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Background: Dance classes for people with Parkinson's Disease (PD) are offered worldwide; however, further studies are needed to explore patients' experiences of how dance affects well-being. Purpose: To explore how Dance for Parkinson (Dance for PD) is experienced, and how it contributes to the well-being and health of participants in Sweden. Methods: This qualitative study collected data from four focus groups. Participants were asked how dance classes impacted their well-being, and their ability to perform activities of daily life. The focus groups were recorded and transcribed. Data were analysed using content analysis, meaning units were coded, and codes were coalesced into categories from which themes were abstracted. Results: Dance for PD provided a multifaceted experience related to social relationships, aesthetic context, feelings of wellbeing and the physical experience of dancing. The main theme contained four sub-themes: Connectedness, Pleasure and glamour, Well-being in mind and body and Customized movements. Conclusion: The present study highlights that health and well-being are improved by Dance for PD. It is an enjoyable activity that meets the specific needs of persons living with the consequences of PD and should therefore be promoted by occupational therapists. [ABSTRACT FROM AUTHOR]

Purpose: The aim was to longitudinally explore changes in fatigue- and cognition-related symptoms during the first year after hospital treatment for COVID-19. Method: Patients hospitalized for COVID-19 in Gothenburg, Sweden, were consecutively included from 01-07-2020 to 28-02-2021. Patients were assessed at the hospital (acute) and at 3 and 12 months after hospital discharge. Cognition was assessed with the Montreal Cognitive Assessment (MoCA), the Trail Making Test B (TMTB), and the Cognitive Failure Questionnaire (CFQ). Fatigue was assessed using the Multidimensional Fatigue Inventory-20 (MFI-20) and the Mental Fatigue Scale (MFS). Data was analyzed with demographics and changes over time calculated with univariable mixed-effects models. Result: In total, 122 participants were included. Analyzes of Z-scores for MoCA indicated improvement over the year, however the results were 1 SD below norm at all assessments. Alertness (TMTB scores) improved significantly from the acute assessment to the 12- month follow-up (p = <0.001, 95% CI 34.67–69.67). CFQ scores indicated cognitive impairment, and the sum scores for MFI reflected a relatively high degree of fatigue at follow-up. Conclusion: In the first year after hospitalization for COVID-19, most patients experienced fatigue and cognitive impairment. Alertness improved, but improvements in other domains were limited. [ABSTRACT FROM AUTHOR]

Introduction: Stroke not only affects the stroke survivor, it also significantly affects their families. Given the important supportive role that relatives of stroke survivor have, they should receive information that helps them plan and cope with the new situation. The objective of the study was to explore how relatives to stroke survivors perceived the information provided by the stroke unit. Methods: This qualitative study was based on extensive semi-structured interviews with an inductive approach. A heterogeneous convenience sample of relatives to stroke survivor (n=14) was selected. Qualitative content analysis served to analyze the transcribed interview texts. Results: The content analysis yielded four categories, each with 2–3 subcategories. The overall theme was "to be acknowledged or not": it encompassed the underlying meaning and the relationships between the categories. The four categories were as follows: shifting information needs; striving for information; lacking of continuity and structure; and taking part and being acknowledged. Conclusions: The study highlighted that the relatives of stroke survivors have a strong need for information and showed that the relatives experienced that they did not always feel satisfactorily informed and supported by the healthcare professionals in the stroke unit. A challenge for the healthcare professionals was to be able to give the right information at the right time and in the appropriate way. The study also showed that when the relatives were acknowledged and invited to participate in the rehabilitation process, they were less anxious of the discharge. [ABSTRACT FROM AUTHOR]

Purpose:The study explored the direction of change (decline vs. improvement) after diffuse axonal injury (DAI) in the domains of the ICF: body structure, body function, and activity.Methods: Thirteen patients with DAI were assessed by using diffusion tensor imaging (DTI) to measure body structure, the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS) to measure body function, and the Assessment of Motor and Process Skills (AMPS) to measure activity. The DTI, BNIS, and AMPS were applied at the acute phase (A1), and at 6 and 12 months post-injury (A2 and A3). Visual and statistical analyses were conducted to explore time-dependent changes in the ICF domains.Results:Improvements were observed for most patients in all ICF domains from injury until six months. Thereafter, the results diverged, with half of the subjects showing a decline in DTI and BNIS scores between A2–A3, and all but one of the patients exhibiting identical or better A2–A3 AMPS process skill scores.Conclusions:From 6 to 12 months post-injury, some patients underwent an ongoing degenerative process, causing a decline in cognitive function. The same decline was not observed in the activity measure, which might be explained by the use of compensatory strategies.Implications for rehabilitationIn rehabilitation it is essential to be aware that in some cases with TBI, an ongoing degenerative process in the white matter can be expected, causing an adverse late effect on cognitive function.The cognitive decline, caused by DAI, does not necessarily mean a concurrent decrease in activity performance, possibly explained by the use of compensatory strategies. This suggests that, after the post-acute phase, rehabilitation offering strategy training may be beneficial to enhance every-day functioning.Strategy use requires awareness, which imply the need to assess level of awareness in order to guide rehabilitation. [ABSTRACT FROM AUTHOR]

BACKGROUND: Positive psychological capital is reported to have positive effects on people's well-being and attitudes to their working lives. OBJECTIVE: The objective of this study was to investigate if it is possible to increase the level of positive psychological capital by two group intervention programs. METHODS: The research design was a controlled study with 2x2 experimental groups and two control groups. Two of the experimental groups received intervention I (IG I), the other two experimental groups received intervention II (IG II). Assessments were made before and after the intervention programs, with a follow-up at six months post-intervention. Instruments measuring the fundamentals of psychological capital: self-efficacy, hope, optimism, as well as health and job satisfaction were used. RESULTS: The results show that it is possible to increase the level of positive emotions, self-efficacy and job satisfaction of members of a working team by using group intervention methods. The positive changes observed at the end of the program remained six months after the intervention, with the exception of job satisfaction in IG II. It seems that the intervention had a greater influence on those persons who at the start of the study reported a low level of self-enhancement. The results were more pronounced in intervention group I where reinforcement of the resources and positive aspects of the work place environment were provided. CONCLUSIONS: A 10-week group intervention program that focused on learned optimism proved to be successful in increasing levels of self-efficacy and job satisfaction. While improvement was maintained six months post-intervention the small sample size and the attrition rate are limitations. Results are promising and further research is warranted. [ABSTRACT FROM AUTHOR]

Background: Working memory (WM) problems influence most activities of daily living. The aim was to evaluate if computerized working memory training after brain injury has a significant effect on functioning in daily life. Method: Outpatients with WM deficits, aged 22-63 years, were randomized to either intervention group (IG, n = 20) or control group (CG, n = 18) and received 5 weeks standard rehabilitation. The IG also received WM training with the Cogmed QM training program. Assessments were made before (A1), immediately (A2) and 3 months (A3) after intervention. After follow-up, the CG was offered the computerized training and assessed after this (A4; n = 8). Assessments included the WAIS-III Digit span reversed, Fatigue Impact Scale (FIS), Assessment of Motor and Process Skills (AMPS), Rivermead Behavioural Memory Test-II (RBMT-II) and a WM questionnaire. Results: The IG improved on digit span and FIS, A1-A2, and significantly more than the CG on the WM questionnaire, A1-A3. Both groups improved in AMPS motor skill and the AMPS process skill score tended towards significant improvement in the IG, from A1-A3. After training (A3-A4), the CG improved in digit span and RBMT-II. Conclusion: The WM training seems to have a generalized effect on functional activity and lessens fatigue. [ABSTRACT FROM AUTHOR]

Objective: To study if computerized working memory (WM) training, in the sub-acute phase after acquired brain injury, in patients with impaired WM, improves WM, cognition and psychological health. Research design: A randomized study ( n = 47) with an intervention group (IG) and a control group (CG), mean age 47.7 years. The WAIS-III NI, Digit span, Arithmetic, Letter-Number Sequences (Working Memory sub-scale), Spatial span, the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS) and the self-rating scales DEX and HADS were administered at baseline and at follow-ups at 6 and 18 weeks. Both groups underwent integrated rehabilitation. The IG also trained with the computerized WM training program, Cogmed QM, which was offered to the CG and followed up after the study completion. Results: Both groups improved after their WM training in Working Memory, BNIS and in Digit span, particularly the reversed section. Both the BNIS and the Digit span differed significantly between the IG and CG due to the greater improvement in the IG after their WM training. Psychological health improved as both groups reported less depressive symptoms and the CG also less anxiety, after the training. Conclusion: Results indicated that computerized WM training can improve working memory, cognition and psychological health. [ABSTRACT FROM AUTHOR]

Background: Stroke is the disease with the highest costs for hospital care and also after discharge. Early supported discharge (ESD) has shown to be efficient and safe and the best results with well-organised discharge teams and patients with less severe strokes. The aim is to investigate if very early supported discharge (VESD) for stroke patients in need for on-going individualised rehabilitation at home is useful for the patient and cost effective. Methods/design: A randomized controlled trial comparing VESD with ordinary discharge. Inclusion criteria: confirmed stroke, >18 years of age, living within 30 min from the stroke unit, on day 2 0-16 points on the National institute of health stroke scale (NIHSS) and 50-100 points on the Barthel Index (BI), with BI 100 then the patient can be included if the Montreal Cognitive Assessment is < 26. Exclusion criteria are: NIHSS >16, BI < 50, life expectancy < 1 year, inability to speak or to communicate in Swedish. The inclusion occurs on day 4 and in block randomization of 20 and with blinded assessor. Primary outcome: levels of anxiety and depression. Secondary outcomes: independence, security, level of function, quality of health, needs of support in activities of daily living and caregiver burden. Power calculation is based on the level of anxiety and with a power of 80%, p-value 0.05 (2 sided test) 44 persons per group are needed. Data is gathered on co-morbidity, re-entry to hospital, mortality and a health economic analysis. Interviews will be accomplished with a strategic sample of 15 patients in the intervention group before discharge, within two weeks after homecoming and 3 months later. Interviews are also planned with 15 relatives in the intervention group 3 months after discharge. Discussion: The ESD studies in the Cochrane review present hospital stays of a length that no longer exist in Sweden. There is not yet, to our knowledge, any study of early supported discharge with present length of hospital stay. Thus it is not clear if home rehabilitation nowadays without risks, is cost effective, or with the same patient usefulness as earlier studies. [ABSTRACT FROM AUTHOR]

The present study was designed to elucidate relational and behavioural effects of soft skin massage in children with severe developmental disability as observed by those administering the massage. Sixteen children aged 7-20 years with congenital brain injury or early acquired brain injury received soft skin massage during a 10-week period. After the intervention period structured interviews were conducted with the soft skin massage providers concerning how they experienced the outcomes of the intervention. The interviews were analysed with qualitative content analysis. Categories found in the interviews concerned closeness, social interaction, bodily responses, feelings and importance of preparation. Soft skin massage was found to contribute to more closeness and social interaction between children with severe developmental disabilities and their caregivers, as well as increased communication skills in the children. The children became more aware of their bodies and increased their bodily activities and a sense of well-being was created. [ABSTRACT FROM AUTHOR]

Introduction: Several factors influence the return to work (RTW) after brain injury (BI). The aims of the study were to follow-up the RTW after a vocational neuropsychological programme for individuals with a brain injury and to explore factors predicting RTW. The hypothesis was that as self-awareness was already addressed in the programme, severity of injury would have a greater impact on RTW. Method: Sixty-five of 72 persons (median age 27) who had attended the programme 1998–2003 were interviewed about their occupation at 1, 2, 3 and 5 years after the programme. A logistic regression was made with the variables concerning process skill, somatic problems and irritability, the digit symbol coding and pre-morbid occupation to explore predictors of RTW. Results: The main cause was TBI (44.6%). Before injury 77% were employed or studied and after the injury 80% did not have any occupation. After 5 years 40% had returned to work. The only significant variable in the regression was the pre-morbid occupation. Discussion: The study stresses the difficulty to know the key elements involved in RTW which confirms the need for rehabilitation to focus on several factors in different contexts in order to affect the outcome. [ABSTRACT FROM AUTHOR]

Objective: To assess the effect of three weeks of rehabilitation in the home setting for younger patients with stroke with the aim of improving activity level. Design: A randomized controlled study with blinded evaluations at discharge, three weeks, three months and one year after discharge. Setting: Home of the patient or the ordinary day rehabilitation clinic at the university hospital. Subjects: Fifty-eight patients (median age 53 years) consecutively discharged from inpatient rehabilitation with a first occurrence of stroke participated in training directly after discharge. Intervention: Rehabilitation was given for 9 hours/week over three weeks. The home group received individually tailored training, based on the patient's needs and desires, with a focus on activities in their natural context. Support and information were also given. The intervention in the day clinic group was aimed mainly at improved functions. Main measures: The main outcome was activity, assessed with the Assessment of Motor and Process Skill (AMPS). The impairment level was also evaluated. Costs were estimated. Result: There were no significant differences between the groups on any of the four assessments. However, there seemed to be an earlier improvement on some measures (including AMPS) for the home group. For both groups there was a greater improvement on the activity level than on the impairment level. The costs of the home group were less than half of the costs of the day clinic group. Conclusion: With the present results, both rehabilitation programmes could be recommended, however, further studies are needed to define patients who may specifically benefit from the home rehabilitation programme. Costs should be taken into consideration. [ABSTRACT FROM AUTHOR]

Virtual reality (VR) technology is altering the health care environment and is changing the options that are available to therapists. This study describes how a haptic device was used as a cinematic assessment utility. Three chronic stroke inpatients at Sahlgrenska University Hospital with left hemisphere damage were assessed. The patients were administered by the box and block manual dexterity test. For comparisons, a reference group was added to the study. Several parameters, including time, speed, and movement of the right upper extremity, were extracted and evaluated. The results indicate that the system shows potential as an assessment device. The feasibility study setup is working well, as is the assessment method. Further research, testing, refinement of the exercises, and use of VR and haptics within neurological rehabilitation are suggested. [ABSTRACT FROM AUTHOR]