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  • 1.
    Jesinkey, Kristina
    et al.
    Karolinska Institutet, Forskningslaboratoriet för motorisk kontroll och sjukgymnastik, Institutionen Neurotec.
    Näslund, Annika
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Hirschfeld, Helga
    Karolinska Institutet, Forskningslaboratoriet för motorisk kontroll och sjukgymnastik, Institutionen Neurotec.
    Initiation of reaching when standing with and without DAFOs in children with spastic diplegia2005In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 7, no 4, p. 144-153Article in journal (Refereed)
    Abstract [en]

    We investigated whether the use of dynamic ankle foot orthoses (DAFOs) can improve the coordination between standing posture and a reaching movement. We investigated the temporal sequence between onset of center of pressure (CoP) displacement and onset of hand displacement by means of two AMTI force plates and a two-camera optoelectronic system (ELITE). The task was to reach for a cup. Reflective markers were placed on hand, trunk and the cup. Four children with spastic diplegia and eight control children (aged 5-12) participated. They were tested wearing DAFOs (diplegia) and the results were compared with wearing shoes (diplegia and control). The children with spastic diplegia were able to make use of anticipatory changes in CoP displacement. The results indicated that more trials in children with spastic diplegia had CoP onset preceding hand onset while wearing DAFOs (18/20) than when wearing only shoes. More trials (27/40) during the 20% reaching condition in the control group had CoP onset preceding hand onset than during the 10% reaching condition (18/40). In spite of different amounts of assistance, anticipatory postural adjustments were found in the diplegia group. Use of anticipatory postural adjustments was not consistent in the control group. Practice of reaching during standing can be carried out with DAFOs and/or hand support, and can promote motor learning of anticipatory postural adjustments.

  • 2.
    Larsson, Agneta
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Näslund, Annika
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Karlqvist, Lena
    Projekt: Hälsa och säkerhet i vård- och socialt servicearbete, i ett samhällsperspektiv2013Other (Other (popular science, discussion, etc.))
    Abstract [sv]

    Syftet med projektet är att utveckla metoder där förebyggande insatser med satsning på ett förbättrat säkerhetsklimat och en ökad fysisk kompetens blandpersonal inom vård- och social service integreras i verksamhetsutvecklingen.

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  • 3.
    Larsson, Agneta
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Näslund, Annika
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Projekt: Tjänsteinnovationer i tiden2013Other (Other (popular science, discussion, etc.))
  • 4.
    Matsui, Kantaro
    et al.
    International Budo University, Japan.
    Larsson, Agneta
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Yamahira, Yoshimi
    International Budo University, Japan.
    Näslund, Annika
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    An invitation to study Budo for the disabled: -Is Budo good for the disabled? -Is Budo for the disabled good for Budo?2015In: 1st World Congress on Health and Martial Arts in Interdisciplinary Approach: HMA 2015, 17–19 September 2015, Czestochowa, Poland / [ed] R.M. Kalina; B.J. Barczynski, Warsaw: Archives of Budo , 2015Conference paper (Refereed)
  • 5.
    Matsui, Kantaro
    et al.
    International Budo University, Japan.
    Larsson, Agneta
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Yamahira, Yoshimi
    International Budo University, Japan.
    Näslund, Annika
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Budo practice for post-stroke patients: reflections on historical and scientific issues2015Conference paper (Refereed)
    Abstract [en]

    Background and Study Aim. While many persons who participate in Budo-based rehabilitation profess improvements in functional ability, and selfefficacy in daily life, it has been extremely difficult to collect quantitative scientific data on the effectiveness of Budo-based rehabilitation. This difficulty is due in part to the wide variety of disabilities. The aim of this present study, therefore, is the scientific data on the effects of Budo rehabilitation targeting post-stroke patients.Material and Methods. The six post-stroke patients were subjected to a period of 4-months Budo practice. Participant data was measured according to Single Subject Experimental Design guidelines. The following tests were used to gather data: 5 repetitions of the sit-to-stand test, 6 meter timed walk test, and Test of Dynamic standing balance. Data was also collected through interviews and self-report regarding: fear of fallingand general health.Results. Data showed that post-stroke patients experienced improved muscle strength, balance, postural control, walking ability and performance of daily activities as a result of the Budo-based rehabilitation in this experiment. Patient self-reporting revealed a reduced fear of falling and indications of a healthier self-image as a result of Budo practice. Patient interviews suggest that the sociality and culture of Budo had a powerfully positive psychological effect aiding the rehabilitative process.Conclusion. Data clearly showed that Budo-based rehabilitation effectively delivered general quantitative improvements as reported by poststroke patients. Not only could the patients perform daily-life tasks better, they exhibited less fear, more self-efficacy, and a healthier self-image.

  • 6.
    Matsui, Kantaro
    et al.
    International Budo University, Japan.
    Näslund, Annika
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Larsson, Agneta
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Budo practice as a means for post-stroke rehabilitation: case studies2013Conference paper (Refereed)
    Abstract [en]

    The presentation gives a brief exposé of the practice conducted within the area of budo for the disabled in Japan and Sweden, and brief results from the first trial in this area performed at Luleå university of technology - physical training based om principles from Japanese martial arts as means for post-stroke rehabilitation. For information about this research, contact Annika Näslund at Luleå university of technology.

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  • 7.
    Melander-Wikman, Anita
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Nyberg, Lars
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Näslund, Annika
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Wiklund-Axelsson, Sari-Anne
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Wikberg-Nilsson, Åsa
    Luleå University of Technology, Department of Business Administration, Technology and Social Sciences, Innovation and Design.
    Lindahl Norberg, Annika
    Uppsala universitet, Sverige.
    Projekt: Äldre personers förväntningar på användandet av informations- och kommunikationsteknologi som stöd2013Other (Other (popular science, discussion, etc.))
    Abstract [sv]

    Informations- och kommunikationsteknologi används idag inom hälso- och sjukvård för bland annat livsstilsrelaterade sjukdomar som tillexempel vid övervikt och fetma, IKT är en del av den verksamhet som hälso- och sjukvården satsar på i framtiden. Användning av IKT i hälsorelaterade sammanhang för större befolkningsgrupper förutsätter en viss grad av beredskap hos befolkningen som sannolikt inte bara är relaterad till kännedom om möjligheterna och vana vid teknologin, utan en förväntan om att det kan vara av värde för personen själv. Kunskaperna är magra om befolkningens beredskap för och inställning till IKT som ett verktyg för kontakten mellan vårdtagare och vårdgivare, och de undersökningar som finns över detta visar på en bild av återhållna förväntningar. I projektet studeras vilken betydelse informations- och kommunikationsteknik har för äldre personers livskvalitet och vilka förväntningar som finns framtida IKT lösningar som stöd för viktnedgång. Datainsamlingar genomförs via enkäter som skickas ut till slumpmässigt valda personer i Sverige och genom intervjuer gemomförda individuellt och i grupp.

  • 8.
    Melander-Wikman, Anita
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Näslund, Annika
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    The patients experience of participation in the process of rehabilitation1999In: Proceedings from the 13th International Congress of The World Confederation for Physical Therapy (WCPT) May 23-28, 1999, Yokohama, Japan, WCPT , 1999, p. 30-Conference paper (Other academic)
  • 9.
    Nordström, Birgitta
    et al.
    Luleå University of Technology, Department of Health Sciences.
    Nyberg, Lars
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Ekenberg, Lilly
    County Council of Norrbotten, Department of Research and Development.
    Näslund, Annika
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    The psychosocial impact on standing devices2014In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 9, no 4, p. 299-306Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of this study was to explore the psychosocial impact of standing devices as experienced by users. Method: This is the second part of a comprehensive survey in five counties in Sweden where all the subjects with standing devices were invited to participate. The impact of standing devices on functional independence, quality of life and wellbeing was assessed using a questionnaire, Psychosocial Impact of Assistive Devices Scale (PIADS). Results: The psychosocial impact of the standing devices was perceived as positive. The highest PIADS scores in relation to age were found in the oldest group, aged 65 years and older. The ability to walk and independence in ambulation resulted in higher scores than the use of a wheelchair and/or dependence on others. Those who stood often awarded higher scores in the PIADS questionnaire compared to those who used the device less frequently. When standing was integrated in various activities, its psychosocial impact received high scores. Conclusion: The psychosocial impact of standing devices was generally experienced positively. The main results indicated that standing in a standing device had a value and we as professionals should ask the users about the intended purpose of their standing in order to prescribe the optimal device.Implications for Rehabilitation •Standing in standing devices has positive psychosocial impact for the user.•As professionals we should broaden our view of the use of standing devices, i.e. to see the standing device as an aid that not only treats the body’s structures or improves the user’s abilities in activities, but also provides a psychosocial impact on the user’s daily life, and to find meaningful goals for the user from a psychosocial perspective

  • 10.
    Nordström, Birgitta
    et al.
    Luleå University of Technology, Department of Health Sciences.
    Näslund, Annika
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Ekenberg, Lilly
    County Council of Norrbotten, Department of Research and Development.
    On an equal footing: adults’ accounts of the experience of using assistive devices for standing2013In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 8, no 1, p. 49-57Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of the study was to illuminate the meaning that standing holds for persons who require standing devices. Method: The phenomenological/hermeneutical analysis of the interviews was carried out using a life world-approach. Fifteen users of standing devices lacking the ability to stand independently participated in the interviews.Result: Each person’s lived experiences of standing in their devices indicated that the upright body position opens up an opportunity for connection to the outside world. An upright body position (i) alters the person’s sense of self, (ii) augments the person’s availability to the outside world, (iii) strengthens social interplay, and (iv) changes a person’s motivation and their expectations over time. Conclusion: Standing may be something that unites the body and self. Understanding the meaning of the altered body position that the use of standing devices opens up is vital for physiotherapists and occupational therapists prescribing these devices. Furthermore, it is important to take account of the subjective body, as well as the biological one, to enhance the adoption of different body positions and the person’s experiences.

  • 11.
    Nordström, Birgitta
    et al.
    Luleå University of Technology, Department of Health Sciences.
    Näslund, Annika
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Ekenberg, Lilly
    County Council of Norrbotten, Department of Research and Development.
    Zingmark, Karin
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    The ambiguity of standing in standing devices: a qualitative interview study concerning children and parents experiences of the use of standing devices2014In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 30, no 7, p. 483-489Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to describe children’s and parents’ experiences of the significance of standing in a standing device. Methods: Individual interviews were performed with six children/teenagers (aged 7–19 years) and 14 parents. The interviews were transcribed and analyzed using a qualitative content analysis. Findings: The analysis resulted in the major theme, the duality of uprightness and the related themes: (1) the instrumental dimension of standing; (2) the social dimension of standing; and (3) the ambivalent dimension of standing. Each of the themes comprised several subthemes. Conclusions: There is an inherent duality related to the use of a standing device. Standing in a standing device was seen as a treatment of body structures and functions, as well as a possible source of pain. Standing was considered to influence freedom in activities and participation both positively and negatively. The parents experienced that standing influenced other peoples’ views of their child, while the children experienced standing as a way to extend the body and as something that gave them benefits in some activities. Physiotherapists working with children should take into account both the social and physical dimensions of using a standing device and consider both the child’s and the parents’ views.

  • 12.
    Nordström, Birgitta
    et al.
    Luleå University of Technology, Department of Health Sciences.
    Näslund, Annika
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Eriksson, Margareta
    County Council of Norrbotten, Department of Research and Development.
    Nyberg, Lars
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Ekenberg, Lilly
    County Council of Norrbotten, Department of Research and Development.
    The impact of supported standing on well-being and quality of life2013In: Physiotherapy Canada, ISSN 0300-0508, E-ISSN 1708-8313, Vol. 65, no 4, p. 344-352Article in journal (Refereed)
    Abstract [en]

    Purpose: To identify the characteristics of people who use standing devices and to explore their degree of device use, experiences with and reasons for standing, and perceived impact of the use of standing devices on well-being and quality of life (QOL). Method: Anyone with a current prescription at the time for the study in any of five counties in Sweden (n 1/4 545), according to a national register of prescribed devices, was invited to participate in a descriptive survey; the questionnaire was mailed to respondents for self-rating. Results: People between 2 and 86 years old were represented among respondents. Standing time decreased with increased age. Respondents who were totally dependent for mobilization or who had received their standing device more than 5 years earlier used their device most frequently. The most common reasons given for standing were to improve circulation and wellbeing and to reduce stiffness. Conclusion: It is important to pay attention to the experiences of standing for this vulnerable group of people, as the use of a standing device has a positive impact on well-being and QOL.

  • 13.
    Näslund, Annika
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Commentaries2004In: International Journal of Therapy and Rehabilitation, ISSN 1741-1645, E-ISSN 1759-779X, Vol. 11, no 3, p. 126-Article in journal (Other academic)
  • 14.
    Näslund, Annika
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Dynamic ankle-foot orthoses in children with spastic diplegia: interview and experimental studies2007Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Dynamic ankle-foot orthosis (DAFO) is a thin supra malleolar orthosis used as a compliment to the total treatment program in children with cerebral palsy (CP) in order to facilitate function in sitting, standing and walking. The DAFO keeps the foot in a functional position and is said to provide the child with proprioceptive feedback for balance- and postural control. The aim of the present thesis was to explore how parents of children with spastic diplegia experience the use of DAFOs and to determine the effects of DAFOs in standing during a reaching movement, in relation to postural orientation, anticipatory- and compensatory postural adjustments, and the quality of the reaching movement. The parents of 15 children, aged 4-18 years, who had spastic diplegia and wore DAFOs were interviewed with a broad research question "How do you perceive that DAFO influence your child" and analysed with content analysis. Children with spastic diplegia, aged 5-12 years, (n=6 in studies II and IV and n=4 in study III) classified at level II-IV according to Gross Motor Function Classification System (GMFCS) and typically developing children (controls) (n=8 in study III and n=6 in study IV) in the same age-group performed a voluntary reaching movement towards a target while standing on force plates. This allowed for registration of forces, movement and muscle activity (EMG). Children with spastic diplegia used DAFOs and/or shoes during the experiment while controls used shoes only. The parents experienced that DAFOs with their stabilizing effect on the foot and ankle enabled postural control and alignment, which contributed to functional activities under more favourable physical conditions. Moreover, psychosocial aspects such as a feeling of security, safety and freedom were regarded by the parents as being as important as the physical effects. Our findings showed that children with more severe spastic diplegia applied their body weight in standing more evenly between the legs and improved extension of the knee using DAFOs compared to wearing shoes alone. To initiate the reaching movement, despite different support conditions, children with spastic diplegia wearing DAFOs, as well as the controls make use of anticipatory postural adjustments. Furthermore, during the acceleration and deceleration phase of the reaching movement, children with spastic diplegia make use of compensatory postural adjustments characterized by co-contraction of tibialis anterior (TA) and lateral gastrocnemius (LG) muscles bilaterally. The postural adjustments in the controls were characterized by increased TA activity on the reach side during the acceleration phase and increased LG activity on the non-reach side during the deceleration phase. Movement quality in reaching in children with spastic diplegia showed that coordination between upward and forward reach velocity differed regarding temporal phasing and amplitudes of velocity peaks compared to the controls. According to parents´ perceptions DAFOs can be regarded as a part of treatment that improves stability, balance and functional skills. Children with severe spastic diplegia wearing DAFOs can, in spite of different support conditions, practice standing with a more evenly distributed body weight on the feet. The practice of reaching movements while standing with DAFOs can promote motor learning of postural adjustments and thereby improve the ability to use the hands in daily activities.

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  • 15.
    Näslund, Annika
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Jesinkey, Kristina
    Karolinska Institutet, Forskningslaboratoriet för motorisk kontroll och sjukgymnastik, Institutionen Neurotec.
    Sundelin, Gunnevi
    Umeå universitet, Institutionen för Samhällsmedicin och Rehabilitering.
    Wendt, Lennart von
    Helsingfors universitet, Institutionen för barnneurologi.
    Hirschfeld, Helga
    Karolinska Institutet, Forskningslaboratoriet för motorisk kontroll och sjukgymnastik, Institutionen Neurotec.
    Effects of dynamic ankle-foot orthoses on standing in children with severe spastic diplegia2005In: International Journal of Therapy and Rehabilitation, ISSN 1741-1645, E-ISSN 1759-779X, Vol. 12, no 5, p. 200-7Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate whether wearing a dynamic ankle-foot orthosis (DAFO) improved standing posture in six children with severe spastic diplegia Kinematics and ground reaction forces were recorded with a three-dimensional optoelectronic movement analysis system and two force plates. The results revealed that on a group level, DAFOs did not improve standing posture, distribution of body weight or lateral standing stability as reflected in the horizontal ground reaction forces. However, some children could benefit from the use of a DAFO through a more equal weight distribution and improved sagittal position of the knee, compared to wearing shoes alone. According to the heterogeneous clinical signs and symptoms in children with severe spastic diplegia, studies on a group level easily lead to negative findings and therefore individual benefits could be showed by using single case designs

  • 16.
    Näslund, Annika
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Larsson, Agneta
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Inter Active movement: on equal terms but different abilities2013Conference paper (Refereed)
    Abstract [en]

    Conference Theme: Social and service innovation in working life.Introduction: People with disabilities express positive effects and experiences of a new rehabilitation method, individually tailored martial arts for health and ability. This method has been developed through the common competence and creativity of physioterapists, a physical education teacher and the role model, a person with unique experience of personal disability and practice of Martial arts. The method acknowledges disabled people’s need for effective rehabilitation methods, and is suitable in a social context. The exercise is performed on equal terms despite the participants’ different prerequisites. Purpose: The project aimed to study the effects of this new rehabilitation method for social interaction through movement. Methods: Data from observations and interviews with participants were analysed using theoretical models of movement and social cognitive models including the theory of self-efficacy. Results and conclusion: Preliminary data indicate increased postural control, balance and performance of daily activities. The participants’ quality of movement and self-efficacy beliefs in a social context will be discussed, as well as the method as a social innovation.

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  • 17.
    Näslund, Annika
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Larsson, Agneta
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Project: Health, fall prevention and community ambulation among citizens2013Other (Other (popular science, discussion, etc.))
    Abstract [sv]

    Faktorer som påverkar risken att råka ut för en fallolycka och faktorer som kan minska risken att skada sig om man väl ramlar studeras ur olika perspektiv - från yttre miljöfaktorer till fysiska förmågor (att undvika fall samt att våga falla).  Fallpreventiv rörelsebaserad träning med utgångspunkt i olika traditionella japanska och kinesiska kampartsformer (Karate, Judo, Chigong etc.) och dess effekter avseende utövarnas hälsa och förmåga studeras. Grupper som studeras är såväl personer i arbetslivet som personer med funktionsnedsättningar. Resultat från det första delprojektet indikerar att budoträning som rehabilitering efter stroke har positiva effekter.Vi samverkar med praktiker och forskare i Luleå och Boden, samt internationellt från Tromsö och Bergen i Norge, och the International Budo University i Tokyo.

  • 18.
    Näslund, Annika
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Larsson, Agneta
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Vikman, Irene
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Projekt: Pilotprojekt - budo som rehabilitering efter stroke2013Other (Other (popular science, discussion, etc.))
  • 19.
    Näslund, Annika
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Sundelin, Gunnevi
    Umeå University, Department of Community Medicine and Rehabilitation, Division of Physiotherapy.
    Hirschfeld, Helga
    Karolinska institutet, Motor Control and Physical Therapy Research Laboratory, NVS Department, Division of Physiotherapy.
    Postural adjustments during reaching in children wth severe spastic diplegia wearing Dafos2007In: 15th International Congress of the World Confederation for Physical Therapy: 2-6 June 2007 Vancouver, Canada, WCPT , 2007Conference paper (Other academic)
    Abstract [en]

    PURPOSE: The aim of this study was to investigate the coordination among reaching kinematics, ground reaction forces and muscle activity in standing in children with severe spastic diplegia wearing dynamic ankle-foot orthoses (DAFOs)and compare the results to age matched non-disabled children. RELEVANCE: Assessment and evaluation are essential because children with spastic diplegia, classified at level III-IV according to GMFCS (Gross Motor Function Classification System), often recieve DAFOs as an adjunct to physiotherapy in order to improve sitting, standing and walking. PARTICIPANTS: All children with spastic diplegia using DAFOs in a county in northern Sweden and had regular follow-ups of their ortohoses, were invited. Six participants at GMFCS level III-IV formed the study group and six age- and sex-matched children with normal motor development served as a control group. METHODS: Bilaterally ground reaction forces and the ankle muscle activity aswell as the reach hand kinematics were investigated by the means of two AMTI forceplates, surface electromyography (EMG)and two-camera optoelectronic system (ELITE). Kinematic, EMG and forceplate signals were recorded simultaniously. The children reached for a cup filled with candy while standing on two forceplates. Reflective markers were placed on the hand and cup. In this study, standing support provided by the parent on the pelvis or by contact of the non-reach hand on the table was necessary during the standing task. ANALYSIS: Because of the small participant number and the heterogeneity of the group with pronounced difficulties in locomotion, the results are presented on group as well as on subject level. RESULTS: Children with severe spastic diplegia, wearing DAFOs, demonstrated that movement quality of upward and forward reach velocity differed regarding temporal phasing and amplitudes of velocity peaks compared to the controls. Furthermore, children with severe spastic diplegia, wearing DAFOs, lacked a coordinated muscle activity pattern and make use of postural adjustments characterized by co-activation of agonist and antagonist muscles. However, the controls demonstrated coordinated muscle activity and an interplay of the ground reaction forces on reach and non-reach side. CONCLUSIONS: In conclusion DAFOs appear to provide some benefit for children with spastic diplegia GMFCS, level III-IV, by the use of postural adjustments for balance control during a reaching movement in standing. An intervention study would be of interest, to assess whether DAFOs could be valuable in the learning of processes considering postural adjustments , since postural control is a result of both maturation and learning. IMPLICATIONS: Children with severe spastic diplegia wearing DAFOs can despite different support conditions practice reaching while standing and thereby promote motor learning of postural adjustments to improve the ability to use the hands in daily standing activities. KEYWORDS: Spastic diplegia, orthoses and postural adjustments. FUNDING ACKNOWLEDGEMENTS: Funding for this project was provided by the Norrbacka -Eugenia Foundation. CONTACT: annika.naslund@ltu.se

  • 20.
    Näslund, Annika
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Sundelin, Gunnevi
    Umeå universitet, Institutionen för Samhällsmedicin, Avdelningen för Sjukgymnastik.
    Hirschfeld, Helga
    Karolinska Institutet, Forskningslaboratoriet för motorisk kontroll och sjukgymnastik, Institutionen Neurotec.
    Reach performance and postural adjustments during standing in children with severe spastic diplegia using dynamic ankle-foot orthoses2007In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 39, no 9, p. 715-23Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate the co-ordination between reaching, ground reaction forces and muscle activity in standing children with severe spastic diplegia wearing dynamic ankle-foot orthoses compared with typically developing children. DESIGN: Clinical experimental study. SUBJECTS: Six children with spastic diplegia (Gross Motor Function Classification System level III-IV) and 6 controls. METHODS: Ground reaction forces (AMTI force plates), ankle muscle activity (electromyography and displacement of the hand (ELITE systems) were investigated while reaching for an object. RESULTS: For the children with severe spastic diplegia who were wearing dynamic ankle-foot orthoses, co-ordination between upward and forward reach velocity differed regarding the temporal sequencing and amplitude of velocity peaks. During reaching, these children lacked interplay of pushing force beneath the reach leg and braking force beneath the non-reach leg and co-ordinated ankle muscle activity, compared with controls. CONCLUSION: The results suggest differences in reach performance and postural adjustments for balance control during a reaching movement in standing between children with spastic diplegia Gross Motor Function Classification System level III-IV, wearing dynamic ankle-foot orthoses compared with typically developing children.

  • 21.
    Näslund, Annika
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Sundelin, Gunnevi
    Umeå University, Department of Community Medicine and Rehabilitation, Division of Physiotherapy.
    Hirschfeld, Helga
    Karolinska institutet, Motor Control and Physical Therapy Research Laboratory.
    Reach performance and postural adjustments in children with severe spastic diplegia wearing Dafos2007Conference paper (Other academic)
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  • 22.
    Näslund, Annika
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Tamm, Maare
    Luleå tekniska universitet.
    Ericsson, Ann Kristin
    Sunderby sjukhus, Barnhabiliteringen.
    Wendt, Lennart von
    Helsingfors universitet, Institutionen för barnneurologi.
    Dynamic ankle-foot orthoses as a part of treatment in children with spastic diplegia: parents' perceptions2003In: Physiotherapy Research International, ISSN 1358-2267, E-ISSN 1471-2865, Vol. 8, no 2, p. 59-68Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND PURPOSE: Dynamic ankle-foot orthoses (DAFOs) are often recommended for children with spastic diplegia in order to facilitate better function. The aim of the present study was to explore how the parents of children with diplegic cerebral palsy experience the use of DAFOs. METHOD: A qualitative interview study with a broad research question: 'How do you perceive that DAFOs influence your child?' The parents of 15 children, aged 4-18 years, who all had spastic diplegia and wore DAFOs were interviewed. RESULTS: Content analysis resulted in the following categories: 'Physical effects'; 'New functions and activities'; 'The orthosis as a part of the treatment'; 'Opportunity for independence and play'; and 'Problems with DAFOs'. According to the parents, DAFOs appeared to contribute to the (mechanical) changes in posture affecting the muscular system. They meant that when wearing DAFOs the foot and ankle are more stable. This in turn enables postural control and alignment, contributing to functional activities under more favourable physiological conditions. The psychosocial effects were regarded by parents as being just as important as the physical effects. CONCLUSION: In clinical practice, DAFOs may (according to parents) be regarded as a suitable complement to other treatments in children with diplegic cerebral palsy.

  • 23.
    Vikman, Irene
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Nordlund, Anders
    Department of Social Work, Stockholm University.
    Näslund, Annika
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Nyberg, Lars
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Incidence and seasonality of falls amongst old people receiving home help services in a municipality in northern Sweden2011In: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 70, no 2, p. 195-204Article in journal (Refereed)
    Abstract [en]

    Objectives. Falls among old people is a well-documented phenomenon; however, falls among people living in the community and receiving home help services have been under-researched. The aim of this study was to investigate the incidence, including possible seasonal variation, circumstances and injuries related to falls among community living home help receivers, and to investigate whether fall incidence is associated with the type and amount of home help services received. Study design. Prospective cohort study. Methods. All 614 persons aged 65 and over who were living in a particular northern Swedish community and receiving municipality home help were included. Data on age, sex and home help service use were collected from home help service records, and falls were reported by staff on report forms specifically designed for the study. Results. A total number of 264 falls were recorded among 122 participants. The overall fall incidence was 626 per 1,000 PY, and incidence rate ratios were significantly correlated to the total amount of services used (p<0.001), as well as to the degree of help for I-ADL needs (p<0.001), P-ADL needs (p<0.001) and escort service (p=0.007). The proportion of falls reported as resulting in injury was 33%. The monthly fall incidence was significantly associated to daylight photoperiod, however it was not associated to temperature. Conclusions. Fall incidence among home help receivers aged 65 and over seems correlated to the amount of services they receive. This is probably explained by the fact that impairments connected to ADL limitations and home help needs also are connected to an increased risk of falls. This implies that fall prevention should be considered when planning home help care for old people with ADL limitations. Further research on the connection between daylight photoperiod and fall incidence in populations at different latitudes is needed.

  • 24.
    Wiklund-Axelsson, Sari-Anne
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Melander-Wikman, Anita
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Näslund, Annika
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Nyberg, Lars
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Older people's health-related ICT-use in Sweden2013In: Gerontechnology, ISSN 1569-1101, E-ISSN 1569-111X, Vol. 12, no 1, p. 36-43Article in journal (Refereed)
  • 25.
    Wiklund-Axelsson, Sari-Anne
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Nyberg, Lars
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Näslund, Annika
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Melander-Wikman, Anita
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Ready to adopt: Swedish older person’s perceptions of psychosocial impact of existing and future mobile health related ICT applications2013Conference paper (Refereed)
  • 26.
    Wiklund-Axelsson, Sari-Anne
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Nyberg, Lars
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Näslund, Annika
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Melander-Wikman, Anita
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    The anticipated positive psychosocial impact of present web-based e-health services and future mobile health applications: an investigation among older Swedes2013In: International Journal of Telemedicine and Applications, ISSN 1687-6415, E-ISSN 1687-6423, ISSN 1687-6415, article id 509198Article in journal (Refereed)
    Abstract [en]

    This study investigates the anticipated psychosocial impact of present web-based e-health services and future mobile health applications among older Swedes. Random sample’s of Swedish citizens aged 55 years old and older were given a survey containing two different e-health scenarios which respondents rated according to their anticipated psychosocial impact by means of the PIADS instrument. Results consistently demonstrated the positive anticipation of psychosocial impacts for both scenarios. The future mobile health applications scored more positively than the present web-based e-health services. An increase in age correlated positively to lower impact scores. These findings indicate that from a psychosocial perspective, web-based e-health services and mobile health applications are likely to positively impact quality of life. This knowledge can be helpful when tailoring and implementing e-health services that are directed to older people.

1 - 26 of 26
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