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  • 151. Lexell, Jan
    et al.
    Sjöström, Michael
    Department of Neurology, University of Umeå.
    Downham, David Y
    Department of Neurology, University of Umeå.
    Differences in fiber number and fiber type proportion within fascicles: A quantitative morphological study of whole vastus lateralis muscle from childhood to old age.1992Inngår i: Anatomical Record, ISSN 0003-276X, E-ISSN 1097-0185, Vol. 234, nr 2, s. 183-189Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Data are presented on the number of fibers and the proportion of different fiber types within fascicles of whole vastus lateralis muscles from 5 male children, 5 to 15 years of age, and compared with results from 25 male adults, middle aged and old individuals. The results verify a difference in the proportion of fibers with different properties within a fascicle. The proportion of type 2 (fast twitch) fibers on the border of fascicles is larger than the proportion internally: the children have (P less than 0.01) greater difference than the adults and the middle aged, whereas the old have (P less than 0.001) less difference than the other age groups. The mean number of fibers per fascicle increases (P less than 0.05) from childhood to adult age, and thereafter reduces (P less than 0.01). The results imply that fascicles continuously rearrange during the normal growth and development and the normal aging process. It is argued that the causes of the difference in fiber type proportions within fascicles are local factors in the muscle, secondary to the overall age related functional demands put on the fiber population.

  • 152. Lexell, Jan
    et al.
    Sjöström, Michael
    Department of Neurology, University of Umeå.
    Nordlund, A S
    Department of Neurology, University of Umeå.
    Taylor, Charles
    Department of Mathematics, University of Strathclyde.
    Growth and development of human muscle: a quantitative morphological study of whole vastus lateralis from childhood to adult age1992Inngår i: Muscle and Nerve, ISSN 0148-639X, E-ISSN 1097-4598, Vol. 15, nr 3, s. 404-409Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The mechanisms underlying the increase in volume of muscle tissue, and the functional development of muscle fibers from childhood through adolescence to adult age, have been studied. Cross sections of autopsied whole vastus lateralis muscle from 22 previously physically healthy males, 5 to 37 years of age, were prepared enzyme histochemically (myofibrillar ATPase) and examined morphometrically. The data obtained on muscle cross-sectional area, size, total number, and proportion of type 1 (slow-twitch) and type 2 (fast-twitch) fibers were analyzed using linear regression techniques. The results show that the increase in muscle cross-sectional area from childhood to adult age is caused by an increase in mean fiber size. This is accompanied by a functional development of the fiber population: the proportion of type 2 fibers increases significantly from the age of 5 (approx. 35%) to the age of 20 (approx. 50%), which, in the absence of any discernible effect on the total number of fibers, is most likely caused by a transformation of type 1 to type 2 fibers.

  • 153. Lexell, Jan
    et al.
    Taylor, C.C.
    A morphometrical comparison of right and left whole human vastus lateralis muscle: how to reduce sampling errors in biopsy techniques1991Inngår i: Clinical Physiology, ISSN 0144-5979, E-ISSN 1365-2281, Vol. 11, nr 3, s. 271-6Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In studies of the effects of different training programmes, one muscle--most commonly the vastus lateralis--is used for the experiment while the contralateral muscle serves as a control, at the same time as muscle biopsies are taken from both sides. In order to increase the reliability of such studies, the sources and the magnitude of the sampling errors in the biopsy techniques need to be assessed in detail. In this study, cross-sections of whole right and left vastus lateralis muscle from six young sedentary right-handed men were prepared, and the total number and size of fibres and the proportion of the different fibre types were calculated. A significant difference (P less than 0.05-P less than 0.001) between the right and the left muscle was found for at least one of the three variables in each of the six men, but there was no systematic difference and, therefore, no significant right-left difference for the whole group. The maximum difference between the right and the left side for the mean fibre size was 25% and for the fibre type proportion 5%; these differences are much smaller than the known variation within individual muscles. In conclusion, any study involving biopsies from both the right and the left vastus lateralis may use either muscle for the experiment while the contralateral muscle serves as a control without leading to systematic sampling error, whereas the errors involved in taking small samples from each muscle are much more important to control and to reduce

  • 154. Lexell, Jan
    et al.
    Taylor, CC
    Fiber density: a fast and accurate way to estimate human muscle fiber areas1991Inngår i: Muscle and Nerve, ISSN 0148-639X, E-ISSN 1097-4598, Vol. 14, nr 5, s. 476-7Artikkel i tidsskrift (Fagfellevurdert)
  • 155. Lexell, Jan
    et al.
    Taylor, C.C.
    "Smoothed histograms": a visual aid for the analysis of distributions of muscle fiber areas2001Inngår i: Muscle and Nerve, ISSN 0148-639X, E-ISSN 1097-4598, s. 826-828Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The Kernel Density Estimator (KDE) is a versatile nonparametric technique with very good theoretical properties. It is used to obtain "smoothed histograms," which allows several distributions to be presented and analyzed more easily on one graph, and direct combination into average distributions. The application of the KDE method as a visual aid for the analysis of distributions of muscle fiber areas is presented here

  • 156. Lexell, Jan
    et al.
    Taylor, C.C.
    Variability in muscle fibre areas in whole human quadriceps muscle: effects of increasing age1991Inngår i: Journal of Anatomy, ISSN 0021-8782, E-ISSN 1469-7580, Vol. 174, s. 239-49Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Cross-sections of whole vastus lateralis muscle from 20 men, 19 to 84 years of age, were prepared, and the cross-sectional area (microns2) of 375 type 1 and 375 Type 2 fibres was measured in five different regions throughout each muscle. In muscles from the old individuals, the mean CSA of Type 2 fibres was on average nearly 35% smaller (P less than 0.001) while the mean CSA of Type 1 fibres was on average just over 6% smaller (NS) than in muscles from the young individuals. There was a highly significant (P less than 0.001) variation in the mean CSA of both fibre types within all muscles. In the old muscles, there was no significant difference in mean fibre CSA between deep and superficial parts while in the young muscles the mean fibre CSA was significantly (P less than 0.05) larger in deep regions than superficially. The range of the fibre CSA was larger in the old muscles with an increased number of both hypotrophied and atrophied fibres as well as large, sometimes very large, fibres. The standard deviation of the fibre CSA of Type 2 fibres was significantly (P less than 0.001) larger than for Type 1 fibres in 60% of the regions of the old muscles compared to 12.5% of the regions of the young muscles, but the standard deviation for the whole muscles was more or less unaffected with increasing age. In the old age group, there were fewer muscles and regions with a correlation between the CSA of Type 1 and Type 2 fibres than in the young age group. In conclusion the age-related changes in the mean fibre CSA, and in the pattern of variation in fibre CSA throughout the muscle and in small sample regions, suggest a combination of a progressive denervation process and an altered physical activity level as the two major mechanisms underlying the effects of normal development and ageing on the human vastus lateralis muscle.

  • 157. Lexell, Jan
    et al.
    Taylor, CC
    Variability in muscle fibre areas in whole human quadriceps muscle: How much and why?1989Inngår i: Acta Physiologica Scandinavica, ISSN 0001-6772, E-ISSN 1365-201X, Vol. 136, nr 4, s. 561-8Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    To determine the variability in fibre areas in the human vastus lateralis muscle, cross-sections (15 microns) of whole autopsied muscles from eight young men have been prepared, and the cross-sectional area (CSA) of 375 type 1 and 375 type 2 fibres has been measured in five different regions throughout each muscle. The CSA of both fibre types varied significantly within all muscle cross-sections. Fibres in the deep parts of the muscle were larger than superficially. There was a significant correlation between the CSA of the two fibre types within each region: if a fibre of a given type was small, or large, the other fibre type was also small, or large. The CSA of type 2 fibres was larger than the CSA of type 1 fibres in 26 of the 40 regions: regions with type 1 fibres larger than type 2 fibres were mostly (71%) found deep in the muscle. The standard deviation of the CSA of type 1 fibres was significantly larger than for type 2 fibres in 35 of the 40 regions. In conclusion, the CSA of the different fibre types in the vastus lateralis of young men varies non-randomly. The pattern of variation, both throughout the muscle and in small sample regions, supports the general opinion that the functional demands placed on the fibre population are an important factor in the development of the fibre properties.

  • 158. Lexell, Jan
    et al.
    Taylor, CC
    Variability in muscle fibre areas in whole human quadriceps muscle: how to reduce sampling errors in biopsy techniques1989Inngår i: Clinical Physiology, ISSN 0144-5979, E-ISSN 1365-2281, Vol. 9, nr 4, s. 333-43Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A single biopsy is a poor estimator of the muscle fibre cross-sectional area (CSA) for a whole human muscle because of the large variability in the fibre area within a muscle. To determine how the sampling errors in biopsy techniques can be reduced, data on the CSA of type 1 and type 2 fibres obtained from cross-sections of whole vastus lateralis muscle of young men, have been analysed statistically. To obtain a good estimate of the mean fibre CSA in a biopsy, measuring all fibres in that biopsy gives the best result. To obtain a good estimate of the mean fibre CSA for a whole muscle, the number of biopsies has a much greater influence on the sampling error than the number of fibres measured in each biopsy, but the number of biopsies needed to obtain a given sampling error can vary by a factor of two. If the fibre CSA in three or more biopsies is measured, it is sufficient to measure only 25 fibres in each biopsy. If less than three biopsies are taken, there is no worthwhile reduction in sampling error when more than 100 fibres are measured. To determine the mean fibre CSA for a whole group of individuals, our preference is to maximize the number of individuals, and only take single biopsies. In conclusion, to determine the mean fibre CSA for this particular muscle with a certain precision, we suggest analysis of three biopsies, taken from different depths of the muscle, and measurement of 25 fibres in each biopsy.

  • 159. Lexell, Jan
    et al.
    Taylor, CC
    Sjöström, Michael
    Department of Anatomy, University of Umea.
    What is the cause of the ageing atrophy?: number, size and proportion of different fiber types studied in whole vastus lateralis muscle from 15- to 83-year-old men1988Inngår i: Journal of the Neurological Sciences, ISSN 0022-510X, E-ISSN 1878-5883, Vol. 84, nr 2-3, s. 275-94Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In order to study the effects of increasing age on the human skeletal muscle, cross-sections (15 micron) of autopsied whole vastus lateralis muscle from 43 previously physically healthy men between 15 and 83 years of age were prepared and examined. The data obtained on muscle area, total number, size, proportion and distribution of type 1 (slow-twitch) and type 2 (fast-twitch) fibers were analysed using multivariate regression. The results show that the ageing atrophy of this muscle begins around 25 years of age and thereafter accelerates. This is caused mainly by a loss of fibers, with no predominant effect on any fiber type, and to a lesser extent by a reduction in fiber size, mostly of type 2 fibers. The results also suggest the occurrence of several other age-related adaptive mechanisms which could influence fiber sizes and fiber number, as well as enzyme histochemical fiber characteristics

  • 160. Lexell, Jan
    et al.
    Taylor, Charles
    Department of Mathematics, University of Strathclyde.
    Sjöström, Michael
    Department of Neurology, University of Umeå.
    Analysis of sampling errors in biopsy techniques using data from whole muscle cross sections1985Inngår i: Journal of applied physiology, ISSN 8750-7587, E-ISSN 1522-1601, Vol. 59, nr 4, s. 1228-35Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Because of the large variability in the proportion of fiber types within a whole muscle, a single biopsy is a poor estimator of the fiber type proportion for a whole muscle. Data on the proportions of type I and II fibers, obtained from cross sections of whole human muscles (vastus lateralis) from young male individuals, have therefore been analyzed statistically in order to determine the sampling errors involved in muscle biopsy techniques. For the purpose of obtaining a good estimate of the fiber type proportion in a whole biopsy, counting all fibers is of great benefit compared with counting only half of the fiber number. The required number of biopsies to obtain a given sampling error of the mean proportion of fiber types in the whole muscle can vary by a factor of six. If less than three biopsies are taken from a muscle, there is a substantial reduction in sampling error taking biopsies with at least 600 fibers. For more than three biopsies there is a small gain in sampling greater than 150 fibers. The precision of the estimate of the mean proportion of fiber types for a group is increased with the number of biopsies per individual and number of individuals. In conclusion, for the muscle in this study, complete counting of three biopsies, each greater than 150 fibers, sampled from different depths of the muscle is recommended

  • 161.
    Lexell, Jan
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Whilney, A-K
    Department of Health Sciences, Lund University.
    Jacobsson, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Vocational outcome 6–15 years after a traumatic brain injury2016Inngår i: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 30, nr 8, s. 969-974Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Primary objective: To describe vocational outcome 6–15 years after a traumatic brain injury (TBI) among individuals who were productive by working or studying at the time of their TBI and determine the associations with variables related to the time of injury and at follow-up.Methods and procedures: Thirty-four individuals with a mild TBI and 45 with a moderate-to-severe TBI were assessed on average 10 years post-injury. Logistic regression was used to determine the association between their current vocational situation and variables related to the time of injury (gender, age, injury severity and educational level) and at follow-up (time since injury, marital status and overall disability).Results: A total of 67% were productive at follow-up. Age at injury, injury severity and the degree of disability at follow-up were strongly associated with being productive. Younger individuals with milder TBI and less severe disability were significantly more likely to be fully productive. No significant associations were found between productivity and gender, education, time since injury or marital status.Conclusions: This study indicates that return to productivity in a long-term perspective after a TBI is possible, in particular when the individual is young, has sustained a mild TBI and has a milder form of overall disability.

  • 162. Lexell, Jan
    et al.
    Wilson, C.
    Downham, David
    Detection of fiber type grouping: further improvements to the enclosed fiber method1989Inngår i: Muscle and Nerve, ISSN 0148-639X, E-ISSN 1097-4598, Vol. 12, nr 12, s. 1024-6Artikkel i tidsskrift (Annet vitenskapelig)
  • 163. Lexell, Jan
    et al.
    Zafonte, Ross D
    Department of Physical Medicine and Rehabilitation, University of Pittsburgh.
    Cullen, Nora
    Physical Medicine and Rehabilitation, University of Toronto.
    Possible applications for dopaminergic agents following traumatic brain injury: part 12000Inngår i: The journal of head trauma rehabilitation, ISSN 0885-9701, E-ISSN 1550-509X, Vol. 15, nr 5, s. 1179-1182Artikkel i tidsskrift (Fagfellevurdert)
  • 164. Lexell, Jan
    et al.
    Zafonte, Ross D
    Physical Medicine and Rehabilitation, University of Pittsburgh.
    Cullen, Nora
    Physical Medicine and Rehabilitation, University of Toronto.
    Possible applications for dopaminergic agents following traumatic brain injury: part 22001Inngår i: The journal of head trauma rehabilitation, ISSN 0885-9701, E-ISSN 1550-509X, Vol. 16, nr 1, s. 112-116Artikkel i tidsskrift (Fagfellevurdert)
  • 165. Lexell, Jan
    et al.
    Zafonte, Ross D
    Department of Physical Medicine and Rehabilitation, University of Pittsburgh.
    Cullen, Nora
    Department of Physical Medicine and Rehabilitation, University of Pittsburgh.
    Serotonin agents in the treatment of acquired brain injury2002Inngår i: The journal of head trauma rehabilitation, ISSN 0885-9701, E-ISSN 1550-509X, Vol. 17, nr 4, s. 322-34Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: The development of novel serotonin agents has led to an increased use of these medications throughout medical practice. An understanding of the basic pharmacological function of these agents is key to understanding their usefulness. Among persons with brain injury, serotonin agents have been used for the treatment of depression, panic disorder, obsessive-compulsive disorders, agitation, sleep disorders, and motor dysfunction. CONCLUSION: This article will review the mechanisms, efficacy, and side effects of serotonin agents with a focus on persons with brain injury.

  • 166.
    Lindgren, Ingrid
    et al.
    Department of Neurology, Skåne University Hospital and Department of Health Sciences, Lund University.
    Lexell, Jan
    Jonsson, Ann Cathrin
    Department of Health Sciences, Lund University.
    Brogårdh, Christina
    Department of Rehabilitation Medicine, Skåne University Hospital.
    Left-Sided Hemiparesis, Pain Frequency, and Decreased Passive Shoulder Range of Abduction Are Predictors of Long-Lasting Poststroke Shoulder Pain2012Inngår i: PM&R, ISSN 1934-1482, E-ISSN 1934-1563, Vol. 4, nr 8, s. 561-568Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To determine the proportion of persons with poststroke shoulder pain 4 months after onset of the stroke in whom long-lasting shoulder pain develops and to assess the extent to which age, side of paresis at stroke onset, pain frequency and pain intensity, passive shoulder range of motion, resistance to passive movements, motor function, and subluxation at 4 months after stroke predict shoulder pain 1 year later. Design: A prospective study. Setting: A university hospital outpatient clinical setting. Participants: Fifty-eight men and women with their first-ever stroke (mean age, 71 years) and affected sensory-motor function in the upper extremity at stroke onset who all reported shoulder pain in the affected side 4 months after onset of the stroke. Methods: At 4 and 16 months after having a stroke, the participants rated their selfperceived shoulder pain (frequency and intensity). Passive range of shoulder abduction and external rotation, resistance to passive movements in the elbow, and motor function in the shoulder were assessed by a physical therapist. Main Outcome Measurements: A question about pain frequency (constant, often, or occasional), the Visual Analogue Scale for Pain for self-perceived shoulder pain intensity, a goniometer for range of motion, the Modified Ashworth Scale for resistance to passive movements, and the Motor Assessment Scale for motor function. Results: Of the 58 participants who had shoulder pain 4 months after having a stroke, 42 (72%) still had pain at 16 months. The logistic regression indicated an association between shoulder pain at 16 months and left-sided hemiparesis at stroke onset (P= .01; odds ratio [OR] 10.47; 95% confidence interval [CI] 1.92-57.05), pain frequency (P = .02; OR 6.85; 95% CI 1.46-32.14), decreased passive abduction at 4 months (P = .05; OR 4.46; 95% CI 0.99-20.10), and age (P = .07; OR 1.05; 95% CI 1.0-1.12). Conclusions: A high proportion of persons with shoulder pain 4 months after having a stroke are at risk of having persistent shoulder pain 1 year later. Left-sided hemiparesis, pain reported frequently, and decreased passive shoulder range of abduction at 4 months are predictors of long-lasting poststroke shoulder pain and require increased attention in the rehabilitation setting.

  • 167.
    Lindström, Britta
    et al.
    Department of Physical Medicine and Rehabilitation Umeå.
    Lexell, Jan
    Department of Rehabilitation, Lund University Hospital, Höör, Sweden.
    Gerdle, Björn
    Faculty of Health Sciences, Department of Rehabilitation Medicine Linköping, Sweden.
    Downham, David
    Department of Mathematical Sciences, University of Liverpool, Liverpool, England.
    Skeletal muscle fatigue and endurance in young and old men and women1997Inngår i: The journals of gerontology. Series A, Biological sciences and medical sciences, ISSN 1079-5006, E-ISSN 1758-535X, Vol. 52A, nr 1, s. B59-B66Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The effects of increasing age on skeletal muscle fatigue and endurance were assessed in 22 healthy young (14 men and 8 women; mean age, 28 +/- 6 years) and 16 healthy old (8 men and 8 women; mean age, 73 +/- 3 years) individuals. All subjects performed 100 repeated maximum dynamic knee extensions at 90 degrees.s-1 (1.57 rad.s-1) using an isokinetic dynamometer (Cybex II). Peak torque was recorded during every contraction, and for each individual the maximal voluntary contraction (MVC), the fatigue rate, the endurance level, and the relative reduction in muscle force were determined. MVC and endurance level were significantly lower in old men and women, but there was no discernible difference in relative muscle force reduction and fatigue rate between young and old individuals. We conclude that thigh muscles of older individuals are weaker than those of younger individuals, but relative to their strength, older individuals have similar properties as younger individuals with respect to muscle fatigue and endurance.

  • 168. Lindén, Anita
    et al.
    Lexell, Jan
    Larsson-Lund, Maria
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Improvements of task performance in daily life after acquired brain injury using commonly available everyday technology2011Inngår i: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 6, nr 3, s. 214-224Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose. To investigate how individualised occupation-based interventions with commonly available everyday technology (ET) can compensate for perceived difficulties with daily life tasks after an aquired brain injury (ABI) and improve satisfaction with occupational performance. Method. This intervention study was designed as a multiple case study according to Yin. Ten men and women with an ABI (traumatic or non-traumatic) participated. Data were collected through interviews, observations and field notes before and after the intervention and at follow-up (on average 11 weeks afterwards). The interventions focused on enabling each participant's prioritised goals related to task performance in daily life. Results. All participants achieved all their goals by learning to use both new functions in their own familiar ET and new ET. The participant's perceived difficulties in occupational performance decreased and their satisfaction with occupational performance increased with the use of ET. Conclusions. An individualised intervention process, involving the use of own familiar ET or ET off-the-shelf, has the potential to compensate for perceived difficulties following an ABI and improve satisfaction with occupational performance in daily life

  • 169.
    Lindén, Anita
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap.
    Lexell, Jan
    Luleå tekniska universitet, Institutionen för hälsovetenskap.
    Larsson-Lund, Maria
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Perceived difficulties using everyday technology after acquired brain injury: influence on activity and participation2010Inngår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 17, nr 4, s. 267-75Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Using everyday technology (ET) is a prerequisite for activities and participation at home and in the community. It is well known that persons with an acquired brain injury (ABI) can have limitations in activities of daily living but our knowledge of their difficulties using ET is not known. Thirty-six persons (27 men and 9 women, mean age 44 years, age range 26-60) with an ABI (2-10 years post injury) were interviewed, using the Everyday Technology Use Questionnaire (ETUQ), about their perceived difficulties using ET and how these difficulties influenced their everyday activities and their possibilities to participate at home and in the community. A majority (78%) of the persons reported difficulties using ET. The most common difficulties were related to the use of telecommunication and computers. Despite these difficulties, a majority still used most objects and services independently. Twenty-six participants (72%) perceived that their difficulties using ET influenced their everyday activities and their possibility to participate at home and in the community. The results indicate that rehabilitation following an ABI should consider whether clients' use of ET influences their activity and participation and adopt interventions accordingly. The results also indicate that difficulties using ET need to be considered in the design of community services to prevent societal barriers.

  • 170.
    Londos, Elisabet
    et al.
    Lund University, Clinical Memory Research Unit, Clinical Sciences Malmo.
    Boschian, Kerstin
    Department of Rehabilitation, Lund University Hospital, Sweden.
    Lindén, Anita
    Department of Rehabilitation, Lund University Hospital, Sweden.
    Persson, Cecilia
    Universitetssjukhuset MAS, Neuropsykiatriska kliniken.
    Minthon, Lennart
    Universitetssjukhuset MAS, Institutionen för kliniska vetenskaper.
    Lexell, Jan
    Effects of a goal-oriented rehabilitation program in mild cognitive impairment: a pilot study2008Inngår i: American Journal of Alzheimer’s Disease and Other Dementia, ISSN 1533-3175, E-ISSN 1938-2731, Vol. 23, nr 2, s. 177-83Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Memory disturbance, deficient concentration, and fatigue are symptoms seen in amnestic mild cognitive impairment (MCI) as well as in mild traumatic brain injury (TBI). The aim of this study was to assess if an established rehabilitation program commonly used in TBI can aid MCI patients to develop compensatory memory strategies that can improve their cognition, occupational performance, and quality of life (QoL). Methods: Fifteen patients with MCI participated in the program 2 days per week for 8 weeks. Cognitive function, occupational performance, and self-perceived QoL were assessed at baseline, at the end of the intervention, and at follow-up after 6 months. Results: Significant improvements were seen in cognitive processing speed, occupational performance, and in some of the QoL domains. Conclusion: As this goal-oriented rehabilitation program in MCI resulted in some improvements in cognition, occupational performance, and QoL, further randomized controlled studies are warranted.

  • 171.
    Lundström, Ulrica
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Lilja, Margareta
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Petersson, Ingela
    Sektionen för arbetsterapi/Institutionen NVS/Karolinska institutet.
    Lexell, Jan
    Institutionen för Hälsovetenskap, Lunds universitet/Avdelningen för rehabiliteringsmedicin, Lunds Universitetssjukhus.
    Isaksson, Gunilla
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Leisure repertoire among persons with a spinal cord injury: Interests, performance, and well-being2014Inngår i: Journal of Spinal Cord Medicine (JSCM), ISSN 1079-0268, E-ISSN 2045-7723, Vol. 37, nr 2, s. 186-192Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To explore and describe the leisure repertoire of persons with traumatic spinal cord injury (SCI) and how the repertoire is related to interest, performance, and well-being.Design: Cross-sectional study.Setting: A total of 97 persons with traumatic SCI were recruited from the non-profit national organization, RG Active Rehabilitation in Sweden.Outcome measure: Data were collected through a two-part postal survey. The first comprised of questions investigating socio-demographic variables and injury characteristics; the second part included an interest checklist with 20 areas of leisure activities.Results: The participants were mostly interested in, performed, and experienced well-being from social and culture activities and TV/DVD/movies. The areas of leisure activities in which they had most likely experienced changes after the SCI were outdoor activities, exercise, and gardening. Gender, age, and to some extent, time since injury were related to interest, performance, well-being, and changed performance.Conclusions: The results provided an explanation and limited description of a changed leisure repertoire among persons after a traumatic SCI. The study showed that gender, age, and time since injury were more closely related to the choice of leisure activities to include in the leisure repertoire than the level of injury. This knowledge can be of importance when professionals in the field of rehabilitation are planning and implementing interventions concerning leisure activities for persons with SCI.

  • 172.
    Lövgren-Engström, Ann-Louice
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap.
    Lexell, Jan
    Luleå tekniska universitet, Institutionen för hälsovetenskap.
    Larsson-Lund, Maria
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Difficulties in using everyday technology after acquired brain injury: a qualitative analysis2010Inngår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 17, nr 3, s. 233-243Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to identify and describe the characteristics of the difficulties using everyday technology in persons with an aquired brain injury (ABI), and their experiences of how these difficulties influenced their life. Thirteen persons with an ABI were interviewed about their difficulties in using everyday technology and were observed in their use of technology. Data were analysed qualitatively with a constant comparative method. The results showed that the persons' experiences formed two categories: "A variety of combinations of difficulties in the use of everyday technology" and "Restrictions in life". The difficulties identified were related not only to everyday technology itself but also to the interaction between the technology, the task, the person, and the environment. These difficulties influenced their experiences of restrictions in occupational performance, personal identification, and participation in society. The results emphasize that occupational therapists who design interventions for people with an ABI need to accommodate both the technology and other interacting aspects in order to overcome difficulties in using everyday technology.

  • 173.
    Miller, Michael
    et al.
    Lunds universitet.
    Flansbjer, Ulla-Britt
    Lunds universitet.
    Lexell, Jan
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Voluntary activation of the knee extensors in chronic poststroke subjects2009Inngår i: American Journal of Physical Medicine & Rehabilitation, ISSN 0894-9115, E-ISSN 1537-7385, Vol. 88, nr 4, s. 286-291Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To assess the extent to which knee extensor muscle weakness in subjects with chronic mild to moderate poststroke hemiparesis is caused by a decreased voluntary activation. Design: Forty community dwelling and ambulant men and women (mean age, 59.8 +/- 5.5 yrs) with residual hemiparesis (19.2 +/- 8.5 mos poststroke) were tested. Torque measurements were performed on a computerized dynamometer and the superimposed electrical stimulation technique was used to assess voluntary activation of the knee extensors in both the paretic and the nonparetic lower limbs.Results: The mean voluntary activation ratio of the knee extensors in the nonparetic and paretic leg was 0.97 +/- 0.04 and 0.86 +/- 0.13, respectively. Subjects who had a greater relative weakness, implying a more pronounced poststroke impairment, also had lower voluntary activation ratios. The mean percentage difference in total torque between the nonparetic and the paretic knee extensors after the electrical stimulation was 36.4% +/- 17.0%.Conclusions: Paretic knee extensor muscle weakness in chronic poststroke subjects is only partially explained by a reduced voluntary activation ability, indicating that other neuromuscular structural or functional factors contribute to poststroke hemiparetic muscle weakness.

  • 174.
    Månsson Lexell, Eva
    et al.
    Department of Health Sciences, Lund University.
    Langdell, I.
    1Department of Health Sciences, Lund University.
    Lexell, Jan
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Vocational situation and experiences from the work environment among individuals with neuromuscular diseases2017Inngår i: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 56, nr 4, s. 519-530Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Neuromuscular diseases (NMD) can affect the ability to be employed and to work, but there is limited knowledge of individuals' own perspectives of factors that are important for their vocational situation. OBJECTIVE: To explore the vocational situation among people with NMD that are employed, and to describe their experiences of how their disability, personal and environmental factors influence their ability to continue to work. METHODS: Nine participants with different NMD were included. A mixed-methods design was used, and data were collected by means of semi-structured and open-ended interviews, and ratings of aspects supporting or interfering with their work performance and the ability to continue to work. Data were analyzed with directed content analysis based on the International Classification of Functioning, Disability and Health, and with descriptive statistics. RESULTS: The participants' personal characteristics, support from others at work and at home, and a flexible work organization were perceived as important factors facilitating work continuation, whereas physically demanding work assignments and factors in the physical environment were perceived as barriers. CONCLUSIONS: Knowledge of how personal characteristics as well as support from the work organization, managers and family members can facilitate the ability to work is important for employers, staff within different parts of the health care system, and the social security system. Future research should focus on interventions that are best suited to enhance the vocational situation for individuals with NMD

  • 175.
    Newsholme, S.J.
    et al.
    Department of Veterinary Pathology, Faculty of Veterinary Science, University of Liverpool.
    Lexell, Jan
    Downsham, David Y.
    Department of Veterinary Pathology, Faculty of Veterinary Science, University of Liverpool.
    Distribution of fibre types and fibre sizes in the tibialis cranialis muscle of beagle dogs1988Inngår i: Journal of Anatomy, ISSN 0021-8782, E-ISSN 1469-7580, Vol. 160, s. 1-8Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The percentages of Type I muscle fibres were measured systematically in ATPase-stained, transverse cryostat sections of whole tibialis cranialis muscles from 8 young, adult beagles. The distance of the section from the origin of the muscle does not significantly affect the mean percentage. There are no identifiable differences in mean percentages between right and left muscles. Differences in mean percentages between individuals are significant when sexes are combined (P less than 0.01) and within sexes (males: P less than 0.01; females: P less than 0.05). Within sections, the percentage tends to be lowest at the superficial (craniolateral) border and to vary less from site to site deeper within the muscle. Fibre cross sectional areas were measured systematically in the same sections of the right muscle from 3 males and 3 females. Mean areas for each section were greater for Type II than for Type I fibres. Mean areas for each fibre-type varied moderately and non-systematically between the sample sites within sections. A needle biopsy taken from deep within this muscle should provide a more consistent and reliable estimate of fibre-type proportion in the whole muscle than a superficial specimen. Proportions are not affected by the distance of the sample site from the muscle origin, and left or right muscles are suitable for sequential samples

  • 176.
    Nolvi, Maria
    et al.
    Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University.
    Brogårdh, Christina
    Department of Health Sciences, Physiotherapy Research Group, Lund University, Lund, Sweden. Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden.
    Jacobsson, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering. Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Lund, Sweden. Department of Rehabilitation Medicine, Sunderby Hospital, Luleå, Sweden.
    Lexell, Jan
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering. Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University, Lund, Sweden. Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden. Department of Rehabilitation Medicine, Sunderby Hospital, Luleå, Sweden.
    Sense of Coherence in persons with late effects of polio2018Inngår i: NeuroRehabilitation (Reading, MA), ISSN 1053-8135, E-ISSN 1878-6448, Vol. 42, nr 1, s. 103-111Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND:

    Sense of Coherence (SOC) is important for successful adaptation and mental well-being in people with life-long medical conditions. Late effects of polio (LEoP) often lead to a life-long disability, but no study has assessed SOC in this population.

    OBJECTIVE:

    To assess SOC in persons with LEoP and to explore the association between SOC, demographics (age, gender, marital status and level of education) and variables related to LEoP (age at polio onset, number of years from polio until onset of LEoP and self-rated disability).

    METHOD:

    Ninety-three community-dwelling persons with clinically verified LEoP responded to a postal survey with the Sense of Coherence Scale (SOC-13). A hierarchical multiple regression analysis was performed to explore the associations with SOC.

    RESULTS:

    SOC varied considerably among the participants. The mean and median SOC-13 total sum score was 71.8 and 76 points, which is similar to age-matched non-disabled people. The number of years before onset of LEoP and self-rated disability together with the participants’ marital status and level of education explained 37% (p < 0.001) of the variance in SOC.

    CONCLUSION:

    Persons with LEoP have a level of SOC indicating that they generally have the ability to understand, handle and being motivated when dealing with stressful events and problems arising in their lives as a result of their disability. Being married and having a higher education, living many years before onset of LEoP and perceiving a mild to moderate disability contributed to a strong SOC.

  • 177.
    Olsson, Malin
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Lexell, Jan
    Söderberg, Siv
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Kvinnors upplevelser att leva med multipel scleros2007Konferansepaper (Annet vitenskapelig)
  • 178.
    Olsson, Malin
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Lexell, Jan
    Söderberg, Siv
    The meaning of fatigue for women with multiple sclerosis2008Inngår i: Chronic Illness Management: The 13th Research Conference of the Workgroup of European Nurse Researchers (WENR), 2nd to 5th September, 2008 Vienna, Austria, WENR , 2008Konferansepaper (Fagfellevurdert)
  • 179.
    Olsson, Malin
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Lexell, Jan
    Söderberg, Siv
    The meaning of fatigue for women with multiple sclerosis2005Inngår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 49, nr 1, s. 7-15Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIM: This paper reports the findings of a study that aimed to elucidate the meaning of fatigue for women with multiple sclerosis (MS). BACKGROUND: Living with chronic illness can involve giving up usual activities. MS is a chronic autoimmune disease of the central nervous system. Fatigue is a common experience among people with MS; however, little is known about the meaning of fatigue experienced by women with this condition. METHOD: Ten women with MS were interviewed about their experience of fatigue. A phenomenological hermeneutic method influenced by Ricoeur was used to interpret the transcribed interviews. FINDINGS: The findings were presented in two major themes with five subthemes; experiencing the body as a barrier and experiencing a different absence. Fatigue seemed to give rise to an experience of being absent and divided into two parts. This also led to a feeling of not being able to participate in the surrounding world. The feeling of being an outsider and lacking the ability as a healthy person is interpreted as a form of suffering. Although the fatigue had a great impact on the women's daily life, the women still hoped for some relief. Fatigue seemed to imply that instead of working as an implement to manage in the world the body has become an enemy of survival. CONCLUSION: This study highlights the importance for nurses of understanding how women with MS experience fatigue, which is a prerequisite for communication based on a shared understanding. This awareness would enhance nurses' opportunities to alleviate suffering. More research is needed to investigate what kinds of interventions can help these women to manage their everyday lives and to maintain a sense of normality despite their fatigue and illness. Such interventions should be subject to empirical evaluation research.

  • 180.
    Olsson, Malin
    et al.
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Lexell, Jan
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Medicinsk vetenskap.
    Söderberg, Siv
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    The meaning of women's experiences of living with multiple sclerosis2008Inngår i: Health Care for Women International, ISSN 0739-9332, E-ISSN 1096-4665, Vol. 29, nr 4, s. 416-430Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    We conducted a qualitative inquiry in order to describe the meaning of women's experiences of living with multiple sclerosis (MS). Multiple sclerosis is a chronic autoimmune disease of the central nervous system. The majority of persons living with MS are women. Living with MS has been described as difficult because of the uncertainty of the illness. Ten women with MS were interviewed and the interviews were analyzed with a phenomenological hermeneutic interpretation. In this study, we suggest that the meaning of living with MS for women can be understood as trying to maintain power and living with an unrecognizable body. The bodies of women with MS serve as hindrances in everyday life. Bodily changes evident to others impose feelings of being met in a different way, which can be understood as an expression of a violated

  • 181.
    Persson, Elisabeth
    et al.
    Department of Health Sciences, Lund University; and Department of Rehabilitation Medicine, Skane University Hospital.
    Lexell, Jan
    Eklund, Mona
    Department of Health Sciences, Lund University.
    Rivano-Fischer, Marcelo
    Department of Health Sciences, Lund University; and Department of Rehabilitation Medicine, Skane University Hospital.
    Positive Effects of a Musculoskeletal Pain Rehabilitation Program Regardless of Pain Duration or Diagnosis2012Inngår i: PM&R, ISSN 1934-1482, E-ISSN 1934-1563, Vol. 4, nr 5, s. 355-366Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: To investigate how sociodemographic and clinical factors are associated with psychosocial functioning and disability at admission to a musculoskeletal pain rehabilitation program and at 1-year follow-up. Design: A cohort pre-post study. Setting: A University hospital specialized pain rehabilitation unit. Participants: Five hundred nine participants with musculoskeletal pain (neck disorders, 29%; fibromyalgia, 24%; low back pain, 24%; myalgia, 14%; and other pain diagnoses, 8%). Intervention: A 5-week outpatient, group-based, and goal-oriented comprehensive musculoskeletal interdisciplinary pain rehabilitation program based on cognitive behavioral principles. Main Outcome Measures: The Multidimensional Pain Inventory (MPI), the Disability Rating Index (DRI), and forms including sociodemographic factors (gender, age, ethnicity, marital status, educational level, and vocational situation) and clinical factors (pain duration and pain diagnoses). Data were analyzed with multivariate logistic regression. Results: At admission, factors associated with more positive scores on the MPI were being older than 40 years, being at work, being Nordic born, attainment of a higher educational level, and a diagnosis of fibromyalgia (compared with a neck disorder) (. P < .05). Being at work and a diagnosis of fibromyalgia (compared with low back pain) were associated with more positive scores on the DRI (. P < .05). On the basis of cut points for clinically important change on the MPI, participants rated themselves as most improved on the Affective Distress (52%), Life Control (49%), and Pain Severity (43%) subscales, and on the DRI index, the improvement rate was 22%. At the 1-year follow-up, neither sociodemographic nor clinical factors were associated with clinically important improvements of the MPI and the DRI, but younger age was related to deteriorations in pain severity. Conclusions: The lack of an association between sociodemographic and clinical factors and psychosocial functioning and disability at a 1-year follow-up after a musculoskeletal pain rehabilitation program suggests that the program was effective regardless of the participants' initial characteristics, except for age. The changes at the 1-year follow-up indicate that the program influenced the participants' psychosocial functioning more than their perception of disability.

  • 182.
    Ponsot, Elodie
    et al.
    Örebro University, Department of Health Sciences.
    Lexell, Jan
    Kadi, Fawzi
    Örebro University, Department of Health Sciences.
    Skeletal muscle telomere length is not impaired in healthy physically active old women and men2008Inngår i: Muscle and Nerve, ISSN 0148-639X, E-ISSN 1097-4598, Vol. 37, nr 4, s. 467-72Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    We have previously shown that the number of satellite cells is lower in old than young men and women. The aim of this study was to further explore the effects of aging on the regenerative potential of skeletal muscle in 16 young and 26 old men and women with comparable physical activity level (young, 25 +/- 4 years; old, 75 +/- 4 years). Mean and minimum telomere lengths were determined using Southern blot analyses on biopsies obtained from the tibialis anterior muscle. There were no significant age or gender effects on mean and minimal telomeric lengths, suggesting that the replicative potential in the remaining satellite cells in the tibialis anterior muscle is not impaired with increasing age and the existence of in vivo regulatory mechanisms allowing the maintenance of telomere length. These results imply that moderate physical activity regularly performed by old subjects is not associated with accelerated telomere loss

  • 183.
    Porter, Michelle M
    et al.
    Faculty of Physical Education and Recreation Studies.
    Koolage, Chris W
    Faculty of Physical Education and Recreation Studies.
    Lexell, Jan
    Biopsy sampling requirements for the estimation of muscle capillarization2002Inngår i: Muscle and Nerve, ISSN 0148-639X, E-ISSN 1097-4598, Vol. 26, nr 4, s. 546-8Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to determine the number of tibialis anterior biopsy samples and muscle fibers required to estimate the capillary supply of individual muscle fibers (C:F(i)). C:F(i) was calculated for 25 type 1 fibers in each of 8 images from 3 biopsies of 5 young healthy individuals. Sequential estimation analysis indicated that 50 fibers from one biopsy are sufficient to characterize the C:F(i) of the tibialis anterior for a group of subjects. Thus, when analyzing the capillarization of the tibialis anterior, the requirements of only one biopsy sample and 50 fibers means a great reduction in time for analysis and in the invasiveness of the procedure. Copyright 2002 Wiley Periodicals, Inc. Muscle Nerve 26: 546-548, 2002

  • 184.
    Ratkevicius, A
    et al.
    Department of Physiology and Biochemistry, Lithuanian Institute of Physical Education, Kaunas.
    Skurvydas, A
    Department of Physiology and Biochemistry, Lithuanian Institute of Physical Education, Kaunas.
    Lexell, Jan
    Submaximal-exercise-induced impairment of human muscle to develop and maintain force at low frequencies of electrical stimulation1995Inngår i: European Journal of Applied Physiology and Occupational Physiology, ISSN 0301-5548, E-ISSN 1432-1025, Vol. 70, nr 4, s. 294-300Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to test the hypothesis that low intensity exercise-induced low frequency fatigue is caused by failure of excitation-contraction coupling. Changes in knee extension torque at 5, 10, 15, 20 and 50 Hz electrical stimulation of quadriceps muscle in ten healthy, young, male subjects were recorded during 20-min voluntary exercise followed by 60-min recovery. In seven of the ten subjects, changes in torque during 3 min of 10-Hz stimulation were recorded 2 min and 20 min after 20 min voluntary exercise. Exercise was performed at 30% of maximal voluntary contraction with a contraction plus relaxation period of 6 plus 4 s. Torque at 5, 10, 15, 20 and 50-Hz stimulation at the end of exercise was reduced to mean 91.0 (SEM 5.4)%, 68.7 (SEM 5.4)%, 67.2 (SEM 3.9)%, 66.5 (SEM 4.5)% and 74.7 (SEM 4.3)% of control values, respectively. During the first 30 s of the 3 min 10-Hz stimulation, torque was reduced in exercised muscle and increased in nonfatigued muscle. The reduction in torque was more marked 20 min after exercise than after 2 min. In conclusion, the pattern of depression and recovery of muscle force observed was in agreement with the hypothesis that the main cause of low intensity exercise-induced low frequency fatigue is an impairment of excitation-contraction coupling

  • 185.
    Rosengren, Lina
    et al.
    Department of Health Sciences, Rehabilitation Medicine Research Group, Lund University.
    Brogårdh, Christina
    Lund University Hospital, Skåne University Hospital, Lund, Institutionen för hälsa, vård och samhälle, Lunds universitet, Department of Health Sciences, Lund University, Department of Rehabilitation Medicine, Skåne University Hospital.
    Jacobsson, Lars
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Lexell, Jan
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Life satisfaction and associated factors in persons with mild to moderate Parkinson's disease2016Inngår i: NeuroRehabilitation (Reading, MA), ISSN 1053-8135, E-ISSN 1878-6448, Vol. 39, nr 2, s. 285-294Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Life satisfaction (LS) is an overall goal in the long-term management and rehabilitation of persons with Parkinson's disease (PD). However, very little is known about LS in persons with PD and no study has examined factors associated with their LS.OBJECTIVE: To describe LS in persons with mild to moderate PD and to evaluate the association with gender, age, years since diagnosis, and sense of coherence, perceived participation, and mental and emotional status.METHODS: Eighty persons with mild to moderate PD (46 men and 34 women, mean age 70.1 years, mean time since diagnosis 7.4 years) responded to a postal survey with the Swedish versions of the Satisfaction With Life Scale (SWLS), the Sense of Coherence scale (SOC-13), the Reintegration to Normal Living Index (RNLI) and the Geriatric Depression Scale (GDS-20). Hierarchical multiple regression analyses were used to evaluate the association with LS.RESULTS: The mean SWLS total score was 21.8 points, and 45% rated themselves as satisfied to highly satisfied with their lives. SOC and years since diagnosis explained 36% of the variance, where a strong SOC, indicating a person's capacity to adapt to the overall strains of the disease, showed the strongest association with a high LS.CONCLUSIONS: Persons with mild to moderate PD seem to be generally satisfied with their lives but LS may decrease as the disease progresses. The strong association with SOC implies that LS may increase through rehabilitation that support persons with PD to understand and confront the nature of problems arising in their lives as a result of their PD.

  • 186.
    Sjödahl Hammarlund, Catharina
    et al.
    Department of Health Sciences, Lund University.
    Lexell, Jan
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Brogårdh, Christina
    Department of Health Sciences, Lund University.
    Perceived consequences of ageing with late effects of polio and strategies for managing daily life: a qualitative study2017Inngår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 17, nr 1, artikkel-id 179Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AbstractBACKGROUND:

    New or increased impairments may develop several decades after an acute poliomyelitis infection. These new symptoms, commonly referred to as late effects of polio (LEoP), are characterised by muscular weakness and fatigue, generalised fatigue, pain at rest or during activities and cold intolerance. Growing older with LEoP may lead to increased activity limitations and participation restrictions, but there is limited knowledge of how these persons perceive the practical and psychological consequences of ageing with LEoP and what strategies they use in daily life. The aim of this qualitative study was therefore to explore how ageing people with LEoP perceive the their situation and what strategies they use for managing daily life.

    METHODS:

    Seven women and seven men (mean age 70 years) were interviewed. They all had a confirmed history of acute poliomyelitis and new impairments after a stable period of at least 15 years. Data were transcribed verbatim and analysed using systematic text condensation.

    RESULTS:

    The latent analysis resulted in three categories 'Various consequences of ageing with LEoP', 'Limitations in everyday activities and participation restrictions', and 'Strategies for managing daily life when ageing with LEoP' and 12 subcategories. The new impairments led to decreased physical and mental health. The participants perceived difficulties in performing everyday activities such as managing work, doing chores, partaking in recreational activities and participating in social events, thereby experiencing emotional and psychological distress. They managed to find strategies that mitigated their worries and upheld their self-confidence, for example finding practical solutions, making social comparisons, minimising, and avoidance.

    CONCLUSION:

    Ageing with LEoP affected daily life to a great extent. The participants experienced considerable impact of the new and increased impairments on their life situation. Consequently, their ability to participate in various social activities also became restricted. Social comparisons and practical solutions are strategies that facilitate adaptation and acceptance of the new situation due to LEoP. This emphasises the need to design rehabilitation interventions that focus on coping, empowerment and self-management for people ageing with LEoP.

  • 187.
    Sjöström, Michael
    et al.
    Department of Neurology, Umeå university.
    Downham, David
    Department of Physical Medicine, Umeå University.
    Lexell, Jan
    Distribution of different fiber types in human skeletal muscles: why is there a difference within a fascicle?1986Inngår i: Muscle and Nerve, ISSN 0148-639X, E-ISSN 1097-4598, Vol. 9, nr 1, s. 30-6Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The proportions of different fiber types (type 1 and type 2) on the borders of fascicles are shown to differ from the proportions internally. This finding is based on the analysis of a total of 245 fascicles from whole cross-sections of the vastus lateralis muscle from 13 men, aged from 26-80 years. Generally, the difference is more marked in the young than in the old. It is argued that the causes of this difference are likely to be local factors in the muscle.

  • 188.
    Sjöström, Michael
    et al.
    Department of Neurology, Umeå university.
    Lexell, Jan
    Downham, David
    Umeå university.
    Fascicles do not have to be static structures!1987Inngår i: Muscle and Nerve, ISSN 0148-639X, E-ISSN 1097-4598, Vol. 10, nr 5, s. 471-Artikkel i tidsskrift (Annet vitenskapelig)
  • 189.
    Sjöström, Michael
    et al.
    Departments of Social Medicine and Surgery, University of Umeå.
    Lexell, Jan
    Eriksson, A.
    Department of Forensic Medicine, University of Umeå.
    Taylor, C.C.
    Department of Statistics, University of Strathclyde, Glasgow.
    Evidence of fibre hyperplasia in human skeletal muscles from healthy young men?: A left-right comparison of the fibre number in whole anterior tibialis muscles1991Inngår i: European Journal of Applied Physiology and Occupational Physiology, ISSN 0301-5548, E-ISSN 1432-1025, Vol. 62, nr 5, s. 301-304Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Cross-sections (thickness 10 microns) of whole autopsied left and right anterior tibialis muscles of seven young previously healthy right-handed men (mean age 23 years, range 18-32 years) were prepared for light-microscope enzyme histochemistry. Muscle cross-sectional area and total number of fibres, mean fibre size (indirectly determined) and proportion of the different fibre types (type 1 and type 2 on basis of myofibrillar adenosine triphosphatase characteristics), in each muscle cross-section were determined. The analysis showed that the cross-sectional area of the left muscle was significantly larger (P less than 0.05), and the total number of fibres was significantly higher (P less than 0.05), than for the corresponding right muscle. There was no significant difference for the mean fibre size or the proportion of the two fibre types. The results imply that long-term asymmetrical low-level daily demands on muscles of the left and the right lower leg in right-handed individuals provide enough stimuli to induce an enlargement of the muscles on the left side, and that this enlargement is due to an increase in the number of muscle fibres (fibre hyperplasia). Calculations based on the data also explain why the underlying process of hyperplasia is difficult, or even impossible, to detect in standard muscle biopsies.

  • 190. Söderberg, Siv
    et al.
    Jumisko, Eija
    Lexell, Jan
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Projekt: Att leva med en traumatisk hjärnskada2010Annet (Annet (populærvitenskap, debatt, mm))
    Abstract [sv]

    Projektets övergripande syfte  Syftet med detta projekt är beskriva innebörden i upplevelsen av att leva med traumatisk hjärnskada (THS) utifrån de berörda personernas samt deras närståendes berättelser.    Kort beskrivning av projektet  Detta projekt fokuserar på upplevelser av det dagliga livet med en traumatisk hjärnskada (THS) utifrån berörda personers och deras närståendes perspektiv. En traumatisk hjärnskada, THS, orsakad av yttre våld vid exempelvis en trafikolycka, fall eller liknande drabbar män oftare än kvinnor. Den drabbade måste ofta tillbringa långa perioder på sjukhus och rehabiliteringar. Studien är kvalitativ och två delstudier är avslutade. De visar att skadan förändrar hela livet och orsakar djupt lidande. Kroppen är för alltid förändrad, ett faktum som i sig förändrar hela livet. De drabbade personerna försöker på olika sätt bemästra känslan av skam samtidigt som de kämpar med att bevara känslan av värdighet. Även för de närstående har livet förändrats totalt. De kämpar med att inte förlora fotfästet när de tvingas ta ökat ansvar, de vill göra allt de kan för att stötta den drabbade, både av kärlek och på grund av det etiska kravet på att ta hand om honom eller henne. Ytterligare två delstudier planeras.

  • 191.
    Wilson, B.C.
    et al.
    Department of Statistics & Computational Mathematics, University of Liverpool.
    Downham, David
    Department of Statistics & Computational Mathematics, University of Liverpool.
    Lexell, Jan
    Sjöström, Michael
    Department of Neurology, Umeå university.
    Some probability models for diagnosing neurogenic disorders1988Inngår i: IMA journal of mathematics applied in medicine and biology, ISSN 0265-0746, E-ISSN 1471-6879, Vol. 5, nr 3, s. 167-79Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Healthy human skeletal muscles are composed of two distinguishable types of fibre, apparently randomly arranged within fascicles (bundles of fibres surrounded by connective tissue). Large groups of fibres of the same type indicate a neurogenic muscle disorder. An objective method for detecting nonrandom arrangements of fibres could improve the diagnosis of such disorders, particularly at an early stage. The number of enclosed fibres (NEF)--fibres surrounded by others of the same type--is considered here as a measure of nonrandomness. The distribution of NEF is shown to be approximately negative binomial for a non-free-sampling model, which is then compared with a free-sampling model studied previously. A modification for a known boundary effect is also investigated. The models are applied to data from m. vastus lateralis obtained post mortem from 24 previously healthy men. Finally, the relationship between size of biopsy and the accuracy of predictions is discussed.

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