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  • 1.
    Andersson, Nilla
    et al.
    Lund Univ, Dept Hlth Sci, Lund, Sweden.
    Lexell, Jan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Lexell: 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 Reintegration to Normal Living Index (RNL-I) to Assess Perceived Participation in Adults With Late Effects of Polio2020In: PM&R, ISSN 1934-1482, E-ISSN 1934-1563, Vol. 12, no 2, p. 147-153Article in journal (Refereed)
    Abstract [en]

    Background: Many individuals with late effects of polio have difficulties participating in daily activities. The Reintegration to Normal Living Index (RNL-I) is a self-report questionnaire that evaluates perceived participation, but knowledge of the test-retest reliability and measurement errors in this population is lacking.

    Objective: To evaluate the test-retest reliability of the RNL-I in adults with late effects of polio.

    Design: A postal survey with a test-retest design.

    Setting: University hospital outpatient clinic.

    Participants: Fifty-one adults (20 women and 31 men; mean age 72 years) with late effects of polio.

    Main Outcome Measurements: The Reintegration to Normal Living Index (RNL-I).

    Methods: The participants responded to the RNL-I twice, 3 weeks apart. Data were analyzed with the following statistical methods: percentage agreement (PA), quadratic kappa coefficients, the intraclass correlation coefficient (ICC), mean difference, standard error of measurement (SEM/SEM%), and the smallest real difference (SRD/SRD%).

    Results: The PA (ie, the same scoring at both test occasions) was >70% for 10 of 11 items. The kappa coefficients showed good test-retest agreement (>0.61) for 7 items. The ICC was 0.88 and the mean difference was -0.74. The SEM (SEM%) was 7.4 (9.7%) and the SRD (SRD%) was 20.5 (27.0%).

    Conclusion: The RNL-I can be considered reliable for adults with mild to moderate late effects of polio. It can thereby be used to assess changes in perceived participation over time or after rehabilitation interventions, both for a group of individuals and a single individual.

  • 2.
    Blauwet, Cheri
    et al.
    Harvard Med Sch, Spaulding Rehabil Hosp, Dept Phys Med & Rehabil, Boston, MA 02115 USA;Harvard Med Sch, Brigham & Womens Hosp, Boston, MA 02115 USA;Kelley Adapt Sports Res Inst, Boston, MA USA.
    Webborn, Nick
    Univ Brighton, Ctr Sport & Exercise Med & Sci, Brighton, E Sussex, England.
    Kissick, James
    Carleton Univ, Univ Ottawa, Sports Med Clin, Dept Family Med, Ottawa, ON, Canada.
    Lexell, Jan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Lexell: Rehabilitation Medicine.
    Stomphorst, Jaap
    Isala Klin, Dept Sport Med, Zwolle, Netherlands.
    van de Vliet, Peter
    Int Paralymp Comm, Med & Sci Dept, Bonn, Germany.
    Lazarovski, Dimitrije
    Int Paralymp Comm, World Para Snow Sports, Bonn, Germany.
    Derman, Wayne
    Stellenbosch Univ, Inst Sport & Exercise Med, Dept Surg Sci, Cape Town, South Africa;Int Olymp Comm, Res Ctr, Cape Town, South Africa.
    When van Mechelen's sequence of injury prevention model requires pragmatic and accelerated action: the case of para alpine skiing in Pyeong Chang 20182019In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 53, no 22, p. 1391-1392Article in journal (Other academic)
  • 3.
    Derman, Wayne
    et al.
    Stellenbosch Univ, Inst Sport & Exercise Med, Dept Surg Sci, Cape Town, South Africa;Int Olymp Comm Res Ctr, Cape Town, South Africa.
    Runciman, Phoebe
    Stellenbosch Univ, Inst Sport & Exercise Med, Dept Surg Sci, Cape Town, South Africa;Int Olymp Comm Res Ctr, Cape Town, South Africa.
    Jordaan, Esme
    MRC, Biostat Unit, Parow, South Africa;Univ Western Cape, Stat & Populat Studies Dept, Bellville, South Africa.
    Schwellnus, Martin
    Univ Pretoria, SEMLI, Fac Hlth Sci, Pretoria, South Africa;IOC Res Ctr, Pretoria, South Africa.
    Blauwet, Cheri
    Spaulding Rehabil Hosp, Dept Phys Med & Rehabil, Boston, MA USA;Harvard Med Sch, Brigham & Womens Hosp, Boston, MA 02115 USA.
    Webborn, Nick
    Univ Brighton, Ctr Sport & Exercise Sci & Med SESAME, Eastbourne, England.
    Lexell, Jan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Lexell: Rehabilitation Medicine.
    van de Vliet, Peter
    Int Paralymp Comm, Med & Sci Dept, Bonn, Germany.
    Kissick, James
    Univ Ottowa, Carleton Univ, Sport Med Clin, Dept Family Med, Ottawa, ON, Canada.
    Stomphorst, Jaap
    Isala Klin, Dept Sports Med, Zwolle, Netherlands.
    Lee, Young-Hee
    Yonsei Univ, Wonju Coll Med, Rehabil Med, Seoul, South Korea.
    Kim, Keun-Suh
    Yonsei Univ, Yonsei Inst Sports Sci & Exercise Med, Seoul, South Korea.
    High incidence of injuries at the Pyeongchang 2018 Paralympic Winter Games: a prospective cohort study of 6804 athlete days2020In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 54, no 1, p. 38-43Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 4.
    Derman, Wayne
    et al.
    Stellenbosch Univ, Inst Sport & Exercise Med, Dept Surg, Div Orthopaed, Cape Town, South Africa; IOC Res Ctr South Africa, Cape Town, South Africa.
    Runciman, Phoebe
    Stellenbosch Univ, Inst Sport & Exercise Med, Dept Surg, Div Orthopaed, Cape Town, South Africa; IOC Res Ctr South Africa, Cape Town, South Africa.
    Jordaan, Esme
    MRC, Biostat Unit, Cape Town, South Africa; Univ Western Cape, Stat & Populat Studies Dept, Cape Town, South Africa.
    Schwellnus, Martin
    IOC Res Ctr South Africa, Cape Town, South Africa; Univ Pretoria, Fac Hlth Sci, Sport Exercise Med & Lifestyle Inst, Pretoria, South Africa.
    Blauwet, Cheri
    Harvard Med Sch, Dept Phys Med & Rehabil, Spaulding Rehabil Hosp, Boston, MA USA; Harvard Med Sch, Womens Hosp, Boston, MA USA.
    Webborn, Nick
    Univ Brighton, Ctr Sport & Exercise Sci & Med, Eastbourne, England.
    Lexell, Jan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Lexell: Rehabilitation Medicine.
    van de Vliet, Peter
    Int Paralymp Comm, Med & Sci Dept, Bonn, Germany.
    Kissick, James
    Univ Ottawa, Carleton Univ Sport Med Clin, Dept Family Med, Ottawa, ON, Canada.
    Stomphorst, Jaap
    Isala Klin, Dept Sports Med, Zwolle, Netherlands.
    Lee, Young-Hee
    Yonsei Univ, Wonju Coll Med, Rehabil Med, Wonju, South Korea.
    Kim, Keun-Suh
    Yonsei Univ, Yonsei Inst Sports Sci & Exercise Med, Seoul, South Korea.
    Incidence rate and burden of illness at the Pyeongchang 2018 Paralympic Winter Games2019In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 53, no 17, p. 1099-1104Article in journal (Refereed)
    Abstract [en]

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

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

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

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

     

  • 5.
    Jacobsson, Lars
    et al.
    Lund Univ, Dept Hlth Sci, Rehabil Med Res Grp, Lund, Sweden;Sunderby Hosp, Dept Rehabil Med, Lulea, Sweden;Lulea Univ Technol, Dept Hlth Sci, Lulea, Sweden.
    Lexell, Jan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Lexell: Rehabilitation Medicine. Lund Univ, Dept Hlth Sci, Rehabil Med Res Grp, Lund, Sweden;Sunderby Hosp, Dept Rehabil Med, Lulea, Sweden.
    Functioning and disability from 10 to 16 years after traumatic brain injury2020In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 141, no 2, p. 115-122Article in journal (Refereed)
    Abstract [en]

    Objectives

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

    Materials & Methods

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

    Results

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

    Conclusions

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

  • 6.
    Nolvi, Maria
    et al.
    Lund Univ, Dept Hlth Sci, Lund, Sweden;Skane Univ Hosp, Dept Neurol & Rehabil Med, Lund, Sweden.
    Brogårdh, Christina
    Lund Univ, Dept Hlth Sci, Lund, Sweden;Skane Univ Hosp, Dept Neurol & Rehabil Med, Lund, Sweden.
    Jacobsson, Lars
    Lund Univ, Dept Hlth Sci, Lund, Sweden;Sunderby Hosp, Dept Rehabil, Lulea, Sweden.
    Lexell, Jan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Lexell: Rehabilitation Medicine. Lund Univ, Dept Hlth Sci, Lund, Sweden.
    Sense of Coherence and the Association with Sociodemographics and Disability Related Factors in Persons with Late Effects of Polio2020In: PM&R, ISSN 1934-1482, E-ISSN 1934-1563, Vol. 12, no 2, p. 154-160Article in journal (Refereed)
    Abstract [en]

    Background: Sense of Coherence (SOC) is important for successful adaptation in persons with life-long disabilities. A previous study has shown that persons with Late Effects of Polio (LEoP) have a level of SOC indicating that they generally have the ability to understand, handle, and have the motivation to deal with stressful events and problems arising in their lives. However, no study has explored the associations between SOC, sociodemographics, and disability-related factors in persons with LEoP.

    Objective: To explore the associations between SOC, sociodemographics, and disability-related factors in persons with LEoP.

    Design: A cross-sectional design.

    Setting: University hospital outpatient clinic.

    Study Participants: Ninety-three persons (mean age 74 years, 52% women) with LEoP.

    Main Outcome Measurements: Swedish versions of the Sense of Coherence scale (SOC-13), Self-reported Impairments in Persons with Late Effects of Polio (SIPP) scale, Reintegration to Normal Living Index (RNL-I) (subscales "Daily Functioning" and "Perceptions of Self"), and Satisfaction With Life Scale (SWLS).

    Methods: The participants responded to a postal survey with background information and the four rating scales. To determine factors associated with SOC, a hierarchical regression analysis was performed with SOC as the dependent variable.

    Results: Higher age, less bothered by symptoms of LEoP, better perceptions of self, and higher life satisfaction were significantly associated with a greater SOC score. The final model explained 60% of the variance in the SOC (R-2 Adj = 0.60, P < .001).

    Conclusions: The strong association between SOC, higher age, and disability-related factors is important to consider in the rehabilitation of persons with LEoP. This knowledge can assist rehabilitation professionals to plan interventions that enable people with LEoP to develop strategies to better manage their daily life.

  • 7.
    Terio, Minna
    et al.
    Danderyds Univ Hosp, Dept Rehabil Med, Danderyd, Sweden.
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Lexell: Rehabilitation Medicine. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Box 23 200, S-14183 Huddinge, Sweden.
    Kamwesiga, Julius T.
    Uganda Allied Hlth Examinat Board, Kampala, Uganda.
    Guidetti, Susanne
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Box 23 200, S-14183 Huddinge, Sweden.
    What's in it for me?: A process evaluation of the implementation of a mobile phone-supported intervention after stroke in Uganda2019In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 19, article id 562Article in journal (Refereed)
    Abstract [en]

    Background

    The prevalence of stroke in Uganda is increasing. In stroke rehabilitation, information and communication technology has been shown to have potential in improving service delivery in high-income countries but there is limited knowledge of its use and impact in low-income countries.The aim of the study was to evaluate the implementation process of a mobile phone-supported family-centred rehabilitation intervention and to gain knowledge on the mechanisms of impact as well as the contextual factors that might have affected the implementation process and its outcome.

    Method

    This was a single-case study design using the integrated Promoting Action on Research Implementation in Health Services framework and the Medical Research Council guidance as frameworks. Quantitative process data was derived from 14 log books used by occupational therapists during the implementation. Qualitative semi-structured interviews were conducted with 12 implementers in different professions, 12months into the implementation, in order to obtain the primary data. Secondary data was derived from six semi-structured interviews conducted directly after pre-intervention workshops and 6 months later. The framework method was used in the data analysis.

    Results

    In 11 out of 14 cases, the clients were compliant with the intervention. Yet, challenges such as technical problems were reported. The target of conducting 16 phone calls for each client was achieved to 74%. Eight categories emerged from the qualitative analysis of the interviews including: 1) perceptions on facilitation, 2) using scientific and experience-based knowledge, 3) tailoring the intervention, 4) supportive working culture, 5) barriers to the service delivery, 6) implementers' interaction with the intervention, 7) perceptions on motivations and values, and 8) improving the model and enabling sustainability. Mechanisms contributing to the implementation of the intervention included engaged facilitators and motivated participants. Challenges in the client recruitment and poor information dissemination were some of the mechanisms impeding the implementation.

    Conclusions

    The intervention was partially delivered in accordance with the logic model for the project, where the implementation process was influenced by several barriers in the context such as technical setbacks. However, there were also several mediators in the process driving the project forward, including strong facilitation and motivated participants.

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