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  • 1. Andréll, Paulin
    et al.
    Schultz, Tomas
    Mannerkorpi, Kaisa
    Nordeman, Lena
    Börjesson, Mats
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology.
    Mannheimer, Clas
    Health-related quality of life in fibromyalgia and refractory angina pectoris: a comparison between two chronic non-malignant pain disorders.2014In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 46, no 4, p. 341-7Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To compare health-related quality of life in 2 different populations with chronic pain: patients with fibromyalgia and patients with refractory angina pectoris. Previous separate studies have indicated that these patient groups report different impacts of pain on health-related quality of life.

    METHODS: The Short-Form 36 was used to assess health- related quality of life. In order to adjust for age and gender differences between the groups, both patient groups were compared with age- and gender-matched normative controls. The difference in health-related quality of life between the 2 patient groups was assessed by transforming the Short-Form 36 subscale scores to a z-score.

    RESULTS: The patients with fibromyalgia (n = 203) reported poorer health-related quality of life in all the subscale scores of Short-Form 36 (p < 0.05-0.0001) than the patients with refractory angina (n = 146) when both groups were compared with their corresponding normal population (z-score).

    CONCLUSION: Patients with fibromyalgia experience greater impairment in health-related quality of life compared with the normal population than do patients with refractory angina pectoris, despite the fact that the latter have a potentially life-threatening disease. The great impairment in health- related quality of life in patients with fibromyalgia should be taken into consideration when planning rehabilitation.

  • 2.
    Bjerkefors, Anna
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Squair, Jordan W
    Chua, Romeo
    Lam, Tania
    Chen, Zhen
    Carpenter, Mark G
    Assessment of abdominal muscle function in individuals with motor-complete spinal cord injury above T6 in response to transcranial magnetic stimulation.2015In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 47, no 2, p. 138-146Article in journal (Refereed)
    Abstract [en]

    Objective: To use transcranial magnetic stimulation and electromyography to assess the potential for preserved function in the abdominal muscles in individuals classified with motor-complete spinal cord injury above T6. Subjects: Five individuals with spinal cord injury (C5-T3) and 5 able-bodied individuals. Methods: Transcranial magnetic stimulation was delivered over the abdominal region of primary motor cortex during resting and sub-maximal (or attempted) contractions. Surface electromyography was used to record motor-evoked potentials as well as maximal voluntary (or attempted) contractions in the abdominal muscles and the diaphragm. Results: Responses to transcranial magnetic stimulation in the abdominal muscles occurred in all spinal cord injury subjects. Latencies of muscle response onsets were similar in both groups; however, peak-to-peak amplitudes were smaller in the spinal cord injury group. During maximal voluntary (or attempted) contractions all spinal cord injury subjects were able to elicit electromyography activity above resting levels in more than one abdominal muscle across tasks. Conclusion: Individuals with motor-complete spinal cord injury above T6 were able to activate abdominal muscles in response to transcranial magnetic stimulation and during maximal voluntary (or attempted) contractions. The activation was induced directly through corticospinal pathways, and not indirectly by stretch reflex activations of the diaphragm. Transcranial magnetic stimulation and electromyography measurements provide a useful method to assess motor preservation of abdominal muscles in persons with spinal cord injury.

  • 3.
    Grigorenko, Anatoli
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Bjerkefors, Anna
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Rosdahl, Hans
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control. Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, The Laboratory of Applied Sports Science (LTIV).
    Hultling, Claes
    Alm, Marie
    Thorstensson, Alf
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Sitting balance and effects of kayak training in paraplegics.2004In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 36, no 3, p. 110-6Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The objectives of this study were to evaluate biomechanical variables related to balance control in sitting, and the effects of kayak training, in individuals with spinal cord injury. SUBJECTS: Twelve individuals with spinal cord injury were investigated before and after an 8-week training period in open sea kayaking, and 12 able-bodied subjects, who did not train, served as controls. METHODS: Standard deviation and mean velocity of centre of pressure displacement, and median frequency of centre of pressure acceleration were measured in quiet sitting in a special chair mounted on a force plate. RESULTS: All variables differed between the group with spinal cord injury, before training, and the controls; standard deviation being higher and mean velocity and median frequency lower in individuals with spinal cord injury. A significant training effect was seen only as a lowering of median frequency. CONCLUSION: The results indicate that individuals with spinal cord injury may have acquired and consolidated an alternative strategy for balance control in quiet sitting allowing for only limited further adaptation even with such a vigorous training stimulus as kayaking.

  • 4.
    Kouwijzer, Ingrid
    et al.
    Reade Amsterdam, Amsterdam Rehabil Res Ctr, Amsterdam, Netherlands.;Heliomare Rehabil Ctr, Res & Dev, Wijk Aan Zee, Netherlands.;Univ Groningen, Univ Med Ctr Groningen, Ctr Human Movement Sci, Groningen, Netherlands..
    Nooijen, Carla F J
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences. Karolinska Inst, Dept Publ Hlth Sci, Solna, Sweden.;Swedish Sch Sport & Hlth Sci GIH, Stockholm, Sweden..
    Van Breukelen, Kees
    Vrije Univ Amsterdam, Fac Behav & Human Movement Sci, Int Wheelchairsport Classifier Handcyding Wheelch, Amsterdam, Netherlands..
    Janssen, Thomas W. J.
    Reade Amsterdam, Amsterdam Rehabil Res Ctr, Amsterdam, Netherlands.;Vrije Univ Amsterdam, Fac Behav & Human Movement Sci, Dept Human Movement Sci, Amsterdam, Netherlands.;Ctr Adapted Sports Amsterdam Reade, Amsterdam, Netherlands..
    De Groot, Sonja
    Reade Amsterdam, Amsterdam Rehabil Res Ctr, Amsterdam, Netherlands.;Univ Groningen, Univ Med Ctr Groningen, Ctr Human Movement Sci, Groningen, Netherlands..
    EFFECTS OF PUSH-OFF ABILITY AND HANDCYCLE TYPE ON HANDCYCLING PERFORMANCE IN ABLE-BODIED PARTICIPANTS2018In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 50, no 6, p. 563-568Article in journal (Refereed)
    Abstract [en]

    Objective: To assess the effects on handcycling performance and physiological responses, of: (i) making a closed chain by comparing handcycling in a recumbent bike with 2-feet footrest (closed chain) with handcycling with 1 footrest (partial closed chain) and without a footrest (no closed chain); (ii) equipment by comparing handcycling in a recumbent bike with a kneeling bike. Methods: Ten able-bodied participants performed submaximal exercise and sprint tests, once in a kneeling bike and 3 times on a recumbent: 2-feet support, 1-foot support and without foot support. Physical strain (submaximal oxygen uptake and heart rate), peak (POpeak) and mean power output (POmean) were measured. Results: Significantly higher POpeak, and POmean were found with 2-feet support (mean 415 W (standard deviation (SD) 163) and mean 281 W (SD 96)) and higher POmean with 1-foot support (mean 279 W (SD 104)) compared with no foot support (mean 332 W (SD 127) and mean 254 W (SD 101)), p<0.05. No differences were found for physical strain. In the kneeling bike, POpeak and POmean were significantly higher (mean 628 W (SD 231) and 391 W (SD 121)) than in the recumbent (mean 415 W (SD 163) and 281 W (SD 96)), p=0.001. Conclusion: The ability to make a closed chain has a significant positive effect on handcycling sprint performance; therefore, this ability may be a discriminating factor. Sprint performance was significantly higher in kneeling compared with recumbent handcycling.

  • 5.
    Lindberg, Thomas
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Arndt, Anton
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Norrbrink, Cecilia
    Department of Clinical Sciences, Karolinska Institutet Danderyd Hospital, Stockholm, Sweden.
    Wahman, Kerstin
    Department of Neurobiology, Care Sciences and Society (NVS), Division of Neurorehabilitation, Karolinska Institutet.
    Bjerkefors, Anna
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Effects of seated double-poling ergometer training on aerobic and mechanical power in individuals with spinal cord injury2012In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 44, no 10, p. 893-898Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To determine whether regular interval training on a seated double-poling ergometer can increase physical capacity and safely improve performance towards maximal level in individuals with spinal cord injury.

    METHODS: A total of 13 subjects with spinal cord injury (injury levels T5-L1) performed 30 sessions of seated double-poling ergometer training over a period of 10 weeks. Sub-maximal and maximal double-poling ergometer tests were performed before (test-retest) and after this training period. Oxygen uptake was measured using the Douglas Bag system. Three-dimensional kinematics were recorded using an optoelectronic system and piezoelectric force sensors were used to register force in both poles.

    RESULTS: The mean intra-class correlation coefficient for test-retest values was 0.83 (standard deviation 0.11). After training significant improvements were observed in people with spinal cord injury in oxygen uptake (22.7%), ventilation (20.7%) and blood lactate level (22.0%) during maximal exertion exercises. Mean power per stroke and peak pole force increased by 15.4% and 23.7%, respectively. At sub-maximal level, significantly lower values were observed in ventilation (-12.8%) and blood lactate level (-25.0%).

    CONCLUSION: Regular interval training on the seated double-poling ergometer was effective for individuals with spinal cord injury below T5 level in terms of improving aerobic capacity and upper-body power output. The training was safe and did not cause any overload symptoms.

  • 6.
    Nooijen, C. F.
    et al.
    Department of Rehabilitation Medicine, Erasmus MC University Medical Center, Rotterdam.
    Stam, H. J.
    Schoenmakers, I.
    Sluis, T. A.
    Post, M. W.
    Twisk, J. W.
    Group, A. A.
    van den Berg-Emons, R. J.
    Working mechanisms of a behavioural intervention promoting physical activity in persons with subacute spinal cord injury2016In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 48, no 7, p. 583-8Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: In order to unravel the working mechanisms that underlie the effectiveness of a behavioural intervention promoting physical activity in persons with subacute spinal cord injury, the aim of this study was to assess the mediating effects of physical and psychosocial factors on the intervention effect on physical activity. DESIGN: Randomized controlled trial. SETTING: Four rehabilitation centres in the Netherlands. SUBJECTS: Thirty-nine persons with subacute spinal cord injury. INTERVENTION: Behavioural intervention promoting an active lifestyle, based on motivational interviewing. The intervention involved a total of 13 individual sessions beginning 2 months before and ending 6 months after discharge from initial inpatient rehabilitation. MAIN MEASURES: The potential mediating effects of fatigue, pain, depression, illness cognition, exercise self-efficacy, coping and social support on the effect of the behavioural intervention on objectively measured physical activity (B = 0.35 h, p < 0.01) were studied. Measurements were performed at baseline, discharge, 6 months and 1 year after discharge. RESULTS: No single factor was found that strongly mediated the effect of the behavioural intervention on physical activity; however, multiple factors could partly explain the effect. Mediating effects greater than 10% were found for proactive coping (17.6%), exercise self-efficacy (15.9%), pain disability (15.3%) and helplessness (12.5%). DISCUSSION: Proactive coping (the ability to anticipate and deal with potential threats before they occur), exercise self-efficacy (self-confidence with respect to performing exercise and daily physical activities), pain disability (interference by pain of daily activities) and helplessness (emphasizing the aversive meaning of the disease) are important concepts in interventions promoting physical activity in persons with subacute spinal cord injury.

  • 7.
    Nooijen, Carla F.
    et al.
    Department of Rehabilitation Medicine and Physical Therapy, Rotterdam.
    Post, M. W.
    Spijkerman, D. C.
    Bergen, M. P.
    Stam, H. J.
    van den Berg-Emons, R. J.
    Exercise self-efficacy in persons with spinal cord injury: psychometric properties of the Dutch translation of the Exercise Self-Efficacy Scale2013In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 45, no 4, p. 347-50Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To assess the reliability and validity of the Dutch version of the exercise self-efficacy scale (ESES) in persons with spinal cord injury. This is the first independent study of ESES psychometric properties, and the first report on ESES test-retest reliability. SUBJECTS/PATIENTS: A total of 53 Dutch persons with spinal cord injury. METHODS: Subjects completed the Dutch ESES twice, with 2 weeks between (ESES_1 and ESES_2). Subjects also completed the General self-efficacy scale (GSE), and a questionnaire regarding demographic characteristics and lesion characteristics. Psychometric properties of the Dutch translation of the ESES were assessed and compared with those of the original English-language version. RESULTS: The Dutch ESES was found to have good internal consistency (Cronbach's alpha for ESES_1 = 0.90, ESES_2 = 0.88). Test-retest reliability was adequate (intra-class correlation coefficient = 0.81, 95% confidence interval 0.70-0.89). For validity, a moderate, statistically significant correlation was found between ESES and the GSE (Spearman's rho ESES_1 = 0.52, ESES_2 = 0.66, p < 0.01). Furthermore, the psychometric properties of the Dutch ESES were found to be similar to those of the original English version. CONCLUSION: The results of this study support the use of the ESES as a reliable and valid measure of exercise self-efficacy.

  • 8.
    Nooijen, Carla
    et al.
    Department of Rehabilitation Medicine and Physical Therapy, Erasmus Medical Center, Rotterdam.
    Slaman, J.
    van der Slot, W.
    Stam, H.
    Roebroeck, M.
    van den Berg-Emons, R.
    Learn2Move Research, Group
    Health-related physical fitness of ambulatory adolescents and young adults with spastic cerebral palsy2014In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 46, no 7, p. 642-7Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To describe in detail the health-related physical fitness of adolescents and young adults with cerebral palsy, compared with able-bodied references, and to assess differences related to Gross Motor Functioning Classification System (GMFCS) level and distribution of cerebral palsy. DESIGN: Cross-sectional. SUBJECTS: Fifty ambulatory persons with spastic cerebral palsy, GMFCS level I or II, aged 16-24 years. METHODS: Physical fitness measures were: (i) cardiopulmonary fitness by maximal cycle ergometry, (ii) muscle strength, (iii) body mass index and waist circumference, (iv) skin-folds, and (v) lipid profile. RESULTS: Regression analyses, corrected for age and gender, showed that persons with bilateral cerebral palsy had lower cardiopulmonary fitness and lower hip abduction muscle strength than those with unilateral cerebral palsy. Comparisons between persons with GMFCS levels I and II showed a difference only in peak power during cycle ergometry. Cardiopulmonary fitness, hip flexion and knee extension strength were considerably lower (< 75%) in persons with cerebral palsy than reference values. CONCLUSION: The distribution of cerebral palsy affects fitness more than GMFCS level does. Furthermore, adolescents and young adults with cerebral palsy have reduced health-related physical fitness compared with able-bodied persons. This stage of life has a strong influence on adult lifestyle, thus it is an important period for intervention.

  • 9. Paanalahti, Markku
    et al.
    Lundgren-Nilsson, Asa
    Arndt, Anton
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Sunnerhagen, Katharina S
    Applying the Comprehensive International Classification of Functioning, Disability and Health Core Sets for stroke framework to stroke survivors living in the community.2013In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 45, no 4, p. 331-40Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aims of this study were to explore the perspective of functioning in community-dwelling people with prior stroke and to confirm, if possible, the comprehensive international classification of functioning, disability and health (ICF) Comprehensive Core Set for stroke.

    METHODS: Qualitative interviews were analysed (using the content analysis method and established ICF linking rules) from 22 persons following stroke (age range 59-87 years), as well as their spouses/partners, where relevant.

    RESULTS: Ninety-nine (76%) of 130 second-level ICF categories in the existing Comprehensive ICF Core Set for stroke were confirmed: 31 categories (of 41) in the component of body functions, 38 categories (of 51) in the component of activities and participation, 26 (of 33) in the component of environmental factors and 4 (of 5) in the component of body structures. Eleven additional ICF categories and one personal factor, a coping style of "I take it as it comes" were also identified in the transcribed text.

    CONCLUSION: The Comprehensive ICF Core Set for stroke was largely confirmed.

  • 10. Squair, Jordan W
    et al.
    Bjerkefors, Anna
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Inglis, J Timothy
    Lam, Tania
    Carpenter, Mark G
    Cortical and vestibular stimulation reveal preserved descending motor pathways in individuals with motor-complete spinal cord injury.2016In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 48, no 7, p. 589-596Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To use a combination of electrophysiological techniques to determine the extent of preserved muscle activity below the clinically-defined level of motor-complete spinal cord injury.

    METHODS: Transcranial magnetic stimulation and vestibular-evoked myogenic potentials were used to investigate whether there was any preserved muscle activity in trunk, hip and leg muscles of 16 individuals with motor-complete spinal cord injury (C4-T12) and 16 able-bodied matched controls.

    RESULTS: Most individuals (14/16) with motor-complete spinal cord injury were found to have transcranial magnetic stimulation evoked, and/or voluntary evoked muscle activity in muscles innervated below the clinically classified lesion level. In most cases voluntary muscle activation was accompanied by a present transcranial magnetic stimulation response. Furthermore, motor-evoked potentials to transcranial magnetic stimulation could be observed in muscles that could not be voluntarily activated. Vestibular-evoked myogenic potentials responses were also observed in a small number of subjects, indicating the potential preservation of other descending pathways.

    CONCLUSION: These results highlight the importance of using multiple electrophysiological techniques to assist in determining the potential preservation of muscle activity below the clinically-defined level of injury in individuals with a motor-complete spinal cord injury. These techniques may provide clinicians with more accurate information about the state of various motor pathways, and could offer a method to more accurately target rehabilitation.

  • 11.
    Åberg, Anna Cristina
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences.
    Gender comparisons of function-related dependence pain and insecurity in geriatric rehabilitation.2006In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 38, no 1, p. 73-9Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate possible gender differences regarding the effect of intervention in geriatric rehabilitation, expressed in terms of change in function-related dependence, pain and insecurity. DESIGN: Comparative study. PARTICIPANTS: A total of 110 women and 44 men undergoing geriatric rehabilitation. METHODS: Performance-based assessments with use of the General Motor Function assessment scale. Non-parametric statistics were mainly used. RESULTS: The women showed higher degrees of function-related dependence, pain and insecurity on admission than the men. Both women and men displayed significant improvement in all 3 variables during the rehabilitation period. However, the positive changes regarding pain and insecurity were according to the analyses of systematic group changes, at a low degree among the men, probably because of the low levels on admission. Gender comparisons of proportions with positive intervention outcome indicated that a significantly larger proportion of the women showed a positive treatment effect after intervention, with a difference in recovery of 19% in dependence, 23% in pain and 33% in insecurity (p<0.05). CONCLUSIONS: Gender differences in disability, with higher degrees of function-related dependence, pain and insecurity among women on admission for geriatric rehabilitation, can be diminished during the rehabilitation period. These promising results may have relevance for the public health of the elderly population.

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