF Children and Youth version (ICF-CY). DESIGN: Quasi-experimental with a questionnaire prior to training and another one year after training. METHODS: Intervention was in-service training in using the ICF and ICF-CY. Subjects were 113 professionals working in habilitation services. Two subgroups were compared: (i) subjects who reported one year after the training that they had used the ICF and ICF-CY in daily practice; and (ii) subjects who had not used these frameworks. RESULTS: The gender, age, and years of work experience of the members in the subgroups were similar. The professionals who used what they learnt from the training, and who already had knowledge about and a positive attitude to the ICF/ICF-CY prior to the training, were found to benefit most from the training. They also increased their ability to apply it to statements about everyday work. These professionals should focus on increasing their understanding and use of the ICF/ICF-CY in their everyday work and in assessment, while those who have limited prior knowledge of the ICF/ICF-CY should focus on gaining knowledge and understanding the purpose, terms and components of the framework. CONCLUSION: It is recommended that in-service training in using the ICF and ICF-CY is tailored to different groups of professionals depending on their degree of knowledge of the ICF/ICF-CY.

  • 34.
    Rasmussen-Barr, Eva
    et al.
    Karolinska Inst, Inst Environm Med, Musculoskeletal & Sports Injury Epidemiol Ctr, Box 210, SE-17177 Stockholm, Sweden.;Karolinska Inst, Div Physiotherapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    Grooten, Wilhelm J. A.
    Karolinska Inst, Div Physiotherapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    Hallqvist, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine. Karolinska Univ Sjukhuset, Dept Publ Hlth Sci, Stockholm, Sweden.
    Holm, Lena W.
    Karolinska Inst, Inst Environm Med, Musculoskeletal & Sports Injury Epidemiol Ctr, Box 210, SE-17177 Stockholm, Sweden.;Univ Toronto, Inst Hlth Policy Management & Evaluat, Toronto, ON, Canada..
    Skillgate, Eva
    Karolinska Inst, Inst Environm Med, Musculoskeletal & Sports Injury Epidemiol Ctr, Box 210, SE-17177 Stockholm, Sweden.;Naprapathogskolan Scandinavian Coll Naprapath Man, Stockholm, Sweden..
    Are job strain and sleep disturbances prognostic factors for low-back pain?: A cohort study of a general population of working age in Sweden2017In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 49, no 7, p. 591-597Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study was to determine whether job strain, i.e. a combination of job demands and decision latitude (job control), and sleep disturbances among persons with occasional low-back pain are prognostic factors for developing troublesome low-back pain; and to determine whether sleep disturbances modify the potential association between job strain and troublesome low-back pain. Methods: A population-based cohort from the Stockholm Public Health Cohort surveys in 2006 and 2010 (n = 25,167) included individuals with occasional low-back pain at baseline 2006 (n = 6,413). Through logistic regression analyses, potential prognostic effects of job strain and sleep disturbances were studied. Stratified analyses were performed to assess modification of sleep disturbances on the potential association between job strain and troublesome low-back pain. Results: Those exposed to job strain; active job (odds ratio (OR) 1.3, 95% confidence interval (95% CI) 1.1-1.6), or high strain (OR 1.5, 95% CI 0.9-2.4) and those exposed to severe sleep disturbances (OR 3.0, 95% CI 2.3-4.0), but not those exposed to passive jobs (OR 1.1, 95% CI 0.9-1.4) had higher odds of developing troublesome low-back pain. Sleep disturbances did not modify the association between job strain and troublesome low-back pain. Conclusion: These findings indicate that active job, high job strain and sleep disturbances are prognostic factors for troublesome low-back pain. The odds of developing troublesome low-back pain due to job strain were not modified by sleep disturbance.

  • 35.
    Sandborgh, Maria
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Lindberg, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Denison, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Pain belief screening instrument: development and preliminary validation of a screening instrument for disabling persistent pain2007In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 39, no 6, p. 461-466Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To develop and test the ability of a screening instrument to identify subgroups among primary healthcare patients with musculoskeletal pain. The Pain Belief Screening Instrument covers pain intensity, disability, self-efficacy, fear avoidance and catastrophizing. DESIGN: Cross-sectional, correlational and comparative study. SUBJECTS: Patients in primary healthcare (n1 = 215; n2 = 93) with a pain duration of 4 weeks or more were included. METHODS: Items for the Pain Belief Screening Instrument were derived from principal component analyses of: the Self-efficacy Scale, the Tampa Scale of Kinesiophobia and the Catastrophizing subscale in the Coping Strategies Questionnaire. Cluster solutions of scores on the screening instrument and the original instruments were cross-tabulated. The reliability of items in the Pain Belief Screening Instrument was examined. RESULTS: The screening instrument identified 2 groups: high- or low-risk profile for pain-related disability. Validity was in-between moderate and substantial (kappa = 0.61, p < 0.001). The reliability of each item in the Pain Belief Screening Instrument in relation to the corresponding item in the original instruments was moderate to high (rs 0.50-0.80, p < 0.01). CONCLUSION: The screening instrument fairly well replicated subgroups identified by the original instruments. The reliability of items in the screening instrument was acceptable. Further testing of predictive validity for a primary healthcare population is needed.

  • 36.
    Skillgate, Eva
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Vingård, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Josephson, Malin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Holm, Lena W
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Alfredsson, Lars
    Is smoking and alcohol consumption associated with long-term sick leave due to unspecific back or neck pain among employees in the public sector? Results of a three-year follow-up cohort study2009In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 41, no 7, p. 550-556Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate the associations between smoking and alcohol consumption, and long-term sick leave due to unspecific back or neck pain among employees in the public sector. DESIGN: A 3-year prospective cohort study. SUBJECTS: Approximately 9000 persons in the public sector in Sweden were invited to participate. Of these, 7533 answered a questionnaire and 6532 were included in the study, classified as having "good health for working". METHODS: New periods of sick leave >or= 28 days were consecutively reported from the employers or the occupational health service during a period of 3 years. Rate ratios were estimated by means of Cox proportional hazard regression model. RESULTS: Smoking was associated with an increased risk of long-term sick leave due to unspecific back or neck pain. Compared with people who have never smoked, "ever smokers" had a higher risk (rate ratio = 1.8, 95% confidence interval: 1.3-2.4). Alcohol consumption tended to be associated with a decreased risk, but the results were not statistically significant. CONCLUSION: Our results suggest that smoking is a risk factor for long-term sick leave due to unspecific back or neck pain. Moderate alcohol consumption tends to have a protective effect, at least among women in the public sector.

  • 37.
    Stålnacke, Britt-Marie
    et al.
    Umeå universitet, Rehabiliteringsmedicin.
    Haukenes, Inger
    Umeå universitet, Institutionen för folkhälsa och klinisk medicin.
    Lehti, Arja
    Umeå universitet, Institutionen för folkhälsa och klinisk medicin.
    Wiklund, Anncristine Fjellman
    Umeå universitet, Fysioterapi.
    Wiklund, Maria
    Umeå universitet, Fysioterapi.
    Hammarström, Anne
    Umeå universitet, Socialmedicin.
    Is there a gender bias in recommendations for further rehabilitation in primary care of patients with chronic pain after an interdisciplinary team assessment?2015In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 47, no 4, p. 365-371Article in journal (Refereed)
    Abstract [en]

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

  • 38. Thelin, Anders
    et al.
    Holmberg, Sara
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology.
    Thelin, Nils
    Functioning in neck and low back pain from a 12-year perspective: a prospective population-based study.2008In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 40, no 7, p. 555-561Article in journal (Refereed)
    Abstract [en]

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

  • 39.
    Wallmark, Svante
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurology.
    Ronne-Engström, Elisabeth
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurosurgery.
    Lundström, Erik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Prevalence of spasticity after aneurysmal subarachnoid haemorrhage2014In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 46, no 1, p. 23-27Article in journal (Refereed)
    Abstract [en]

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

  • 40.
    Westerdahl, Elisabeth
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Lindmark, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Almgren, Stig-Olof
    Tenling, Arne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Thoracic Surgery.
    Chest physiotherapy after coronary artery bypass graft surgery: a comparison of three different deep breathing techniques2001In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 33, no 2, p. 79-84Article in journal (Refereed)
  • 41.
    Wolf, Olof
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Mattsson, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Milbrink, Jan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Larsson, Sune
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Mallmin, Hans
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Effects of postoperative weight-bearing on body composition and bone mineral density after uncemented total hip arthroplasty2013In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 45, no 5, p. 498-503Article in journal (Refereed)
    Abstract [en]

    Objective:

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

    Design:

    Secondary analysis of a previous randomized controlled trial.

    Methods:

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

    Results:

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

    Conclusion:

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

  • 42.
    Ytterberg, Charlotte
    et al.
    Karolinska Inst, Huddinge, Sweden.
    Dyback, Malin
    Vasternorrland Cty Council, Sundsvall, Sweden.
    Bergstrom, Aileen
    Karolinska Inst, Huddinge, Sweden.
    Guidetti, Susanne
    Karolinska Inst, Huddinge, Sweden.
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine. Karolinska Inst, Huddinge, Sweden.
    Perceived impact of stroke six years after onset, and changes in impact between one and six years2017In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 49, no 8, p. 637-643Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 43.
    Ytterberg, Charlotte
    et al.
    Karolinska Inst, Huddinge, Sweden.
    Dyback, Malin
    Vasternorrland Cty Council, Sundsvall, Sweden.
    Bergstrom, Aileen
    Karolinska Inst, Huddinge, Sweden.
    Guidetti, Susanne
    Karolinska Inst, Huddinge, Sweden.
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine. Karolinska Inst, Huddinge, Sweden.
    Perceived impact of stroke six years after onset, and changes in impact between one and six years2017In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 49, no 8, p. 637-643Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 44.
    Zetterberg, Lena
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Lindmark, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Söderlund, Anne
    Åsenlöf, Pernilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy.
    Self-perceived non-motor aspects of cervical dystonia and their association with disability2012In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 44, no 11, p. 950-954Article in journal (Refereed)
    Abstract [en]

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

  • 45.
    Åberg, Anna Cristina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Gender comparisons of function-related dependence pain and insecurity in geriatric rehabilitation2006In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 38, no 1, p. 73-79Article in journal (Refereed)
    Abstract [en]

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

  • 46.
    Åberg, Anna Cristina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Lundin-Olsson, Lillemor
    Rosendahl, Erik
    Implementation of evidence-based prevention of falls in rehabilitation units: a staff's interactive approach2009In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 41, no 13, p. 1034-1040Article in journal (Refereed)
    Abstract [en]

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

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