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  • 1.
    Areskoug Josefsson, Kristina
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Thidell, Fredrik
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Rolander, Bo
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Social Work. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue).
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Prosthetic and orthotic students’ attitudes toward addressing sexual health in their future profession2018In: Prosthetics and Orthotics International, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 42, no 6, p. 612-619Article in journal (Refereed)
    Abstract [en]

    Background:

    Prosthetists and orthotists have a responsibility to direct treatment toward enabling their clients to perform desired activities and to facilitate participation of their clients in all areas of life. This may include provision of assistive technologies to help clients meet goals related to participation in sexual activities. To help prosthetic and orthotic students develop competencies in dealing with the sexual health of their future clients, it is necessary to generate knowledge of their own perceived competence and capacity.

    Objectives:

    To explore prosthetic and orthotic students’ attitudes and competence toward working with sexual health and to evaluate reliability and validity of the Students’ Attitudes Towards Addressing Sexual Health questionnaire.

    Study design:

    Cross-sectional study.

    Methods:

    Students enrolled in all three years of an undergraduate prosthetic and orthotic program were requested to complete the Students’ Attitudes Towards Addressing Sexual Health questionnaire (n = 65). Reliability and validity were evaluated using the content validity index and Cronbach’s alpha.

    Results:

    Students felt unprepared to talk about sexual health with future clients and thought that they would be embarrassed if they raised the issue. No differences were identified between students enrolled in each of the three years of the program and few differences were observed between male and female students. The content validity index values were low but improved as the students’ level of education increased. Internal consistency of the questionnaire was acceptable (α = 0.86).

    Conclusion:

    Prosthetic and orthotic students are unprepared to address sexual health issues with their future clients. There is a need to provide students with training related to sexual health issues.

    Clinical relevance:

    This study indicates the need for additional education of prosthetic and orthotic students in issues related to sexual health and how to address sexual health issues with clients. Results can be used to develop training programs for students and will serve to improve the sexual health of individuals who receive prosthetic and orthotic services.

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  • 2.
    Blomstrand, Peter
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Department of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform. Linkoping Univ, Dept Hlth Med & Caring Sci, Linkoping, Sweden..
    Tesan, Dario
    Futurum Acad Hlth & Care, Reg Jonkoping Cty, Jonkoping, Sweden..
    Nylander, Elisabeth
    Jönköping University, The University Library.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Department of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Mind body exercise improves cognitive function more than aerobic- and resistance exercise in healthy adults aged 55 years and older: an umbrella review2023In: European Review of Aging and Physical Activity, ISSN 1813-7253, E-ISSN 1861-6909, Vol. 20, no 1, article id 15Article, review/survey (Refereed)
    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.

  • 3.
    Dillon, M. P.
    et al.
    Department Physiotherapy, Podiatry, Prosthetics and Orthotics. La Trobe University, Melbourne, Australia.
    Fatone, S.
    Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
    Hafner, B. J.
    Department of Rehabilitation Medicine University of Washington, Seattle, WA, USA.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    2020 in Review: A Perspective From the Immediate Past Editors-in-Chief2021In: Prosthetics and Orthotics International, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 45, no 1, p. 1-5Article in journal (Other academic)
  • 4. Dillon, M. P.
    et al.
    Fatone, S.
    Hafner, B. J.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Keeping pace with the ever-growing orthotic and prosthetic profession: New faces and changes at Prosthetics and Orthotics International2019In: Prosthetics and Orthotics International, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 43, no 2, p. i-iiiArticle in journal (Other academic)
  • 5.
    Dillon, Michael P.
    et al.
    Department of Physiotherapy, Podiatry, and Prosthetics and Orthotics, La Trobe University, Melbourne, Australia.
    Fatone, Stefania
    Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, USA.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Hafner, Brian J.
    Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA.
    Prosthetics and Orthotics International welcomes qualitative research submissions2019In: Prosthetics and Orthotics International, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 43, no 4, p. 366-368Article in journal (Other academic)
  • 6.
    Dillon, Michael P.
    et al.
    Department of Physiotherapy, Podiatry, and Prosthetics and Orthotics, La Trobe University, Melbourne, Australia.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Fatone, Stefania
    Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, USA.
    Hafner, Brian J.
    Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA.
    2019 in review: A perspective from the Editors-in-Chief2020In: Prosthetics and Orthotics International, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 44, no 1, p. 6-9Article in journal (Other (popular science, discussion, etc.))
  • 7.
    Elgmark Andersson, Elisabeth
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Larsen, Louise B.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    A modified Job Demand, Control, Support model for active duty police2017In: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 58, no 3, p. 361-370Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The Job Demand Control Support model (JDCS) is one of the most widely used theoretical models relating job characteristics to health and wellbeing.

    OBJECTIVE: This study aimed to assess the predictive power of the JDCS model for determining job satisfaction and fatigue in uniformed Swedish police. An additional aim was to determine if predictive power of the model would be improved with the addition of two occupation specific items.

    METHODS: Questionnaire data, based upon the Swedish Work Environment Survey were collected from Swedish police (n = 4244). A hierarchical multiple regression analysis was run to explore the predictive value of the model and to determine if the additional variables improved predictive power with respect to job satisfaction and fatigue.

    RESULTS: Regression analysis demonstrated that the JDSC model had high predictive power in relation to job satisfaction and fatigue. Job demands was the strongest predictor of fatigue (14%), while support was the strongest predictor of job satisfaction (12%). The addition of exposure to threats significantly improved predictive power for both job satisfaction and fatigue, while addition of shift work did not significantly affect predictive power of the model.

    CONCLUSIONS: Workplace interventions to address issues related to job satisfaction and fatigue in police should focus on maintaining a bearable level of job demands and provision of adequate support.

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  • 8.
    Elgmark Andersson, Elisabeth
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Larsen, Louise B.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Tranberg, Roy
    Ortopeden, Sahlgrenska Universitetssjukhuset, Gothenburg University, Göteborg.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics. Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Fysiska aspekter2013Report (Other (popular science, discussion, etc.))
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  • 9.
    Elgmark Andersson, Elisabeth
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Larsen, Louise B.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Tranberg, Roy
    Ortopeden, Sahlgrenska Universitetssjukhuset, Gothenburg University, Göteborg.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics. Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Psykosociala aspekter2014Report (Other (popular science, discussion, etc.))
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  • 10.
    Fatone, S.
    et al.
    Northwestern University, Chicago, IL, United States.
    Dillon, M. P.
    La Trobe University, Melbourne, VIC, Australia.
    Hafner, B. J.
    University of Washington, Seattle, WA, United States.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    The challenges of double-blind peer review in an era of increasing research transparency2020In: Prosthetics and Orthotics International, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 44, no 4, p. 189-191Article in journal (Other academic)
    Abstract [en]

    Last year, we presented a vision to make Prosthetics and Orthotics International the journal of choice for all those who wish to access and contribute to the ever-increasing body of knowledge in our field.1 For Editors-in-Chief, this entails not only day-to-day management of manuscript submission, peer review, and publication processes, but also consideration of evolving principles and practices regarding the reporting of research. In this editorial, we discuss the challenges we experience in maintaining a double-blind peer review process while also encouraging research transparency.

  • 11.
    Fatone, Stefania
    et al.
    Northwestern Univ, Chicago, IL 60611 USA..
    Hafner, Brian J.
    Univ Washington, Seattle, WA 98195 USA..
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD. Jonkoping Univ, Jonkoping, Sweden..
    Dillon, Michael P.
    La Trobe Univ, Melbourne, Vic, Australia..
    2020 SAGE Elite Reviewer Award2020In: Prosthetics and Orthotics International, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 44, no 3, p. 114-115Article in journal (Other academic)
  • 12.
    Fatone, Stefania
    et al.
    Northwestern University, Chicago, USA.
    Paul, Charlton
    Barnett, Cleveland
    Nottingham Trent University, UK.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Balancing Act: Exploring Clinical, Theoretical, and Evidence-Based Perspectives in the Optimization of Balance using orthoses in Peripheral Neuropathy2018In: Journal of prosthetics and orthotics, ISSN 1040-8800, E-ISSN 1534-6331, Vol. 30, no 2S, article id 0S9Article in journal (Refereed)
  • 13.
    Glemne, Maria
    et al.
    Ortopedteknik, Southern Älvsborg Hospital, Borås, Sweden.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Crafoord, Jessica
    Ortopedteknik, Southern Älvsborg Hospital, Borås, Sweden.
    Nygren, Linus
    Ortopedteknik, Southern Älvsborg Hospital, Borås, Sweden.
    Preoperative characteristics and functional outcomes of lower limb amputees treated at Southern Älvsborg Hospital, Sweden2013In: Prosthetics and Orthotics International, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 37, no 4, p. 298-304Article in journal (Refereed)
    Abstract [en]

    Background:Within the prosthetics profession, there is a lack of evidence to support many clinical practices. It is therefore important that clinicians systematically document and evaluate their daily practices.Objectives:To record preoperative characteristics and functional outcomes for patients with a lower limb amputation and to investigate variations between prosthetic users and non-prosthetic users.Study Design:Prospective cohort study.Methods:A total of 23 patients (mean age = 80 years, standard deviation = 7.3) who underwent a major lower limb amputation were assessed within 2 weeks of admission and 6 months post-operatively. Locomotor Capabilities Index-5, the Timed-Up-and-Go Test and prosthetic use were used to evaluate functional outcomes.Results:A total of 13 participants (57%) received a prosthesis within 6 months of amputation. Mean time to prosthetic fitting was 48 days (range = 28-97). No statistically significant difference was found between prosthetic users and non-prosthetic users regarding age, time to rehabilitation and Locomotor Capabilities Index-5 (p > 0.05). Locomotor Capabilities Index-5 basic was significantly lower at 6 months than prior to amputation (p = 0.039).Conclusion:The functional outcome at 6 months indicates a sizable restriction in mobility among lower limb amputees. No variation in preoperative characteristics between prosthetic users and non-prosthetic users could be confirmed in this study.Clinical relevanceThis study highlights the need for prosthetists to better incorporate research findings into their daily practice and presents an example of how to implement a procedure for assessment and documentation of patients' functional outcomes in a clinical setting. Results confirm difficulties in identifying amputees who will become prosthetic users based on preoperative characteristics.

  • 14.
    Jarl, Gustav
    et al.
    Örebro University, Sweden.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    A model to facilitate implementation of the International Classification of Functioning, Disability and Health into prosthetics and orthotics2018In: Prosthetics and Orthotics International, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 42, no 5, p. 468-475Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The International Classification of Functioning, Disability and Health is a classification of human functioning and disability and is based on a biopsychosocial model of health. As such, International Classification of Functioning, Disability and Health seems suitable as a basis for constructing models defining the clinical P&O process. The aim was to use International Classification of Functioning, Disability and Health to facilitate development of such a model. Proposed model: A model, the Prosthetic and Orthotic Process (POP) model, is proposed. The Prosthetic and Orthotic Process model is based on the concepts of the International Classification of Functioning, Disability and Health and comprises four steps in a cycle: (1) Assessment, including the medical history and physical examination of the patient. (2) Goals, specified on four levels including those related to participation, activity, body functions and structures and technical requirements of the device. (3) Intervention, in which the appropriate course of action is determined based on the specified goal and evidence-based practice. (4) Evaluation of outcomes, where the outcomes are assessed and compared to the corresponding goals. After the evaluation of goal fulfilment, the first cycle in the process is complete, and a broad evaluation is now made including overriding questions about the patient's satisfaction with the outcomes and the process. This evaluation will determine if the process should be ended or if another cycle in the process should be initiated.

    CONCLUSION: The Prosthetic and Orthotic Process model can provide a common understanding of the P&O process. Concepts of International Classification of Functioning, Disability and Health have been incorporated into the model to facilitate communication with other rehabilitation professionals and encourage a holistic and patient-centred approach in clinical practice. Clinical relevance The Prosthetic and Orthotic Process model can support the implementation of International Classification of Functioning, Disability and Health in P&O practice, thereby providing a common understanding of the P&O process and a common language to facilitate communication with other rehabilitation professionals.

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  • 15.
    Jensen, A. -M
    et al.
    Ortos A/S, Odense, Denmark.
    Andersen, J. Q.
    Ortos A/S, Kolding, Denmark.
    Quisth, L.
    Ortos A/S, Odense, Denmark.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Finger orthoses for management of joint hypermobility disorders: Relative effects on hand function and cognitive load2021In: Prosthetics and Orthotics International, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 45, no 1, p. 36-45Article in journal (Refereed)
    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.

  • 16. Johannesson, Anton
    et al.
    Larsson, Gert-Uno
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Lauge-Pedersen, Henrik
    Wagner, Philippe
    Atroshi, Isam
    Outcomes of a standardized surgical and rehabilitation program in transtibial amputation for peripheral vascular disease: a prospective cohort study2010In: American Journal of Physical Medicine & Rehabilitation, ISSN 0894-9115, E-ISSN 1537-7385, Vol. 89, no 4, p. 293-303Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To study the outcomes of a new surgical and rehabilitation program for initial unilateral transtibial amputation in patients with peripheral vascular disease. The program consists of sagittal incision, rigid dressing, compression therapy using silicone liner, and direct manufacturing prosthetic technique. DESIGN: A prospective cohort study with 1-yr follow-up. RESULTS: Of the 217 consecutive patients with peripheral vascular disease who underwent transtibial amputation (mean age, 77 yrs; 51% diabetic; 116 could walk before amputation), 119 (55%) were fitted with a prosthesis at a median time of 41 (range, 12-147) days after amputation. Of the prosthetic recipients, 76 (64%) obtained good function with the prosthesis within 6 mos. Within 1 yr, reamputation was performed on 8.2%, and contralateral amputation was performed on 5.5%. The 90-day mortality was 24% (53 patients). The total 1-yr mortality was 40% (86 patients): 17% among patients who received a prosthesis and 67% among those who did not receive a prosthesis or had undergone reamputation. CONCLUSIONS: Following this standardized surgical and rehabilitation program, prosthetic fitting was achieved in more than half of transtibial amputees, almost two-thirds of prosthetic recipients obtained good function, and the reamputation rate was low. Comparison with outcomes of alternative strategies is needed.

  • 17. Johannesson, Anton
    et al.
    Larsson, Gert-Uno
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Turkiewicz, Aleksandra
    Wiréhn, Ann-Britt
    Atroshi, Isam
    Incidence of Lower Limb Amputation in the Diabetic and Nondiabetic General Population: A 10-year population-based cohort study of initial unilateral and contralateral amputations and reamputations2009In: Diabetes Care, ISSN 0149-5992, E-ISSN 1935-5548, Vol. 32, no 2, p. 275-280Article in journal (Refereed)
    Abstract [en]

    Objective: To compare the incidence of vascular lower limb amputation (LLA) in the diabetic and nondiabetic general population. Research design & methods: A population-based cohort study was conducted in a representative Swedish region. All vascular LLA (at or proximal to transmetatarsal level) performed from 1997 through 2006 were consecutively registered and classified into initial unilateral amputation, contralateral amputation or re-amputation. The incidence rates were estimated in the diabetic and nondiabetic general population aged 45 years or older. Results: During the 10-year period, LLA was performed on 62 women and 71 men with diabetes and on 79 women and 78 men without diabetes. The incidence of initial unilateral amputation per 100,000 person-years (95% CI) was for diabetic women 192 (145-241) and for diabetic men 197 (152-244) and for nondiabetic women 22 (17-26) and for nondiabetic men 24 (19-29). The incidence increased from the age of 75 years. 74% of all amputations were transtibial. The incidence of contralateral amputation and of re-amputation per 100 amputee-years (95% CI) in diabetic women amputees was 15 (7-27) and 16 (8-28) and in diabetic men 18 (10-29) and 21 (12-32), respectively, and in nondiabetic women amputees were 14 (7-24) and 18 (10-28) and in men 13 (6-22) and 24 (15-35), respectively. Conclusions: In the general population aged 45 years or older the incidence of vascular lower limb amputation at or proximal to transmetatarsal level is 8 times higher in diabetic than in nondiabetic persons. One in four amputees may require contralateral amputation and/or re-amputation.

  • 18.
    Kuhlmann, A.
    et al.
    Martin Luther University Halle-Wittenberg, Germany.
    Hagberg, K.
    Sahlgrenska University Hospital, Sweden and Department of Orthopedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Kamrad, I.
    Departments of Orthopedics and Clinical Sciences, Lund University and Skåne University Hospital Malmö Sweden, Sweden.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Seidinger, S.
    Otto Bock Healthcare Products GmbH, Vienna, Austria.
    Berg, H.
    Karolinska University Hospital and Division of Orthopedics and Biotechnology, CLINTEC, Karolinska Institutet, Stockholm, Sweden.
    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 analysis2022In: Prosthetics and Orthotics International, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 46, no 5, p. 414-424Article in journal (Refereed)
    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.

  • 19.
    Larsen, Louise B.
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Elgmark Andersson, Elisabeth
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Tranberg, Roy
    Ortopeden, Sahlgrenska Universitetssjukhuset, Gothenburg University, Göteborg.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Jämförande studie av Svensk polis rörelseförmåga vid användandet av bål och/eller bäcken fixerad utrustning2014Report (Other (popular science, discussion, etc.))
    Abstract [sv]

    Under det senaste decenniet har det blivit allt vanligare med arbetsrelaterade besvär hos uniformerad polis i yttre tjänst, främst är det besvär från nedre delen av ryggen som uppgetts. Hälsohögskolan i Jönköping har fått i uppdrag av Rikspolisstyrelsen att belysa och utreda den uppkomna problematiken. Två tidigare rapporter, Polisens fysiska arbetsmiljö och Polisens psykosociala miljö, har presenterats. I rapporten om polisens fysiska arbetsmiljö framkom en hög förekomst av besvär från muskler och leder, främst nedre delen av ryggen under förhållande med bärande av utrustningsbältet i kombination med mycket stillasittande i tjänstebilar. I den andra rapporten framkom att en stor del av poliserna arbetar treskift och i många fall långa arbetspass, vilket yttrar sig i att de har svårt att psykiskt återhämta sig, inte har tid för familj och vänner samt att de ofta upplever sig trötta. I den tredje och sammanfattande rapporten presenteras vilka bakomliggande variabler som påverkar den fysiska och psykosociala arbetsmiljön.

    Syftet med studien var att analysera vilka variabler och vilka kombinationer av variabler som påverkar den fysiska och psykosociala arbetsmiljön för uniformerad polis i yttre tjänst i Sverige. Rapporten baseras på 4244 enkätsvar från poliser i yttre uniformerad tjänst.

    Resultatet från föreliggande studie har visat att det finns skillnaden i besvärsfrekvens mellan myndigheterna när det gäller otillräcklig fysisk och psykisk återhämtning samt besvär ifrån nedre delen av ryggen. Orsakerna till skillnaden mellan myndigheterna är inte utredda. Studien har visat att besvärsfrekvensen ökar då det föreligger krav att arbeta på ett rullande treskiftsschema. Utifrån detta föreslår vi att man:

    • utför benchmarking av polismyndigheter för att öka förståelsen för de stora skillnader som förekommer

    • utvärderar olika modeller av schemaläggning avseende treskift

    • fortsätter arbetet med att utreda hur polisens uniform och kroppsburna utrustning, i kombination med bilsätets utformning, påverkar besvär från nedre delen av ryggen.

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  • 20.
    Larsen, Louise B.
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Elgmark Andersson, Elisabeth
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Tranberg, Roy
    Department of Orthopaedics, Institute of Clinical Sciences, University of Gothenburg, PO Sahlgrenska University Hospital, Gothenburg, Sweden.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Multi-site musculoskeletal pain in Swedish police: associations with discomfort from wearing mandatory equipment and prolonged sitting2018In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 91, no 4, p. 425--433Article in journal (Refereed)
    Abstract [en]

    Purpose: Musculoskeletal disorders are considered as a major issue affecting the health and well-being of active duty police. Discomfort from wearing mandatory equipment and sitting for long periods of time in fleet vehicles are workload factors linked to musculoskeletal disorders in police. This study aims to determine the prevalence of multi-site musculoskeletal pain among Swedish police and to explore the possible association to discomfort experience when wearing mandatory equipment and sitting for long periods in fleet vehicles.

    Methods: In this cross-sectional study responses from 4185 police were collected through a self-administered online survey including questions about physical work environment, mandatory equipment and musculoskeletal pain. Multi-site pain was determined through summing pain sites from four body regions. Binomial logistic regression was performed to explore the association between multi-site musculoskeletal pain: (1) discomfort from wearing mandatory equipment and (2) sitting for long periods in fleet vehicles.

    Results: The prevalence of multi-site musculoskeletal pain at least 1 day per week within the previous 3 months was 41.3%. A statistically significant association between discomfort from wearing mandatory equipment and multi-site musculoskeletal pain was found; duty belt [OR 5.42 (95% CI 4.56–6.43)] as well as body armour [OR 2.69 (95% CI 2.11–3.42)]. Sitting for long periods in fleet vehicles was not significantly associated to multi-site musculoskeletal pain.

    Conclusion: Multi-site musculoskeletal pain is a considerable problem among Swedish police and modifying mandatory equipment to decrease discomfort is suggested as a potential means of decreasing the musculoskeletal pain experienced by many police officers. 

  • 21.
    Larsen, Louise B.
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Fransson, Eleonor I.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Psychosocial job demand and control: multi-site musculoskeletal pain in Swedish police2019In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 47, no 3, p. 318-325Article in journal (Refereed)
    Abstract [en]

    Aims

    Police have a high prevalence of musculoskeletal disorders. While physical factors contributing to this have been explored, little is known regarding the contribution of the psychosocial work environment. This study explores the association between elements of the JDC model, social support and multi-site musculoskeletal pain among Swedish police.

    Methods

    In this cross-sectional study, response from 4185 police were collected using a self-administered online survey. The survey included questions on psychosocial work environment and musculoskeletal pain, as well as several potential confounding factors. Binominal regression analyses were performed to explore the degree of association between 1) the indices for job demands, job control, social support and multi-site musculoskeletal pain and 2) the four categories of the JDC model, social support and multi-site musculoskeletal pain.

    Results

    The overall psychosocial work environment of Swedish police was characterised by low control and high social support. Police who reported active and high strain jobs were found to have an increase in the odds ratio for multi-site musculoskeletal pain (OR 1.45 (95% CI 1.08-1.94), and 1.84 (1.51-2.24) respectively). High demands, which is a component in the categories for active and high strain jobs, was also found to be associated with an increase in the odds ratio for multi-site musculoskeletal pain (OR 1.66 (1.45-1.91)). High social support was associated with a decrease in the odds ratio formulti-site musculoskeletal pain (OR 0.72 (0.57-0.86)).

    Conclusions

    Psychosocial work environment should be considered when investigating factors related to the health and wellbeing of police.

  • 22.
    Larsen, Louise B.
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Tranberg, Roy
    Department of Orthopaedics, Institute of Clinical Sciences, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Duty belt or load-bearing vest? Discomfort and pressure distribution for police driving standard fleet vehicles2019In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 80, p. 146-151Article in journal (Refereed)
    Abstract [en]

    Police working in active duty have a high prevalence of musculoskeletal pain, with lower back pain being the most frequently reported. As a part of uniform regulations, Swedish police are mandated to wear body armour and duty belts at all times during work. This study aimed to investigate the effect of different load carriage designs on in-vehicle sitting pressure and self-rated discomfort among police. Results showed less discomfort when wearing the alternate load carriage system incorporating a load-bearing vest and thigh holster compared to the standard load carriage system consisting of a duty belt. Pressures in the lower back were reduced when wearing the load-bearing vest whereas pressures in the upper back region increased. Relocating appointments away from the waist has the potential to improve sitting positions and the ergonomic situation for police when driving fleet vehicles.

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  • 23.
    Larsen, Louise B.
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Tranberg, Roy
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Department of Orthopaedics, Institute of Clinical Sciences, University of Gothenburg, PO Sahlgrenska University Hospital, Gothenburg, Sweden.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Effects of thigh holster use on kinematics and kinetics of active duty police officers2016In: Clinical Biomechanics, ISSN 0268-0033, E-ISSN 1879-1271, Vol. 37, p. 77-82Article in journal (Refereed)
    Abstract [en]

    Background: Body armour, duty belts and belt mounted holsters are standard equipment used by the Swedish police and have been shown to affect performance of police specific tasks, to decrease mobility and to potentially influence back pain. This study aimed to investigate the effects on gait kinematics and kinetics associated with use of an alternate load carriage system incorporating a thigh holster.

    Methods: Kinematic, kinetic and temporospatial data were collected using three dimensional gait analysis. Walking tests were conducted with nineteen active duty police officers under three different load carriage conditions: a) body armour and duty belt, b) load bearing vest, body armour and thigh holster and c) no equipment (control).

    Findings: No significant differences between testing conditions were found for temporospatial parameters. Range of trunk rotation was reduced for both load carriage conditions compared to the control condition (p < 0.017). Range of hip rotation was more similar to the control condition when wearing thigh holster rather than the belt mounted hip holster (p < 0.017). Moments and powers for both left and right ankles were significantly greater for both of the load carriage conditions compared to the control condition (p < 0.017).

    Interpretation: This study confirms that occupational loads carried by police have a significant effect on gait kinematics and kinetics. Although small differences were observed between the two load carriage conditions investigated in this study, results do not overwhelmingly support selection of one design over the other.

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  • 24.
    Maddock, Alan
    et al.
    School of Social Policy, Social Work and Social Justice, University College Dublin, Dublin, Ireland.
    Best, Paul
    School of Social Sciences, Education and Social Work, Queen's University Belfast, Belfast, Northern Ireland.
    Ean, Nil
    School of Psychology, The Royal University of Phnom Penh, Phnom Penh, Cambodia.
    Armour, Cherie
    School of Psychology, Queen's University Belfast, Belfast, Northern Ireland.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Rates and correlates of psychological distress and PTSD among persons with physical disabilities in Cambodia2023In: International Journal for Equity in Health, E-ISSN 1475-9276, Vol. 22, no 1, article id 30Article in journal (Refereed)
    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.

  • 25.
    Magnusson, Lina
    et al.
    Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics. Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Ahlström, Gerd
    Lunds universitet.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics. Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Fransson, Eleonor
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Malawian prosthetic and orthotic users' mobility and satisfaction with their lower limb assistive device2013In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 45, no 4, p. 385-391Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate patients’ mobility and satisfaction with their lower limb prosthetic or orthotic device and related service delivery in Malawi and to compare groups of patients regarding type and level of device and demographics.

    METHODS: Questionnaires were used to collect self-report data from 83 patients.

    RESULTS: Ninety percent of prostheses or orthoses were in use by patients, but approximately half of these needed repair. Thirty-nine percent reported pain when using their assistive device. The majority of patients were able to rise from a chair (77%), move around the home (80%), walk on uneven ground (59%) and travel by bus or car (56%). However, patients had difficulties walking up and down hills (78%) and stairs (60%). In general, patients were quite satisfied with their assistive device (mean of 3.9 out of 5) and very satisfied with the service provided (mean of 4.4 out of 5). Access to repairs and servicing were rated as most important, followed by durability and follow-up services. Lack of finances to pay for transport was a barrier to accessing the prosthetic and orthotic centre.

    CONCLUSION: Patients were satisfied with the assistive device and service received, despite reporting pain associated with use of the device and difficulties ambulating on challenging surfaces.

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  • 26.
    Magnusson, Lina
    et al.
    Jönköping University, School of Health Science, HHJ. Prosthetics and Orthotics. Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health Science, HHJ. Prosthetics and Orthotics. Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation.
    Prosthetist/Orthotist Educational Experience & Professional Development in Pakistan2009In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 4, no 6, p. 385-392Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To explore areas in which the education at the Pakistan Institute of Prosthetic & Orthotic Science (PIPOS) could be improved or supplemented to facilitate clinical practice of graduates. To describe educational opportunities PIPOS graduates have had since their graduation and explore their further educational needs.

    METHOD: 15 graduates from PIPOS participated in semi-structured interviews. A qualitative content analysis was applied to the transcripts.

    FINDINGS: Respondents indicated a need to upgrade the education at PIPOS. This should include upgrading of resources such as literature and internet access as well as providing staff with the opportunity to further their own education. Females experienced inequality throughout their education but were supported by management. Upon entering the workforce graduates reported that they were supported by senior staff but experienced difficulties in determining appropriate prescriptions. They further indicated that a multidisciplinary approach to patient care is lacking. Graduates knowledge of workshop management was identified as a problem when entering the workforce. Limited awareness of the prosthetics and orthotics profession by both the general community and the medical community was also identified as a problem. If offered the opportunity to continue their studies the respondents would like to specialize. "Brain drain" was noted as a risk associated with post graduate education. Interaction from international collaborators and networking within the country was desired.

    CONCLUSION: The education at PIPOS meets a need in the country. Graduates indicated that P&O services for Pakistan can be better provided by modifying program content, upgrading teachers' knowledge, improving access to information and addressing issues of gender equality. PIPOS graduates have had limited opportunities for professional development and have a desire for further education.

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  • 27.
    Magnusson, Lina
    et al.
    Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics. Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Fransson, Eleonor
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Ahlström, Gerd
    Lund University.
    Mobility and satisfaction with lower-limb prostheses and orthoses among users in Sierra Leone: A cross-sectional study2014In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 46, no 5, p. 438-446Article in journal (Refereed)
    Abstract [en]

    Objectives: To investigate patients' mobility and satisfaction with their lower-limb prosthetic or orthotic device and related service delivery in Sierra Leone; to compare groups of patients regarding type and level of assistive device, gender, area of residence, income; and to identify factors associated with satisfaction with the assistive device and service. Methods: A total of 139 patients answered questionnaires, including the Quebec User Evaluation of Satisfaction with Assistive Technology questionnaire (QUEST 2.0). Results: Eighty-six percent of assistive devices were in use, but half needed repair. Thirty-three percent of patients reported pain when using their assistive device. Patients had difficulties or could not walk at all on: uneven ground (65%); hills (75%); and stairs (66%). Patients were quite satisfied with their assistive device and the service (mean 3.7 out of 5 in QUEST), but reported 886 problems. Approximately half of the patients could not access services. In relation to mobility and service delivery, women, orthotic patients and patients using above-knee assistive devices had the poorest results. The general condition of the assistive device and patients' ability to walk on uneven ground were associated with satisfaction with the assistive devices and service. Conclusion: Patients reported high levels of mobility while using their device although they experienced pain and difficulties walking on challenging surfaces. Limitations in the effectiveness of assistive devices and limited access to follow-up services and repairs were issues desired to be addressed.

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  • 28.
    Mlakar, Maja
    et al.
    University Rehabilitation Institute, Ljubljana, Slovenia.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Burger, Helena
    University Rehabilitation Institute, Ljubljana, Slovenia.
    Vidmar, Gaj
    University Rehabilitation Institute, Ljubljana, Slovenia.
    Effect of custom-made and prefabricated orthoses on grip strength in persons with carpal tunnel syndrome2014In: Prosthetics and Orthotics International, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 38, no 3, p. 193-198Article in journal (Refereed)
    Abstract [en]

    Background: Based on the literature, patients with carpal tunnel syndrome are suggested to wear a custom-made wrist orthosis immobilizing the wrist in a neutral position. Many prefabricated orthoses are available on the market, but the majority of those do not assure neutral wrist position. Objectives: We hypothesized that the use of orthosis affects grip strength in persons with carpal tunnel syndrome in a way that supports preference for custom-made orthoses with neutral wrist position over prefabricated orthoses. Study design: Experimental. Methods: Comparisons of grip strength for three types of grips (cylindrical, lateral, and pinch) were made across orthosis types (custom-made, prefabricated with wrist in 20 degrees of flexion, and none) on the affected side immediately after fitting, as well as between affected side without orthosis and nonaffected side. Results: Orthosis type did not significantly affect grip strength (p = 0.661). Cylindrical grip was by far the strongest, followed by lateral and pinch grips (p < 0.050). The grips of the affected side were weaker than those of the nonaffected side (p = 0.002). Conclusions: In persons with carpal tunnel syndrome, neither prefabricated orthoses with 20 degrees wrist extension nor custom-made wrist orthoses with neutral wrist position influenced grip strength of the affected hand. Compared to the nonaffected side, the grips of the affected side were weaker. Clinical relevance The findings from this study can be used to guide application of orthoses to patients with carpal tunnel syndrome.

  • 29.
    Möller, Saffran
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ADULT. 0000-0002-5360-7776.
    Hagberg, Kerstin
    Department of Prosthetics and Orthotics, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Samuelsson, Kersti
    Department of Rehabilitation Medicine and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Perceived self-efficacy and specific self-reported outcomes in persons with lower-limb amputation using a non-microprocessor-controlled versus a microprocessor-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 amputation and investigate the relationship between self-efficacy and prosthetic-specific outcomes including prosthetic use, mobility, amputation-related problems and global health. A second purpose was to examine if differences 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 for Persons with a Transfemoral Amputation (Q-TFA). Forty-two individuals participated in the study. Twenty-three used 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 to the Q-TFA prosthetic use, mobility and problem scores. High GSE scores were related to higher levels of prosthetic use, mobility, global scores and negatively related to problem score. No significant difference was 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-efficacy was related to higher level of mobility, global scores and fewer problems related to the amputation in individuals who have undergone a lower-limb amputation and were using a non-MPK or MPK knee. Implications for rehabilitationPerceived self-efficacy has has been shown to be related to quality of life, prosthetic mobility and capability as well as social activities in daily life. Prosthetic rehabilitation is primary focusing on physical improvement rather than psychological interventions. More attention should be directed towards the relationship between self-efficacy and prosthetic related outcomes during prosthetic rehabilitation after a lower-limb amputation. 

  • 30.
    Möller, Saffran
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Department of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Department of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Hagberg, Kerstin
    Advanced Reconstruction of Extremities, Sahlgrenska University Hospital.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Department of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Can Microprocessor-Controlled Prosthetic Knees Reduce Attentional Demand during Single and Dual-task Walking?2019Conference paper (Refereed)
    Abstract [en]

    BACKGROUND

    Walking with a lower-limb prosthesis while performing a secondary task (dual-tasking) has been suggested to increase demand on attentional resources, negatively affecting balance and gait performance.[1, 2] Brain imaging research has suggested that microprocessor-controlled prosthetic knees (MPKs) reduce attentional demands during single-task walking.[3] To date the effects of MPK on brain activity during dual-task walking has not been investigated.

    AIM

    To evaluate effects of single- and dual-task walking on cortical brain activity in individuals using a non-MPK or MPK and controls and compare differences between the 3 groups.

    METHOD

    A cross-sectional study was performed involving twenty-nine individuals with a transfemoral amputation or knee disarticulation who were provided with either a non-MPK or an MPK, and 16 controls. Functional near-infrared spectroscopy was used to evaluate cortical brain activity (oxygenated haemoglobin (oxyHb) concentration level changes) while participants walked on a stable level surface and simultanously performed 2 dual-task activities; 1) walking while sorting through keys; and, 2) walking in sequence around randomly number cones. Temporospatial variables was recorded for each activity.

    RESULTS

    Increased brain activity (oxyHb concentration level changes) were observed when a secondary task was added in the MPK-group (p=.000) and in the control group (p=.007). No significant differences were observed between single- and dual-task walking in the non-MPK group (p>.05). Significantly increased brain activity (oxyHb concentrations level changes) was observed during single-task walking in the non-MPK group when compared to the MPK-group and controls. Significantly different results in temporospatial parameters were also observed.

    DISCUSSION AND CONCLUSION

    Results suggest that dual-task walking increases cognitive demand in individuals fitted with MPKs and controls. The lack of difference with the non-MPK group may suggests that their maximum capacity was already reached during single-task walking.

    REFERENCES

    [1] Morgan, Prosthet Orthot Int 2016. [2] Nagamatsu, Psychol Aging 2011. [3] Möller, Prosthet Orthot Int 2018.

    ACKNOWLEDGEMENTS

    Thanks to Jette Schack, Evin Güler, Vera Kooiman, Lamija Pasalic, Promobilia Foundation, ALF/LUA Research Grants, Össur and Team Olmed.

  • 31.
    Möller, Saffran
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Hagberg, Kerstin
    Department of Prosthetics and Orthotics, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Cortical brain activity in transfemoral or knee-disarticulation prosthesis users performing single and dual-task walking activities2020In: Journal of Rehabilitation and Assistive Technologies Engineering, E-ISSN 2055-6683, Vol. 7, article id 2055668320964109Article in journal (Refereed)
    Abstract [en]

    Introduction: Walking with a prosthesis while performing secondary tasks increases demand on cognitive resources, compromising balance and gait. This study investigated effects of a secondary task on patterns of brain activity and temporospatial gait parameters in individuals using a prosthesis with or without a microprocessor-controlled prosthetic knee(MPK) and controls.Methods: A cross-sectional study with repeated measures was performed. Twenty-nine individuals with amputations and 16 controls were recruited. Functional near-infrared spectroscopy was used to evaluate changes in oxygenated and de-oxygenated haemoglobin in the prefrontal cortex and temporospatial variables during single-and dual-task walking.Results: Differences in brain activity were observed within the MPK-group and controls without changes in temporospatial parameters. The Trail-Walking test was associated with highest levels of brain activity in both groups. No differences were observed between single- and dual-task walking in the non-MPK-group (p > 0.05). The Non-MPK and the MPK-group recorded higher levels of brain activity than controls during single-task walking and poorer results on temporospatial variables compared to controls.Conclusions: For the MPK-group and controls, introduction of a secondary task led to an increase in brain activity. This was not seen in the Non-MPK-group. Significant differences in brain activity were observed in the absence of changes in temporospatial parameters.

  • 32.
    Möller, Saffran
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Hagberg, Kerstin
    Department of Prosthetics and Orthotics, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Differences in mobility for individuals using a non-microprocessor-controlled versus a microprocessor-controlled prosthetic kneeManuscript (preprint) (Other academic)
  • 33.
    Möller, Saffran
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Hagberg, Kerstin
    Advanced Reconstruction of Extremities, Sahlgrenska University Hospital, Sweden.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Reduced cortical brain activity with the use of microprocessor-controlled prosthetic knees during walking2019In: Prosthetics and Orthotics International, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 43, no 3, p. 257-265Article in journal (Refereed)
    Abstract [en]

    Background: Individuals using a lower-limb prosthesis indicate that they need to concentrate on every step they take. Despite self-reports of increased cognitive demand, there is limited understanding of the link between cognitive processes and walking when using a lower-limb prosthesis.

    Objective: The objective was to assess cortical brain activity during level walking in individuals using different prosthetic knee components and compare them to healthy controls. It was hypothesized that the least activity would be observed in the healthy control group, followed by individuals using a microprocessor-controlled prosthetic knee and finally individuals using a non-microprocessor-controlled prosthetic knee.

    Study Design: Cross-sectional study.

    Methods:: An optical brain imaging system was used to measure relative changes in concentration of oxygenated and de-oxygenated haemoglobin in the frontal and motor cortices during level walking. The number of steps and time to walk 10 m was also recorded. The 6-min walk test was assessed as a measure of functional capacity.

    Results: Individuals with a transfemoral or knee-disarticulation amputation, using non-microprocessor-controlled prosthetic knee ( n = 14) or microprocessor-controlled prosthetic knee ( n = 15) joints and healthy controls ( n = 16) participated in the study. A significant increase was observed in cortical brain activity of individuals walking with a non-microprocessor-controlled prosthetic knee when compared to healthy controls ( p < 0.05) and individuals walking with an microprocessor-controlled prosthetic knee joint ( p < 0.05).

    Conclusion: Individuals walking with a non-microprocessor-controlled prosthetic knee demonstrated an increase in cortical brain activity compared to healthy individuals. Use of a microprocessor-controlled prosthetic knee was associated with less cortical brain activity than use of a non-microprocessor-controlled prosthetic knee.

    Clinical Relevance: Increased understanding of cognitive processes underlying walking when using different types of prosthetic knees can help to optimize selection of prosthetic components and provide an opportunity to enhance functioning with a prosthesis.

  • 34.
    Nylander, Elisabeth
    et al.
    Jönköping University, The University Library.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Hjort, Margareta
    Jönköping University, The University Library.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Development and validation of a sensitive MEDLINE search strategy to identify literature relevant to limb prostheses2021In: Prosthetics and Orthotics International, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 45, no 3, p. 289-294Article in journal (Refereed)
    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).

  • 35.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    A comparison of foot placement strategies of transtibial amputees and able-bodies subjects during stair ambulation2009In: Prosthetics and Orthotics International, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 33, no 4, p. 348-355Article in journal (Refereed)
    Abstract [en]

    Ambulation on stairs presents a significant challenge for lower extremity amputees and increases the risk of falling and sustaining a serious injury. This study aimed to compare foot placement and foot clearance during stair ambulation in a group of transtibial amputees and a group of able-bodied subjects Three-dimensional motion analysis was used to determine foot positioning and to calculate temporospatial parameters during stair ascent and descent of 10 transtibial amputees (mean age = 56) and a control group consisting of 10 healthy able-bodied individuals (mean age = 26 7) No significant difference was observed in foot positioning and foot clearance between the amputee and control groups Temporospatial data revealed a number of significant differences between the groups, particularly during stair ascent Amputees were observed to walk with a slower velocity and cadence (p < 0 01), to increase the time spent in stance phase and double support (p < 0 01) and to increase their step width during both stair ascent and descent (p < 0.01) Results suggest that foot placement and clearance are not factors that would contribute to a stumble or fall on stairs in established amputees but that balance related issues, such as relative motion of the centre of mass, require further investigation.

  • 36.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Clinical outcome measures to evaluate the effects of lower-limb orthotic management post-stroke2018Conference paper (Other academic)
  • 37.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Considerations for developing an evidenced-based practice in orthotics and prosthetics2018In: International Central European ISPO conference 2018, September 20-22, 2018, Portorož, Slovenia: Book of abstracts, 2018, p. 54-54Conference paper (Refereed)
  • 38.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    The Prosthetic and Orthotic process model (POP)2018Conference paper (Refereed)
  • 39.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Translating research into prosthetic and orthotic practice2013In: Prosthetics and Orthotics International, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 37, no 2, p. 108-112Article in journal (Refereed)
    Abstract [en]

    Background: Evidence-based practice is commonly accepted as a means of improving patient outcomes; however, there is little understanding of the processes required to successfully implement it into prosthetic and orthotic practice.

    Objectives: To discuss factors affecting adoption of evidence-based practice and present a theoretical framework for its implementation into prosthetic and orthotic practice.

    Discussion: Numerous factors that affect adoption of evidence-based practice are discussed, ranging from individual factors to those that can be attributed to administrative and environmental issues. Specific factors are likely to be context specific and are influenced by the manner in which evidence-based practice is introduced into the working environment. It is argued that successful implementation of evidence-based practice requires consideration of numerous interrelated factors. A formal translating research into practice model is presented as a means of developing a strategic plan that considers all relevant factors and maximizes acceptance of evidence-based practice into prosthetics and orthotics clinical practice.

    Conclusions: The use of a theoretical model for implementation of evidence-based practice is likely to improve its adoption by prosthetic and orthotic clinicians.

  • 40.
    Ramstrand, Nerrolyn
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Andersson, Christina Björk
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Effects of an unstable shoe construction on standing balance in children with developmental disabilities: a pilot study2008In: Prosthetics and Orthotics International, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 32, no 4, p. 422-433Article in journal (Refereed)
    Abstract [en]

    This study aimed to investigate if prolonged use of shoes incorporating an unstable sole construction could facilitate improvements of balance in a sample of developmentally disabled children. Ten children (six male and four female) aged between 10 and 17 years participated in the study. Children were fitted with shoes incorporating an unstable sole (Masai Barefoot Technology) and instructed to wear them for a minimum of two hours per day for eight weeks. A within subjects repeated measures design was used. Children were tested prior to receiving the shoes, four weeks after receiving the shoes and eight weeks after receiving the shoes. A force plate capable of rotating about a single axis (NeuroCom International Inc, Oregon) was used to test static balance, reactive balance and directional control. Static balance was not found to be influenced by prolonged use of the footwear; however, significant improvements were noted in children's reactive balance both with the shoes and barefoot. Results suggest that reactive balance can be improved by prolonged and regular use of shoes incorporating an unstable sole construction.

  • 41.
    Ramstrand, Nerrolyn
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Brodtkorb, T.-H.
    Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Considerations for developing an evidenced-based practice in orthotics and prosthetics2008In: Prosthetics and Orthotics International, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 32, no 1, p. 93-102Article in journal (Refereed)
    Abstract [en]

    Evidence-based practice has become somewhat of a catchphrase over the past ten years. In this paper evidence-based practice is defined and its importance for the development of the prosthetics and orthotics profession is highlighted. The authors suggest that evidence-based practice needs to be prioritized within the profession and that a cultural change needs to be initiated which supports clinicians in incorporating research findings into their daily practice. In addition, the authors highlight the need for prosthetists/orthotists to become more active in generating research rather than relying on other professional groups to contribute to their professional body of knowledge.

  • 42.
    Ramstrand, Nerrolyn
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Dillon, Michael P.
    Department of Physiotherapy, Podiatry, and Prosthetics and Orthotics, La Trobe University, Melbourne, Victoria, Australia.
    Fatone, Stefania
    Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, Illinois, USA.
    Hafner, Brian J.
    Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA.
    Charting the future: Feedback from Prosthetics and Orthotics International readers and authors2019In: Prosthetics and Orthotics International, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 43, no 6, p. 573-575Article in journal (Other academic)
  • 43.
    Ramstrand, Nerrolyn
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Fatone, S.
    Dillon, M. P.
    Hafner, B. J.
    Peering into the peer review process and acknowledging those who do it well2019In: Prosthetics and Orthotics International, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 43, no 3, p. 247-249Article in journal (Other academic)
  • 44.
    Ramstrand, Nerrolyn
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Fatone, S.
    Northwestern University, Chicago, IL, United States.
    Dillon, M. P.
    La Trobe University, Melbourne, Australia.
    Hafner, B. J.
    University of Washington, Seattle, WA, United States.
    Sharing research data2020In: Prosthetics and Orthotics International, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 44, no 2, p. 49-51Article in journal (Other academic)
  • 45.
    Ramstrand, Nerrolyn
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Fatone, Stefania
    Northwestern University, Chicago, IL, USA.
    Dillon, Michael P.
    La Trobe University, Melbourne, VIC, Australia.
    Hafner, Brian J
    University of Washington, Seattle, WA, USA.
    Promoting quality and transparency in clinical research2019In: Prosthetics and Orthotics International, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 43, no 5, p. 474-477Article in journal (Refereed)
  • 46.
    Ramstrand, Nerrolyn
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Gjøvaag, T.
    Starholmen, I.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Effects of knee orthosis design on proprioception and balance2017Conference paper (Refereed)
  • 47.
    Ramstrand, Nerrolyn
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Gjøvaag, Terje
    Oslo Metropolitan University, Norway.
    Starholm, Inger Marie
    Oslo Metropolitan University, Norway.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Effects of knee orthoses on kinesthetic awareness and balance in healthy individuals2019In: Journal of Rehabilitation and Assistive Technologies Engineering, ISSN 2055-6683, Vol. 6Article in journal (Refereed)
    Abstract [en]

    Introduction: Conflicting evidence exists regarding the effects of knee orthoses on proprioception. One belief is that pressure applied by orthoses heightens kinesthetic awareness and that this affects balance. This study aimed to investigate effects of two different orthosis designs on kinesthetic awareness and balance in healthy individuals.

    Methods: Twenty individuals (13 women) participated in this case series study. Each were tested wearing 1/no orthosis, 2/soft elastic orthosis and 3/non-elastic jointed orthosis. Pressure under orthoses was recorded. Kinesthetic awareness was investigated by testing Joint Position Sense (JPS) and Threshold to Detection of Passive Motion (TDPM). Balance was tested using a Modified Sensory Organization Test (mSOT).

    Results: Non-elastic jointed orthoses applied the greatest pressure to the knee. With non-elastic jointed orthoses, TDPM was significantly poorer for pooled results (p= 0.02) and when the start position of the knee was 70 degrees (mean threshold = 0.6 º, 0.6 º, 0.7º for no-orthosis, elastic and jointed-orthoses; p= 0.03). No major differences were observed in JPS or balance and correlation between proprioception and balance was poor.

    Conclusions: There may be a limit to the amount of pressure that should be applied to the knee joint by an orthosis. Exceeding this limit may compromise kinesthetic awareness.

  • 48.
    Ramstrand, Nerrolyn
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Jacobs, Norman
    ISPO Consensus Conference on Appropriate Lower Limb Orthotics for Developing Countries: Conclusions and Recommendations2007In: Prosthetics and Orthotics International, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 31, no 2, p. 214-216Article in journal (Other academic)
  • 49.
    Ramstrand, Nerrolyn
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Johansson, Ann
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Weissova, Lucie
    Jönköping University, University Services, International Office.
    Nylander, Elisabeth
    Jönköping University, The University Library.
    Evaluation of intercultural competence (ICC) in students studying at higher education institutions – a systematic review [protocol]2021Other (Other academic)
  • 50.
    Ramstrand, Nerrolyn
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Larsen, Louise B.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Musculoskeletal injuries in the workplace: perceptions of Swedish police2012In: International Journal of Police Science and Management, ISSN 1461-3557, E-ISSN 1478-1603, Vol. 14, no 4, p. 334-342Article in journal (Refereed)
    Abstract [en]

    Swedish police officers experience an increased incidence of musculoskeletal injury, but little is known of the underlying cause. This paper explores police officers' own perceptions of the most common types of musculoskeletal injury sustained in the workplace and explores what police themselves feel are the major causes of such injuries. A nominal group process technique was used because of its benefits in generating and prioritising ideas. Six focus group sessions were conducted involving 33 police from three different regions in Sweden. Police perceived lower back pain as the most common musculoskeletal injury sustained in the workplace. Seven specific areas were perceived as contributing to an increased risk of musculoskeletal injury; duty belt, clothing, shoes, working hours, safety vests, physical condition and patrol vehicles.

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