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  • 1.
    Anttila, Heidi
    et al.
    National Institute for Health and Welfare (THL), Injuries and Functional Capacity Unit, Assistive Technology, Helsinki, Finland.
    Samuelsson, Kersti
    Linköping University, Department of Medical and Health Sciences, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine.
    Salminen, Anna-Liisa
    Social Insurance Institution, Helsinki, Finland.
    Brandt, Åse
    Danish Centre for Assistive Technology, Department of Research & Development, Århus, Denmark.
    Quality of evidence of assistive technology interventions for people with disability: An overview of systematic reviews2012In: Technology and Disability, ISSN 1055-4181, E-ISSN 1878-643X, Vol. 24, no 1, p. 9-48Article in journal (Refereed)
    Abstract [en]

    This overview summarizes the available evidence from systematic reviews of outcomes studies on various assistive technologies (AT) for persons with disabilities. Systematic reviews published between January 2000 and April 2010 were identified by comprehensive literature searches. Study selection, data extraction and methodological quality evaluation were done by two authors independently. The quality of evidence was summarized by explicit methods. Types of disabilities, settings, and AT interventions were recorded. Outcomes were mapped according to the Taxonomy of Assistive Technology Device Outcomes. Forty-four systematic reviews were included in this overview. High-quality evidence was found in single AT (positive effects of providing AT in connection with home assessment and hearing aids, no effects of hip protectors) for limited populations (older people at home, people with hearing loss, and older people in institutional care, respectively). Low-quality or unclear evidence was found for the effectiveness of the other evaluated AT interventions. Current gaps in AT outcomes research were identified. Many frequently used devices have not been systematically reviewed. Well-designed outcomes research to inform clinical decision-making is urgently needed. The systematic review methodology seems to be feasible for summarising AT outcomes research, but methodological development for grading and for primary studies is warranted.

  • 2.
    Bergström, Aileen
    et al.
    Department of Occupational Therapy, Uppsala University Hospital, Uppsala Sweden.
    Samuelsson, Kersti
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Reconstruction Centre, Department of Rehabilitation Medicine UHL.
    Evaluation of manual wheelchairs by individuals with spinal cord injuries2006In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 1, no 3, p. 175-182Article in journal (Refereed)
    Abstract [en]

    Purpose. The aim of this study was to investigate how adults with spinal cord injury assess their satisfaction regarding various aspects and use of their manual wheelchair. Method. The Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 2.0) together with seven additional questions was sent to 205 adults with SCI. Results. One hundred and twenty-four responses were available. The QUEST 2.0 showed a high level of satisfaction with manual wheelchair properties. However, the respondents were less satisfied with the services offered. Ease of use and comfort were identified as most important. Eighty-nine percent of the respondents rated their level of satisfaction as 'quite satisfied' or 'very satisfied' in ease of using a manual wheelchair compared with 68% of the respondents that were 'quite satisfied' or 'very satisfied' with the level of comfort. A greater satisfaction of ease in propulsion indoors compared with sitting comfort in various activities was found. Conclusions. A discrepancy was shown between users not being as satisfied with comfort in sitting in various activities as opposed to satisfaction with propulsion. This indicates the need for increased knowledge and developments concerning individual solutions, incorporating comfort as well as ease of use of a manual wheelchair.

  • 3.
    Gunnarsson, Stina
    et al.
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine. Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Samuelsson, Kersti
    Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine. Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Patient experiences with intrathecal baclofen as a treatment for spatsticity - a pilot study2015In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, no 10, p. 834-841Article in journal (Refereed)
    Abstract [en]

    Purpose: This study describes how patients experience intrathecal baclofen (ITB) treatment. Methods: Data were collected from interviews with 14 patients (19–76 years old) who were diagnosed with spinal cord injury (SCI), multiple sclerosis (MS), or cerebral palsy (CP). Data were analyzed using conventional content analysis. Result: The analysis resulted in 16 subcategories arranged into five main categories: procedures before treatment, the effect of ITB on daily life and activities, continuous follow-up, expected and unexpected consequences of ITB, and overall level of satisfaction with ITB. Together these categories described the patients' experiences with ITB treatment. When the patients were asked whether they would undergo ITB again, they all stated that they would. Conclusion: Patients stated that they were highly satisfied with the ITB treatment. However, the patients identified several areas that could be improved. Specifically, the patients wanted more information about the different steps in the treatment process and what to expect from ITB treatment.Implications for Rehabilitation

    • An overall satisfaction with the effect from ITB treatment was shown, but some areas still need to be improved.

    • Complications following ITB treatment still remain a major concern for the patient group.

    • Future clinical practice, should address how to take into account patients' expectations and define relevant goals with respect to ITB treatment as well as how to supply professional information.

  • 4.
    Hellgren, Lovisa
    et al.
    Clinical Department of Rehabilitation Medicine, County Hospital Ryhov, Jönköping, Sweden.
    Samuelsson, Kersti
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine.
    Lundqvist, Anna
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine.
    Börsbo, Björn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Clinical Department of Rehabilitation Medicine, County Hospital Ryhov, Jönköping, Sweden.
    Computerized Training of Working Memoryfor Patients with Acquired Brain Injury2015In: Open Journal of Therapy and Rehabilitation, ISSN 2332-1822, Vol. 3, p. 46-55Article in journal (Refereed)
    Abstract [en]

    Background: Patients with acquired brain injury often experience impaired working memory(WM), a condition that can make everyday life activities and work difficult. Objectives: This studyinvestigates the effects of computerized WM training on WM skills, cognitive tests, activity performanceand estimated health and whether the effects of computerized WM training can be attributedto sex or time since injury. Methods: Forty-eight patients with acquired brain injury underwentcomputerized WM training. Patients were tested by a neuropsychologist and interviewedby an occupational therapist just prior and 20 weeks after completion of training. Results: Patientswho participated in computerized WM training significantly improved their WM skills shown inWM index, their neuropsychological test scores, and their self-estimated health scores. They alsosignificantly improved their performance of individually defined WM-related everyday activitiesand their satisfaction with the performance of these activities. There was a significant differencein terms of WM index, WM-related daily activity performance, and satisfaction with respect to timesince injury. Conclusion: Computerized WM training can improve cognitive and everyday performancefor patients with acquired brain injury. Patients can improve their cognitive functions along time after suffering a brain injury or disease. This effect is greater if WM training is used earlyin the rehabilitation.

  • 5.
    Hesselstrand, Malin
    et al.
    Linköping University, Department of Medical and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Linköping University, Faculty of Medicine and Health Sciences.
    Samuelsson, Kersti
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine.
    Liedberg, Gunilla
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences.
    Occupational Therapy Interventions in Chronic Pain - A Systematic Review2015In: Occupational Therapy International, ISSN 0966-7903, E-ISSN 1557-0703, Vol. 22, no 4, p. 183-194Article, review/survey (Refereed)
    Abstract [en]

    The use of interventions based on the best available evidence in occupational therapy is essential, and evaluation of research is part of an evidence-based practice. The aim of this study was to assess the quality of studies describing and evaluating the effects of occupational therapy interventions on chronic pain. A systematic review of studies with diverse designs was carried out. A quality assessment was conducted, and the level of evidence was defined using the Research Pyramid Model. Of 19 included studies, three received the highest evidence level, and three were considered to be of high quality. The clinical recommendations that can be derived from this study are the following: occupational therapy interventions should start from the identified needs of the person with chronic pain; no support exists for the effectiveness of electromyographic biofeedback training as a supplement, more studies are needed to confirm this result; the efficacy of instructions on body mechanics was significant during work-hardening treatment; and occupational therapists need to perform and present more clinical studies of high quality and high-evidence level to build up a trustworthy arsenal of evidence-based interventions, for example, in persons with chronic pain. Copyright (C) 2015 John Wiley & Sons, Ltd.

  • 6.
    Lilliecreutz, Eva Kristina
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine.
    Felixson, Beatrice
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Department of Rehabilitation Medicine, Västervik Hospital, Västervik, Sweden.
    Lundqvist, Anna
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine.
    Samuelsson, Kersti
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine.
    Effects of guided aerobic exercise and mindfulness after acquired brain injury: a pilot study2017In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 19, no 4, p. 229-236Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this study was to examine whether a specific guided programme of aerobic exercise together with mindfulness could have an effect on estimated health status and occupational performance in individuals with acquired brain injury (ABI). As secondary outcomes, the effects on health-related quality of life, cognition and mental fatigue were analysed.

    Methods: The study included individuals with mild to moderate ABI (n = 21) with residual cognitive impairments. Guided interventions were given three times per week for 12 weeks. Neuropsychological and physical tests as well as patient-reported outcome measures were used as outcomes.

    Results: Estimated health status, self-reported occupational performance as well as satisfaction with performance improved together with physical capacity. Improvements in cognitive functions were related to attention and information processing speed; in addition, self-reported mental fatigue was reduced after the intervention. Cognitive function related to working memory and health-related quality of life were not affected.

    Conclusions: Support to improve physical capacity combined with practicing mindfulness, bringing attention to the present moment, seems to have a positive impact on occupational performance, estimated health status, attention and information processing speed as well as mental fatigue in individuals with cognitive dysfunction after ABI.

  • 7. Lilliecreutz Huitema, Eva
    et al.
    Samuelsson, Kersti
    Linköping University, Department of Medical and Health Sciences, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine.
    Andersson, Gunnar
    Lifestyle changes with help from Health Profile Assessment in combination with support in individual interventions for persons with aquired brain injury - a pilot study2014In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 16, no 3, p. 151-158Article in journal (Refereed)
    Abstract [en]

    Little is known about how to support a lifestyle change for persons with acquired brain injury (ABI), who have poor health compared with the rest of the population. This study investigates whether the Health Profile Assessment (HPA) combined with individual support in individually adjusted interventions could affect the lifestyle of persons with ABI. This longitudinal prospective and quasi-experimental study has a before and after design. HPA aims to improve health habits, perceived health and physiological measurements. In addition, this study includes interventions based on individual goals and actions decided on by the participants. The intervention process was supported through various communication methods such as Motivational Interviewing (MI) and Transactional Analyses (TA). The studied group (n = 25) included persons with cognitive impairments due to ABI who were considered for outpatient rehabilitation at a specialized facility at a university hospital in south-eastern Sweden. Results at follow-up showed significant improvements in physical activity, perceived health and diet. Significant improvements were also shown in sagittal abdominal diameter, waist circumference, body mass index (BMI) and physical fitness. Consequently, this study describes a method that successfully supported lifestyle changes in persons with ABI.Read

  • 8.
    Lundqvist, Anna
    et al.
    Östergötlands Läns Landsting, Sinnescentrum, Pain and Rehabilitation Centre.
    Grundström, Kerstin
    Östergötlands Läns Landsting, Sinnescentrum, Pain and Rehabilitation Centre.
    Samuelsson, Kersti
    Linköping University, Department of Medical and Health Sciences, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of Rehabilitation Medicine.
    Rönnberg, Jerker
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Computerized training of working memory in a group of patients suffering from acquired brain injury2012In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 26, no 4-5, p. 423-424Article in journal (Refereed)
    Abstract [en]

    Objective: Study short- and long-term transfer effects of a computerized working memory (WM) training program for patients suffering from working memory deficits after acquired brain injury.

    Methods: (Research design: A controlled experimental study with a crossover design.) The study group included a consecutive sample of 21 subjects. Mean age 43.2 years, time since injury/illness onset 37 months (median). The subjects were randomly selected into two groups where one group served as controls. All subjects trained five days a week for five weeks in a computer WM task program. They were followed-up at four and 20 weeks after the training.

    Results: The study results showed a significant improvement in the trained WM tasks (p < 0.001), significant improvements in neuropsychological WM-test results at four and twenty weeks after training compared to baseline (p< 0.05). Results also showed a significant improvement in the subjects' rated level of occupational performance and satisfaction with performance in individually pre-defined occupational problems (p<0.05 for occupational performance versus p < 0.001 for satisfaction with performance) . Rated health-related quality of life did not change. However, rated overall health had significantly increased twenty weeks after training (p<0.05).

    Conclusions: Structured and intense computerized WM training improves subjects' cognitive functioning as measured by neuropsychological WM-demanding tests, rated occupational performance, satisfaction with performance and rated overall health. The training probably has an impact on the rehabilitation outcome, returning to work, as well as on daily activities for individuals with verified WM impairments. We propose further research with a larger study group, including subgroups with different diagnoses, to confirm our current findings and select for whom this cognitive rehabilitation programme is most suitable.

     

  • 9.
    Lundqvist, Anna
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Rehabilitation Medicine UHL.
    Grundström, Kerstin
    Östergötlands Läns Landsting, Reconstruction Centre, Department of Rehabilitation Medicine UHL.
    Samuelsson, Kersti
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Rehabilitation Medicine UHL.
    Rönnberg, Jerker
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Computerized training of working memory in a group of patients suffering from acquired brain injury2010In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 24, no 10, p. 1173-1183Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Study short- and long-term transfer effects of a computerized working memory (WM) training programme for patients suffering from working memory deficits after acquired brain injury. RESEARCH DESIGN: A controlled experimental study with a cross-over design. METHODS: A consecutive sample of 21 subjects. Mean age 43.2 years, time since injury/illness onset 37 months (median). The subjects were randomly selected into two groups where one group served as controls. All subjects trained daily for 5 weeks in a computer WM task program. They were followed-up at 4 and 20 weeks after the training. RESULTS: A significant improvement in the trained WM tasks, significant improvements in neuropsychological WM-test results at 4 and 20 weeks after training compared to baseline. Improvement in the subjects rated occupational performance and satisfaction with performance in pre-defined occupational problems. Rated quality-of-life did not change. However, rated overall health increased 20 weeks after training. CONCLUSIONS: Structured and intense computerized WM training improves subjects cognitive functioning as measured by neuropsychological WM-demanding tests, rated occupational performance, satisfaction with performance and rated overall health. The training probably has an impact on the rehabilitation outcome, returning to work, as well as on daily activities for individuals with verified WM impairments.

  • 10.
    Lundqvist, Anna
    et al.
    Östergötlands Läns Landsting, Reconstruction Centre, Department of Rehabilitation Medicine UHL.
    Linnros, Hannah
    Östergötlands Läns Landsting, Reconstruction Centre, Department of Rehabilitation Medicine UHL.
    Orlenius, Helene
    Östergötlands Läns Landsting, Reconstruction Centre, Department of Rehabilitation Medicine UHL.
    Samuelsson, Kersti
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Rehabilitation Medicine UHL.
    Improved self-awareness and coping strategies for patients with acquired brain injury-A group therapy programme2010In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 24, no 6, p. 823-832Article in journal (Refereed)
    Abstract [en]

    Primary objective: This study evaluates the effects of a group therapy programme for anticipatory self-awareness and coping strategies. Design: The study includes methodological triangulation using three methods to gather data: an overall self-report questionnaire, Self Regulation Skills Interview (SRSI) and focus group interview. Subjects: Twenty-one individuals with acquired brain injury participated in a group therapy programme. Methods: A self-report questionnaire developed and used especially for evaluation of the described intervention was used at the end of the last session of the group therapy programme. The Self Regulation Skills Interview-SRSI, was used within 2 weeks before and after the subjects participated in one group program. Three Focus groups were used as a third method for data collection. The Focus group interviews were accomplished 1 month after each group programme. Results: The individuals increased their self-awareness and strategy behaviour significantly. Participating in the group therapy programme had had an effect on their life and work situation and on their self-confidence. Conclusions: A structured group therapy programme helps patients with acquired brain injury understand the consequences of their neuropsychological deficits, helps them improve awareness of their impairments and helps them develop coping strategies.

  • 11.
    Lundqvist, Anna
    et al.
    Östergötlands Läns Landsting, Sinnescentrum, Department of Rehabilitation Medicine.
    Samuelsson, Kersti
    Linköping University, Department of Medical and Health Sciences, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of Rehabilitation Medicine.
    Return to work after acquired brain injury: A patient perspective2012In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 26, no 13-14, p. 1574-1585Article in journal (Refereed)
    Abstract [en]

    Primary objective: To study significant factors supporting vocational rehabilitation after acquired brain injury from a patient perspective. less thanbrgreater than less thanbrgreater thanMethods: Two focus group interviews were accomplished with former patients. One focus group interview with professional rehabilitation personnel was performed to review the correspondence between patients and professionals opinion. less thanbrgreater than less thanbrgreater thanSubjects: Fourteen informants with acquired brain injury (ABI) were interviewed. All were working at the time of the focus group interviews. Three occupational therapists and two psychologists participated in the professional group. less thanbrgreater than less thanbrgreater thanResults: Two themes were identified as significant for returning to work: Personal and Society factors. Identified meaningful units could be categorized into sub-categories, which were grouped into six main-and 14 sub-categories. The main categories were: Self-continuity, Coping, Social factors, Rehabilitation intervention, Professionalism and Health insurance. Length of treatment time was described as crucial for the rehabilitation process and for utilizing individual resources. less thanbrgreater than less thanbrgreater thanConclusions: The effects of various synergies and processes form the basis for a successful return to work, which are dependent on, influence and reinforce each other. Society factors support personal factors to be used for returning to work after acquired brain injury. The impact of individual resources and rehabilitation highlights that vocational rehabilitation is inseparable from the individuals capacity, society and the context in which the individual lives.

  • 12.
    Möller, Saffran
    et al.
    School of Health and Welfare, Jönköping University, Jönköping, Sweden.
    Hagberg, Kerstin
    Department of Prosthetics and Orthotics, Sahlgrenska University Hospital, Gothenburg, Sweden; dDepartment of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, SwedenAdvanced Reconstruction of Extremities, Sahlgrenska University Hospital, Gothenburg, Sweden .
    Samuelsson, Kersti
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine.
    Ramstrand, Nerrolyn
    School of Health and Welfare, Jönköping University, Jönköping, Sweden.
    Perceived self-efficacy and specific self-reported outcomes in persons withlower-limb amputation using a non-microprocessor-controlled versus amicroprocessor-controlled prosthetic knee2018In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 13, no 3, p. 220-225Article in journal (Refereed)
    Abstract [en]

    Purpose: To measure self-efficacy in a group of individuals who have undergone a lower-limb amputationand investigate the relationship between self-efficacy and prosthetic-specific outcomes including prostheticuse, mobility, amputation-related problems and global health. A second purpose was to examine ifdifferences exist in outcomes based upon the type of prosthetic knee unit being used.Method: Cross-sectional study using the General Self-Efficacy (GSE) Scale and the Questionnaire forPersons with a Transfemoral Amputation (Q-TFA). Forty-two individuals participated in the study. Twentythreeused a non-microprocessor-controlled prosthetic knee joint (non-MPK) and 19 used a microprocessor-controlled prosthetic knee joint (MPK).Results: The study sample had quite high GSE scores (32/40). GSE scores were significantly correlated tothe Q-TFA prosthetic use, mobility and problem scores. High GSE scores were related to higher levels ofprosthetic use, mobility, global scores and negatively related to problem score. No significant differencewas observed between individuals using a non-MPK versus MPK joints.Conclusions: Individuals with high self-efficacy used their prosthesis to a higher degree and high self-efficacywas related to higher level of mobility, global scores and fewer problems related to the amputationin individuals who have undergone a lower-limb amputation and were using a non-MPK or MPK knee.

  • 13.
    Salminen, Anna-Liisa
    et al.
    The Social Insurance Institution of Finland, Helsinki, Finland.
    Brandt, Åse
    The Danish Centre for Assistive Technology, Århus, Denmark.
    Samuelsson, Kersti
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.
    Töytäri, Uti
    National Institute for Health and Welfare, Helsinki, Finland.
    Malmivaara, Antti
    National Institute for Health and Welfare, Helsinki, Finland.
    Mobility devices to promote activity and participation: a systematic review2009In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 41, no 9, p. 697-706Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To determine the effectiveness of mobility device interventions in terms of activity and participation for people with mobility limitations.

    DESIGN: Systematic review. Search of 7 databases during the period 1996 to 2008.

    METHODS: Controlled studies and non-controlled follow-up studies were included if they covered both baseline and follow-up data and focused on activity and participation. Study participants had to be aged over 18 years with mobility limitations. Mobility device interventions encompassed crutches, walking frames, rollators, manual wheelchairs and powered wheelchairs (including scooter types). Two reviewers independently selected the studies, performed the data extraction, and 4 reviewers assessed the studies’ methodological quality. Disagreements were resolved by consensus.

    RESULTS: Eight studies were included: one randomized controlled trial, 4 controlled studies, and 3 follow-up studies that included before and after data. Two studies dealt with the effects of powered wheelchair interventions and the other studies with various other types of mobility device. Two studies were of high, internal and external methodological quality. Interventions were found to be clinically effective in terms of activity and participation in 6 studies. The results did not, however, give a unanimous verdict on the effectiveness of mobility devices in enhancing the activity and participation of mobility impaired people.

    CONCLUSION: Interventions and outcome measurement methods varied between the studies; consequently, it was not possible to draw any general conclusions about the effectiveness of mobility device interventions. However, evidence was found that mobility devices improve users’ activity and participation and increase mobility. A lack of high-quality research hampers conclusions about effectiveness. More original, well-designed research is required.

  • 14.
    Samuelsson, Kersti
    Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.
    Active wheelchair use in daily life: considerations for mobility and seating2002Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Introduction: Wheelchair fit and prescription are central in the rehabilitation process of a spinal cord injured client with an impaired walking ability. The knowledge and consequences of wheelchair use in active wheelchair users is deficient, which might lead to unnecessary problems and disabilities.

    Objective: The general aim of the research underlying this thesis was to increase and deepen the knowledge of wheelchair use, considering both mobility and seating aspects.

    Methods: The thesis includes five different studies, two of them with a focus on wheelchair mobility, two with a focus on secondary complications common in wheelchair users and one intervention study with a focus on wheelchair seating. Methods used to measure and describe wheelchair use from mobility and seating aspects are well-standardized, valid and reliable methods, custom-made newly developed forms and client estimations.

    Results: The power output and mechanical efficiency of wheelchair propulsion was found to be low compared to arm-crank ergometry in a group of experienced wheelchair users. Another study found that it was not possible to affect this mechanical efficiency in a uniform positive way, by a change in rear-wheel position. A significant change in propulsion technique was found which, however, did not correlate to physical effort. Secondary complications such as back pain, spinal defonnities and shoulder pain were common in clients with a spinal cord injury. In the intervention study a change in seating prerequisites had a positive effect on estimated seating comfort, posture and activity.

    Conclusion: Wheelchair propulsion and seating mean high physical and musculoskeletal load on the individual with a risk for secondary complications. A prescriber of hand-rim wheelchairs to clients who will spend many years in their wheelchairs has a major responsibility to understand and use available knowledge, to carefully examine the physical prerequisites of each client, and to interrelate these findings to individual needs and wishes. There is a great need for continuous development of new methods and knowledge in this area in order to avoid unnecessary complications due to wheelchair use. There is also a need for new thinking in the construction and design of new wheelchairs.

    List of papers
    1. Back pain and spinal deformity: common among wheelchair users with spinal cord injuries
    Open this publication in new window or tab >>Back pain and spinal deformity: common among wheelchair users with spinal cord injuries
    1996 (English)In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 3, no 1, p. 28-32Article in journal (Refereed) Published
    Abstract [en]

    During the past 15 years, wheelchair development has focused on driving properties. Back pain, however, is a problem among wheelchair users. Thirty-one wheelchair users, mean age 46 years (range 21–79), (3 women and 28 men), with spinal cord injuries were studied with regard to back pain and spinal deformity. Sixteen subjects had tetraplegia and 15 had paraplegia; median time since injury was 11 years (range 2–37). Pain was assessed using pain drawings, visual analogue scale and questionnaire. Spinal deformity was examined using X-ray, weight distribution, 3D magnetic motion tracker, photographs and physical examination. Some degree of back pain was found in 84% of the patients. Most patients could modify their pain by changing their sitting posture or by rest in bed, and had some kind of spinal deformity that might be related to neurological injury and sitting posture. Further wheelchair research considering the ergonomics of both driving and sitting seems important.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-81541 (URN)10.3109/11038129609106679 (DOI)
    Available from: 2012-09-18 Created: 2012-09-18 Last updated: 2017-12-07Bibliographically approved
    2. Power output for wheelchair driving on a treadmill compared with arm crank ergometry
    Open this publication in new window or tab >>Power output for wheelchair driving on a treadmill compared with arm crank ergometry
    1997 (English)In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 31, no 1, p. 41-44Article in journal (Refereed) Published
    Abstract [en]

    OBJECTIVES: The limiting factors with regard to power output available for wheelchair ambulation have not been identified. The aim of the present study was to correlate power output during wheelchair driving with (i) power output and oxygen uptake during arm crank ergometry and (ii) arm muscle strength.

    METHODS: Eleven disabled men were examined for maximal power output (POmax) during wheelchair driving on a treadmill and during arm crank ergometry. Oxygen uptake (VO2) was recorded at submaximal and maximal arm crank ergometry in all men and during submaximal wheelchair driving on a treadmill in four men. Power output during wheelchair driving on a treadmill was measured. Static and dynamic elbow muscle strength was measured isokinetically.

    RESULTS: POmax was significantly lower (P < 0.001) for wheelchair driving (109 (31) W; mean (SD)) than for arm ergometry (163 (49) W). There was a significant correlation between POmax for arm crank ergometry and wheelchair driving (r = 0.73). There was no correlation between POmax and elbow strength. The mechanical efficiency was constant for the different levels on the arm crank ergometry test. The submaximal testing showed a consistently lower mechanical efficiency for wheelchair driving than for arm crank ergometry.

    CONCLUSIONS: It is suggested that the lower level of power output for wheelchair driving is fully explained by the lower mechanical efficiency. Any improvement in power output available for ambulation must be based on wheelchair ergonomics.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-81542 (URN)10.1136/bjsm.31.1.41 (DOI)
    Available from: 2012-09-18 Created: 2012-09-18 Last updated: 2017-12-07Bibliographically approved
    3. Wheelchair seating intervention: Results from a client-centred approach
    Open this publication in new window or tab >>Wheelchair seating intervention: Results from a client-centred approach
    2001 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 23, no 15, p. 677-682Article in journal (Refereed) Published
    Abstract [en]

    Purpose : The aim of this study was to analyse the effects of wheelchair intervention from a client-centred perspective.

    Method : Results from 38 consecutive active wheelchair users visiting the wheelchair-seating department at the University Hospital in Linköping, Sweden, were analysed and described. All clients had defined problems related to wheelchair seating. Back pain was estimated before intervention and at follow-up, using a Visual Analogue Scale. The effect of intervention on different aspects of wheelchair functionality, seating and occupational performance was estimated by the clients at follow-up.

    Results : Two initial main problem areas were identified among the group; seating discomfort (87% ) and back pain (63% ). Back pain was significantly reduced at follow-up (p<0.001). Problems initially defined by the clients, e.g. seating discomfort, were affected positively, in 79% of all clients, as estimated by the clients at follow-up. No significant correlation was found between the initial cause of intervention or the highest ranked wheelchair functionality aspect and final acceptance of intervention.

    Conclusions : The results from this study confirm the possibility of reducing, or even eliminating, common secondary problems such as back pain and discomfort, related to wheelchair seating by individually adjusted measures. Further research and development in this field is both necessary and cost-effective.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-27770 (URN)10.1080/09638280110049900 (DOI)12517 (Local ID)12517 (Archive number)12517 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
    4. Shoulder pain and its consequences in paraplegic spinal cord-injured, wheelchair users
    Open this publication in new window or tab >>Shoulder pain and its consequences in paraplegic spinal cord-injured, wheelchair users
    2004 (English)In: Spinal Cord, ISSN 1362-4393, E-ISSN 1476-5624, Vol. 42, no 1, p. 41-46Article in journal (Refereed) Published
    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.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-23464 (URN)10.1038/sj.sc.3101490 (DOI)2919 (Local ID)2919 (Archive number)2919 (OAI)
    Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2017-12-13Bibliographically approved
    5. Consequences of a change in rear-wheel position on seating ergonomics and mobility in spinal cord injured wheelchair users
    Open this publication in new window or tab >>Consequences of a change in rear-wheel position on seating ergonomics and mobility in spinal cord injured wheelchair users
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    The aim of this study was to analyse the consequences of a change in rear-wheel position on mobility and seating ergonomic aspects. Twelve randomly selected paraplegic wheelchair users were tested iu two different activities, treadmill propulsion and computer work, in two different seating positions. The change in wheel position did affect chair ergonomics with respect to weight distribution and seat-inclination. These changes did have an effect on push frequency and stroke angle during treadmill, propulsion. We found no consistent effect on mechanical efficiency, estimated exertion, breathlessness or seating quality in this group. Nor did we find any consistent significant effect on pelvic position or under-seat pressure. There are effects from wheelchair adaptation, but these seem to be individual. With the knowledge of risk factors related to seating posture in mind, future research concerning effects of wheelchair adaptation has to be performed with considerations for individual changes.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-81543 (URN)
    Available from: 2012-09-18 Created: 2012-09-18 Last updated: 2012-09-18Bibliographically approved
  • 15.
    Samuelsson, Kersti
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Rehabilitation Medicine UHL.
    Björk, Maarit
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Rehabilitation Medicine UHL.
    Erdugan, Ann-Marie
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Rehabilitation Medicine UHL.
    Hansson, Anna-Karin
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Rehabilitation Medicine UHL.
    Rustner, Birgitta
    Östergötlands Läns Landsting, Reconstruction Centre, Department of Rehabilitation Medicine UHL.
    The effect of shaped wheelchair cushion and lumbar supports on under-seat pressure, comfort, and pelvic rotation.2009In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 4, no 5, p. 329-336Article in journal (Refereed)
    Abstract [en]

    AIM: A wheelchair seat and position help clients perform daily activities. The comfort of the wheelchair can encourage clients to participate in daily activities and can help prevent future complications. PURPOSE: This study evaluates how a shaped seat-cushion and two different back supports affect under-seat pressure, comfort, and pelvic rotation. METHOD: Thirty healthy subjects were tested using two differently equipped manual wheelchairs. One wheelchair had a Velcro adjustable back seat and a plane seat-cushion. The other wheelchair had a non-adjustable sling-back seat and a plane cushion. The second wheelchair was also equipped with a shaped cushion and/or a detachable lumbar support. Under-seat pressure, estimated comfort, and pelvic rotation were measured after 10 min in each wheelchair outfit. RESULTS: Peak pressure increased with the shaped cushion compared to the plane cushion. No significant difference in estimated comfort was found. Pelvic posterior-rotation was reduced with the adjustable or detachable back-support irrespective of the shape of the seat cushion. CONCLUSIONS: To support a neutral pelvic position and spinal curvature, a combination of a shaped cushion and a marked lumbar support is most effective.

  • 16.
    Samuelsson, Kersti
    et al.
    Linköping University, Department of Medical and Health Sciences, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine.
    Carlberg, Ulla
    Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Linköping University, Department of Medical and Health Sciences, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.
    Hesselstrand, Malin
    Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Linköping University, Department of Medical and Health Sciences, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.
    Ölander, Elisabet
    Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Linköping University, Department of Medical and Health Sciences, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.
    Wressle, Ewa
    Linköping University, Department of Clinical and Experimental Medicine, Geriatric. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Geriatric Medicine in Linköping.
    Patient-Reported Outcome of a Multidisciplinary Pain Management Program, Focusing on Occupational Performance and Satisfaction with Performance2011In: The Open Rehabilitation Journal, ISSN 1874-9437, E-ISSN 1874-9437, Vol. 4, p. 42-50Article in journal (Refereed)
    Abstract [en]

    Aim: The aim was to describe the effect of a multidisciplinary pain management program, in terms of patientreported occupational performance and satisfaction with performance.

    Methods: The study is a retrospective, case series study. Data from interviews documented routinely in patient medical records were used. Interviews were made at introduction, on conclusion and six months after a pain management program. Data from all participants (n=85) introduced during one year, were analysed. The Canadian Occupational Performance Measure (COPM) was used as the main outcome measure.

    Results: Estimated occupational performance as well as satisfaction with performance improved between measures (occupational performance p<0.001; satisfaction with performance p<0.001). The percentage of participants, who improved two or more points on the COPM ten-point scale between baseline and the 6-month follow up, was 27% for occupational performance and 40% for satisfaction with performance.

    Conclusion: The findings raise questions regarding what the team might learn from different ways of scrutinizing results; the relevant level of MID in this program; and the overall objective in terms of the proportion of clients who reported a ‘successful’ outcome in occupational performance and satisfaction with performance, based on the identified MID. These questions need to be further analysed and discussed within the professional team.

  • 17.
    Samuelsson, Kersti
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Internal Medicine. Östergötlands Läns Landsting, Reconstruction Centre, Department of Neurosurgery UHL.
    Larsson, H.
    Thyberg, Mikael
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
    Wheelchair intervention - a client centered approach.1999In: Technology and Disability, ISSN 1055-4181, Vol. 10, p. 123-127Article in journal (Refereed)
  • 18.
    Samuelsson, Kersti
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.
    Larsson, H.
    Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.
    Thyberg, Mikael
    Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.
    Tropp, Hans
    Linköping University, Department of Clinical and Experimental Medicine, Orthopaedics. Linköping University, Faculty of Health Sciences.
    Back pain and spinal deformity: common among wheelchair users with spinal cord injuries1996In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 3, no 1, p. 28-32Article in journal (Refereed)
    Abstract [en]

    During the past 15 years, wheelchair development has focused on driving properties. Back pain, however, is a problem among wheelchair users. Thirty-one wheelchair users, mean age 46 years (range 21–79), (3 women and 28 men), with spinal cord injuries were studied with regard to back pain and spinal deformity. Sixteen subjects had tetraplegia and 15 had paraplegia; median time since injury was 11 years (range 2–37). Pain was assessed using pain drawings, visual analogue scale and questionnaire. Spinal deformity was examined using X-ray, weight distribution, 3D magnetic motion tracker, photographs and physical examination. Some degree of back pain was found in 84% of the patients. Most patients could modify their pain by changing their sitting posture or by rest in bed, and had some kind of spinal deformity that might be related to neurological injury and sitting posture. Further wheelchair research considering the ergonomics of both driving and sitting seems important.

  • 19.
    Samuelsson, Kersti
    et al.
    Linköping University, Department of Medical and Health Sciences, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of Rehabilitation Medicine.
    Toytari, Outi
    National Institute for Health and Welfare, Helsinki, Finland .
    Salminen, Anna-Liisa
    Social Insurance Institution, Helsinki, Finland .
    Brandt, Ase
    Danish Centre for Assistive Technology, Aarhus C, Denmark .
    Effects of lower limb prosthesis on activity, participation, and quality of life: a systematic review2012In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 36, no 2, p. 145-158Article, review/survey (Refereed)
    Abstract [en]

    Background: Effects presented on the use of assistive devices such as prosthesis are often based on laboratory findings (i.e. efficacy). Objectives: To summarise and evaluate findings from studies on effectiveness of lower limb prostheses for adults in real life contexts, primarily in terms of activity, participation, and quality of life (QoL) and secondarily in terms of user satisfaction, use/non-use, and/or cost-effectiveness. Study Design: Systematic review. Methods: We included controlled studies and non-controlled follow-up studies including both baseline and follow-up data. Using 14 different databases supplemented with manual searches, we searched for studies published from 1998 until June 2009. Results: Out of an initial 818 identified publications, eight met the inclusion criteria. Four studies reported on the effectiveness of a microprocessor-controlled knee (MP-knee) compared to a non-microprocessor-controlled knee (NMP-knee). Results were inconsistent except for quality of life and use/non-use, where the authors reported an improvement with the MP-knee compared to the NMP-knee. The remaining four studies included a diversity of prosthetic intervention measures and types of endpoints. Conclusions: Overall, there was an inconsistency in results and study quality. This review highlights the need for high-quality research studies that reflect the effectiveness of different prosthesis interventions in terms of users daily living and QoL.

  • 20.
    Samuelsson, Kersti
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.
    Tropp, Hans
    Department of Orthopedic Surgery, Vrinnevi Hospital, Norrköping, Sweden.
    Gerdle, Björn
    Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.
    Shoulder pain and its consequences in paraplegic spinal cord-injured, wheelchair users2004In: Spinal Cord, ISSN 1362-4393, E-ISSN 1476-5624, Vol. 42, no 1, p. 41-46Article in journal (Refereed)
    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.

  • 21.
    Samuelsson, Kersti
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.
    Tropp, Hans
    Linköping University, Department of Clinical and Experimental Medicine, Orthopaedics. Linköping University, Faculty of Health Sciences.
    Nylander, Eva
    Linköping University, Department of Medicine and Care, Clinical Physiology. Linköping University, Faculty of Health Sciences.
    Gerdle, Björn
    Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.
    Consequences of a change in rear-wheel position on seating ergonomics and mobility in spinal cord injured wheelchair usersManuscript (preprint) (Other academic)
    Abstract [en]

    The aim of this study was to analyse the consequences of a change in rear-wheel position on mobility and seating ergonomic aspects. Twelve randomly selected paraplegic wheelchair users were tested iu two different activities, treadmill propulsion and computer work, in two different seating positions. The change in wheel position did affect chair ergonomics with respect to weight distribution and seat-inclination. These changes did have an effect on push frequency and stroke angle during treadmill, propulsion. We found no consistent effect on mechanical efficiency, estimated exertion, breathlessness or seating quality in this group. Nor did we find any consistent significant effect on pelvic position or under-seat pressure. There are effects from wheelchair adaptation, but these seem to be individual. With the knowledge of risk factors related to seating posture in mind, future research concerning effects of wheelchair adaptation has to be performed with considerations for individual changes.

  • 22.
    Samuelsson, Kersti
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Reconstruction Centre, Department of Rehabilitation Medicine UHL.
    Tropp, Hans
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Orthopaedics and Sports Medicine. Östergötlands Läns Landsting, Orthopaedic Centre, Department of Orthopaedics Linköping.
    Nylander, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Physiology. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Gerdle, Björn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
    The effect of rear-wheel position on seating ergonomics and mobility efficiency in wheelchair users with spinal cord injuries: A pilot study2004In: Journal of rehabilitation research and development, ISSN 0748-7711, E-ISSN 1938-1352, Vol. 41, no 1, p. 65-74Article in journal (Refereed)
    Abstract [en]

    This study analyzed the effect of rear-wheel position on seating comfort and mobility efficiency. Twelve randomly selected paraplegic wheelchair users participated in the study. Wheelchairs were tested in two rear-wheel positions while the users operated the wheelchair on a treadmill and while they worked on a computer. Propulsion efficiency, seating comfort, and propulsion qualities were registered at different loads during the treadmill session. During the computer session, pelvic position, estimated seating comfort, and estimated activity performance were measured. The change in rear-wheel position affected wheelchair ergonomics with respect to weight distribution (p < 0.0001) and seat inclination angle (position I = 5° and position II = 12°). These changes had a significant effect on push frequency (p < 0.05) and stroke angle (p < 0.05) during wheelchair propulsion. We found no consistent effect on mechanical efficiency, estimated exertion, breathlessness, seating comfort, estimated propulsion qualities, pelvic position, or activity performance.

  • 23.
    Samuelsson, Kersti
    et al.
    Linköping University, Department of Medical and Health Sciences, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine.
    Tropp, Maria
    Lundqvist, Anna
    Vocational rehabilitation after aquired brain injury: a pilot study on benefits and costs.2014In: Open journal of therapy and rehabilitation, no 2, p. 133-145Article in journal (Refereed)
    Abstract [en]

    Purpose: To examine the benefits from a vocational rehabilitation program for patients suffering from Acquired Brain Injury (ABI) in terms of quality of life, and overall health. In addition, to examine the direct societal costs of healthcare interventions related to vocational rehabilitation and indirect societal costs related to production loss. Method: Identified interventions in 45 patients with ABI who were discharged from a vocational rehabilitation program between 2010 and 2011 were documented, classified and translated into costs. Expenses associated with production loss were calculated by comparing sick leave production loss at first contact with the team, with sick leave production loss at discharge. Health related QoL and overall health, was measured at first contact and at discharge by using the EQ5D. Results: For vocational rehabilitation interventions, mean costs were €6303/individual/month. At first contact with the team, mean production loss was estimated to be €4409/individual/month compared; at discharge to be €2446. QoL-ratings increased from first contact to discharge, although estimated health did not change. At discharge, significant correlations were found between QoL ratings and estimated health and the extent of production loss (p < 0.05). Conclusion: Healthcare interventions that help ABI patients resume work are cost effective for society as well as for patients.

  • 24.
    Samuelsson, Kersti
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine.
    Tropp, Maria
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine. Linkoping Univ, Dept Med and Hlth Sci, Linkoping, Sweden.
    Lundqvist, Anna
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine.
    Wressle, Ewa
    Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine and Geriatrics.
    Development, concurrent validity and internal consistency of a simulator tool for assessing continued car driving after a brain injury/disease2019In: British Journal of Occupational Therapy, ISSN 0308-0226, E-ISSN 1477-6006, Vol. 82, no 9, p. 544-552Article in journal (Refereed)
    Abstract [en]

    Introduction

    Beyond relevant cognitive tests, a simulated driving activity could be useful to observe performance and behaviour in a standardized ‘driving-like’ situation and provide information on attention, reaction time and information processing speed when evaluating the ability to continue driving after a brain injury or disease. The aim was to develop and evaluate concurrent validity and internal consistency of a computerized simulated driving task tool.

    Methods

    Results from a new tool (CyberSiM, including three subtests and four result variables) were compared with results from the Trail Making Test, Useful Field of View test and Nordic Stroke Driver Screening Assessment. There were 126 healthy adults included in the study.

    Results

    The correlation analysis showed significant correlations (p<0.001) for CyberSiM reaction time and all cognitive tests except for Useful Field of View 1. The CyberSiM showed good internal consistency, with Cronbach’s alpha=0.85.

    Conclusion

    The analysis of concurrent validity showed conformity to most cognitive tests. CyberSiM might be a useful complement to cognitive testing with the opportunity to observe some behaviours ‘in a driving-like activity’. Further studies on clinical groups are needed to confirm its usefulness.

  • 25.
    Samuelsson, Kersti
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine.
    Wressle, Ewa
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Geriatric Medicine in Linköping.
    Powered wheelchairs and scooters for outdoor mobility: a pilot study on costs and benefits2014In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 9, no 4, p. 330-334Article in journal (Refereed)
    Abstract [en]

    Purpose: This study evaluates the effect of electric powered wheelchairs/scooters (PWC/S) on occupational performance, social participation, health, and life satisfaction. In addition, this study estimates the costs and benefits of PWC/S and describes users’ experiences with the delivery process.

    Methods: This prospective study has a before-and-after design. Postal questionnaires were sent to 24 first-time PWC/S users before delivery of the PWC/S and four months after delivery. The participants used their PWC/S for outdoor mobility.

    Results: PWC/S improved the users’ daily lives, their ability to engage in mobility-related activities, and their social participation. For a majority of the users, estimated independence, feelings of safety, and self-esteem increased although overall health and life satisfaction were not significantly affected. All users thought that the therapist had considered their needs during the providing process. Most participants (73%) were satisfied with their device at follow-up. For the 12 users who reported no change in health status between measures, the mean societal savings based on calculated costs for assistance was € 6 227 per person per year.

    Conclusions: PWC/S seems to improve occupational performance, social participation, and life satisfaction for users. Moreover, these improvements seem to have an economic advantage for both users and society.

  • 26.
    Samuelsson, Kersti
    et al.
    Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine. Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Wressle, Ewa
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Geriatric Medicine in Linköping.
    Turning evidence into practice: Barriers to research use among occupational therapists2015In: British Journal of Occupational Therapy, ISSN 0308-0226, E-ISSN 1477-6006, Vol. 78, no 3, p. 175-181Article in journal (Refereed)
    Abstract [en]

    Introduction: Research has demonstrated that occupational therapists generally have a positive attitude regarding the use of evidence in their daily practice and decision-making. In addition, occupational therapists are expected to implement evidencebased practice, which is often understood as equivalent to research. However, evidence-based practice might be difficult to reconcile with occupational therapy from a client-centred focus. This study examines what occupational therapists perceive as barriers to research use and discusses the challenge of clinical implementation.

    Method: This study uses a descriptive cross-sectional design. The Barriers to Research Utilization Scale questionnaire was mailed to 807 randomly selected Swedish occupational therapists. The response rate was 59%.

    Findings: The occupational therapists identified three main barriers to the use of research: insufficient facilities (82%); lack of time to read research (77%); difficulty understanding statistical analyses (75%). Degree of education was shown to affect results; occupational therapists with higher education levels indicated a higher use of research.

    Conclusion: Implementing research in clinical practice is a challenge. Occupational therapists are interested but they lack the optimal prerequisites and time.

  • 27.
    Samuelsson, Kersti
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine. Östergötlands Läns Landsting, Reconstruction Centre, Department of Rehabilitation Medicine UHL.
    Wressle, Ewa
    Linköping University, Department of Clinical and Experimental Medicine, Geriatric. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Geriatric Medicine in Linköping.
    User satisfaction with mobility assistive devices: An important element in the rehabilitation process2008In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 30, no 7, p. 551-558Article in journal (Refereed)
    Abstract [en]

    Background. An assistive device often means an evident change in a person's ability, more easy to notice than the effects of most of other types of physiotherapy or occupational therapy intervention. In spite of this, there is very little evidence in this area. Purpose. The objective was to follow-up user satisfaction with and the use and usefulness of rollators and manual wheelchairs. The objective was also to determine any difference in satisfaction between users of the two different types of mobility assistive products. Methods. A random sample of 262 users participated in the study, 175 rollator users and 87 wheelchair users. The Quebec User Evaluation of Satisfaction with Assistive Technology - QUEST 2.0 and an additional questionnaire were used for data collection. Results. Overall satisfaction with both types of device was high and most clients reported use of their device on a daily basis. There was a difference in how the users estimated the usefulness and other characteristics as well as some service aspects related to prescription and use of the two types of device. Most users reported not having had any follow-up, however, most users had not experienced any need for one. Conclusions. A standardized follow-up will give rehabilitation professionals continuous and valuable information about the effect of and satisfaction with assistive devices.

  • 28.
    Sandström, Karin
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Physiotherapy. Östergötlands Läns Landsting, Reconstruction Centre, Department of Rehabilitation Medicine UHL.
    Samuelsson, Kersti
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Rehabilitation Medicine UHL.
    Öberg, Birgitta
    Linköping University, Department of Medicine and Health Sciences, Physiotherapy. Linköping University, Faculty of Health Sciences.
    Prerequisites for carrying out physiotherapy and physical activity: experiences from adults with cerebral palsy2009In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 31, no 3, p. 161-169Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of this study was to get a deeper understanding into how adults with cerebral palsy (CP) experience physiotherapy and physical activity in a perspective from childhood to adulthood; and how personal and environmental factors influence possibilities for physiotherapy and physical activity.

    Method: Data was collected through interviews with 22 community-living adults (35 - 68 years) with CP, from five counties in Sweden. The questions were open-ended and the interviews were taped and transcribed to written language. The material was analysed through qualitative content analysis, a classification process resulting in different themes.

    Results: The narratives from the 22 informants, based on experiences from childhood to adulthood, resulted in a description of prerequisites for carrying out physiotherapy and physical activity. Five different themes were identified: (i) Being enjoyable, (ii) Giving effects, (iii) Being comprehensible, (iv) Being integrated in daily life, and (v) Supportive healthcare with competent professionals.

    Conclusion: The information from the interviews elucidates the importance of a lifelong support from healthcare professionals. Physiotherapists with attentiveness to different life situations in combination with good understanding and knowledge in CP could facilitate continuous physical activity in people growing up and ageing with CP.

  • 29.
    Thyberg, Mikael
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.
    Gerdle, Björn
    Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.
    Samuelsson, Kersti
    Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.
    Larsson, Harriet
    Linköping University, Department of Neuroscience and Locomotion, Neurology. Linköping University, Faculty of Health Sciences.
    Wheelchair seating intervention: Results from a client-centred approach2001In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 23, no 15, p. 677-682Article in journal (Refereed)
    Abstract [en]

    Purpose : The aim of this study was to analyse the effects of wheelchair intervention from a client-centred perspective.

    Method : Results from 38 consecutive active wheelchair users visiting the wheelchair-seating department at the University Hospital in Linköping, Sweden, were analysed and described. All clients had defined problems related to wheelchair seating. Back pain was estimated before intervention and at follow-up, using a Visual Analogue Scale. The effect of intervention on different aspects of wheelchair functionality, seating and occupational performance was estimated by the clients at follow-up.

    Results : Two initial main problem areas were identified among the group; seating discomfort (87% ) and back pain (63% ). Back pain was significantly reduced at follow-up (p<0.001). Problems initially defined by the clients, e.g. seating discomfort, were affected positively, in 79% of all clients, as estimated by the clients at follow-up. No significant correlation was found between the initial cause of intervention or the highest ranked wheelchair functionality aspect and final acceptance of intervention.

    Conclusions : The results from this study confirm the possibility of reducing, or even eliminating, common secondary problems such as back pain and discomfort, related to wheelchair seating by individually adjusted measures. Further research and development in this field is both necessary and cost-effective.

  • 30.
    Tropp, Hans
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.
    Samuelsson, Kersti
    Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.
    Jorfeldt, L.
    Department of Clinical Physiology, Karolinska Hospital, Stockholm, Sweden.
    Power output for wheelchair driving on a treadmill compared with arm crank ergometry1997In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 31, no 1, p. 41-44Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The limiting factors with regard to power output available for wheelchair ambulation have not been identified. The aim of the present study was to correlate power output during wheelchair driving with (i) power output and oxygen uptake during arm crank ergometry and (ii) arm muscle strength.

    METHODS: Eleven disabled men were examined for maximal power output (POmax) during wheelchair driving on a treadmill and during arm crank ergometry. Oxygen uptake (VO2) was recorded at submaximal and maximal arm crank ergometry in all men and during submaximal wheelchair driving on a treadmill in four men. Power output during wheelchair driving on a treadmill was measured. Static and dynamic elbow muscle strength was measured isokinetically.

    RESULTS: POmax was significantly lower (P < 0.001) for wheelchair driving (109 (31) W; mean (SD)) than for arm ergometry (163 (49) W). There was a significant correlation between POmax for arm crank ergometry and wheelchair driving (r = 0.73). There was no correlation between POmax and elbow strength. The mechanical efficiency was constant for the different levels on the arm crank ergometry test. The submaximal testing showed a consistently lower mechanical efficiency for wheelchair driving than for arm crank ergometry.

    CONCLUSIONS: It is suggested that the lower level of power output for wheelchair driving is fully explained by the lower mechanical efficiency. Any improvement in power output available for ambulation must be based on wheelchair ergonomics.

  • 31.
    Tropp, Maria
    et al.
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine. Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Lundqvist, Anna
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine. Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Persson, Cecilia
    Department of Clinical Sciences, Lund University, Lund, Sweden.
    Samuelsson, Kersti
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine.
    Levander, Sten
    Department of Criminology, Malmö University, Malmo, Sweden.
    Self-ratings of everyday memory problems in patients with aquired brain injury - a tool for rehabilitation2015In: International Journal of Physical Medicine Rehabilitation, E-ISSN 2329-9096, Vol. 3, no 2Article in journal (Refereed)
    Abstract [en]

    Introduction: Memory problems are common in everyday life of patients with acquired brain injury (ABI). Some patients with ABI also have problems with self-monitoring/awareness. The ecological validity of neuropsychological tests for everyday life memory problems is questionable. Can self-report instruments supply complementary information? Aims: 1) To document the frequency/impact of self-reported memory problems in a sample of consecutive referrals of ABI patients using PEEM and REEM. 2) To characterize the instruments with respect to psychometrics and internal consistency. 3) To document differences in memory problem patterns for various kinds/localization of brain lesions, and associated anxiety/ depression symptoms. Methods: A descriptive retrospective study of consecutive referrals of ABI patients was performed. Ratings from the Evaluation of Everyday Memory (EEM), in a patient version (PEEM) and a version for relatives/proxies (REEM) were analysed as well as self-ratings of anxiety and depression. Results: The EEM instruments displayed good psychometric characteristics. The mean PEEM score were close to the tenth percentile of healthy controls. PEEM and REEM versions were strongly inter-correlated. Sex, age, and lesion characteristics did not matter much with one exception. Right-hemisphere lesion patients rated their memory problems significantly lower than the proxy, for all other lesions it was vice versa. Anxiety and depression symptoms were associated with memory problems.

  • 32.
    Wressle, Ewa
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Occupational Therapy. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Geriatric Medicine.
    Samuelsson, Kersti
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Reconstruction Centre, Department of Rehabilitation Medicine UHL.
    Barriers and bridges to client-centred occupational therapy in Sweden2004In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 11, no 1, p. 12-16Article in journal (Refereed)
    Abstract [en]

    This study investigates barriers to client-centred practice and solutions to overcome these barriers as experienced by Swedish occupational therapists. A British questionnaire was translated into Swedish and completed by 97 occupational therapists. The questionnaire consists of three sections: background information, a list of barriers identified in a literature review, and a list of methods to resolve barriers. The results show that the highest ranked barrier was "the therapist does not know enough about client-centred practice". The highest ranked method to resolve barriers was "management and peer support for use of client-centred practice". Introducing client-centred practice takes time, commitment, education, training, interview skills, discussions with colleagues, and reflection on the therapists' own attitudes. © 2004 Taylor & Francis.

  • 33.
    Wressle, Ewa
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Occupational Therapy. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Geriatric Medicine.
    Samuelsson, Kersti
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Reconstruction Centre, Department of Rehabilitation Medicine UHL.
    Barriers and bridges to occupational therapy in Sweden2004In: 7th European Congress of Occupational Therapy,2004, 2004Conference paper (Other academic)
  • 34.
    Wressle, Ewa
    et al.
    Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Geriatric Medicine in Linköping. Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience.
    Samuelsson, Kersti
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine.
    High job demands and lack of time: A future challenge in occupational therapy2014In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 21, no 6, p. 421-428Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study was to identify work-related stress factors that contributed to work-related stress among Swedish occupational therapists and to investigate the association between work-related stress, demographic factors and perceived overall stress. Methods: A postal questionnaire and a letter of invitation were sent to 807 Swedish occupational therapists, selected at random and representing 10% of occupational therapists working in Sweden. The response rate was 59%. A stress index presenting 49 stress factors graded on a scale from 1 (indicating no source of stress) to 6 (definitely a source of stress) was included. In addition, the level of perceived overall stress during the last 2 weeks was scored on a rating scale with the end points 0 (no stress) and 10 (extreme stress). Results: The main findings indicated that lack of resources and lack of time were the main stressors. “Working at a superficial level due to lack of time” was the only variable associated with high overall stress when both work-related and personal factors were included. Professional identity and clarity about the role were graded low with regard to stress. Conclusions: Work-related stress is just one aspect of the overall stress experienced but knowledge about its consequences highlights the importance of further studies.

  • 35.
    Wressle, Ewa
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Occupational Therapy.
    Samuelsson, Kersti
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Neurology.
    Testing the Swedish version of the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST) 2.02003In: Assistive technology, ISSN 1040-0435, E-ISSN 1949-3614, p. 927-930Article in journal (Refereed)
  • 36.
    Wressle, Ewa
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Geriatric Medicine in Linköping.
    Samuelsson, Kersti
    Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine. Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    The self-reported use of research in clinical practice: A survey of occupational therapists in Sweden2015In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 22, no 3, p. 226-234Article in journal (Refereed)
    Abstract [en]

    Background: Today, healthcare providers and occupational therapists are increasingly required to rely on evidence-based practices. In both out-patient and in-patient settings, the use of research-based practices can be identified using the questionnaire Research Utilization Measure. Aim: This study explores how occupational therapists in Sweden perceive research utilization. Method: The Research Utilization measure was sent to 807 randomly selected occupational therapists in Sweden, and the response rate was 59% (n=472). Results: The majority of respondents (56%, n=256) reported use of research-based knowledge in their practice “very or rather often”, although 49% (n=225) of these therapists noted that they “very seldom or never” discussed research findings with their managers. Differences in answers for most items were related to degree of education and length of experience. Occupational therapists with higher education levels more often reported use of research in their clinical practice and therapists with greater experience less often reported use of research in their clinical practice. Conclusion: Education seems to influence the degree to which occupational therapists rely on research to inform their practices. A future challenge for managers and occupational therapists is to create strategic discussions on how to implement treatment that is based on current research.

  • 37.
    Wressle, Ewa
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Occupational Therapy. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Geriatric Medicine.
    Samuelsson, Kersti
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Reconstruction Centre, Department of Rehabilitation Medicine UHL.
    User satisfaction with mobility assistive devices2004In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 11, no 3, p. 143-150Article in journal (Refereed)
    Abstract [en]

    In Sweden, the most common assistive devices are related to mobility. A study was undertaken to evaluate users' opinions on prescription of mobility devices and their satisfaction with devices and services using a cross-sectional design. A random sample of adult users of mobility assistive devices living in three county councils of Sweden was selected. A postal package comprising a questionnaire and QUEST 2.0 was sent out to 400 users of manual wheelchairs, powered wheelchairs, or walkers. Included in the analysis were 208 questionnaires, a response rate of 52%. Most devices were used on a daily basis and satisfaction with the device was high. Satisfaction with the service was scored lower than satisfaction with the device. Follow-up was the single item with the lowest mean score, and 69% of the users reported that they had not received any follow-up. A positive effect especially on users' ability to be active, transport oneself, feel secure, and to take part in social activities was found. Owing to the low response rate the results have to be interpreted with caution. However, follow-up seems to be an area that needs to be improved. The majority of users are satisfied with the device but not with service.

  • 38.
    Wressle, Ewa
    et al.
    Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Geriatric Medicine.
    Samuelsson, Kersti
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Rehabilitation Medicine UHL.
    Henriksson, Chris
    Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Health Sciences.
    Responsiveness of the Swedish version of the Canadian Occupational Performance Measure1999In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, Vol. 6, no 2, p. 84-89Article in journal (Refereed)
    Abstract [en]

    In a client-centred approach, clients and therapists work together to define the occupational performance problem, the focus of and need for intervention and the preferred outcomes. Application of specific theories or techniques to involve clients in goal-setting may influence the therapist to use a client participation approach. The Canadian Occupational Performance Measure (COPM) presents a structure for formulating the treatment goals identified by the client in co-operation with the therapist. The aim of this study was to test the responsiveness of the Swedish version of the COPM. After translation into Swedish, the COPM was introduced to 21 occupational therapists who performed data collection. A sample of 108 clients within geriatric, neurologic and orthopaedic rehabilitation identified 418 problems at initial scoring and reassessment. Inclusion criteria for patients were the need for rehabilitation interventions and the ability to communicate well enough in an interview. The results indicate that the Swedish version of the COPM is responsive to change, with 73% of the problems identified having a change in score of 2 points or more.

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