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  • 1.
    Algurén, Beatrix
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Bostan, C
    Christensson, Lennart
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Fridlund, Bengt
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. ADULT.
    Cieza, A
    A Multidisciplinary Cross-Cultural Measurement of Functioning After Stroke: Rasch Analysis of the Brief ICF Core Set for Stroke2011In: Topics in Stroke Rehabilitation, ISSN 1074-9357, E-ISSN 1945-5119, Vol. 18, no 6, p. 573-586Article in journal (Refereed)
    Abstract [en]

    Purpose: To investigate the possibility of constructing a multiprofessional cross-cultural measure of functioning after stroke across categories of the International Classification of Functioning, Disability and Health (ICF). Method: Data on 757 stroke survivors from China, Germany, Italy, and Sweden, including ratings of 15 categories from the Brief ICF Core Set for stroke, were analyzed using the Rasch model. Unidimensionality, reliability, fit of the ICF categories to the model, ordering of response options of the ICF qualifier, and presence of differential item functioning (DIF) were studied. Results: Of the 15 ICF categories, response options for 7 categories were collapsed, 5 categories were deleted due to misfit, and 4 ICF categories showed DIF for country and were accordingly split into country-specific categories. The proposed final clinical measure consists of 20 ICF categories (6 categories were country-common) with an overall fit statistic of χ2180 = 184.87, P = .386, and a person separation index of r = 0.72, which indicates good reliability. Based on an individual's functioning after stroke, the ratings across the different ICF categories can be summed on an interval scale ranging from 0 to 100. Conclusion: A construction of a cross-cultural clinical measure after stroke based on ICF categories across body functions, structures, and activities and participation was possible. With this kind of clinical measure, stroke survivors' functional levels can be compared even across countries. Despite the promising results, further studies are necessary to develop definitive measures based on ICF categories.

  • 2.
    Blane, Alison
    et al.
    School of Occupational Therapy and Social Work, Curtin University, Perth, Australia.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD. School of Occupational Therapy and Social Work, Curtin University, Perth, Australia.
    Lee, Hoe C.
    School of Occupational Therapy and Social Work, Curtin University, Perth, Australia.
    Willstrand, Tania D.
    Human Factors, Swedish National Road and Transport Research Institute (VTI), Göteborg, Sweden.
    Investigating cognitive ability and self-reported driving performance of post-stroke adults in a driving simulator2018In: Topics in Stroke Rehabilitation, ISSN 1074-9357, E-ISSN 1945-5119, Vol. 25, no 1, p. 44-53Article in journal (Refereed)
    Abstract [en]

    Background

    Safe driving is a complex activity that requires calibration. This means the driver can accurately assess the level of task demand required for task completion and can accurately evaluate their driving capability. There is much debate on the calibration ability of post-stroke drivers.

    Objectives

    The aim of this study was to assess the cognition, self-rated performance, and estimation of task demand in a driving simulator with post-stroke drivers and controls.

    Methods

    A between-groups study design was employed, which included a post-stroke driver group and a group of similarly aged older control drivers. Both groups were observed driving in two simulator-based driving scenarios and asked to complete the NASA Task Load Index (TLX) to assess their perceived task demand and self-rate their driving performance. Participants also completed a battery of psychometric tasks to assess attention and executive function, which was used to determine whether post-stroke cognitive impairment impacted on calibration.

    Results

    There was no difference in the amount of perceived task demand required to complete the driving task. Despite impairments in cognition, the post-stroke drivers were not more likely to over-estimate their driving abilities than controls. On average, the post-stroke drivers self-rated themselves more poorly than the controls and this rating was related to cognitive ability.

    Conclusion

    This study suggests that post-stroke drivers may be aware of their deficits and adjust their driving behavior. Furthermore, using self-performance measures alongside a driving simulator and cognitive assessments may provide complementary fitness-to-drive assessments, as well as rehabilitation tools during post-stroke recovery.

  • 3.
    Ma, Christina Zong-Hao
    et al.
    Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong.
    Zheng, Yong-Ping
    Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong.
    Lee, Winson C.-C.
    Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong.
    Changes in gait and plantar foot loading upon using vibrotactile wearable biofeedback system in patients with stroke2018In: Topics in Stroke Rehabilitation, ISSN 1074-9357, E-ISSN 1945-5119, Vol. 25, no 1, p. 20-27Article in journal (Refereed)
    Abstract [en]

    Background: Patients with stroke walk with excessive foot inversion at the affected side, which may disturb their balance and gait.

    Objectives: This study aimed to investigate the effects of instant biofeedback of plantar force at the medial and lateral forefoot regions on gait and plantar foot loading in patients with stroke.

    Methods: A total of eight patients with hemiplegic stroke, who had flexible rearfoot varus deformity at the affected side, participated in this study. A vibrotactile biofeedback system was developed and evaluated. It analyzed forces at the medial and lateral forefeet, and instantly provided vibration clues when the plantar force at medial forefoot was less than a threshold. Each subject’s three-dimensional gait parameters and plantar-pressure distribution during walking were measured under two experimental conditions (sequence randomized): with and without the device turned on (Trial-registration number: ChiCTR-IPB-15006530 and HKCTR-1853).

    Results: Providing biofeedback significantly reduced the foot inversion and increased the mid-stance foot–floor contact area and medial midfoot plantar pressure of the affected limb, bringing the values of these parameters closer to those of the unaffected side. The biofeedback also significantly reduced the unaffected side’s excessive knee flexion and hip abduction.

    Conclusions: There were signs of improved foot loading characteristics and gait upon provision of instant vibrotactile biofeedback of plantar force. The positive results of this study further support the development of wearable biofeedback devices for improving gait of patients with stroke. 

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