uu.seUppsala University Publications
Change search
Refine search result
123 1 - 50 of 102
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the Create feeds function.
  • 1.
    Abu Hamdeh, Sami
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurosurgery.
    Marklund, Niklas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurosurgery.
    Lannsjö, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Howells, Tim
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurosurgery.
    Raininko, Raili
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
    Wikström, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
    Enblad, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurosurgery.
    Extended anatomical grading in diffuse axonal injury using MRI: Hemorrhagic lesions in the substantia nigra and mesencephalic tegmentum indicate poor long-term outcome2017In: Journal of Neurotrauma, ISSN 0897-7151, E-ISSN 1557-9042, Vol. 5, no 34, p. 341-352Article in journal (Refereed)
    Abstract [en]

    Clinical outcome after traumatic diffuse axonal injury (DAI) is difficult to predict. In this study, three magnetic resonance imaging (MRI) sequences were used to quantify the anatomical distribution of lesions, to grade DAI according to the Adams grading system, and to evaluate the value of lesion localization in combination with clinical prognostic factors to improve outcome prediction. Thirty patients (mean 31.2 years ±14.3 standard deviation) with severe DAI (Glasgow Motor Score [GMS] <6) examined with MRI within 1 week post-injury were included. Diffusion-weighted (DW), T2*-weighted gradient echo and susceptibility-weighted (SWI) sequences were used. Extended Glasgow outcome score was assessed after 6 months. Number of DW lesions in the thalamus, basal ganglia, and internal capsule and number of SWI lesions in the mesencephalon correlated significantly with outcome in univariate analysis. Age, GMS at admission, GMS at discharge, and low proportion of good monitoring time with cerebral perfusion pressure <60 mm Hg correlated significantly with outcome in univariate analysis. Multivariate analysis revealed an independent relation with poor outcome for age (p = 0.005) and lesions in the mesencephalic region corresponding to substantia nigra and tegmentum on SWI (p  = 0.008). We conclude that higher age and lesions in substantia nigra and mesencephalic tegmentum indicate poor long-term outcome in DAI. We propose an extended MRI classification system based on four stages (stage I—hemispheric lesions, stage II—corpus callosum lesions, stage III—brainstem lesions, and stage IV—substantia nigra or mesencephalic tegmentum lesions); all are subdivided by age (≥/<30 years).

  • 2.
    Abu Hamdeh, Sami
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurosurgery.
    Marklund, Niklas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurosurgery.
    Lannsjö, Marianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Howells, Tim
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurosurgery.
    Raininko, Raili
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
    Wikström, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
    Enblad, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurosurgery.
    MRI analysis of diffuse axonal injury - Hemorrhagic lesions in the mesencephalon idicate poor long-term outcome2016In: MRI analysis of diffuse axonal injury - Hemorrhagic lesions in the mesencephalon idicate poor long-term outcome, Springer, 2016, Vol. 7, Suppl. 1, article id B-0814Conference paper (Refereed)
    Abstract [en]

    Purpose: Clinical outcome after traumatic diffuse axonal injury (DAI) is difficult to predict. Three MRI techniques were compared in demonstrating acute brain lesions.  Relationship of the anatomical distribution of the lesions in combination with clinical prognostic factors to outcome after 6 months was evaluated.  

    Methods and Materials: Thirty patients, aged 16-60 years (mean 31.2 years) with severe DAI (Glasgow Motor Score = GMS < 6) were examined with MRI at 1.5T within one week after the injury. A diffusion-weighted (DW) sequence (SE-EPI, b value 1000 s/mm2), a T2*-weighted gradient echo (T2*GRE) sequence and a susceptibility-weighted (SWI) sequence were evaluated by two independent reviewers with short and long neuroradiological experiences. Clinical outcome was assessed with Extended Glasgow Outcome Score (GOSE) after ≥ 6 months.

    Results: Interreviewer agreement for DAI classification was very good (ҡ 0.82 – 0.91) with all three sequences. SWI visualized more lesions than the T2*GRE or DW sequence.  In univariate analysis, number of DW lesions in the deep gray matter area including the internal capsules, number of SWI lesions in the mesencephalon, age, and GMS at admission and discharge correlated significantly with poor outcome.  Multivariate analysis only revealed an independent relation with poor outcome for age (p = 0.011) and lesions in the mesencephalic region including crura cerebri, substantia nigra and tegmentum on SWI (p = 0.032).

    Conclusion: SWI is the most sensitive technique to visualize lesions in DAI. Age over 30 years and hemorrhagic mesencephalic lesions anterior to the tectum are indicators of poor long-term outcome in DAI.

  • 3. Bergstrom, Aileen
    et al.
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Asaba, Eric
    Erikson, Anette
    Tham, Kerstin
    The lived experience of enacting agency in everyday life after a stroke2014In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 28, no 5-6, p. 674-674Article in journal (Other academic)
  • 4.
    Bergstrom, Aileen
    et al.
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, S-14183 Huddinge, Sweden..
    Guidetti, Susanne
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, S-14183 Huddinge, Sweden..
    Tham, Kerstin
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, S-14183 Huddinge, Sweden..
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, S-14183 Huddinge, Sweden.
    Association between satisfaction and participation in everyday occupations after stroke2017In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 24, no 5, p. 339-348Article in journal (Refereed)
    Abstract [en]

    Background: Within occupational therapy, it is assumed that individuals are satisfied when participating in everyday occupations that they want to do. However, there is little empirical evidence to show this. Aims: The aim of this study is to explore and describe the relation between satisfaction and participation in everyday occupations in a Swedish cohort, 5 years post stroke. Methods: Sixty-nine persons responded to the Occupational Gaps Questionnaire (OGQ). The questionnaire measures subjective restrictions in participation, i.e. the discrepancy between doing and wanting to do 30 different occupations in everyday life, and satisfaction per activity. Results were analysed with McNemar/chi-square. Results: Seventy percent of the persons perceived participation restrictions. Individuals that did not perceive restrictions in their participation had a significantly higher level of satisfaction (p=.002) compared to those that had restrictions. Participants that performed activities that they wanted to do report between 79 and 100% satisfaction per activity. Conclusion: In this cohort, there was a significant association between satisfaction and participating in everyday occupations one wants to do, showing that satisfaction is an important aspect of participation and substantiates a basic assumption within occupational therapy. The complexity of measuring satisfaction and participation in everyday occupations is discussed.

  • 5. 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.

  • 6.
    Bergström, Aileen L.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Disability and Habilitation.
    Asaba, Eric
    Erikson, Anette
    Tham, Kerstin
    Complex negotiations: The lived experience of enacting agency after a stroke2015In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 22, no 1, p. 43-53Article in journal (Refereed)
    Abstract [en]

    Objective: This qualitative, longitudinal, descriptive study aimed to understand the lived experience of enacting agency, and to describe the phenomenon of agency and the meaning structure of the phenomenon during the year after a stroke. Agency is defined as making things happen in everyday life through one's actions. Methods: This study followed six persons (three men and three women, ages 63 to 89), interviewed on four separate occasions. Interview data were analysed using the Empirical Phenomenological Psychological method. Results: The main findings showed that the participants experienced enacting agency in their everyday lives after stroke as negotiating different characteristics over a span of time, a range of difficulty, and in a number of activities, making these negotiations complex. The four characteristics described how the participants made things happen in their everyday lives through managing their disrupted bodies, taking into account their past and envisioning their futures, dealing with the world outside themselves, and negotiating through internal dialogues. Conclusions: This empirical evidence regarding negotiations challenges traditional definitions of agency and a new definition of agency is proposed. Understanding clients' complex negotiations and offering innovative solutions to train in real-life situations may help in the process of enabling occupations after a stroke.

  • 7.
    Bergström, Aileen L.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Disability and Habilitation.
    Asaba, Eric
    Erikson, Anette
    Tham, Kerstin
    Complex negotiations: The lived experience of enacting agency after a stroke2015In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 22, no 1, p. 43-53Article in journal (Refereed)
    Abstract [en]

    Objective: This qualitative, longitudinal, descriptive study aimed to understand the lived experience of enacting agency, and to describe the phenomenon of agency and the meaning structure of the phenomenon during the year after a stroke. Agency is defined as making things happen in everyday life through one's actions. Methods: This study followed six persons (three men and three women, ages 63 to 89), interviewed on four separate occasions. Interview data were analysed using the Empirical Phenomenological Psychological method. Results: The main findings showed that the participants experienced enacting agency in their everyday lives after stroke as negotiating different characteristics over a span of time, a range of difficulty, and in a number of activities, making these negotiations complex. The four characteristics described how the participants made things happen in their everyday lives through managing their disrupted bodies, taking into account their past and envisioning their futures, dealing with the world outside themselves, and negotiating through internal dialogues. Conclusions: This empirical evidence regarding negotiations challenges traditional definitions of agency and a new definition of agency is proposed. Understanding clients' complex negotiations and offering innovative solutions to train in real-life situations may help in the process of enabling occupations after a stroke.

  • 8. Bergström, Aileen L.
    et al.
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    von Koch, Lena
    Tham, Kerstin
    Combined life satisfaction of persons with stroke and their caregivers: associations with caregiver burden and the impact of stroke2011In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 9, p. 1-Article in journal (Refereed)
    Abstract [en]

    Background: Little is known about the life satisfaction of the person with stroke combined with their caregiver, i.e. the dyad, despite the fact that life satisfaction is an important rehabilitation outcome. The aim of this study was to describe the dyads combined life satisfaction and to understand this in relationship to the perceived impact of stroke in everyday life and caregiver burden. Methods: In this cross-sectional study, the life satisfaction of persons and their informal caregivers was measured in 81 dyads one year post stroke. Their global life satisfaction, measured with LiSat-11, was combined to a dyad score and the dyads were then categorized as satisfied, dissatisfied or discordant. The groups were compared and analyzed regarding levels of caregiver burden, measured with the Caregiver Burden scale, and the perceived impact of stroke in everyday life, measured with the Stroke Impact Scale (SIS). Results: The satisfied dyads comprised 40%, dissatisfied 26% and those that were discordant 34%. The satisfied dyads reported a significantly lower impact of the stroke in everyday life compared with the dyads that were not satisfied. As expected, dyads that were not satisfied reported a significantly greater caregiver burden compared with the satisfied dyads. The discordant group was further broken down into a group of dissatisfied and satisfied caregivers. The caregivers that were not satisfied in the discordant group perceived a significantly greater level of caregiver burden compared with the satisfied group. Even caregivers who were satisfied with life but whose care recipients were not satisfied reported caregiver burden. Conclusions: Measuring combined life satisfaction provides a unique focus and appears to be a feasible way of attaining the dyads' perspective. The findings suggest that those dyads with a discordant life satisfaction could be vulnerable because of the caregivers' reported caregiver burden. These findings support the importance of a dyadic perspective and add to the understanding of the reciprocal influences between the caregiver and recipient. This knowledge has clinical implications and contributes to the identification of possible vulnerable dyads in need of tailored support.

  • 9. Bergström, Aileen L.
    et al.
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    von Koch, Lena
    Tham, Kerstin
    Combined life satisfaction of persons with stroke and their caregivers: associations with caregiver burden and the impact of stroke2011In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 9, p. 1-Article in journal (Refereed)
    Abstract [en]

    Background: Little is known about the life satisfaction of the person with stroke combined with their caregiver, i.e. the dyad, despite the fact that life satisfaction is an important rehabilitation outcome. The aim of this study was to describe the dyads combined life satisfaction and to understand this in relationship to the perceived impact of stroke in everyday life and caregiver burden. Methods: In this cross-sectional study, the life satisfaction of persons and their informal caregivers was measured in 81 dyads one year post stroke. Their global life satisfaction, measured with LiSat-11, was combined to a dyad score and the dyads were then categorized as satisfied, dissatisfied or discordant. The groups were compared and analyzed regarding levels of caregiver burden, measured with the Caregiver Burden scale, and the perceived impact of stroke in everyday life, measured with the Stroke Impact Scale (SIS). Results: The satisfied dyads comprised 40%, dissatisfied 26% and those that were discordant 34%. The satisfied dyads reported a significantly lower impact of the stroke in everyday life compared with the dyads that were not satisfied. As expected, dyads that were not satisfied reported a significantly greater caregiver burden compared with the satisfied dyads. The discordant group was further broken down into a group of dissatisfied and satisfied caregivers. The caregivers that were not satisfied in the discordant group perceived a significantly greater level of caregiver burden compared with the satisfied group. Even caregivers who were satisfied with life but whose care recipients were not satisfied reported caregiver burden. Conclusions: Measuring combined life satisfaction provides a unique focus and appears to be a feasible way of attaining the dyads' perspective. The findings suggest that those dyads with a discordant life satisfaction could be vulnerable because of the caregivers' reported caregiver burden. These findings support the importance of a dyadic perspective and add to the understanding of the reciprocal influences between the caregiver and recipient. This knowledge has clinical implications and contributes to the identification of possible vulnerable dyads in need of tailored support.

  • 10.
    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.

  • 11.
    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.

  • 12.
    Bertilsson, Ann-Sofie
    et al.
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    Ekstam, Lisa
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.; Lund Univ, Dept Hlth Sci, Lund, Sweden.; Karolinska Univ Hosp, Dept Occupat Therapy, Huddinge, Sweden .
    Tham, Kerstin
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.; Karolinska Univ Hosp, Dept Occupat Therapy, Huddinge, Sweden.
    Andersson, Magnus
    Karolinska Inst, Dept Clin Neurosci, Solna, Sweden.; Karolinska Univ Hosp, Dept Neurol, Stockholm, Sweden.
    von Koch, Lena
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.; Karolinska Univ Hosp, Dept Neurol, Stockholm, Sweden.
    Johansson, Ulla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    A cluster randomized controlled trial of a client-centred, activities of daily living intervention for people with stroke: One year follow-up of caregivers2016In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 30, no 8, p. 765-775Article in journal (Refereed)
    Abstract [en]

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

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

    Setting: Inpatient and outpatient rehabilitation.

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

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

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

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

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

  • 13.
    Bertilsson, Ann-Sofie
    et al.
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    Ekstam, Lisa
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.; Lund Univ, Dept Hlth Sci, Lund, Sweden.; Karolinska Univ Hosp, Dept Occupat Therapy, Huddinge, Sweden .
    Tham, Kerstin
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.; Karolinska Univ Hosp, Dept Occupat Therapy, Huddinge, Sweden.
    Andersson, Magnus
    Karolinska Inst, Dept Clin Neurosci, Solna, Sweden.; Karolinska Univ Hosp, Dept Neurol, Stockholm, Sweden.
    von Koch, Lena
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.; Karolinska Univ Hosp, Dept Neurol, Stockholm, Sweden.
    Johansson, Ulla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    A cluster randomized controlled trial of a client-centred, activities of daily living intervention for people with stroke: One year follow-up of caregivers2016In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 30, no 8, p. 765-775Article in journal (Refereed)
    Abstract [en]

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

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

    Setting: Inpatient and outpatient rehabilitation.

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

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

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

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

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

  • 14. Bertilsson, Ann-Sofie
    et al.
    Ranner, Maria
    von Koch, Lena
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Disability and Habilitation.
    Johansson, Ulla
    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.
    Ytterberg, Charlotte
    Guidetti, Susanne
    Tham, Kerstin
    A client-centred ADL intervention: three-month follow-up of a randomized controlled trial2014In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 21, no 5, p. 377-391Article in journal (Refereed)
    Abstract [en]

    Objective: The aim was to study a client-centred activities of daily living (ADL) intervention (CADL) compared with the usual ADL intervention (UADL) in people with stroke regarding: independence in ADL, perceived participation, life satisfaction, use of home-help service, and satisfaction with training and, in their significant others, regarding: caregiver burden, life satisfaction, and informal care. Methods: In this multicentre study, 16 rehabilitation units were randomly assigned to deliver CADL or UADL. The occupational therapists who provided the CADL were specifically trained. Eligible for inclusion were people with stroke treated in a stroke unit 3 months after stroke, dependent in two ADL, not diagnosed with dementia, and able to understand instructions. Data were collected at inclusion and three months thereafter. To detect a significant difference between the groups in the Stroke Impact Scale (SIS) domain "participation", 280 participants were required. Intention-to-treat analysis was applied. Results: At three months, there was no difference in the outcomes between the CADL group (n = 129) and the UADL group (n = 151), or their significant others (n = 87/n = 93) except in the SIS domain "emotion" in favour of CADL (p = 0.04). Conclusion: The CADL does not appear to bring about short-term differences in outcomes and longer follow-ups are required.

  • 15. Bertilsson, Ann-Sofie
    et al.
    Ranner, Maria
    von Koch, Lena
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Disability and Habilitation.
    Johansson, Ulla
    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.
    Ytterberg, Charlotte
    Guidetti, Susanne
    Tham, Kerstin
    A client-centred ADL intervention: three-month follow-up of a randomized controlled trial2014In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 21, no 5, p. 377-391Article in journal (Refereed)
    Abstract [en]

    Objective: The aim was to study a client-centred activities of daily living (ADL) intervention (CADL) compared with the usual ADL intervention (UADL) in people with stroke regarding: independence in ADL, perceived participation, life satisfaction, use of home-help service, and satisfaction with training and, in their significant others, regarding: caregiver burden, life satisfaction, and informal care. Methods: In this multicentre study, 16 rehabilitation units were randomly assigned to deliver CADL or UADL. The occupational therapists who provided the CADL were specifically trained. Eligible for inclusion were people with stroke treated in a stroke unit 3 months after stroke, dependent in two ADL, not diagnosed with dementia, and able to understand instructions. Data were collected at inclusion and three months thereafter. To detect a significant difference between the groups in the Stroke Impact Scale (SIS) domain "participation", 280 participants were required. Intention-to-treat analysis was applied. Results: At three months, there was no difference in the outcomes between the CADL group (n = 129) and the UADL group (n = 151), or their significant others (n = 87/n = 93) except in the SIS domain "emotion" in favour of CADL (p = 0.04). Conclusion: The CADL does not appear to bring about short-term differences in outcomes and longer follow-ups are required.

  • 16. Bertilsson, Ann-Sofie
    et al.
    Ranner, Maria
    von Koch, Lena
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Disability and Habilitation.
    Johansson, Ulla
    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.
    Ytterberg, Charlotte
    Guidetti, Susanne
    Tham, Kerstin
    A client-centred ADL intervention: three-month follow-up of a randomized controlled trial2014In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 21, no 5, p. 377-391Article in journal (Refereed)
    Abstract [en]

    Objective: The aim was to study a client-centred activities of daily living (ADL) intervention (CADL) compared with the usual ADL intervention (UADL) in people with stroke regarding: independence in ADL, perceived participation, life satisfaction, use of home-help service, and satisfaction with training and, in their significant others, regarding: caregiver burden, life satisfaction, and informal care. Methods: In this multicentre study, 16 rehabilitation units were randomly assigned to deliver CADL or UADL. The occupational therapists who provided the CADL were specifically trained. Eligible for inclusion were people with stroke treated in a stroke unit 3 months after stroke, dependent in two ADL, not diagnosed with dementia, and able to understand instructions. Data were collected at inclusion and three months thereafter. To detect a significant difference between the groups in the Stroke Impact Scale (SIS) domain "participation", 280 participants were required. Intention-to-treat analysis was applied. Results: At three months, there was no difference in the outcomes between the CADL group (n = 129) and the UADL group (n = 151), or their significant others (n = 87/n = 93) except in the SIS domain "emotion" in favour of CADL (p = 0.04). Conclusion: The CADL does not appear to bring about short-term differences in outcomes and longer follow-ups are required.

  • 17.
    Beyaert, Christian
    et al.
    Université de Lorraine, Faculty of Medicine, Nancy, France.
    Vasa, Rajul
    Rajul Vasa Foundation, Mumbai, India.
    Frykberg, Gunilla E
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Gait post-stroke: Pathophysiology and rehabilitation strategies2015In: Neurophysiologie clinique, ISSN 0987-7053, E-ISSN 1769-7131, Vol. 45, no 4-5, p. 335-355Article, review/survey (Refereed)
    Abstract [en]

    We reviewed neural control and biomechanical description of gait in both non-disabled and post-stroke subjects. In addition, we reviewed most of the gait rehabilitation strategies currently in use or in development and observed their principles in relation to recent pathophysiology of post-stroke gait. In both non-disabled and post-stroke subjects, motor control is organized on a task-oriented basis using a common set of a few muscle modules to simultaneously achieve body support, balance control, and forward progression during gait. Hemiparesis following stroke is due to disruption of descending neural pathways, usually with no direct lesion of the brainstem and cerebellar structures involved in motor automatic processes. Post-stroke, improvements of motor activities including standing and locomotion are variable but are typically characterized by a common postural behaviour which involves the unaffected side more for body support and balance control, likely in response to initial muscle weakness of the affected side. Various rehabilitation strategies are regularly used or in development, targeting muscle activity, postural and gait tasks, using more or less high-technology equipment. Reduced walking speed often improves with time and with various rehabilitation strategies, but asymmetric postural behaviour during standing and walking is often reinforced, maintained, or only transitorily decreased. This asymmetric compensatory postural behaviour appears to be robust, driven by support and balance tasks maintaining the predominant use of the unaffected side over the initially impaired affected side. Based on these elements, stroke rehabilitation including affected muscle strengthening and often stretching would first need to correct the postural asymmetric pattern by exploiting postural automatic processes in various particular motor tasks secondarily beneficial to gait.

  • 18.
    Borg, Jörgen
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Hjärnskakning kan ge långvariga bevär: Identifiering av riskpatienter lika viktigt som det akuta omhändertagandet2008In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 105, p. 1828-1829Article in journal (Other academic)
    Abstract [sv]

    Hjärnskakning är förenad med låg risk för akuta, intrakraniella komplikationer och högre risk för postkommotionella besvär.

    Akut datortomografi medger säker diagnostik av intrakraniella komplikationer. Kliniska faktorer kan identifiera riskpatienter för selektiv datortomografi, eventuellt med stöd av biokemiska skademarkörer.

    Icke-skaderelaterade faktorer påverkar långtidsutfallet efter hjärnskakning och erbjuder mål för intervention.

  • 19.
    Ehrenfors, Rita
    et al.
    Karolinska Univ, Neurobiol Care Sci & Soc, Stockholm, Sweden..
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Seiger, Åke
    Karolinska Univ, Neurobiol Care Sci & Soc, Stockholm, Sweden..
    Assessing self-perceived cognitive functioning in everyday life after ABI prior goal-setting in rehabilitation2016In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 30, no 5-6, p. 806-807Article in journal (Other academic)
  • 20.
    Ehrenfors, Rita
    et al.
    Karolinska Univ, Neurobiol Care Sci & Soc, Stockholm, Sweden..
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Seiger, Åke
    Karolinska Univ, Neurobiol Care Sci & Soc, Stockholm, Sweden..
    Assessing self-perceived cognitive functioning in everyday life after ABI prior goal-setting in rehabilitation2016In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 30, no 5-6, p. 806-807Article in journal (Other academic)
  • 21.
    Ekstam, Lisa
    et al.
    Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.;Karolinska Univ Hosp, Dept Occupat Therapy, Stockholm, Sweden..
    Johansson, Ulla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    Guidetti, Susanne
    Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine. Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    Ytterberg, Charlotte
    Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.;Karolinska Univ Hosp, Div Neurol, Dept Clin Neurosci, Huddinge, Sweden.;Karolinska Inst, Div Physiotherapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    The combined perceptions of people with stroke and their carers regarding rehabilitation needs 1 year after stroke: a mixed methods study2015In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 5, no 2, article id e006784Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of the study was to explore the associations between the dyad's (person with stroke and informal caregiver) perception of the person with stroke's rehabilitation needs and stroke severity, personal factors (gender, age, sense of coherence), the use of rehabilitation services, amount of informal care and caregiver burden. Further, the aim was to explore the personal experience of everyday life changes among persons with stroke and their caregivers and their strategies for handling these 1 year after stroke. Design: A mixed methods design was used combining quantitative and qualitative data and analyses. Setting: Data were mainly collected in the participants' homes. Outcome measures: Data were collected through established instruments and open-ended interviews. The dyad's perceptions of the person with stroke's rehabilitation needs were assessed by the persons with stroke and their informal caregivers using a questionnaire based on Ware's taxonomy. The results were combined and classified into three groups: met, discordant (ie, not in agreement) and unmet rehabilitation needs. To assess sense of coherence (SOC) in persons with stroke, the SOC-scale was used. Caregiver burden was assessed using the Caregiver Burden Scale. Data on the use of rehabilitation services were obtained from the computerised register at the Stockholm County Council. Participants: 86 persons with stroke (mean age 73 years, 38% women) and their caregivers (mean age 65 years, 40% women). Results: Fifty-two per cent of the dyads perceived that the person with stroke's need for rehabilitation was met 12 months after stroke. Met rehabilitation needs were associated with less severe stroke, more coping strategies for solving problems in everyday activities and less caregiver burden. Conclusions: Rehabilitation interventions need to focus on supporting the dyads' process of psychological and social adaptation after stroke. Future studies need to explore and evaluate the effects of using a dyadic perspective throughout rehabilitation.

  • 22.
    Ekstam, Lisa
    et al.
    Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.;Karolinska Univ Hosp, Dept Occupat Therapy, Stockholm, Sweden..
    Johansson, Ulla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    Guidetti, Susanne
    Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine. Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    Ytterberg, Charlotte
    Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.;Karolinska Univ Hosp, Div Neurol, Dept Clin Neurosci, Huddinge, Sweden.;Karolinska Inst, Div Physiotherapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    The combined perceptions of people with stroke and their carers regarding rehabilitation needs 1 year after stroke: a mixed methods study2015In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 5, no 2, article id e006784Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of the study was to explore the associations between the dyad's (person with stroke and informal caregiver) perception of the person with stroke's rehabilitation needs and stroke severity, personal factors (gender, age, sense of coherence), the use of rehabilitation services, amount of informal care and caregiver burden. Further, the aim was to explore the personal experience of everyday life changes among persons with stroke and their caregivers and their strategies for handling these 1 year after stroke. Design: A mixed methods design was used combining quantitative and qualitative data and analyses. Setting: Data were mainly collected in the participants' homes. Outcome measures: Data were collected through established instruments and open-ended interviews. The dyad's perceptions of the person with stroke's rehabilitation needs were assessed by the persons with stroke and their informal caregivers using a questionnaire based on Ware's taxonomy. The results were combined and classified into three groups: met, discordant (ie, not in agreement) and unmet rehabilitation needs. To assess sense of coherence (SOC) in persons with stroke, the SOC-scale was used. Caregiver burden was assessed using the Caregiver Burden Scale. Data on the use of rehabilitation services were obtained from the computerised register at the Stockholm County Council. Participants: 86 persons with stroke (mean age 73 years, 38% women) and their caregivers (mean age 65 years, 40% women). Results: Fifty-two per cent of the dyads perceived that the person with stroke's need for rehabilitation was met 12 months after stroke. Met rehabilitation needs were associated with less severe stroke, more coping strategies for solving problems in everyday activities and less caregiver burden. Conclusions: Rehabilitation interventions need to focus on supporting the dyads' process of psychological and social adaptation after stroke. Future studies need to explore and evaluate the effects of using a dyadic perspective throughout rehabilitation.

  • 23.
    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.

  • 24.
    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.

  • 25.
    Elmgren Frykberg, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Movement Control after Stroke: Studies on Sit-to-walk and on the Relations between Clinical and Laboratory Measures2010Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Aims: The principal aims of this research were 1) to extend existing knowledge of the everyday sit-to-walk (STW) transfer in subjects with stroke and in matched controls by exploring temporal, kinematic, and kinetic aspects, and 2) to investigate the relations between some clinical and laboratory measures of postural control and locomotion in stroke rehabilitation and research.

    Methods: Ten community-living subjects with stroke (mean age 59 years) and ten matched controls were enrolled in the STW studies (Studies I, II, and IV). In the study regarding relations between clinical and laboratory measures the same samples (part of Study II) and also 20 outpatient subjects with stroke (mean age 50 years) participated (Study III). Data collections were performed in laboratory environments with clinical assessment instruments, video cameras, force plates and a movement analysis system.

    Results: 1) Study I: A temporal aspect of STW was studied. Four phases were defined. The subjects with stroke used significantly more time during the 2nd STW phase, defined from seat-off to the loading peak of the 1st swing leg. Study II: A movement aspect of STW was investigated. The stroke subjects generated significantly less centre of mass momenta in horizontal and vertical directions, and the momenta peaks occurred significantly earlier than in the controls. Study IV: A force aspect of STW was explored. The subjects with stroke generated significantly larger propulsive impulse beneath the (non-paretic) stance buttock and significantly more braking impulses were exerted by both buttocks and particularly by the stance foot.

    2) Part of Study II: A strong correlation was found between the clinical measure Fluidity Scale and the laboratory measure Fluidity Index. Study III: Moderate correlations were shown between Berg Balance Scale, ratings of weight distribution during quiet stance, and force measures.

    Conclusions: The findings of the STW studies show a changed force interaction between the lower extremities post-stroke, likely influencing movement patterns and temporal characteristics of the everyday transfer. The results are considered to reflect compensatory motor strategies. The results of the studies on relations between some clinical and laboratory measures indicate that the strength of the relation is multidimensional.

     

    List of papers
    1. Temporal coordination of the sit-to-walk task in subjects with stroke and in controls
    Open this publication in new window or tab >>Temporal coordination of the sit-to-walk task in subjects with stroke and in controls
    Show others...
    2009 (English)In: Archives of Physical Medicine and Rehabilitation, ISSN 0003-9993, E-ISSN 1532-821X, Vol. 90, no 6, p. 1009-1017Article in journal (Refereed) Published
    Abstract [en]

    Objectives: To explore events and describe phases for temporal coordination of the sit-to-walk (STW) task, within a semistandardized set up, in subjects with stroke and matched controls. In addition, to assess variability of STW phase duration and to compare the relative duration of STW phases between the 2 groups.

    Design: Cross-sectional.

    Setting: Research laboratory.

    Participants: A convenience sample of persons with hemiparesis (n=10; age 50–67y), more than 6 months after stroke and 10 controls matched for sex, age, height, and body mass index.

    Interventions: Not applicable.

    Main Outcome Measures: Relative duration of STW phases, SE of measurement in percentage of the mean, and intraclass correlation coefficients (ICCs).

    Results: Four STW phases were defined: rise preparation, transition, primary gait initiation, and secondary gait initiation. The subjects with stroke needed 54% more time to complete the STW task than the controls did. ICCs ranged from .38 to .66 and .22 to .57 in the stroke and control groups, respectively. SEs of measurement in percentage of the mean values were high, particularly in the transition phase: 54.1% (stroke) and 50.4% (controls). The generalized linear model demonstrated that the relative duration of the transition phase was significantly longer in the stroke group.

    Conclusions: The present results extend existing knowledge by presenting 4 new phases of temporal coordination of STW, within a semistandardized set-up, in persons with stroke and in controls. The high degree of variability regarding relative STW phase duration was probably a result of both the semistandardized set up and biological variability. The significant difference in the transition phase across the 2 groups requires further study.

    Keywords
    stroke, motor activity, rehabilitation, reproducibility of results
    National Category
    Physiotherapy Control Engineering
    Research subject
    Rehabilitation Medicine
    Identifiers
    urn:nbn:se:uu:diva-120712 (URN)10.1016/j.apmr.2008.12.023 (DOI)000266787000016 ()19480878 (PubMedID)
    Available from: 2010-03-16 Created: 2010-03-16 Last updated: 2017-12-12Bibliographically approved
    2. Locomotor coordination during the sit-to-walk transfer is different in subjects with stroke and controls
    Open this publication in new window or tab >>Locomotor coordination during the sit-to-walk transfer is different in subjects with stroke and controls
    Show others...
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    Objectives: To describe and to compare coordination of centre of mass (COM) horizontal and vertical momenta, and fluidity during the sit-to-walk (STW) transfer in subjects with stroke and in matched controls.

    Design: Cross-sectional.

    Setting: Research laboratory.

    Participants: Ten subjects with stroke in the post-acute phase (> 6 months) and ten control subjects, matched for sex, age, height and weight, were recruited through a convenience sample.

    Interventions: Not applicable.

    Main Outcome Measures: Magnitudes and timing of COM peak horizontal and peak vertical momenta, scores on the Fluidity Scale (FS) and values of the Fluidity Index (FI).

    Results: The stroke subjects generated significantly less COM peak horizontal and peak vertical momenta. Latencies from STW-onset and seat-off to the peaks differed significantly between the two groups. The subjects with stroke displayed significantly lower scores on the FS as well as lower percentages of the FI.

    Conclusions: While rising to walk, scaling and timing parameters of COM horizontal and vertical momenta differed significantly between subjects with stroke and matched controls. This atypical motor strategy needs to be further investigated before it is possible to make clinical recommendations.

     

    Keywords
    Stroke, motor activity, rehabilitation
    National Category
    Physiotherapy
    Research subject
    Rehabilitation Medicine
    Identifiers
    urn:nbn:se:uu:diva-120630 (URN)
    Available from: 2010-03-16 Created: 2010-03-15 Last updated: 2010-03-21
    3. Correlation between clinical assessment and force plate measurement of postural control after stroke
    Open this publication in new window or tab >>Correlation between clinical assessment and force plate measurement of postural control after stroke
    2007 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 39, no 6, p. 448-453Article in journal (Refereed) Published
    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.

    Keywords
    Postural control, stroke, Berg Balance Scale, force plate measures, weight distribution
    National Category
    Medical and Health Sciences
    Research subject
    Rehabilitation Medicine
    Identifiers
    urn:nbn:se:uu:diva-11302 (URN)10.2340/16501977-0071 (DOI)000248226400003 ()17624478 (PubMedID)
    Available from: 2007-11-19 Created: 2007-11-19 Last updated: 2017-12-11Bibliographically approved
    4. Impact of stroke on anterior–posterior force generation prior to seat-off during sit-to-walk
    Open this publication in new window or tab >>Impact of stroke on anterior–posterior force generation prior to seat-off during sit-to-walk
    Show others...
    2012 (English)In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 35, no 1, p. 56-60Article in journal (Refereed) Published
    National Category
    Physiotherapy Control Engineering
    Research subject
    Rehabilitation Medicine
    Identifiers
    urn:nbn:se:uu:diva-120704 (URN)10.1016/j.gaitpost.2011.08.005 (DOI)000300267400010 ()21900011 (PubMedID)
    Available from: 2011-09-06 Created: 2010-03-16 Last updated: 2017-12-12Bibliographically approved
  • 26.
    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.

  • 27.
    Elmgren Frykberg, Gunilla
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Thierfelder, Tomas
    Åberg, Anna Cristina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Halvorsen, Kjartan
    Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Division of Systems and Control. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Automatic control.
    Borg, Jörgen
    Hirschfeld, Helga
    Impact of stroke on anterior–posterior force generation prior to seat-off during sit-to-walk2012In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 35, no 1, p. 56-60Article in journal (Refereed)
  • 28.
    Elmgren Frykberg, Gunilla
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Åberg, Anna Cristina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Halvorsen, Kjartan
    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.
    Hirschfeld, Helga
    Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy.
    Temporal coordination of the sit-to-walk task in subjects with stroke and in controls2009In: Archives of Physical Medicine and Rehabilitation, ISSN 0003-9993, E-ISSN 1532-821X, Vol. 90, no 6, p. 1009-1017Article in journal (Refereed)
    Abstract [en]

    Objectives: To explore events and describe phases for temporal coordination of the sit-to-walk (STW) task, within a semistandardized set up, in subjects with stroke and matched controls. In addition, to assess variability of STW phase duration and to compare the relative duration of STW phases between the 2 groups.

    Design: Cross-sectional.

    Setting: Research laboratory.

    Participants: A convenience sample of persons with hemiparesis (n=10; age 50–67y), more than 6 months after stroke and 10 controls matched for sex, age, height, and body mass index.

    Interventions: Not applicable.

    Main Outcome Measures: Relative duration of STW phases, SE of measurement in percentage of the mean, and intraclass correlation coefficients (ICCs).

    Results: Four STW phases were defined: rise preparation, transition, primary gait initiation, and secondary gait initiation. The subjects with stroke needed 54% more time to complete the STW task than the controls did. ICCs ranged from .38 to .66 and .22 to .57 in the stroke and control groups, respectively. SEs of measurement in percentage of the mean values were high, particularly in the transition phase: 54.1% (stroke) and 50.4% (controls). The generalized linear model demonstrated that the relative duration of the transition phase was significantly longer in the stroke group.

    Conclusions: The present results extend existing knowledge by presenting 4 new phases of temporal coordination of STW, within a semistandardized set-up, in persons with stroke and in controls. The high degree of variability regarding relative STW phase duration was probably a result of both the semistandardized set up and biological variability. The significant difference in the transition phase across the 2 groups requires further study.

  • 29.
    Eriksson, Gunilla
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Baum, Caroline
    Washington University, St Louis, USA.
    Wolf, Timothy
    Washington University, St Louis, USA.
    Connor, Lisa Tabor
    Washington University, St Louis, USA.
    Perceived Participation After Stroke: The Influenceof Activity Retention, Reintegration, andPerceived Recovery2013In: American Journal of Occupational Therapy, ISSN 1943-7676, Vol. 67, no 6, p. e131-e138Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE

    We sought to determine the extent to which perceptions of participation in everyday occupationswere affected in a sample of people with predominantly mild stroke. Demographic variables, strokeseverity, community integration, participation in everyday occupations, and perceptions of recovery wereexamined as potential contributors to their perceptions of participation.

    METHOD

    We conducted a cross-sectional study with 116 people with mild to moderate first strokeassessed approximately 6 mo after stroke.

    RESULTS

    Perceptions of participation assessed using the Stroke Impact Scale varied (range 5 19–100),with a mean score of 82. Regression analyses revealed three factors that contributed to perceptions ofparticipation: retention of previous activities, reintegration in home and community, and perception ofstroke recovery.

    CONCLUSION

    Although the majority of participants reported a high level of perceived participation, morethan a third failed to report successful participation.

  • 30.
    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.

  • 31.
    Eriksson, Gunilla M.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Chung, Jenny C. C.
    Beng, Lim Hua
    Hartman-Maeir, Adina
    Yoo, Eunyoung
    Orellano, Elsa M.
    van Nes, Fenna
    de Jonge, Desleigh
    Baum, Carolyn M.
    Occupations of Older Adults: A Cross Cultural Description2011In: OTJR (Thorofare, N.J.), ISSN 1539-4492, E-ISSN 1938-2383, Vol. 31, no 4, p. 182-192Article in journal (Refereed)
    Abstract [en]

    Participation in everyday occupations influences people's health and well-being. To enable individuals to do the activities they want and need to do is the main concern of occupational therapy practice. Many daily occupations are universal, but they also depend on culture. The development of the Activity Card Sort in eight countries has offered the opportunity to describe occupations across cultures. In the developmental process of culturally relevant versions of the Activity Card Sort by occupational therapists in each country, the instrument versions included samples of older adults (N = 468). These data are used in the current description with the aim of identifying central activities across cultures and central activities for Asian and Western cultures. Ten activities were identified as being central across cultures (i.e., more than half of the older adults in all eight countries performed them). They were the following: shopping in a store, doing grocery shopping, doing dishes, doing laundry, reading books or magazines, sitting and thinking, watching television, listening to radio or music, visiting with friends and relatives, and talking on the telephone. Further, 16 additional activities central to Asian culture and 18 activities central to Western culture were identified. The identification of central activities deepens knowledge of activities with cultural significance. This knowledge is needed in clinical practice and multicultural research. This description provides a starting point for further exploration of everyday occupations among older adults.

  • 32.
    Eriksson, Gunilla
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Tham, Kerstin
    The Meaning of Occupational Gaps in Everyday Life in the First Year After Stroke2010In: OTJR (Thorofare, N.J.), ISSN 1539-4492, E-ISSN 1938-2383, Vol. 30, no 4, p. 184-192Article in journal (Refereed)
    Abstract [en]

    This longitudinal study identified how occupational gaps were characterized in people's lived experiences of performing everyday occupations during the first year after stroke. Four participants were interviewed four times during the year after stroke. The data were collected and analyzed using the Empirical, Phenomenological, Psychological method. Five main characteristics were identified: (1) encountering occupational gaps in formerly taken-for-granted activities, (2) striving to narrow gaps in desired occupations, (3) recognizing oneself in doing, (4) searching for a new sense of self through doing, and (5) creating strategies to enable doing. The findings show the importance of being able to preserve some sense of self in everyday doings after a life course disruption caused by stroke. Important implications for clinical practice include sensitivity to clients' experiences during this process, enablement of experiences in occupations promoting recognition, and support of clients in recapturing desired occupations.

  • 33.
    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.

  • 34.
    Eriksson, Gunilla
    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, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Disability and Habilitation.
    Tham, Kerstin
    Kottorp, Anders
    A cross-diagnostic validation of an instrument measuring participation in everyday occupations: The Occupational Gaps Questionnaire (OGQ)2013In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 20, no 2, p. 152-160Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to validate the Occupational Gaps Questionnaire (OGQ) when used in samples of people with acquired brain injuries (ABI), stroke, stress-related disorders, concussion, and persons receiving rehabilitation after ABI to investigate whether the OGQ could be used as a generic scale. A total of 601 individuals answered the OGQ at various time points after illness/injury. A Rasch analysis was performed on the data to evaluate evidence of internal scale validity and person response validity, and the capability of the OGQ to separate people into different levels of participation in everyday occupations. The results provided evidence that the OGQ is a valid measure across different diagnostic groups. A generic version of the OGQ can separate at least two levels of perceived occupational gaps and is therefore recommended as a screening tool to be used by occupational therapists working with different diagnostic groups.

  • 35. Eriksson, Therese
    et al.
    Jonsson, Hans
    Tham, Kerstin
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    A comparison of perceived occupational gaps between people with stress-related ill health or musculoskeletal pain and a reference group2012In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 19, no 5, p. 411-420Article in journal (Refereed)
    Abstract [en]

    Aim: To describe and compare how occupational gaps were reported in everyday occupations in a rehabilitation group of people with musculoskeletal pain or stress-related ill health and in a reference group from the Swedish population.

    Method: Seventy-two persons with musculoskeletal pain or stress-related ill health and 261 people from the Swedish population were included. The Occupational Gaps Questionnaire, measuring to what extent individuals perceive a discrepancy between what they want to do and what they actually do, was completed by the participants. Descriptive statistics were used to analyse the data.

    Results: Occupational gaps were reported more often in the rehabilitation group. Leisure activities were the gaps reported most often. The occupational repertoire seemed to decrease over time as the number of activities was decreasing, particularly leisure and work-related activities. Instrumental ADL were more desirable as the length of sick leave extended.

    Conclusions: Being on sick leave appears to start a process towards occupational deprivation where the areas that remain in the occupational repertoire become more important. Our study highlights the need to emphasize the whole occupational repertoire in rehabilitation and to facilitate engagement in valued activities to create a sound base for the process of returning to work.

  • 36.
    Frykberg E, Gunilla
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Johansson, Gudrun M
    Inst för Samhällsmedicin och Rehabilitering/Fysioterapi, Umeå Universitet, Umeå.
    Schelin, Lina
    Inst för Samhällsmedicin och Rehabilitering/Fysioterapi, Umeå Universitet, Umeå.
    Häger, Charlotte K
    Inst för Samhällsmedicin och Rehabilitering/Fysioterapi, Umeå Universitet, Umeå.
    The Arm Posture Score for assessing arm swing during gait: an evaluation of adding rotational components and the effect of different gait speeds2014In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 40, no 1, p. 64-69Article in journal (Refereed)
    Abstract [en]

    In 3D gait analysis, quantification of leg movements is well established, whereas a measure of arm swing has been lacking. Recently, the Arm Posture Score (APS) was introduced to characterize arm movements in children with cerebral palsy, including information from four variables (APS4) in the sagittal and frontal planes. A potential limitation of the APS is that it does not include rotational movements and has not yet been evaluated with regard to gait speed. The aims of this study were (i) to investigate the effect on APS of adding two components of arm rotation (APS6) and (ii) to determine the influence of gait speed on the APS measures, when applied to non-disabled adults. Forty-two subjects walked 10 m at a self-selected speed (1.34 m/s), and in addition a subgroup of 28 subjects walked at a slow speed (0.66 m/s) set by a metronome. Data were collected from markers in a whole-body set up and by eight optoelectronic cameras. The results demonstrated significantly higher APS6 than APS4 values for both arms, irrespective of gait speed. Speed condition, whether self-selected or slow, had a significant effect on both APS measures. The two additional arm components are suggested to provide relevant information about arm swing during walking. However, APS6 needs to be implemented in gait analysis of individuals with gait arm pathologies in order to further examine its utility. We recommend that gait speed should to be taken into account when using APS measures to quantify arm swing during gait.

  • 37.
    Frykberg, Gunilla E.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Vasa, Rajul
    RV Foundation, Mumbai, India.
    Neuroplasticity in action post-stroke: challenges for physiotherapists2015In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 17, no 2, p. 56-65Article, review/survey (Refereed)
    Abstract [en]

    Knowledge regarding neuroplasticity post-stroke is increasingly expanding. In spite of this, only a few physiotherapy interventions have been able to demonstrate effectiveness in achieving recovery of lost sensorimotor control. The aims of this review article are to highlight and discuss challenges for physiotherapists working with patients post-stroke, to question some current assessment methods and treatment approaches, and to pose critical questions indicating a possible new direction for physiotherapists in stroke rehabilitation. Differentiation between recovery and compensation post-stroke is increasingly being emphasized. Implementation of this goal in the clinic is insufficient, with a lack of assessment tools with potential to discriminate between the concepts. Large-scale reviews are performed without considering whether functional gains are achieved through “more effective” compensatory strategies or through recovery. Cortical plasticity in neurorehabilitation research and voluntary control in contemporary treatment methods are in focus. Challenges for physiotherapists in stroke rehabilitation consist of rethinking, including looking upon the body under the influence of gravity, focusing on implicit factors that impact movement control and developing new assessment tools. The introduction of a new assessment and treatment concept aiming at expanding the boundaries of center of mass movements towards the paretic side is proposed. In conclusion, we need to assume our responsibilities and step forward as the experts in movement science that we have the potential to be.

  • 38.
    Frykberg, Gunilla
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Åberg, Anna Cristina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Thierfelder, Tomas
    Department of Energy and Technology, Swedish University of Agricultural Sciences, Uppsala.
    Halvorsen, Kjartan
    Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Division of Systems and Control. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Automatic control.
    Hirschfeld, Helga
    Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet.
    Borg, Jörgen
    Department of Clinical Sciences, Rehabilitation Medicine, Karolinska Institutet.
    Locomotor coordination during the sit-to-walk transfer is different in subjects with stroke and controlsManuscript (preprint) (Other academic)
    Abstract [en]

    Objectives: To describe and to compare coordination of centre of mass (COM) horizontal and vertical momenta, and fluidity during the sit-to-walk (STW) transfer in subjects with stroke and in matched controls.

    Design: Cross-sectional.

    Setting: Research laboratory.

    Participants: Ten subjects with stroke in the post-acute phase (> 6 months) and ten control subjects, matched for sex, age, height and weight, were recruited through a convenience sample.

    Interventions: Not applicable.

    Main Outcome Measures: Magnitudes and timing of COM peak horizontal and peak vertical momenta, scores on the Fluidity Scale (FS) and values of the Fluidity Index (FI).

    Results: The stroke subjects generated significantly less COM peak horizontal and peak vertical momenta. Latencies from STW-onset and seat-off to the peaks differed significantly between the two groups. The subjects with stroke displayed significantly lower scores on the FS as well as lower percentages of the FI.

    Conclusions: While rising to walk, scaling and timing parameters of COM horizontal and vertical momenta differed significantly between subjects with stroke and matched controls. This atypical motor strategy needs to be further investigated before it is possible to make clinical recommendations.

     

  • 39.
    Fugl-Meyer, Axel R
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
    Althof, Stanley
    Center for Marital and Sexual Health of South Florida, West Palm Beach, Florida, USA.
    Buvat, Jacques
    CETPARP, Lille, France.
    Paget, Marie-Ange
    Eli Lilly France, Suresnes, France.
    Sotomayor, Mariano
    Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán,” Department of Urology, Mexico D.F., Mexico.
    Stothard, Diane
    Eli Lilly, Indianapolis, Indiana, USA.
    Aspects of Sexual Satisfaction in Men with Erectile Dysfunction: A factor analytic and logistic regression approach2009In: Journal of Sexual Medicine, ISSN 1743-6095, Vol. 6, no 1, p. 232-242Article in journal (Refereed)
    Abstract [en]

    Introduction. The International Index of Erectile Function (IIEF), Sexual Encounter Profile (