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Nesoddtangen, Norway

Solbakk A.-K.,University of Oslo | Lovstad M.,Sunnaas Rehabilitation Hospital | Lovstad M.,University of Oslo
Scandinavian Journal of Psychology | Year: 2014

The human capacity to maintain an overarching control over mental states and behavior relies on multiple, distributed and dynamically interacting brain networks, in which prefrontal cortex (PFC) plays a critical role. PFC exerts top-down executive control over subcortical and posterior cortical areas via extensive reciprocal connections. The orbital, lateral, and medial PFC subdivisions are associated with distinct executive functions, but their precise roles in large-scale neural networks remain to be determined. The main objective of our research program is to specify cognitive and neural mechanisms that govern executive control functions. We study effects of focal PFC lesions on behavioral and electrophysiological correlates of attention and action control utilizing experiments that relate to real-life requirements for executive control. We provide a selective review of studies on the impact of lesions to PFC subregions on novelty processing, anticipatory attention, and action preparation and motor inhibition. The studies provide evidence for the contribution of both lateral, dorsomedial and orbital PFC in novelty processing and dynamic contextual updating. We also report evidence for a role of lateral PFC in motor preparation and anticipatory attention. In contrast to the common view that orbitofrontal cortex plays a general role in inhibitory control, we report findings indicating an involvement in action outcome monitoring rather than in behavioral inhibition as such. We argue that improved understanding of how basic aspects of attentional control and inhibition is regulated in the brain, will shed light on the complex behavioral, cognitive and emotional problems experienced by patients with executive dysfunction. © 2014 Scandinavian Psychological Associations and John Wiley & Sons Ltd. Source

Andelic N.,University of Oslo | Anke A.,University of Tromso | Skandsen T.,Norwegian University of Science and Technology | Sigurdardottir S.,Sunnaas Rehabilitation Hospital | And 3 more authors.
Neuroepidemiology | Year: 2012

Aims: The aims of this study were to assess the incidence of hospital-admitted severe traumatic brain injury (TBI) in the adult population in Norway, and to determine whether there were differences in the epidemiological characteristics of severe TBI between rural and urban regions. Methods: A prospective population-based study on adults with severe TBI admitted to the Norwegian Trauma Referral Centres during the 2-year period (2009-2010). The electronic patient register was searched weekly for ICD-10 diagnoses of intracranial injuries (S06.0-S06.9) to identify patients. Severe TBI was defined as lowest unsedated Glasgow Coma Scale Score ≤8 during the first 24 h after injury. Results: The annual age-adjusted incidence was estimated at 5.2/100,000 in 2009 and 4.1/100,000 in 2010. The highest frequency of hospitalized patients was found among the youngest and the oldest age groups. The most common causes of injury were falls and transport accidents. The highest in-hospital case-fatality rate was found among the oldest patients. There were consistent epidemiological characteristics of severe TBI from both rural and urban regions. Conclusions: The incidence of hospital-admitted patients with severe TBI in this national study supports the declining incidence of TBI reported internationally. No major differences were found in epidemiological characteristics between the urban and rural parts of Norway. Copyright © 2012 S. Karger AG, Basel. Source

Johansson A.E.,Sunnaas Rehabilitation Hospital
Work (Reading, Mass.) | Year: 2011

The purpose was to explore and describe the everyday life experiences among people with a disability pension and their expectations for future occupational life. A purposeful sample of 14 men and women were interviewed. Of these, ten people received full-time disability pension and four people were on partial disability pension while working part time. A content analysis approach revealed three themes: strategies for handling a changed life situation, adaptations to remaining functional capacity, and expectations on future occupational life. Initially, leaving the work market entailed a period of emotional discomfort. To help handle this discomfort, structures for participation and performance came to signify a balanced everyday life. The central conclusion drawn is that the informants with full-time disability pension reconciled themselves to their situation, changing their conception of what life on a disability pension means, while those informants who worked part-time saw their future role as that of worker. Thus, being employed constitutes one factor that promotes a future work career. Another factor related to work capacity is the need for balance between paid work and domestic work reported by disability pensioners working part-time. This area could serve as a point of departure for work rehabilitation. Source

Andelic N.,University of Oslo | Stevens L.F.,Virginia Commonwealth University | Sigurdardottir S.,Sunnaas Rehabilitation Hospital | Arango-Lasprilla J.C.,Virginia Commonwealth University | Roe C.,University of Oslo
Brain Injury | Year: 2012

Objective: To investigate associations between disability and employment 1 year after traumatic brain injury (TBI) using the International Classification of Functioning, Disability and Health (ICF) as a conceptual model. Design and methods: A prospective study including 93 patients with moderate-to-severe TBI (aged 1655 year). Disability components of the ICF model (impairments, activity limitations and participation restrictions) and personal factors (age, gender, pre-injury employment status) were used as independent variables. The outcome measure was employment at 1 year post-injury categorized into unemployed and employed groups. Results: Personal factors, impairments (brain injury severity, overall trauma severity and number of impaired body functions) and activity limitations (motor and cognitive abilities) accounted for 57% of the variance in employment outcome. Multivariate analyses showed that the probabilities of being employed 1 year post-injury were 95% lower for patients who were unemployed pre-injury (OR=0.05), 74% lower for those with more severe brain injury (OR=0.26) and 82% lower for those with more cognitive limitations (OR=0.18). Conclusion: Rehabilitation professionals should take into account the importance of the ICF model when planning vocational rehabilitation interventions for individuals with TBI and focus on targeting modifiable aspects related to employment outcome, such as the individual's cognitive ability. © 2012 Informa UK Ltd All rights reserved. Source

Roislien J.,University of Oslo | Rennie L.,Sunnaas Rehabilitation Hospital | Skaaret I.,University of Oslo
Gait and Posture | Year: 2012

Three dimensional measurements of gait is a widely used tool in clinical gait analysis, and the evaluation of the reliability and reproducibility of the method is a recurring topic in the literature. The reliability of gait curve measurements is often assessed by extraction of single points from the gait curves before applying traditional reliability measures for scalars. This approach does, however, not explore the entire gait curves as continuous functions of time. In order to assess agreement between gait curves measured by different measurement methods, or measurers, we propose an extension of the concept of limits of agreement (LoA) to curve data. The LoA represent the estimated variation in the actual observations, which are then to be accompanied by an evaluation of whether this observed variation is within clinically acceptable limits. The generalization of the methodology from scalars to continuous function, e.g. gait curves, can be done using functional data analysis (FDA), a statistical methodology particularly developed for analyzing functional data. The resulting functional limits of agreement (FLoA) are continuous functions from 0 to 100% of the gait cycle, representing the difference in gait curves as measured by different measurement methods. The FLoA are presented in actual degrees for each joint and plane under study. The proposed methodology is demonstrated on real data from an inter-rater repeatability study. © 2012 Elsevier B.V. Source

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