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Levi, Richard
Publications (10 of 77) Show all publications
Magaard, G., Wester, P., Levi, R., Lindvall, P., Gustafsson, E., Sedeh, A. N., . . . Hu, X. (2018). Identifying Unmet Rehabilitation Needs in Patients After Stroke With a Graphic Rehab-Compass (TM). Journal of Stroke & Cerebrovascular Diseases, 27(11), 3224-3235
Open this publication in new window or tab >>Identifying Unmet Rehabilitation Needs in Patients After Stroke With a Graphic Rehab-Compass (TM)
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2018 (English)In: Journal of Stroke & Cerebrovascular Diseases, ISSN 1052-3057, E-ISSN 1532-8511, Vol. 27, no 11, p. 3224-3235Article in journal (Refereed) Published
Abstract [en]

Background: Unmet rehabilitation needs are common among stroke survivors. We aimed to evaluate whether a comprehensive graphic "Rehab-Compass," a novel combination of structured patient-reported outcome measures, was feasible and useful in facilitating a capture of patients rehabilitation needs in clinical practice. Methods: A new graphic overview of broad unmet rehabilitation needs covers deficits in functioning, daily activity, participation, and quality of life. It was constructed by using 5 patient-oriented, well-validated, and reliable existing instruments with converted data into a 0 (worst outcome) to 100 (best outcome) scale but unchanged in terms of variable properties. Satisfaction of the Rehab-Compass (TM) was studied by a qualitative interview of 9 patients with stroke and 3 clinicians. Practical feasibility and capacity of the instrument were evaluated in a cross sectional study with 48 patients at 5-month follow-ups after subarachnoid hemorrhage. Results: The Rehab-Compass (TM) identified and graphically visualized a panoramic view of the multidimensional needs over time which was completed before clinical consultation. The Rehab-Compass (TM) appeared to be feasible and time efficient in clinical use. The interviews of both patients and clinicians showed high satisfaction when using the Rehab-Compass (TM) graph. In the studied stroke patients, the Rehab-Compass (TM) identified memory and processing information, fatigue, mood, and pain after subarachnoid hemorrhage as the most common problems. Conclusions: The graphic Rehab-Compass (TM) seems to be a feasible, useful, and time-saving tool for identification of unmet rehabilitation needs among stroke survivors in clinical practice. Further research is needed to make the Rehab-Compass (TM) more concise and evaluate the instrument among different stroke subgroups.

Place, publisher, year, edition, pages
ELSEVIER SCIENCE BV, 2018
Keywords
Stroke; rehabilitation; needs assessment; outcome and process assessment; referral and consultation; quality improvement
National Category
Neurology
Identifiers
urn:nbn:se:liu:diva-153387 (URN)10.1016/j.jstrokecerebrovasdis.2018.07.013 (DOI)000450569700044 ()30097401 (PubMedID)
Note

Funding Agencies|Vasterbotten County Council; Umea University (ALF Foundation); Swedish Stroke Foundation (Stroke Riksforbundet); Northern Swedish Stroke Fund (Strokeforskning I Norrland Insamlingsstiftelse); Swedish Heart and Lung Foundation

Available from: 2018-12-18 Created: 2018-12-18 Last updated: 2019-04-30
Divanoglou, A., Augutis, M., Sveinsson, T., Hultling, C. & Levi, R. (2018). SELF-REPORTED HEALTH PROBLEMS AND PRIORITIZED GOALS IN COMMUNITY-DWELLING INDIVIDUALS WITH SPINAL CORD INJURY IN SWEDEN. Journal of Rehabilitation Medicine, 50(10), 872-878
Open this publication in new window or tab >>SELF-REPORTED HEALTH PROBLEMS AND PRIORITIZED GOALS IN COMMUNITY-DWELLING INDIVIDUALS WITH SPINAL CORD INJURY IN SWEDEN
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2018 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 50, no 10, p. 872-878Article in journal (Refereed) Published
Abstract [en]

Objective: To explore self-reported health problems and functional goals in community-dwelling individuals with spinal cord injury in Sweden. Design: Cross-sectional descriptive study that used a survey designed by an experienced peer mentor with spinal cord injury. Subjects: Community-dwelling individuals with spinal cord injury from Sweden. Methods: The survey was distributed online by the community peer-based organization RG Active Rehabilitation. Results: A total of 203 individuals (55% males, 90% acquired spinal cord injury) from all regions in Sweden completed the survey. Of these, 33% reported living with amp;gt; 2 unbearable physical or psychological problems. While some problems (e.g. problems related to bladder and balance) were consistently ranked to be common across all years since injury and type of spinal cord injury, distribution of some other unbearable problems (e.g. type of pain, excessive weight) varied between subgroups. Years since injury, level of acquired spinal cord injury and sex, but not age-group or type of spinal cord injury, explained some of the variation in the goals. Conclusion: The high proportion of reported "unbearable" problems point to the stronger need for systematic, comprehensive, life-long, multi-disciplinary follow-up for people with spinal cord injury. The high rate of goals related to improving strength and fitness across all participants independently of their characteristics highlight the important role of community organizations that offer such lifetime services.

Place, publisher, year, edition, pages
FOUNDATION REHABILITATION INFORMATION, 2018
Keywords
spinal cord injuries; goals; independent living; complications; community rehabilitation; peer support; pain
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-152603 (URN)10.2340/16501977-2383 (DOI)000447776700005 ()30225513 (PubMedID)
Available from: 2018-11-09 Created: 2018-11-09 Last updated: 2019-04-30
Augutis, M., Ertzgaard, P. & Levi, R. (2017). Sverige bör centralisera den pediatriska ryggmärgsskadevården. Läkartidningen, 114(35-36)
Open this publication in new window or tab >>Sverige bör centralisera den pediatriska ryggmärgsskadevården
2017 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 114, no 35-36Article in journal, Editorial material (Other academic) Published
Abstract [en]

[No abstract available]

Place, publisher, year, edition, pages
Swedish Medical Association, 2017
National Category
Neurology
Identifiers
urn:nbn:se:liu:diva-147498 (URN)2-s2.0-85028655987 (Scopus ID)
Available from: 2018-04-20 Created: 2018-04-20 Last updated: 2018-05-03
Engman-Bredvik, S., Carballeira, S. N., Levi, R. & Nilsson, K. (2016). Multi-family therapy in anorexia nervosa-A qualitative study of parental experiences.. Eating Disorders, 24(2), 186-197
Open this publication in new window or tab >>Multi-family therapy in anorexia nervosa-A qualitative study of parental experiences.
2016 (English)In: Eating Disorders, ISSN 1064-0266, E-ISSN 1532-530X, Vol. 24, no 2, p. 186-197Article in journal (Refereed) Published
Abstract [en]

This qualitative study from northern Sweden investigated experiences of multi-family therapy (MFT) in 12 parents of children with anorexia nervosa (AN). The main reported benefit was the opportunity to talk to others in a similar situation, thereby sharing experiences and struggles. MFT resulted in new perspectives and insights that improved family dynamics and enabled new constructive behaviors. In conclusion, MFT seems to be a useful therapeutic modality in the treatment of AN in a northern European setting.

Place, publisher, year, edition, pages
Informa Healthcare, 2016
National Category
Applied Psychology
Identifiers
urn:nbn:se:liu:diva-126310 (URN)10.1080/10640266.2015.1034053 (DOI)25879257 (PubMedID)
Available from: 2016-03-22 Created: 2016-03-22 Last updated: 2017-11-30
Stenberg, M., Godbolt, A., Nygren, D. B., Levi, R. & Stålnacke, B. (2015). Cognitive Impairment after Severe Traumatic Brain Injury, Clinical Course and Impact on Outcome: A Swedish-Icelandic Study. Behavioural Neurology, 2015, 12, Article ID 680308.
Open this publication in new window or tab >>Cognitive Impairment after Severe Traumatic Brain Injury, Clinical Course and Impact on Outcome: A Swedish-Icelandic Study
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2015 (English)In: Behavioural Neurology, ISSN 0953-4180, E-ISSN 1875-8584, Vol. 2015, p. 12-, article id 680308Article in journal (Refereed) Published
Abstract [en]

Objective: To assess the clinical course of cognitive and emotional impairments in patients with severe TBI (sTBI) from 3 weeks to 1 year after trauma and to study associations with outcomes at 1 year.andlt;br /andgt;Methods: Prospective, multicenter, observational study of sTBI in Sweden and Iceland. Patients aged 18-65 years with acute Glasgow Coma Scale 3-8 were assessed with the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS) and the Hospital Anxiety and Depression Scale (HADS). Outcome measures were Glasgow Outcome Scale Extended (GOSE) and Rancho Los Amigos Cognitive Scale-Revised (RLAS-R).andlt;br /andgt;Results: Cognition was assessed with the BNIS assessed for 42 patients out of 100 at 3 weeks, 75 patients at 3 months, and 78 patients at 1 year. Cognition improved over time, especially from 3 weeks to 3 months. The BNIS subscales "orientation" and "visuospatial and visual problem solving" were associated with the GOSE and RLAS-R at 1 year.andlt;br /andgt;Conclusion: Cognition seemed to improve over time after sTBI and appeared to be rather stable from 3 months to 1 year. Since cognitive function was associated with outcomes, these results indicate that early screening of cognitive function could be of importance for rehabilitation planning in a clinical setting.

Place, publisher, year, edition, pages
Hindawi, 2015
National Category
Neurology
Identifiers
urn:nbn:se:liu:diva-126309 (URN)10.1155/2015/680308 (DOI)26783381 (PubMedID)
Available from: 2016-03-22 Created: 2016-03-22 Last updated: 2017-11-30
Levi, R. & Ertzgaard, P. (2015). Förvärvade ryggmärgsskador (1ed.). In: Jörgen Borg, Kristian Borg, Björn Gerdle, Katharina Stibrant Sunnerhagen (Ed.), Rehabiliteringsmedicin: teori och praktik (pp. 375-388). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Förvärvade ryggmärgsskador
2015 (Swedish)In: Rehabiliteringsmedicin: teori och praktik / [ed] Jörgen Borg, Kristian Borg, Björn Gerdle, Katharina Stibrant Sunnerhagen, Lund: Studentlitteratur AB, 2015, 1, p. 375-388Chapter in book (Other academic)
Abstract [sv]

Rehabiliteringsmedicinsk kunskap är relevant vid alla sjukdomar och skador som medför långvariga, komplexa funktionshinder och är därför relevant inom stora delar av sjukvården. Inom den rehabiliteringsmedicinska specialiteten handläggs idag främst patienter med skador och sjukdomar i nervsystemet respektive med långvariga smärttillstånd.

Denna reviderade upplaga inleds med en sektion som avhandlar rehabiliteringsmedicinens utveckling och nuvarande plats i sjukvården, centrala rehabiliteringsmedicinska koncept, mät- och arbetsmetoder. Följande sektioner omfattar rehabiliteringsmedicinsk funktionsdiagnostik, läkningsmekanismer och behandling vid långvariga smärttillstånd respektive vid skador och kroniska sjukdomar i nervsystemet. Bokens omfång har ökat något. Några kapitel har fått större utrymme och nya kapitel om beteendestörning och medicinska komplikationer efter svår hjärnskada liksom om anoxisk hjärnskada har tillkommit. Andra kapitel, som inte rör dagens kärnverksamhet inom praktisk rehabiliteringsmedicin, har utgått.

Rehabiliteringsmedicin är avsedd för grundutbildning av läkare, arbetsterapeuter och sjukgymnaster, logopeder samt för läkare under ATtjänstgöring. Den är också lämplig som introduktion i specialistutbildningen i rehabiliteringsmedicin, geriatrik, neurologi och smärtlindring, i vidareutbildningar av olika vårdyrkesgrupper och som referenslitteratur av yrkesverksamma med intresse för rehabiliteringsmedicin.

Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2015 Edition: 1
Keywords
Ryggmärgsskador
National Category
Clinical Medicine Neurology
Identifiers
urn:nbn:se:liu:diva-126546 (URN)978-91-4410-196-5 (ISBN)
Available from: 2016-03-30 Created: 2016-03-30 Last updated: 2016-04-19Bibliographically approved
Awad, A., Levi, R., Lindgren, L., Hultling, C., Westling, G., Nyberg, L. & Eriksson, J. (2015). Preserved somatosensory conduction in a patient with complete cervical spinal cord injury.. Journal of Rehabilitation Medicine, 47(5), 426-431
Open this publication in new window or tab >>Preserved somatosensory conduction in a patient with complete cervical spinal cord injury.
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2015 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 47, no 5, p. 426-431Article in journal (Refereed) Published
Abstract [en]

Objective: Neurophysiological investigation has shown that patients with clinically complete spinal cord injury can have residual motor sparing ("motor discomplete"). In the current study somatosensory conduction was assessed in a patient with clinically complete spinal cord injury and a novel methodology for assessing such preservation is described, in this case indicating "sensory discomplete" spinal cord injury.andlt;br /andgt;Methods: Blood oxygenation level-dependent functional magnetic resonance imaging (BOLD fMRI) was used to examine the somatosensory system in a healthy subject and in a subject with a clinically complete cervical spinal cord injury, by applying tactile stimulation above and below the level of spinal cord injury, with and without visual feedback.andlt;br /andgt;Results: In the participant with spinal cord injury, somatosensory stimulation below the neurological level of the lesion gave rise to BOLD signal changes in the corresponding areas of the somatosensory cortex. Visual feedback of the stimulation strongly modulated the somatosensory BOLD signal, implying that cortico-cortical rather than spino-cortical connections can drive activity in the somatosensory cortex. Critically, BOLD signal change was also evident when the visual feedback of the stimulation was removed, thus demonstrating sensory discomplete spinal cord injury.andlt;br /andgt;Conclusion: Given the existence of sensory discomplete spinal cord injury, preserved but hitherto undetected somatosensory conduction might contribute to the unexplained variability related to, for example, the propensity to develop decubitus ulcers and neuropathic pain among patients with clinically complete spinal cord injury.

Place, publisher, year, edition, pages
Foundation of Rehabilitation Information, 2015
National Category
Neurology
Identifiers
urn:nbn:se:liu:diva-126311 (URN)10.2340/16501977-1955 (DOI)25808357 (PubMedID)
Available from: 2016-03-22 Created: 2016-03-22 Last updated: 2017-11-30
Stenberg, G., Henje, C., Levi, R. & Lindström, M. (2014). Living with an electric wheelchair - the user perspective.. Disability and Rehabilitation: Assistive Technology, 11(5), 385-394
Open this publication in new window or tab >>Living with an electric wheelchair - the user perspective.
2014 (English)In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 11, no 5, p. 385-394Article in journal (Refereed) Published
Abstract [en]

Abstract Purpose: To explore the experiences of using an electric wheelchair in daily living. Methods: Fifteen participants, eight women and seven men, living in different parts of a Nordic country were interviewed. The interviews were conducted in the home or at the workplace. Open-ended questions were used. The data were collected and analyzed according to the grounded theory. Results: Analysis resulted in one core category: "Integrating the electric wheelchair - a manifold process", describing a process commencing from initial resistance against use of an electric wheelchair, to acceptance with various extent of integration. Six categories emerged that represent this core process: incorporating the electric wheelchair into the self-identity process, calculating functional consequences, encountering the reactions of others, facing duality in movability, using proactive strategies, and being at the mercy of the system. Findings indicate that the integration process is complex and manifold. Practical, personal, and social dimensions were intertwined and significantly involved. Conclusions: Integrating an electric wheelchair is a process closely connected to symbolic value, usability, community mobility and identity. These aspects should be considered in the production, prescription, and adaptation processes. Implications for Rehabilitation Integrating an electric wheelchair is a process closely connected to symbolic value, usability, community mobility, and identity. These aspects should be considered in the wheelchair production, prescription, and adaptation processes.

Place, publisher, year, edition, pages
Taylor & Francis, 2014
National Category
Occupational Therapy
Identifiers
urn:nbn:se:liu:diva-126374 (URN)10.3109/17483107.2014.968811 (DOI)25270614 (PubMedID)
Available from: 2016-03-23 Created: 2016-03-23 Last updated: 2017-11-30
Flank, P., Fahlström, M., Boström, C., Lewis, J., Levi, R. & Wahman, K. (2014). Self-reported physical activity and risk markers for cardiovascular disease after spinal cord injury.. Journal of Rehabilitation Medicine, 46(9), 886-890
Open this publication in new window or tab >>Self-reported physical activity and risk markers for cardiovascular disease after spinal cord injury.
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2014 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 46, no 9, p. 886-890Article in journal (Refereed) Published
Abstract [en]

Objective: To examine whether self-reported physical activity of a moderate/vigorous intensity influences risk markers for cardiovascular disease in persons with paraplegia due to spinal cord injury.andlt;br /andgt;Design: Descriptive, cross-sectional study.andlt;br /andgt;Subjects: A total of 134 wheelchair-dependent individuals (103 men, 31 women) with chronic (≥ 1 year) post-traumatic spinal cord injury with paraplegia.andlt;br /andgt;Methods: Cardiovascular disease markers (hypertension, blood glucose and a blood lipid panel) were analysed and related to physical activity.andlt;br /andgt;Results: One out of 5 persons reported undertaking physical activity ≥  30 min/day. Persons who were physically active ≥ 30 min/day were significantly younger than inactive persons. Systolic and diastolic blood pressures were lower in the physically active group. When adjusting for age, the association between systolic blood pressure and physical activity disappeared. Physical activity ≥ 30 min/day had a tendency to positively influence body mass index and low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio. Men had significantly higher systolic and diastolic blood pressures than women, lower high-density lipoprotein cholesterol, higher low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio and higher triglycerides. No other significant differences between men and women were found.andlt;br /andgt;Conclusion: Self-reported physical activity ≥ 30 min/day in persons with spinal cord injury positively influenced diastolic blood pressure. No other reductions in cardiovascular disease risk markers were seen after controlling for age. These results indicate a positive effect of physical activity, but it cannot be concluded that recommendations about physical activity in cardiovascular disease prevention for the general population apply to wheelchair-dependent persons with spinal cord injury.

Place, publisher, year, edition, pages
Foundation of Rehabilitation Information, 2014
National Category
Geriatrics
Identifiers
urn:nbn:se:liu:diva-126312 (URN)10.2340/16501977-1857 (DOI)25211062 (PubMedID)
Available from: 2016-03-22 Created: 2016-03-22 Last updated: 2017-11-30
Levi, R., Jan, Z. & Olofsson, C. (2014). Symtom, diagnos, terapi (1ed.). Studentlitteratur
Open this publication in new window or tab >>Symtom, diagnos, terapi
2014 (Swedish)Book (Other academic)
Abstract [sv]

En stor del av den akuta sjukvården handläggs utanför sjukhusen. Sjukvårdsupplysningen och distriktssköterskor hänvisar flertalet oklara och misstänkt allvarligare akutfall till hälsocentralen. Andra hänvisas till egenvård eller mer eller mindre akut sjukhuskontakt. Därtill söker många patienter direkt till hälsocentral. En liten andel av dessa patienter är så uppenbart svårt sjuka, att deras akuta remittering till sjukhus är given. I de flesta fall är dock situationen betydligt svårare att handlägga. Varje dags tjänstgöring vid hälsocentral eller akutmottagning kräver hundratals bedömningar och beslut. Patienterna strömmar in utan diagnostiska etiketter och antalet möjliga orsaker är mycket stort. Processen från symtom, via diagnos, till åtgärd måste ofta genomföras vid det aktuella kontakttillfället, under stark tidspress.

Det är precis i denna kritiska beslutssituation som denna bok vill utgöra ett användbart stöd. Den möjliggör att, på ett fåtal minuter, erinra om vad som är vanligt, vad som är viktigt och vad som är försåtligt. Den ger stöd i den primära differentialdiagnostiken i ett osorterat patientklientel, och även förslag på konkret handläggning.

Symtom – Diagnos – Terapi är en genomgripande omarbetning av en symtombaserad handbok som författarna skrev som unga läkare 1985. Boken som helhet har granskats och kompletterats av en erfaren specialist i allmänmedicin. Den primära målgruppen är läkare verksamma inom öppen akutsjukvård. Den är av värde även för andra yrkeskategorier inom detta verksamhetsområde och för studerande på läkarutbildningen.

Place, publisher, year, edition, pages
Studentlitteratur, 2014. p. 742 Edition: 1
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-126455 (URN)978-91-44029-45-0 (ISBN)
Available from: 2016-03-26 Created: 2016-03-26 Last updated: 2016-04-06
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