Center for Rehabilitation Research

Örebro, Sweden

Center for Rehabilitation Research

Örebro, Sweden

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Lundqvist L.-O.,Center for Rehabilitation Research | Lundqvist L.-O.,Örebro University | Zetterlund C.,Center for Rehabilitation Research | Zetterlund C.,Örebro University | And 2 more authors.
Archives of Physical Medicine and Rehabilitation | Year: 2014

Objective To determine whether the Feldenkrais method is an effective intervention for chronic neck/scapular pain in patients with visual impairment. Design Randomized controlled trial with an untreated control group. Setting Low vision center. Participants Patients (N=61) with visual impairment (mean, 53.3y) and nonspecific chronic (mean, 23.8y) neck/scapular pain. Interventions Participants were randomly assigned to the Feldenkrais method group (n=30) or untreated control group (n=31). Patients in the treatment group underwent one 2-hour Feldenkrais method session per week for 12 consecutive weeks. Main Outcome Measures Blind assessment of perceived pain (visual analog scale [VAS]) during physical therapist palpation of the left and right occipital, upper trapezius, and levator scapulae muscle areas; self-assessed degree of pain on the Visual, Musculoskeletal, and Balance Complaints questionnaire; and the Medical Outcomes Study 36-Item Short-Form Health Survey bodily pain scale. Results Patients undergoing Feldenkrais method reported significantly less pain than the controls according to the VAS and Visual, Musculoskeletal, and Balance Complaints questionnaire ratings at posttreatment follow-up and 1-year follow-up. There were no significant differences regarding the Medical Outcomes Study 36-Item Short-Form Health Survey bodily pain scale ratings. Conclusions Feldenkrais method is an effective intervention for chronic neck/scapular pain in patients with visual impairment. © 2014 by the American Congress of Rehabilitation Medicine.


Ylimainen K.,Örebro University | Nachemson A.,Sahlgrenska University Hospital | Sommerstein K.,Lund University | Stockselius A.,Red Cross | And 2 more authors.
Acta Paediatrica, International Journal of Paediatrics | Year: 2010

Aim: To investigate health-related quality of life (HRQoL) in young persons with limb reduction deficiency (LRD). Methods: One hundred and forty children with LRD aged 8-16 answered the DISABKIDS questionnaire for children with chronic health conditions. Of their parents, 137 answered a corresponding questionnaire concerning their child. Results: Compared to reference data from children with other health conditions, children with LRD showed higher overall HRQoL and higher HRQoL in all subscales except social exclusion. Overall, the results were not related to gender or age, but girls with longitudinal, bilateral or lower LRD reported significantly lower HRQoL in most subscales than girls with other forms of LRD. Unexpected attention and perceived physical appearance had a significant impact on HRQoL. There was poor agreement between parent and child report of the child's HRQoL. Conclusion: Children and adolescents with limb reduction deficiency have a better HRQoL than children with other health conditions but there are subgroups of children who experience a significantly lower HRQoL than their peers. The difference between parent and child ratings should be considered in clinical practice. © 2010 Foundation Acta Pædiatrica.


Holmefur M.,Örebro University | Holmefur M.,Center for Rehabilitation Research | Sundberg K.,Karolinska Institutet | Wettergren L.,Karolinska Institutet | Langius-Eklof A.,Karolinska Institutet
Quality of Life Research | Year: 2015

Purpose: The sense of coherence (SOC) scale is widely used and has an extensive history in research. The psychometric properties of the SOC scale have been investigated using classic test theory, but modern test theory enables a more multifaceted investigation of the properties of the SOC scale. The aim of this study was to explore the measurement properties of the SOC scale using the Rasch measurement model. Methods: SOC questionnaires from a sample of 623 healthy adults were analysed using Rasch analysis. Aspects analysed were rating scale functioning, item fit, unidimensionality, differential item functioning (DIF), targeting, and reliability. Results: Rating scale analysis showed that the seven scale steps were not utilized in the intended manner and that a shortening to five categories would be beneficial. Twelve out of the 13 items showed acceptable goodness-of-fit and 43 % of the variance was explained by the SOC dimension in the principal components analysis. There was no DIF between subgroups in the sample. The items were well targeted to the sample SOC level with no ceiling or floor effects. Item and person reliability were good and the person separation index was 2.05 indicating that the scale can separate three different levels of SOC, which corresponds well to its theoretical base. Conclusions: The SOC scale is generally well functioning; however, the three components of SOC seem to influence the PCA results. The scale would benefit from a reduction from seven to five scale steps, which would need to be investigated further. © 2014, Springer International Publishing Switzerland.


Eliasson A.-C.,Karolinska Institutet | Holmefur M.,Center for Rehabilitation Research | Holmefur M.,Örebro University
Developmental Medicine and Child Neurology | Year: 2015

Aim: There is evidence that modified constraint-induced movement therapy (mCIMT) has a short-term positive effect on hand function in children with unilateral cerebral palsy (CP), but the long-term effect is unknown. The aim of this study was to investigate whether or not a single block of mCIMT (2h/d for 2mo) at age 2 to 3 years influences the course of development of bimanual hand function at around 8 years of age. Method: A convenience sample of 45 children (24 males, 21 females) with unilateral CP and mean (SD) age at first assessment 32 months (13mo) was included in this study. The participants were divided into the mCIMT group (n=26) and the reference group (no mCIMT; n=19). Brain lesion characteristics were available for 32 children. The children were measured repeatedly with the Assisting Hand Assessment (AHA) for a mean period of 4 years and 6 months. Development curves were created and compared with a non-linear mixed effects model. Results: Children who were receiving mCIMT had an upper limit of development of bimanual hand function that was 8.5 AHA units higher than in the reference group (p=0.022). However, when controlling for brain lesion characteristics and baseline in a subgroup of 32 children, the difference was considerably smaller and no longer significant. Conclusion: mCIMT may have a positive impact on long-term development of bimanual hand function, but the results are inconclusive and further research is necessary. © 2014 Mac Keith Press.


Schroder A.,Psychiatric Research Center | Larsson B.W.,Karlstad University | Ahlstrom G.,Health Science University | Lundqvist L.-O.,Center for Rehabilitation Research
International Journal of Health Care Quality Assurance | Year: 2010

Purpose: The purpose of this paper is to test the psychometric properties and dimensionality of a new instrument, quality in psychiatric care (QPC), and to describe and compare quality of care among in-patients as measured by this instrument. Design/methodology/approach: The instrument quality in psychiatric care measures patients' experiences regarding quality of care. The instrument is based on a definition of quality of care from the patients' perspective. A sample of 265 in-patients at eight general psychiatric wards in Sweden was assessed. Findings: Exploratory factor analysis revealed that the original five-dimensional 69-item QPC was better with six dimensions and reduced to 30 items, hereinafter denoted quality in psychiatric care-in-patients (QPC-IP) with retained internal consistency. The patients' ratings of quality of care were generally high; the highest rating was for quality of encounter and the lowest for participation. Research limitations/implications: Analysis of the dropouts was not possible because of incomplete registrations at the wards. Practical implications: QPC-IP is a simple, inexpensive and quick way to evaluate quality of care and thus contributes to health care improvement in the field of psychiatry. Originality/value: The new 30 items instrument, QPC-IP includes important aspects of patients' perceptions of quality of care. The QPC-IP is psychometrically adequate and thus recommended for evaluating patients' experiences of the quality of psychiatric care. © Emerald Group Publishing Limited.


Lundqvist L.-O.,Center for Rehabilitation Research | Lundqvist L.-O.,Örebro University | Lorentzen K.,Public Health and Quality Improvement Center | Riiskjaer E.,Public Health and Quality Improvement Center | And 2 more authors.
Journal of Forensic Nursing | Year: 2014

Objective: The aims of this study were to adapt and evaluate the psychometric properties and factor structure of the Danish version of the Quality in Psychiatric Care-Forensic In-Patient (QPC-FIP) questionnaire. Methods: A sample of 139 inpatients from 25 wards in Denmark who received care during 5 weeks in March and April 2012 participated in the study by completing the QPC-FIP instrument. Results: Confirmatory factor analysis revealed that the factor structure of the Danish version was equivalent to that of the original Swedish QPC-FIP. The results indicate that the concept of quality of care expressed in the QPC-FIP is equivalent among forensic inpatients in nationally different healthcare systems and cultural contexts. Conclusion: The Danish version of QPC-FIP is a reliable and valid measurement instrument recommended for use in evaluating quality of care in forensic inpatient care. Copyright © 2014 International Association of Forensic Nurses.


Amer A.O.,Örebro University | Amer A.O.,Center for Rehabilitation Research | Jarl G.M.,Örebro University | Hermansson L.N.,Örebro University
Prosthetics and Orthotics International | Year: 2014

Background: Foot pain decreases individuals' ability to perform daily activities. Insoles are often prescribed to reduce the pain which, in turn, may promote return to normal activities. Objectives: To evaluate the effects of insoles on foot pain and daily activities, and to investigate the relationship between individuals' satisfaction with insoles and actual use of them. Study design: A 4-week pre-post intervention follow-up. Methods: Brief Pain Inventory, International Physical Activity Questionnaire and Lower Extremities Functional Status were used as outcome measures. Client Satisfaction with Device was used in the follow-up. Results: A total of 67 participants answered the questionnaires (81% women). Overall, a reduction in Pain Severity (p = 0.002) and Pain Interference (p = 0.008) was shown. Secondary analyses revealed a significant effect only in women. No changes in daily activities (Walking, p = 0.867; Total Physical Activity, p = 0.842; Lower Extremities Functional Status, p = 0.939) could be seen. There was no relation between Client Satisfaction with Device measures and duration of insole use. A difference in sex was shown; women scored higher than men on Pain Severity. Conclusion: Insoles reduce pain and pain interference with daily activities for women with foot pain. Satisfaction with the insoles is not a predictor of actual insole use. The effect of insoles on activity performance needs further study. Clinical relevance This study provides evidence for prescribing insoles to people with foot pain. Nonetheless, insoles are not enough to increase their physical activity level in the short term. Satisfaction with insoles and duration of use are not correlated and cannot be inferred from each other. © The International Society for Prosthetics and Orthotics 2013.


Lundqvist L.-O.,Center for Rehabilitation Research | Lundqvist L.-O.,Örebro University | Schroder A.,Örebro University | Schroder A.,Psychiatric Research Center
Journal of Forensic Nursing | Year: 2015

The study describes and compares perceived quality of care among patients and staff using theQuality in Psychiatric Care-Forensic In-Patient and the Quality in Psychiatric Care-Forensic In-Patient Staff questionnaires. The questionnaires are both based on the perception of the quality of the forensic psychiatric care given to the patients, but the wording is adjusted to fit patients or staff. The study sample consisted of 66 patients and 202 staff members from 12 forensic units in Sweden. Using multiple regression analyses to adjust for demographic variables, it was found that patients perceived the quality of support and secluded environment lower than did staff, whereas staff had lower perceptions than patients of the quality of secure environment. The combination of these questionnaires provides new possibilities for assessing the quality of forensic psychiatric care and evaluating interventions, important factors in the management and planning of forensic care. © 2015 International Association of Forensic Nurses.


Jarl G.M.,Örebro University | Jarl G.M.,Center for Rehabilitation Research | Heinemann A.W.,Rehabilitation Institute of Chicago | Heinemann A.W.,Northwestern University | And 2 more authors.
Disability and Rehabilitation: Assistive Technology | Year: 2012

Purpose: To evaluate the validity of a modified version of the Orthotics and Prosthetics Users' Survey (OPUS) with persons using different prosthetic and orthotic (P&O) devices.Method: Two-hundred-and-eighty-two adults using prosthesis, orthosis, shoe insoles or orthopaedic shoes completed OPUS. OPUS comprises five modules - Lower and Upper Extremity Functional Status, respectively (LEFS and UEFS), Client Satisfaction with Device and Services, respectively (CSD and CSS), and, Health-Related Quality of Life (HRQoL). Eight new items were added to LEFS and six to UEFS. Rasch analysis was used for data analyses.Results: Rating scales functioned satisfactory after some modifications. All modules demonstrated a ceiling effect. Unidimensionality was satisfactory after deleting some items and dividing HRQoL into two subscales, although somewhat weak on CSD and CSS. Item reliability was excellent for all modules and person reliability good for all but CSD and CSS. Some items demonstrated differential item functioning related to sex and age, but the impact on person measures was small.Conclusions: This study supports the validity of a modified version of OPUS for persons using different P&O devices, but also reveals limitations to be addressed in future studies. OPUS could be useful in clinical rehabilitation and research to evaluate P&O outcomes. Implications for Rehabilitation The rehabilitation of individuals with musculoskeletal dysfunction often includes prosthetic or orthotic devices. There is a need for validated instruments to assess the outcomes of prosthetic and orthotic (P&O) interventions. This study provides validity evidence in support of using the Orthotics and Prosthetics Users' Survey (OPUS) as an outcome measure for P&O interventions. © 2012 Informa UK, Ltd.


Jarl G.,Center for Rehabilitation Research | Jarl G.,Örebro University | Holmefur M.,Center for Rehabilitation Research | Holmefur M.,Örebro University | And 2 more authors.
Prosthetics and Orthotics International | Year: 2014

Background: The Orthotics and Prosthetics Users' Survey consists of five modules to assess outcomes of orthotic and prosthetic interventions: lower extremity functional status, upper extremity functional status, client satisfaction with device, client satisfaction with services and health-related quality of life. Objectives: To investigate the test-retest reliability and calculate the smallest detectable difference for all modules of the Swedish Orthotics and Prosthetics Users' Survey. Study design: Test-retest reliability study design. Methods: A total of 69 patients at a Department of Prosthetics and Orthotics completed Orthotics and Prosthetics Users' Survey on two occasions separated by a 2-week interval, giving 18 answers on lower extremity functional status, 41 on upper extremity functional status, 53 on client satisfaction with device, 12 on client satisfaction with services and 67 answers on health-related quality of life. Raw scores were converted into Orthotics and Prosthetics Users' Survey units on a 0-100 scale. Intra-class correlation coefficients, Bland-Altman plots, common person linking plots and t-tests of person mean measures were used to investigate the reliability. The 95% confidence level smallest detectable differences were calculated. Results: The intra-class correlation coefficients ranged from 0.77 to 0.96 for the modules, and no systematic differences were detected between the response occasions. The smallest detectable differences ranged from 7.4 to 16.6 units. Conclusions: The test-retest reliability was satisfactory for all Orthotics and Prosthetics Users' Survey modules. The smallest detectable difference was large on all modules except the health-related quality of life module. © The International Society for Prosthetics and Orthotics 2013.

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