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  • 1.
    Augutis, M
    et al.
    Department of Public Health and Research, Sundsvall Hospital, Sundsvall, Sweden.
    Abel, R
    Orthopädische Universitätsklinik, Heidelberg-Schlierbach, Germany.
    Levi, Richard
    Karolinska Institute and Rehab Station Stockholm, Sweden.
    Pediatric spinal cord injury in a subset of European countries.2006Ingår i: Spinal Cord, ISSN 1362-4393, E-ISSN 1476-5624, Vol. 44, nr 2, s. 106-112Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Study design:Postal survey.Setting:A total of 19 countries in Europe.Objectives:Firstly, to collect information about incidence and systems of care for pediatric spinal cord injury (pedSCI); including prevention, initial care and follow-up in a subset of European countries. Secondly, to initiate a network of involved professionals for exchange of information and development of research and care programs.Methods:A short semi-structured questionnaire was sent to respondents working with spinal cord injury (SCI) in 19 countries in Europe.Results:Only in Portugal and Sweden, is the incidence of pedSCI (fatal injuries included) established, that is 27 children/million children/year and 4.6 children/million children/year, respectively. For the other countries, the estimated incidence of pedSCI (nonfatal injuries) varied from 0.9 to 21.2 children/million children/year in the age group of 0–14 years. Although the incidence varies considerably, pedSCI is rare throughout Europe. The management differs between the countries depending on the age of the child and the local organization of health care.Conclusions:The survey confirms that pedSCI is rare. In order to establish high-quality standardized care, further integration of knowledge in this area is needed throughout Europe. The contacts initiated by this survey may be used to create an international network serving as a reference for health professionals, researchers and families, thereby possibly alleviating some of the unwanted variations of care identified in this study.Spinal Cord (2006) 44, 106–112. doi:andlt;highlightandgt;10.1038andlt;/highlightandgt;/andlt;highlightandgt;sj.scandlt;/highlightandgt;.andlt;highlightandgt;3101793andlt;/highlightandgt;; published online 30 August 2005 [ABSTRACT FROM AUTHOR]

  • 2.
    Augutis, M
    et al.
    FoU, Sundsvall Hospital, Sundsvall, Sweden.
    Levi, Richard
    Rehab Station Stockholm and Karolinska Institute, Stockholm, Sweden.
    Pediatric spinal cord injury in Sweden: incidence, etiology and outcome.2003Ingår i: Spinal Cord, ISSN 1362-4393, E-ISSN 1476-5624, Vol. 41, nr 6, s. 328-336Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    STUDY DESIGN:: Retrospective descriptive study. OBJECTIVES:: To assess incidence, causes and early outcome of traumatic spinal cord injury (SCI) among children in Sweden, thereby identifying high-risk groups and situations as a basis for preventative measures and improved care. METHODS:: Data from population registers, County Habilitation Centers as well as from informal sources were used to estimate the incidence of SCI in Sweden during the years 1985-1996 among children aged 0-15 years. Contacts with the treating hospitals, reviews of medical records and/or personal interviews were used to verify primary data. In total, 92 children were thus identified. RESULTS:: The incidence was found to be 4.6/million children/year (95% CI 3.6-5.5). When excluding prehospital fatalities, the incidence was 2.4 (95% CI 1.8-3.1). The main cause of injury among fatalities was traffic accidents. Associated injuries occurred in 41% of the children. Among survivors (10-15 years), sports-related injuries (43%) were as common a cause as traffic accidents (39%). The survivors were treated in 18 different hospitals. CONCLUSION:: Pediatric SCI in Sweden is rare, presumably because of effective primary prevention. Preventative measures should be further differentiated for each age group of children in accordance with their differing risk profiles. In contrast to the effective preventative measures that have been implemented in Sweden, care of these patients is still too fractionated and decentralized for sufficient specialization to emerge.Spinal Cord (2003) 41, 328-336. doi:andlt;highlightandgt;10.1038andlt;/highlightandgt;/andlt;highlightandgt;sj.scandlt;/highlightandgt;.andlt;highlightandgt;3101478andlt;/highlightandgt; [ABSTRACT FROM AUTHOR]

  • 3.
    Augutis, M
    et al.
    FoU, Sundsvall Hospital, Sundsvall, Sweden.
    Malker, H
    Mid Sweden Research and Development Center, Vasternorrland County Council, Sundsvall, Sweden.
    Levi, Richard
    Karolinska Institute and Frosunda Center, Stockholm, Sweden.
    Pediatric spinal cord injury in Sweden; how to identify a cohort of rare events.2003Ingår i: Spinal Cord, ISSN 1362-4393, E-ISSN 1476-5624, Vol. 41, nr 6, s. 337-346Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    STUDY DESIGN:: Register study enhanced and verified by medical records and personal interviews and examinations. SETTINGS:: Sweden. OBJECTIVES:: To define a method of identifying a study population of rare events. To point out the relative importance of every step, an example is given of identifying persons who sustained traumatic spinal cord injury (SCI) in childhood. METHODS:: Cases were identified in seven steps that all needed to be fulfilled, from definition of selection criteria through combination of several data sources, to the use of several verification methods. RESULTS:: Initial screening by registers identified 384 possible cases, which however were found by subsequent analysis to include a large number of incorrect cases. At completion of all analytic steps, 35 living cases could be fully verified and 14 deceased cases could be partially verified. CONCLUSIONS:: Registers offer a practical initial source for study population identification. The screening of International Classification of Diseases codes defining SCI only included less than 30% of true SCIs. Subsequently, further refinement and quality control is necessary in order to ensure validity. Such further verification is time-consuming, but nevertheless necessary in order to verify a true cohort.Spinal Cord (2003) 41, 337-346. doi:andlt;highlightandgt;10.1038andlt;/highlightandgt;/andlt;highlightandgt;sj.scandlt;/highlightandgt;.andlt;highlightandgt;3101456andlt;/highlightandgt; [ABSTRACT FROM AUTHOR]

  • 4.
    Baunsgaard, Carsten Bach
    et al.
    Univ Copenhagen, Denmark.
    Nissen, Ulla Vig
    Univ Copenhagen, Denmark.
    Brust, Anne Katrin
    SPC, Switzerland.
    Frotzler, Angela
    SPC, Switzerland.
    Ribeill, Cornelia
    Ulm Univ, Germany.
    Kalke, Yorck-Bernhard
    Ulm Univ, Germany.
    Leon, Natacha
    FLM, Spain.
    Gomez, Belen
    FLM, Spain.
    Samuelsson, Kersti
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Rehabiliteringsmedicinska kliniken.
    Antepohl, Wolfram
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Rehabiliteringsmedicinska kliniken.
    Holmstrom, Ulrika
    Uppsala Univ Hosp, Sweden.
    Marklund, Niklas
    Uppsala Univ Hosp, Sweden.
    Glott, Thomas
    Sunnaas Rehabil Hosp, Norway.
    Opheim, Arve
    Sunnaas Rehabil Hosp, Norway; Univ Gothenburg, Sweden.
    Benito, Jesus
    Neurorehabil Hosp, Spain.
    Murillo, Narda
    Neurorehabil Hosp, Spain.
    Nachtegaal, Janneke
    Heliomare Rehabil Ctr, Netherlands.
    Faber, Willemijn
    Heliomare Rehabil Ctr, Netherlands.
    Biering-Sorensen, Fin
    Univ Copenhagen, Denmark.
    Gait training after spinal cord injury: safety, feasibility and gait function following 8 weeks of training with the exoskeletons from Ekso Bionics2018Ingår i: Spinal Cord, ISSN 1362-4393, E-ISSN 1476-5624, Vol. 56, nr 2, s. 106-116Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Study design Prospective quasi-experimental study, pre-and post-design. Objectives Assess safety, feasibility, training characteristics and changes in gait function for persons with spinal cord injury (SCI) using the robotic exoskeletons from Ekso Bionics. Setting Nine European rehabilitation centres. Methods Robotic exoskeleton gait training, three times weekly over 8 weeks. Time upright, time walking and steps in the device (training characteristics) were recorded longitudinally. Gait and neurological function were measured by 10 Metre Walk Test (10 MWT), Timed Up and Go (TUG), Berg Balance Scale (BBS), Walking Index for Spinal Cord Injury (WISCI) II and Lower Extremity Motor Score (LEMS). Results Fifty-two participants completed the training protocol. Median age: 35.8 years (IQR 27.5-52.5), men/women: N = 36/16, neurological level of injury: C1-L2 and severity: AIS A-D (American Spinal Injury Association Impairment Scale). Time since injury (TSI) amp;lt; 1 year, N = 25; amp;gt; 1 year, N = 27. No serious adverse events occurred. Three participants dropped out following ankle swelling (overuse injury). Four participants sustained a Category II pressure ulcer at contact points with the device but completed the study and skin normalized. Training characteristics increased significantly for all subgroups. The number of participants with TSI amp;lt; 1 year and gait function increased from 20 to 56% (P=0.004) and 10MWT, TUG, BBS and LEMS results improved (P amp;lt; 0.05). The number of participants with TSI amp;gt; 1 year and gait function, increased from 41 to 44% and TUG and BBS results improved (P amp;lt; 0.05). Conclusions Exoskeleton training was generally safe and feasible in a heterogeneous sample of persons with SCI. Results indicate potential benefits on gait function and balance.

  • 5.
    Divanoglou, A
    et al.
    Division of Neuro-rehabilitation, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Levi, Richard
    Division of Neuro-rehabilitation, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Incidence of traumatic spinal cord injury in Thessaloniki, Greece and Stockholm, Sweden: a prospective population-based study2009Ingår i: Spinal Cord, ISSN 1362-4393, E-ISSN 1476-5624, Vol. 47, nr 11, s. 796-801Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Study design: Prospective population-based open-ended study. This paper is part of the Stockholm Thessaloniki Acute Traumatic Spinal Cord Injury Study.andlt;br /andgt;Objectives: To calculate incidence and evaluate the epidemiological profile of the incident population with traumatic spinal cord injury (TSCI). Settings: The greater Thessaloniki region in Greece and the greater Stockholm region in Sweden.andlt;br /andgt;Methods: TSCI individuals, older than 15 years of age, who had survived the first 7 days post-trauma, were identified through an active surveillance system. The forms of the Nordic Spinal Cord Injury Registry were used.andlt;br /andgt;Results: 87 individuals were injured in the greater Thessaloniki and 49 in the greater Stockholm region. Annual crude incidence was 33.6 per million for Thessaloniki and 19.5 per million for the Stockholm region. The leading causes of injury for the Thessaloniki region were transportation accidents (51%) and falls (37%), and those for the Stockholm region were falls (47%) and transportation accidents (23%). A significantly larger number of individuals of the Thessaloniki group were injured in transportation accidents. There was no significant difference between regions with regard to the type of resulting impairment.andlt;br /andgt;Conclusions: Incidence of TSCI was considerably higher in the Thessaloniki region as compared with that in the Stockholm region, probably chiefly reflecting differences in preventative measures with regard to driving. Spinal Cord (2009) 47, 796-801; doi:andlt;highlightandgt;10.1038andlt;/highlightandgt;/andlt;highlightandgt;scandlt;/highlightandgt;.andlt;highlightandgt;2009.28andlt;/highlightandgt;; published online 7 April 2009

  • 6.
    Divanoglou, A
    et al.
    Division of Neuro-rehabilitation, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Seiger, A
    Division of Neuro-rehabilitation, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Levi, Richard
    Division of Neuro-rehabilitation, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Acute management of traumatic spinal cord injury in a Greek and a Swedish region: a prospective, population-based study2010Ingår i: Spinal Cord, ISSN 1362-4393, E-ISSN 1476-5624, Vol. 48, nr 6, s. 477-482Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Study design: Prospective, population-based study. This paper is part of the Stockholm Thessaloniki Acute Traumatic Spinal Cord Injury Study (STATSCIS).andlt;br /andgt;Objectives: To characterize patient populations and to compare acute management after traumatic spinal cord injury (TSCI).andlt;br /andgt;Settings: The Greater Thessaloniki region in Greece and the Greater Stockholm region in Sweden.andlt;br /andgt;Methods: Inception cohorts with acute TSCI that were hospitalized during the study period, that is September 2006 to October 2007, were identified. Overall, 81 out of 87 cases consented to inclusion in Thessaloniki and 47 out of 49 in Stockholm. Data from Thessaloniki were collected through physical examinations, medical record reviews and communication with TSCI cases and medical teams. Data from Stockholm were retrieved from the Nordic Spinal Cord Injury Registry.andlt;br /andgt;Results: There were no significant differences between study groups with regard to core clinical characteristics. In contrast, there were significant differences in (1) transfer logistics from the scene of trauma to a tertiary-level hospital (number of intermediate admissions, modes of transportation and duration of transfer) and (2) acute key therapeutic interventions, that is, the use of mechanical ventilation (49% in Thessaloniki versus 20% in Stockholm), and performance of tracheostomy (36% in Thessaloniki versus 15% in Stockholm); spinal surgery was performed significantly more often and earlier in Stockholm than in Thessaloniki.andlt;br /andgt;Conclusions: Despite largely similar core clinical characteristics, Stockholm and Thessaloniki cases underwent significantly different acute management, most probably to be attributed to adaptations to the differing regional approaches of care one following a systematic approach of SCI care and the other not. Spinal Cord (2010) 48, 477-482; doi: andlt;highlightandgt;10.1038andlt;/highlightandgt;/andlt;highlightandgt;scandlt;/highlightandgt;.andlt;highlightandgt;2009.160andlt;/highlightandgt;; published online 22 December 2009

  • 7.
    Divanoglou, A
    et al.
    Division of Neuro-rehabilitation, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Westgren, N
    Division of Neuro-rehabilitation, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Bjelak, S
    Rehab Station Stockholm, Stockholm, Sweden.
    Levi, Richard
    Division of Neuro-rehabilitation, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Medical conditions and outcomes at 1 year after acute traumatic spinal cord injury in a Greek and a Swedish region: a prospective, population-based study2010Ingår i: Spinal Cord, ISSN 1362-4393, E-ISSN 1476-5624, Vol. 48, nr 6, s. 470-476Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Study design: Prospective, population-based study. This paper is part of the Stockholm Thessaloniki Acute Traumatic Spinal Cord Injury Study (STATSCIS).andlt;br /andgt;Objectives: To evaluate and compare outcomes, length of stay (LOS), associated conditions and medical complications at 1-year post-trauma.andlt;br /andgt;Settings: The Greater Thessaloniki region, Greece, and the Greater Stockholm region, Sweden. While Stockholm follows a SCI system of care, Thessaloniki follows a fragmented non-system approach.andlt;br /andgt;Subjects: Out of the 87 cases in Thessaloniki and the 49 cases in Stockholm who comprised the study population of STATSCIS, 75 and 42 cases respectively were successfully followed-up during the first year post-trauma.andlt;br /andgt;Results: Significantly superior outcomes (that is, survival with neurological recovery, functional ability and discharge to home) and shorter LOS for initially motor complete cases occurred in Stockholm. Management routines known to increase long-term morbidity, for example, long-term tracheostomy and indwelling urethral catheters were significantly more common in Thessaloniki. Major medical complications, that is, multiple pressure ulcers, heterotopic ossification and bacteremia/sepsis were more frequent in Thessaloniki.andlt;br /andgt;Conclusions: Our findings show how two rather similar cohorts of TSCI manifest large discrepancies in terms of 1-year outcomes and complications, depending on the type of management they receive. As the major difference between regions was the presence or absence of a SCI system of care, rather than differences in availability of modern medicine, the mere presence of the latter does not seem to be sufficient to guarantee adequate outcomes. This study provides strong evidence as to the urgent need of implementing a SCI system of care in Greece. Spinal Cord (2010) 48, 470-476; doi: andlt;highlightandgt;10.1038andlt;/highlightandgt;/andlt;highlightandgt;scandlt;/highlightandgt;.andlt;highlightandgt;2009.147andlt;/highlightandgt;; published online 22 December 2009

  • 8.
    Forslund, E B
    et al.
    Rehab Station Stockholm R & D Unit, Neurotec Department, Karolinska Institutet, Sweden.
    Granström, A
    Rehab Station Stockholm R & D Unit, Neurotec Department, Karolinska Institutet, Sweden.
    Levi, Richard
    Rehab Station Stockholm R & D Unit, Neurotec Department, Karolinska Institutet, Sweden.
    Westgren, N
    Spinalis SCI Research Unit, Neurotec Department, Karolinska Institutet, Sweden.
    Hirschfeld, H
    Motor Control and Physical Therapy Research Laboratory, Neurotec Department, Karolinska Institutet, Sweden.
    Transfer from table to wheelchair in men and women with spinal cord injury: coordination of body movement and arm forces.2007Ingår i: Spinal Cord, ISSN 1362-4393, E-ISSN 1476-5624, Vol. 45, nr 1, s. 41-48Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Study design:A complex set-up was used to investigate kinematics and ground reaction forces.Setting:Motor Control and Physical Therapy Research Laboratory, Neurotec Department, Karolinska Institutet, Huddinge, Sweden.Objective:To investigate how men and women with spinal cord injury (SCI) perform transfers from table to wheelchair with regard to timing and magnitude of force generation beneath the hands and associated body movements.Methods:A total of 13 subjects (seven men, six women) with thoracic SCI. Kinematics of body movement were recorded (Elite 2000 system) simultaneously with the signals from three force plates (AMTI) placed beneath the buttocks and hands. Temporal and spatial parameters regarding head, trunk and trailing arm displacement, loading amplitudes and loading torque directions of both hands were analyzed for each trial and subject and compared between genders.Results:Men and women used similar amplitudes of head bending and forward displacement of the trailing shoulder, while female subjects had significantly larger trunk rotation. Both genders applied significantly more weight on the trailing hand. Differences between genders were seen in direction and timing of peak torque beneath the hands.Conclusions:The forces beneath the trailing hand were larger than those in the leading, if there is weakness or pain in one arm, this arm should be selected as the leading. To avoid excessive load on the arms, technical aids and environmental factors should be very well adapted.Sponsorship:This project was funded by the Swedish Research Council and the Health Care Science Committee of Karolinska Institutet.Spinal Cord (2007) 45, 41–48. doi:andlt;highlightandgt;10.1038andlt;/highlightandgt;/andlt;highlightandgt;sj.scandlt;/highlightandgt;.andlt;highlightandgt;3101935andlt;/highlightandgt;; published online 2 May 2006 [ABSTRACT FROM AUTHOR]

  • 9.
    Klefbeck, B
    et al.
    Department of Physical Therapy, Karolinska Institute, Stockholm, Sweden.
    Sternhag, M
    Department of Clinical Neuroscience, Karolinska Hospital, Stockholm, Sweden.
    Weinberg, J
    Department of Neurology, Huddinge Hospital, Huddinge, Sweden.
    Levi, Richard
    Spinalis SCI Research Unit, Karolinska Institute, Stockholm, Sweden.
    Hultling, C
    Spinalis SCI Research Unit, Karolinska Institute, Stockholm, Sweden.
    Borg, J
    Department of Clinical Neuroscience, Karolinska Hospital, Stockholm, Sweden.
    Obstructive sleep apneas in relation to severity of cervical spinal cord injury.1998Ingår i: Spinal Cord, ISSN 1362-4393, E-ISSN 1476-5624, Vol. 36, nr 9, s. 611-628Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Thirty-three subjects (28 men, five women) with complete or incomplete cervical cord injury representing a wide range of neurological impairment were investigated with regard to the prevalence of Obstructive Sleep Apnea (OSA). The relation between OSA and neurological function, respiratory capacity, body mass index and symptoms associated with OSA were studied. Overnight sleep recordings employed combined oximetry and respiratory movement monitoring. Pulmonary function tests included static and dynamic spirometry, maximal static inspiratory and expiratory pressures at the mouth. The subjects answered a questionnaire concerning sleep quality and tiredness. The prevalence of OSA was 15% (5/33) in this nonobese cervical cord injury study population. Nine percent of the subjects (3/33) fulfilled the criteria for obstructive sleep apnea syndrome, but daytime sleepiness or fatigue were also common in subjects without OSA. There was an inverse correlation between oxygen desaturation index and American Spinal Injury Association (ASIA) motor score in the subjects with complete injury, while there was no such correlation in the whole study group. There were significant correlations between maximal inspiratory and expiratory pressures and vital capacity and between ASIA motor score and vital capacity.

  • 10.
    Nilsson, S
    et al.
    Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, Umeå 901 85, Sweden.
    Levi, Richard
    Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, Umeå 901 85, Sweden.
    Nordstrom, A
    Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, Umeå 901 85, Sweden.
    Treatment-resistant sensory motor symptoms in persons with SCI may be signs of restless legs syndrome2011Ingår i: Spinal Cord, ISSN 1362-4393, E-ISSN 1476-5624, Vol. 49, nr 6, s. 754-756Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Study design: Case report on the successful treatment with pramipexole in four men with chronic spinal cord injury (SCI) suffering from refractory symptoms that were previously considered to be manifestations of a post-traumatic spastic syndrome or neuropathic pain.andlt;br /andgt;Objective: To raise awareness among health professionals regarding the diagnostic and therapeutic possibility of restless legs syndrome (RLS) and periodic limb movements (PLMs) in some patients with SCI responding poorly to conventional treatment for spasticity or neuropathic pain.andlt;br /andgt;Setting: Neurorehabilitation department of the Rehabilitation Medicine Center of Northern University Hospital, Umea, Sweden.andlt;br /andgt;Methods: Medical records and clinical data were retrospectively reviewed.andlt;br /andgt;Results: All cases obtained treatment with pramipexole, initially 0.09-0.72 mg day(-1). Two of the cases had RLS and PLMs, one RLS only and one PLMs only. All four reported symptoms in the lower extremities and one also in the upper extremities. Three patients with residual gait function reported RLS score with/without treatment as follows: 32/11, 37/12 and 33/12. One patient with complete paraplegia (with incomplete RLS score) reported 22/10. After a follow-up period of 16, 20, 43 and 49 months, respectively, all four still reported excellent outcomes. Two remained on initial dosage; one had increased dosage from 0.09 to 0.18 mg day(-1) and one from 0.27 to 0.80 mg day(-1) during the follow-up period.andlt;br /andgt;Conclusions: In persons with SCI suffering from infralesional involuntary movements and/or dysesthesia and with poor response to conventional antispastic or analgesic treatment, the possibility of RLS or PLMs should be considered, as these conditions seem eminently treatable. Spinal Cord (2011) 49, 754-756; doi:andlt;highlightandgt;10.1038andlt;/highlightandgt;/andlt;highlightandgt;scandlt;/highlightandgt;.andlt;highlightandgt;2010.164andlt;/highlightandgt;; published online 30 November 2010

  • 11.
    Norrbrink, Budh C
    et al.
    Spinalis SCI Unit, Karolinska Hospital and Faculty of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
    Lund, I
    Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
    Hultling, C
    Spinalis SCI Unit, Karolinska Hospital and Faculty of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
    Levi, Richard
    Frösunda Center, Solna and Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Werhagen, L
    Spinalis SCI Unit, Karolinska Hospital and Faculty of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
    Ertzgaard, Per
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Lundeberg, T
    Spinalis SCI Unit, Karolinska Hospital and Faculty of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
    Gender related differences in pain in spinal cord injured individuals.2003Ingår i: Spinal Cord, ISSN 1362-4393, E-ISSN 1476-5624, Vol. 41, nr 2, s. 122-128Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    STUDY DESIGN:: Out of a population of 456 patients with spinal cord injuries (SCI), 130 having pain were selected after matching, based on gender, age, American Spinal Injury Association (ASIA) impairment grade and level of lesion. OBJECTIVE:: To investigate whether gender differences with regard to pain perception and prevalence exist in a population of patients following spinal cord injury. SETTING:: Spinalis SCI Unit (out-patient clinic), Stockholm, Sweden. METHOD:: 130 patients suffering from pain were assessed over a 12-month period in a yearly health control. RESULTS:: SCI women had a higher prevalence of nociceptive pain than men and their use of analgesics was greater. However, no differences between the sexes could be seen regarding pain and localization, onset, distribution, factors affecting pain, number of painful body regions, pain descriptors, ratings of pain intensities or in pain and life satisfaction. CONCLUSION:: This study showed that SCI men and women describe their pain very similarly. However, SCI women had a higher prevalence of nociceptive pain than men and their use of opiates and non-steroid anti-inflammatory drugs (NSAIDs) was greater.Spinal Cord (2003) 41, 122-128. doi:andlt;highlightandgt;10.1038andlt;/highlightandgt;/andlt;highlightandgt;sj.scandlt;/highlightandgt;.andlt;highlightandgt;3101407andlt;/highlightandgt; [ABSTRACT FROM AUTHOR]

  • 12.
    Samuelsson, Kersti
    et al.
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Tropp, Hans
    Department of Orthopedic Surgery, Vrinnevi Hospital, Norrköping, Sweden.
    Gerdle, Björn
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet.
    Shoulder pain and its consequences in paraplegic spinal cord-injured, wheelchair users2004Ingår i: Spinal Cord, ISSN 1362-4393, E-ISSN 1476-5624, Vol. 42, nr 1, s. 41-46Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Study design: Cross-sectional.

    Objectives: To describe the consequences of shoulder pain on activity and participation in spinal cord-injured paraplegic wheelchair users. To describe the prevalence and type of shoulder pain.

    Setting: Two spinal cord injury (SCI) centres in Sweden.

    Methods: All subjects with paraplegia due to an SCI of more than 1 year living in the counties of Uppsala and Linköping, Sweden were contacted by mail and asked to fill in a questionnaire (89 subjects). Those of the responding 56 subjects with current shoulder pain were asked to participate in further examination and interviews. A physiotherapist examined 13 subjects with shoulder pain in order to describe type and site of impairment. To describe consequences of shoulder pain on activity and participation, the Constant Murley Scale (CMS), the Wheelchair Users Shoulder Pain Index (WUSPI) the Klein & Bell adl-index and the Canadian Occupational Performance Measure (COPM) were used.

    Results: Out of all respondents, 21 had shoulder pain (37.5%). Data from 13 of those subjects were used in the description of type and consequences of shoulder pain. Findings of muscular atrophy, pain, impingement and tendinits were described. We found no difference in ADL-performance with, respectively without, shoulder pain (P=0.08) using the Klein & Bell adl-index. No correlation was found between the various descriptions of impairment, activity limitations and participation restriction (P>0.08). All together 52 problems with occupational performance due to shoulder pain were identified using the COPM. Of these, 54% were related to self-care activities.

    Conclusion: The consequences of shoulder pain in paraplegic wheelchair users are mostly related to wheelchair activities. Since the wheelchair use itself presumably cause shoulder problems, this will become a vicious circle. More research is needed in order to reduce shoulder problems in wheelchair users.

  • 13.
    Österåkeri, A-L
    et al.
    Karolinska Institute, NEUROTEC, Stockholm, Sweden.
    Levi, Richard
    Karolinska Institute, NEUROTEC, Stockholm, Sweden.
    Indicators of psychological distress in postacute spinal cord injured individuals.2005Ingår i: Spinal Cord, ISSN 1362-4393, E-ISSN 1476-5624, Vol. 43, nr 4, s. 223-229Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    STUDY DESIGN::Consecutive inclusion of spinal cord injured patients admitted for postacute rehabilitation from June 2000 to January 2002. OBJECTIVE::Assessment of prevalence of indicators of psychological distress in the subacute and early chronic stages after acute-onset spinal cord injury (SCI). SETTING::A Swedish rehabilitation center. METHODS::In all, 36 patients participated. Psychological assessment was obtained at admission, discharge and 6 months follow-up by psychological measures based on the DSM-IV (ie Becks Depression Inventory, SPIFA, SCID-screen, AUDIT) and clinical interview. Ongoing psychotropic medication was noted. RESULTS::Clinical depression was infrequent. However, ongoing psychotropic medication was common, possibly indicating a relatively high incidence of underlying depressive and anxiety disorders. In all, 25%of the sample showed indicators of high alcohol consumption. Few patients had a previously diagnosed personality disorder. By contrast, there was frequent occurrence of personality traits outside normal ranges. CONCLUSION::Medication of psychological problems commonly occurs after SCI, especially for depression and anxiety. There are indications of alcohol overconsumption in a substantial minority of SCI patients. The study raises the question of whether suppression of psychological symptoms by drug therapy is the optimal treatment of such problems in a rehabilitation process. SPONSORSHIP::This study was funded by grants from‘Stiftelsen Tekniska Hjälpmedelåt Handikappade’.Spinal Cord (2005) 43, 223-229. doi:andlt;highlightandgt;10.1038andlt;/highlightandgt;/andlt;highlightandgt;sj.scandlt;/highlightandgt;.andlt;highlightandgt;3101703andlt;/highlightandgt;; Published online 7 December 2004 [ABSTRACT FROM AUTHOR]

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