Jenny Röding

Positive attitudes and preserved high level of motor performance are important factors for return to work in younger persons after stroke : a national survey

OBJECTIVE Significant numbers of younger persons with stroke should be given the opportunity to return to work. The aim of this study was to investigate factors of importance for return to work among persons after first ever stroke, in the age range 18-55 years. METHODS A questionnaire was sent to all persons who had experienced a first ever stroke, 18-55 years of age, registered in the Swedish national quality register for stroke care, Riks-Stroke. Of the 1068 who answered the questionnaire, 855 (539 men and 316 women) were in paid employment before their stroke, and were included in this study. RESULTS Sixty-five percent returned to work and, of these, an equal proportion were men and women. Significant factors associated with return to work were the perceived importance of work (odds ratio (OR) 5.10), not perceiving themselves as a burden on others (OR 3.33), support from others for return to work (OR 3.66), retaining the ability to run a short distance (OR 2.77), and higher socioeconomic codes (OR 2.12). A negative association was found between those rehabilitated in wards intended for younger persons and return to work (OR 0.37). CONCLUSION External support from others, and positive attitudes towards return to work, were factors associated with successful return to work after stroke. Contrary to what was expected, independence in personal activities of daily living and cognitive factors were not associated with return to work to the same extent as persistent higher level of physical functions, such as ability to run a short distance.

Life satisfaction in younger individuals after stroke: different predisposing factors among men and women.

OBJECT To describe self-reported life satisfaction of younger persons after stroke and to investigate differences between men and women and factors associated with life satisfaction. DESIGN A cross-sectional study. METHODS Subjects were all persons after stroke, aged 18-55 years, registered in the Swedish National Quality Register for Stroke Care. A questionnaire was completed by 1068 individuals 8-36 months after stroke. Perceived Life Satisfaction was measured with LiSat-9. RESULTS Less than half of the participants were satisfied with life as a whole. For women, significant associations were found between not being satisfied with life as a whole and haemorrhage (odds ratio (OR) 4.00) as well as a deteriorated ability to concentrate (OR 2.11). For men, significant associations were found to be not having a significant other (OR 3.17), not working (OR 2.26) and deteriorated ability to concentrate (OR 2.04). CONCLUSION There were different factors for being satisfied with life as a whole between men and women, indicating a need for a more gender-specific rehabilitation than is currently used. The impact that deteriorated ability to concentrate has on life satisfaction is an important finding that needs to be considered in the rehabilitation process of younger patients after stroke.

Perceived impaired physical and cognitive functions after stroke in men and women between 18 and 55 years of age – a national survey

Purpose. We describe self-reported consequences for physical and cognitive functions, detect possible gender differences, and find factors that were associated with deteriorated physical function in younger stroke patients, independent in their personal activities of daily life. Methods. This study involved all first ever stroke patients, aged 18–55 years, registered in the Swedish national quality register for stroke. A questionnaire was answered by 1068 patients 8–36 months after the stroke. Changes were sought in physical and cognitive functions as compared with the pre-stroke condition. Results. Eight hundred and sixty-seven patients (83%) were independent in personal activities of daily life. Significant differences between men and women were found: deteriorated physical ability was reported by 56–71% of the men and 65–79% of the women; deteriorated cognitive function was reported by 48–57% of the men and 57–68% of the women. Many patients (70% men, 77% women) reported that they had received insufficient information about physical exertion. Significant associations were found between deteriorated physical function and deteriorated cognitive function as well as fear of physical exertion. Conclusions. Deterioration was found in physical and cognitive functions greater in women then in men. Insecurity regarding physical exertion existed indicating that younger stroke patients might need information directly aimed at physical functioning and more gender specific than today. This study has raised the awareness that there also might be gender differences in other fields, which needs further studies.

Hand grip strength is associated with forced expiratory volume in 1 second among subjects with COPD: report from a population-based cohort study

Background Cardiovascular diseases and skeletal muscle dysfunction are common comorbidities in COPD. Hand grip strength (HGS) is related to general muscle strength and is associated with cardiovascular disease and all-cause mortality, while the results from small selected COPD populations are contradictory. The aim of this population-based study was to compare HGS among the subjects with and without COPD, to evaluate HGS in relation to COPD severity, and to evaluate the impact of heart disease. Subjects and methods Data were collected from the Obstructive Lung disease in Northern Sweden COPD study, where the subjects with and without COPD have been invited to annual examinations since 2005. In 2009–2010, 441 subjects with COPD (postbronchodilator forced expiratory volume in 1 second [FEV1]/vital capacity <0.70) and 570 without COPD participated in structured interviews, spirometry, and measurements of HGS. Results The mean HGS was similar when comparing subjects with and without COPD, but those with heart disease had lower HGS than those without. When compared by Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades, the subjects with GOLD 3–4 had lower HGS than those without COPD in both sexes (females 21.4 kg vs 26.9 kg, P=0.010; males 41.5 kg vs 46.3 kg, P=0.038), and the difference persisted also when adjusted for confounders. Among the subjects with COPD, HGS was associated with FEV1% of predicted value but not heart disease when adjusted for height, age, sex, and smoking habits, and the pattern was similar among males and females. Conclusion In this population-based study, the subjects with GOLD 3–4 had lower HGS than the subjects without COPD. Among those with COPD, HGS was associated with FEV1% of predicted value but not heart disease, and the pattern was similar in both sexes.

An initial field trial of a haptic navigation system for persons with a visual impairment

Purpose – The purpose of this paper is to describe conceptions of feasibility of a haptic navigation system for persons with a visual impairment (VI). Design/methodology/approach – Six persons with a VI who were white cane users were tasked with traversing a predetermined route in a corridor environment using the haptic navigation system. To see whether white cane experience translated to using the system, the participants received no prior training. The procedures were video-recorded, and the participants were interviewed about their conceptions of using the system. The interviews were analyzed using content analysis, where inductively generated codes that emerged from the data were clustered together and formulated into categories. Findings – The participants quickly figured out how to use the system, and soon adopted their own usage technique. Despite this, locating objects was difficult. The interviews highlighted the desire to be able to feel at a distance, with several scenarios presented to illustr...