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Ramstrand, N., Sterner, A. & Palmér, L. (2023). Lower limb prosthesis users' perceptions of everyday life-A phenomenographic study. Prosthetics and Orthotics International
Open this publication in new window or tab >>Lower limb prosthesis users' perceptions of everyday life-A phenomenographic study
2023 (English)In: Prosthetics and Orthotics International, ISSN 0309-3646, E-ISSN 1746-1553Article in journal (Refereed) Epub ahead of print
Abstract [en]

INTRODUCTION: A lack of understanding of personal experiences related to limb amputation and prosthetic use limits the extent to which clinicians involved in rehabilitation can support and advise their clients in a person-centered consultation. The objective of this qualitative study was to explore the personal experience of daily life as a lower limb prosthesis user.

METHODS: Fifteen lower limb prosthesis users participated in individual semistructured interviews. Transcripts were analyzed using a phenomenographic approach.

RESULTS: The extent to which prosthesis users were able to adjust to their impairment and move on with their life was influenced by social interactions with other prosthesis users, access to relevant information about prosthetic solutions that may benefit them, and finding a balance between desired activities and their physical and/or cognitive capacity.

CONCLUSIONS: After a period of existential adjustment, prosthesis users described themselves as living active, fulfilling lives. This was facilitated to a large extent by social interactions with other prosthesis users and access to information they perceived as relevant. Social media plays a particularly important role in establishing connections with other prosthesis users and is perceived as a useful source of information.

Place, publisher, year, edition, pages
Wolters Kluwer, 2023
Keywords
limb prosthesis; amputee; lived experience; everyday life; qualitative; phenomenography
National Category
Orthopaedics Occupational Therapy
Identifiers
urn:nbn:se:hj:diva-61501 (URN)10.1097/PXR.0000000000000246 (DOI)37318282 (PubMedID)
Funder
Knowledge Foundation
Available from: 2023-06-22 Created: 2023-06-22 Last updated: 2023-06-22Bibliographically approved
Blomstrand, P., Tesan, D., Nylander, E. & Ramstrand, N. (2023). Mind body exercise improves cognitive function more than aerobic- and resistance exercise in healthy adults aged 55 years and older: an umbrella review. European Review of Aging and Physical Activity, 20(1), Article ID 15.
Open this publication in new window or tab >>Mind body exercise improves cognitive function more than aerobic- and resistance exercise in healthy adults aged 55 years and older: an umbrella review
2023 (English)In: European Review of Aging and Physical Activity, ISSN 1813-7253, E-ISSN 1861-6909, Vol. 20, no 1, article id 15Article, review/survey (Refereed) Published
Abstract [en]

Exercise is often cited as a major factor contributing to improved cognitive functioning. As a result, the relationship between exercise and cognition has received much attention in scholarly literature. Systematic reviews and meta-analyses present varying and sometimes conflicting results about the extent to which exercise can influence cognition. The aim of this umbrella review was to summarize the effects of physical exercise on cognitive functions (global cognition, executive function, memory, attention, or processing speed) in healthy adults & GE; 55 years of age.Methods An umbrella review of systematic reviews with meta-analyses investigating the effect of exercise on cognition was performed. Databases (CINAHL, Cochrane Library, MEDLINE, PsycInfo, Scopus, and Web of Science) were searched from inception until June 2023 for reviews of randomized or non-randomised controlled trials. Full-text articles meeting the inclusion criteria were reviewed and methodological quality assessed. Overlap within included reviews was assessed using the corrected covered area method (CCA). A random effects model was used to calculate overall pooled effect size with sub-analyses for specific cognitive domains, exercise type and timing of exercise.Results Database searches identified 9227 reviews. A total of 20 met the inclusion criteria. They were based on 332 original primary studies. Overall quality of the reviews was considered moderate with most meeting 8 or more of the 16 AMSTAR 2 categories. Overall pooled effects indicated that exercise in general has a small positive effect on cognition (d = 0.22; SE = 0.04; p < 0.01). Mind-body exercise had the greatest effect with a pooled effect size of (d = 0.48; SE = 0.06; p < 0.001). Exercise had a moderate positive effect on global cognition (d = 0.43; SE = 0,11; p < 0,001) and a small positive effect on executive function, memory, attention, and processing speed. Chronic exercise was more effective than acute exercise. Variation across studies due to heterogeneity was considered very high.Conclusions Mind-body exercise has moderate positive effects on the cognitive function of people aged 55 or older. To promote healthy aging, mind-body exercise should be used over a prolonged period to complement other types of exercise. Results of this review should be used to inform the development of guidelines to promote healthy aging.

Place, publisher, year, edition, pages
Springer, 2023
Keywords
Cognitive function, Exercise, Older adults, Umbrella review, Meta-analysis
National Category
Geriatrics Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:hj:diva-62295 (URN)10.1186/s11556-023-00325-4 (DOI)001044908100001 ()37558977 (PubMedID)2-s2.0-85168271063 (Scopus ID)HOA;;899180 (Local ID)HOA;;899180 (Archive number)HOA;;899180 (OAI)
Available from: 2023-08-25 Created: 2023-08-25 Last updated: 2023-08-29Bibliographically approved
Maddock, A., Best, P., Ean, N., Armour, C. & Ramstrand, N. (2023). Rates and correlates of psychological distress and PTSD among persons with physical disabilities in Cambodia. International Journal for Equity in Health, 22(1), Article ID 30.
Open this publication in new window or tab >>Rates and correlates of psychological distress and PTSD among persons with physical disabilities in Cambodia
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2023 (English)In: International Journal for Equity in Health, E-ISSN 1475-9276, Vol. 22, no 1, article id 30Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Compared to the general population, persons with disabilities are at increased risk of poor mental health. The aim of this study was to determine the rates and correlates of psychological distress and post-traumatic stress disorder (PTSD) among persons with physical disabilities in Cambodia.

METHODS: From July to December 2021 data were collected as part of a mental health screening programme for persons with physical disabilities who access prosthetic and orthotic services. Psychological distress was measured using the Kessler-10 (K-10) and PTSD using the PC-PTSD-5. Bivariate and multiple linear regression analyses were conducted to identify factors associated with levels of psychological distress and PTSD among this population.

RESULTS: Our study found a high prevalence of psychological distress and PTSD in this patient cohort. Of the 213 participants, 31.5% were likely to be experiencing mild to moderate psychological distress indicative of a mental health disorder, with 13.6% likely to have a severe mental health disorder. Sixty-five percent of patients reported experiencing PTSD symptoms, with forty-six percent meeting the criteria for probable PTSD. Psychological distress was associated with pathological worry, rumination, and facets of mindfulness. Rumination and pathological worry were found to be significant predictors of psychological distress. PTSD symptoms were associated with pathological worry but not facets of mindfulness or rumination. Facets of mindfulness and pathological worry were found to be significant predictors of PTSD.

CONCLUSION: Integration of mental health services within the disability sector is required to address psychological distress and PTSD symptoms among people with physical disabilities in Cambodia. Health system interventions, such as screening, referral, and the training of health providers, need to be strengthened. Further studies focussing on the psychosocial determinants of mental health of persons with disabilities in Cambodia are required.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
Keywords
Cambodia, Mental Health, PTSD, Physical Disability, Psychological Distress
National Category
Psychiatry
Identifiers
urn:nbn:se:hj:diva-59845 (URN)10.1186/s12939-023-01842-5 (DOI)000929971700001 ()36765360 (PubMedID)2-s2.0-85147893243 (Scopus ID)GOA;intsam;861781 (Local ID)GOA;intsam;861781 (Archive number)GOA;intsam;861781 (OAI)
Available from: 2023-02-16 Created: 2023-02-16 Last updated: 2024-01-17Bibliographically approved
Ramstrand, N. & Stevens, P. M. (2022). Clinical outcome measures to evaluate the effects of orthotic management post-stroke: a systematic review. Disability and Rehabilitation, 44(13), 3019-3038
Open this publication in new window or tab >>Clinical outcome measures to evaluate the effects of orthotic management post-stroke: a systematic review
2022 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 44, no 13, p. 3019-3038Article, review/survey (Refereed) Published
Abstract [en]

Purpose

To identify, and classify, according to International Classification of Functioning, Disability and Health (ICF), clinically applicable outcome measures that have been used to evaluate lower limb orthotic management post-stroke and to investigate which outcome measures recorded the largest effect sizes.

Materials and methods

Electronic searches were performed in Pubmed, Cochrane, Web of Science, Cinahl, Scopus and Embase databases from inception to May 2020. Articles were included if they investigated clinical outcomes in people post-stroke who had received a lower-limb orthotic intervention.

Results

88 articles underwent full-text review and 54 were included in the review, which was performed in accordance with the Preferred Reporting Items for Systematic Review (PRISMA) principles. 48 different outcome measures were identified; effect sizes were able to be calculated from 39 studies. The most frequently applied outcome measures were the 10-metre Walk Test and the timed-up-and-go test. Outcome measures that recorded large effect sizes in two or more studies were the 10-metre Walk Test, Functional Reach Test, and Physiological Cost Index. When coded according to the ICF, the most frequently represented codes were d450 (Walking) and d455 (moving around).

Conclusions

Results suggest that outcome measures related to mobility (ICF chapter d4) are most often applied to evaluate orthotic management post-stroke. Effect sizes appear to be greatest in outcome measures related to velocity, balance, and energy expenditure.

IMPLICATIONS FOR REHABILITATION

  • The 10-meter Walk Test appears to have the greatest effect size when evaluating orthotic management post-stroke.
  • While outcome measures related to mobility are commonly applied when evaluating orthotic management post-stroke, rehabilitation professionals should consider complementing these with measures representing the participation domain of the ICF.
Place, publisher, year, edition, pages
Taylor & Francis, 2022
Keywords
Orthotic device; AFO; cerebrovascular disorders; outcome assessment; ICF
National Category
Orthopaedics
Identifiers
urn:nbn:se:hj:diva-51477 (URN)10.1080/09638288.2020.1859630 (DOI)000607239500001 ()33438496 (PubMedID)2-s2.0-85099422334 (Scopus ID)HOA;intsam;51477 (Local ID)HOA;intsam;51477 (Archive number)HOA;intsam;51477 (OAI)
Available from: 2021-01-13 Created: 2021-01-13 Last updated: 2022-12-02Bibliographically approved
Kuhlmann, A., Hagberg, K., Kamrad, I., Ramstrand, N., Seidinger, S. & Berg, H. (2022). The Kenevo microprocessor-controlled prosthetic knee compared with non-microprocessor-controlled knees in individuals older than 65 years in Sweden: A cost-effectiveness and budget-impact analysis. Prosthetics and Orthotics International, 46(5), 414-424
Open this publication in new window or tab >>The Kenevo microprocessor-controlled prosthetic knee compared with non-microprocessor-controlled knees in individuals older than 65 years in Sweden: A cost-effectiveness and budget-impact analysis
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2022 (English)In: Prosthetics and Orthotics International, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 46, no 5, p. 414-424Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Growing evidence suggests that individuals with transfemoral amputation or knee disarticulation using a prosthesis equipped with a microprocessor-controlled knee (MPK) benefit from enhanced mobility and safety, including less falls. In elderly individuals, high mortality rates are assumed to reduce the expected useful life of MPKs, and this raises concerns regarding their economic effectiveness. OBJECTIVE: To investigate the cost-effectiveness and budget impact of the Kenevo/MPK (Ottobock, Germany) compared with non-microprocessor-controlled knees (NMPKs) in people older than 65 years at the time of transfemoral amputation/knee disarticulation, from a Swedish payer's perspective. METHODS: A decision-analytic model was developed to conduct the economic analysis of the Kenevo/MPK. Model parameters were derived from Swedish databases and published literature. Univariate and probabilistic sensitivity analyses were performed to explore parameter uncertainty. RESULTS: Compared with NMPKs, the Kenevo/MPK reduced the frequency of hospitalizations by 137 per 1,000 person years while the frequency of fatal falls was reduced by 19 per 1,000 person-years in the simulation. Over a 25-year time horizon, the incremental cost-effectiveness ratio was EUR11,369 per quality-adjusted life year. The probability of the MPK being cost-effective at a threshold of EUR40,000 per quality-adjusted life year was 99%. The 5-year budget impact model predicted an increase in payer expenditure of EUR1.76 million if all new patients received a Kenevo/MPK, and 50% of current NMPK users switched to the MPK. CONCLUSIONS: Results of the modeling suggest that the Kenevo/MPK is likely to be cost-effective for elderly individuals, primarily because of a reduction in falls.

Place, publisher, year, edition, pages
Wolters Kluwer, 2022
Keywords
Aged, Amputees, Cost-Benefit Analysis, Humans, Microcomputers, Prosthesis Design, Sweden, amputee, cost benefit analysis, human, microcomputer
National Category
Orthopaedics
Identifiers
urn:nbn:se:hj:diva-58694 (URN)10.1097/PXR.0000000000000138 (DOI)000920440300003 ()35511441 (PubMedID)2-s2.0-85139572780 (Scopus ID)HOA;intsam;839074 (Local ID)HOA;intsam;839074 (Archive number)HOA;intsam;839074 (OAI)
Available from: 2022-10-25 Created: 2022-10-25 Last updated: 2023-02-24Bibliographically approved
Dillon, M. P., Fatone, S., Hafner, B. J. & Ramstrand, N. (2021). 2020 in Review: A Perspective From the Immediate Past Editors-in-Chief. Prosthetics and Orthotics International, 45(1), 1-5
Open this publication in new window or tab >>2020 in Review: A Perspective From the Immediate Past Editors-in-Chief
2021 (English)In: Prosthetics and Orthotics International, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 45, no 1, p. 1-5Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
Wolters Kluwer, 2021
National Category
Orthopaedics
Identifiers
urn:nbn:se:hj:diva-52319 (URN)10.1097/01.PXR.0000732800.39054.b1 (DOI)000656628800001 ()33834738 (PubMedID)2-s2.0-85104167874 (Scopus ID)
Available from: 2021-04-26 Created: 2021-04-26 Last updated: 2022-01-23Bibliographically approved
Sterner, A., Ramstrand, N., Palmér, L. & Hagiwara, M. A. (2021). A study of factors that predict novice nurses’ perceived ability to provide care in acute situations. Nursing Open, 8(4), 1958-1969
Open this publication in new window or tab >>A study of factors that predict novice nurses’ perceived ability to provide care in acute situations
2021 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 8, no 4, p. 1958-1969Article in journal (Refereed) Published
Abstract [en]

Aims: To explore factors that predict novice nurses’ trust in their ability to provide care in acute situations and identify factors that are related to their perceived ability to make clinical judgements in acute situations.

Design: Exploratory cross-sectional study.

Methods: Novice nurses employed within somatic care in Swedish hospitals completed an online survey. Univariate analysis facilitated exploration of the data and identification of predictor variables with the greatest association with: (1) trust in their own ability (one item) and (2) ability to make clinical judgements (four items). Multivariate binary logistic regression modelling was used to model the likelihood of outcomes based on each predictor variable.

Results: The two most important predictors related to trust in ability to provide care were duration of work experience and participation in acute situations during nursing education. For clinical judgement, duration of work experience was significant in all four models and experience of acute situations post-graduation was significant in two models.

Place, publisher, year, edition, pages
John Wiley & Sons, 2021
Keywords
acute care, clinical judgement, experience, graduate nurse, novice nurse
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-52245 (URN)10.1002/nop2.871 (DOI)000635983400001 ()33798279 (PubMedID)2-s2.0-85103962817 (Scopus ID)GOA;;735554 (Local ID)GOA;;735554 (Archive number)GOA;;735554 (OAI)
Available from: 2021-04-19 Created: 2021-04-19 Last updated: 2021-12-06Bibliographically approved
Nylander, E., Ramstrand, N., Hjort, M. & Rusaw, D. (2021). Development and validation of a sensitive MEDLINE search strategy to identify literature relevant to limb prostheses. Prosthetics and Orthotics International, 45(3), 289-294
Open this publication in new window or tab >>Development and validation of a sensitive MEDLINE search strategy to identify literature relevant to limb prostheses
2021 (English)In: Prosthetics and Orthotics International, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 45, no 3, p. 289-294Article in journal (Refereed) Published
Abstract [en]

Background: Researchers and clinicians may find it challenging to identify relevant articles about limb prostheses in online databases. Searches may be improved by using standardized strategies, also known as filters or hedges.

Objectives: To develop and validate a highly sensitive MEDLINE (EBSCOHost) search strategy for limb prostheses.

Study Design: Search strategy development/validation.

Methods: A gold standard (GS) list of peer-reviewed articles on the topic of limb prostheses was created using a relative recall method. This involved identifying and including relevant systematic reviews/meta-analyses and then adding articles that were included in the analysis section of these reviews. Possible terms for the search strategy were identified through brainstorming and exploration of medical subject headings in MEDLINE (MeSH) and standards from the International Organization for Standardization (ISO). Concepts were grouped using relevant Boolean operators (e.g. AND and OR) and database record search fields (i.e. MeSH terms, title, and abstract). Part of the GS was used to refine the search strategy and reduce the number of records retrieved in total. The remaining GS set was used to validate and calculate sensitivity of the search strategy. Performance of the search strategy was compared against searches using only relevant MeSH terms.

Results: After screening, the final GS totaled 853 records. The developed search strategy was highly sensitive (99.80%) and performed with higher relative recall than searches with relevant MeSH terms.

Conclusions: This study provides a highly sensitive search strategy that can be used by clinicians and researchers when searching for relevant literature on limb prostheses in MEDLINE (EBSCOHost).

Place, publisher, year, edition, pages
Wolters Kluwer, 2021
Keywords
artificial limbs, prostheses and implants, information seeking behavior, systematic reviews as topic, information storage and retrieval, bibliographic databases, search filters
National Category
Information Studies Orthopaedics
Identifiers
urn:nbn:se:hj:diva-52146 (URN)10.1097/PXR.0000000000000019 (DOI)000756180700014 ()34016871 (PubMedID)2-s2.0-85107711637 (Scopus ID)HOA;;52146 (Local ID)HOA;;52146 (Archive number)HOA;;52146 (OAI)
Available from: 2021-04-06 Created: 2021-04-06 Last updated: 2022-03-04Bibliographically approved
Ramstrand, N., Johansson, A., Weissova, L. & Nylander, E. (2021). Evaluation of intercultural competence (ICC) in students studying at higher education institutions – a systematic review [protocol]. Center for Open Science
Open this publication in new window or tab >>Evaluation of intercultural competence (ICC) in students studying at higher education institutions – a systematic review [protocol]
2021 (English)Other (Other academic)
Place, publisher, year, pages
Center for Open Science, 2021. p. 7
Keywords
intercultural competence, evaluation, higher education
National Category
Other Social Sciences
Identifiers
urn:nbn:se:hj:diva-55013 (URN)
Funder
The Swedish Foundation for International Cooperation in Research and Higher Education (STINT), SG2020-8596
Available from: 2021-11-03 Created: 2021-11-03 Last updated: 2022-09-23Bibliographically approved
Jensen, A.-M. -., Andersen, J. Q., Quisth, L. & Ramstrand, N. (2021). Finger orthoses for management of joint hypermobility disorders: Relative effects on hand function and cognitive load. Prosthetics and Orthotics International, 45(1), 36-45
Open this publication in new window or tab >>Finger orthoses for management of joint hypermobility disorders: Relative effects on hand function and cognitive load
2021 (English)In: Prosthetics and Orthotics International, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 45, no 1, p. 36-45Article in journal (Refereed) Published
Abstract [en]

Background: Joint hypermobility refers to joints that move beyond their normal limits. Individuals with hypermobility of the fingers experience difficulties in activities of daily living. Finger orthoses are available for managing hypermobility of the fingers, but their effectiveness has received little attention in scholarly literature. Objectives: To determine if use of custom fit finger orthoses leads to improvements in time needed to perform standardised hand function tests, and attentional demand required to perform these tests, in individuals with joint hypermobility syndrome, Hypermobile Ehlers-Danlos syndrome or Classical Ehlers-Danlos syndrome. Study design: Repeated-measures study. Methods: Fourteen participants performed three different hand function tests (target box and block test, writing and picking up coins), with and without their finger orthoses. Time to complete each test was recorded as a measure of functional performance. Brain activity was recorded in the pre-frontal cortices as a measure of attentional demand. Results: Functional performance significantly improved for all but one test (picking up coins with non-dominant hand) when participants wore finger orthoses (p < 0.05). Activity in the pre-frontal cortex was lower when using the orthosis to perform the coin test (dominant hand; p < 0.05). No differences were observed in other tests (p > 0.05). Conclusions: Results suggested that finger orthoses improved hand function and provided limited evidence to suggest that they may also affect attentional demand. While the limited sample does not provide conclusive evidence supporting the use of finger orthosis in this clinical population, results warrant further investigation in large scale longitudinal studies or randomised controlled trials.

Place, publisher, year, edition, pages
Sage Publications, 2021
Keywords
Ehlers-Danlos syndrome, fNIRS, hand function, hand orthosis, silver splint
National Category
Health Sciences
Identifiers
urn:nbn:se:hj:diva-50823 (URN)10.1177/0309364620956866 (DOI)000575439000001 ()32996434 (PubMedID)2-s2.0-85091826897 (Scopus ID)HOA;intsam;1475188 (Local ID)HOA;intsam;1475188 (Archive number)HOA;intsam;1475188 (OAI)
Available from: 2020-10-12 Created: 2020-10-12 Last updated: 2021-06-14Bibliographically approved
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