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  • 1.
    Aghanavesi, Somayeh
    et al.
    Högskolan Dalarna, Akademin Industri och samhälle, Mikrodataanalys.
    Bergquist, Filip
    Nyholm, Dag
    Senek, Marina
    Memedi, Mevludin
    Motion sensor-based assessment of Parkinson’s disease motor symptoms during leg agility tests: results from levodopa challenge2019Ingår i: IEEE journal of biomedical and health informatics, ISSN 2168-2194, E-ISSN 2168-2208Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Parkinson’s disease (PD) is a degenerative, progressive disorder of the central nervous system that mainly affects motor control. The aim of this study was to develop data-driven methods and test their clinimetric properties to detect and quantify PD motor states using motion sensor data from leg agility tests. Nineteen PD patients were recruited in a levodopa single dose challenge study. PD patients performed leg agility tasks while wearing motion sensors on their lower extremities. Clinical evaluation of video recordings was performed by three movement disorder specialists who used four items from the motor section of the Unified PD Rating Scale (UPDRS), the treatment response scale (TRS) and a dyskinesia score. Using the sensor data, spatiotemporal features were calculated and relevant features were selected by feature selection. Machine learning methods like support vector machines (SVM), decision trees and linear regression, using 10-fold cross validation were trained to predict motor states of the patients. SVM showed the best convergence validity with correlation coefficients of 0.81 to TRS, 0.83 to UPDRS #31 (body bradykinesia and hypokinesia), 0.78 to SUMUPDRS (the sum of the UPDRS items: #26-leg agility, #27-arising from chair and #29-gait), and 0.67 to dyskinesia. Additionally, the SVM-based scores had similar test-retest reliability in relation to clinical ratings. The SVM-based scores were less responsive to treatment effects than the clinical scores, particularly with regards to dyskinesia. In conclusion, the results from this study indicate that using motion sensors during leg agility tests may lead to valid and reliable objective measures of PD motor symptoms.

  • 2.
    Cedervall, Ylva
    et al.
    Institutionen för folkhälso- och vårdvetenskap, Geriatrik, Uppsala universitet.
    Halvorsen, Kjartan
    Department of Information Technology, Division of Systems and Control, Uppsala University.
    Åberg, Anna Cristina
    Department of Public Health and Caring Sciences/Geriatrics, Uppsala University.
    A longitudinal study of gait function and characteristics of gait disturbances in individuals with Alzheimer's disease2014Ingår i: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 39, nr 4, s. 1022-1027Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Walking in daily life places high demands on the interplay between cognitive and motor functions. A well-functioning dual-tasking ability is thus essential for walking safely. The aims were to study longitudinal changes in gait function during single- and dual-tasking over a period of two years among people with initially mild AD (n = 21). Data were collected on three occasions, twelve months apart. An optical motion capture system was used for three-dimensional gait analysis. Gait parameters were examined at comfortable gait speed during single-tasking, dual-tasking naming names, and naming animals. The dual-task cost for gait speed was pronounced at baseline (names 26%, animals 35%), and remained so during the study period. A significant (p < 0.05) longitudinal decline in gait speed and step length during single- and dual-tasking was observed, whereas double support time, step width and step height showed inconsistent results. Systematic visual examination of the motion capture files revealed that dual-tasking frequently resulted in gait disturbances. Three main characteristics of such disturbances were identified: Temporal disturbance, Spatial disturbance and Instability in single stance. These aberrant gait performances may affect gait stability and increase the risk of falling. Furthermore, the observed gait disturbances can contribute to understanding and explaining previous reported gait variability among individuals with AD. However, the role that dual-task testing and aberrant dual-task gait performance play in the identification of individuals with early signs of cognitive impairment and in predicting fall risk in AD remains to be studied.

  • 3.
    Elmgren Frykberg, Gunilla
    et al.
    Uppsala universitet, Rehabiliteringsmedicin.
    Thierfelder, Tomas
    Department of Energy and Technology, Swedish University of Agricultural Sciences, Uppsala, Sweden.
    Åberg, Anna Cristina
    Department of Public Health and Caring Sciences/Geriatrics, Uppsala University.
    Halvorsen, Kjartan
    Department of Information Technology, Division of Systems and Control, Uppsala University.
    Borg, Jörgen
    Department of Clinical Sciences, Rehabilitation Medicine, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden.
    Hirschfeld, Helga
    Motor Control and Physical Therapy Research Laboratory, Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Impact of stroke on anterior–posterior force generation prior to seat-off during sit-to-walk2012Ingår i: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 35, nr 1, s. 56-60Artikel i tidskrift (Refereegranskat)
  • 4.
    Elmgren Frykberg, Gunilla
    et al.
    Department of Neuroscience, Rehabilitation Medicine, Uppsala University.
    Åberg, Anna Cristina
    Department of Public Health and Caring Sciences/Geriatrics, Uppsala University; Swedish School of Sport and Health Sciences, Stockholm, Sweden.
    Halvorsen, Kjartan
    Department of Information Technology, Division of Systems and Control, Uppsala University; School of Technology and Health, the Royal Institute of Technology, Stockholm, Sweden.
    Borg, Jörgen
    Department of Neuroscience/Rehabilitation Medicine, Uppsala University, Uppsala, Sweden.
    Hirschfeld, Helga
    Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy.
    Temporal coordination of the sit-to-walk task in subjects with stroke and in controls2009Ingår i: Archives of Physical Medicine and Rehabilitation, ISSN 0003-9993, E-ISSN 1532-821X, Vol. 90, nr 6, s. 1009-1017Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: To explore events and describe phases for temporal coordination of the sit-to-walk (STW) task, within a semistandardized set up, in subjects with stroke and matched controls. In addition, to assess variability of STW phase duration and to compare the relative duration of STW phases between the 2 groups.

    Design: Cross-sectional.

    Setting: Research laboratory.

    Participants: A convenience sample of persons with hemiparesis (n=10; age 50–67y), more than 6 months after stroke and 10 controls matched for sex, age, height, and body mass index.

    Interventions: Not applicable.

    Main Outcome Measures: Relative duration of STW phases, SE of measurement in percentage of the mean, and intraclass correlation coefficients (ICCs).

    Results: Four STW phases were defined: rise preparation, transition, primary gait initiation, and secondary gait initiation. The subjects with stroke needed 54% more time to complete the STW task than the controls did. ICCs ranged from .38 to .66 and .22 to .57 in the stroke and control groups, respectively. SEs of measurement in percentage of the mean values were high, particularly in the transition phase: 54.1% (stroke) and 50.4% (controls). The generalized linear model demonstrated that the relative duration of the transition phase was significantly longer in the stroke group.

    Conclusions: The present results extend existing knowledge by presenting 4 new phases of temporal coordination of STW, within a semistandardized set-up, in persons with stroke and in controls. The high degree of variability regarding relative STW phase duration was probably a result of both the semistandardized set up and biological variability. The significant difference in the transition phase across the 2 groups requires further study.

  • 5.
    Grenholm, Anton
    et al.
    Umeå Universitet.
    Stensdotter, Ann-Katrin
    Umeå Universitet.
    Häger-Ross, Charlotte
    Umeå Universitet; Sør-Trøndelag University College, Trondheim.
    Kinematic analyses during stair descent in young women with patellofemoral pain.2009Ingår i: Clinical Biomechanics, ISSN 0268-0033, E-ISSN 1879-1271, Vol. 24, nr 1, s. 88-94Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Compensatory movement strategies may develop in response to pain to avoid stress on the affected area. Patellofemoral pain is characterised by intermittent periods of pain and the present study addresses whether long-term pain leads to compensatory movement strategies that remain even when the pain is absent.

    METHOD: Lower extremity kinematics in three dimensions was studied in stair descent in 17 women with patellofemoral and in 17 matched controls. A two-dimensional geometric model was constructed to normalise kinematic data for subjects with varying anthropometrics when negotiating stairs of fixed proportions.

    RESULTS: There were minor differences in movement patterns between groups. Knee joint angular velocity in the stance leg at foot contact was lower and the movement trajectory tended to be jerkier in the patellofemoral group. The two-dimensional model showed greater plantar flexion in the swing leg in preparation for foot placement in the patellofemoral group.

    INTERPRETATION: The results indicate that an altered stair descent strategy in the patellofemoral group may remain also in the absence of pain. The biomechanical interpretation presumes that the strategy is aimed to reduce knee joint loading by less knee joint moment and lower impact force.

  • 6.
    Nyberg, André
    et al.
    Umeå universitet, Institutionen för samhällsmedicin och rehabilitering.
    Tistad, Malin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap. Umeå universitet, Institutionen för samhällsmedicin och rehabilitering.
    Wadell, Karin
    Umeå universitet, Institutionen för samhällsmedicin och rehabilitering.
    Can the COPD Web be used to promote self-management in patients with COPD in Swedish primary care: a controlled pragmatic pilot trial with 3 month and 12 month follow-up2019Ingår i: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 37, nr 1, s. 69-82Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE:

    Evaluate the feasibility of the COPD Web and its study design and study procedures and to increase the understanding of the potential effect of the tool in order to provide guidance for a future large scale trial.

    DESIGN:

    Parallel-group controlled pragmatic pilot trial.

    SUBJECTS:

    There was a total of 83 patients with COPD (mean age 70 ± 8 years with a forced expiratory volume in first second percent predicted of 60 ± 17%). The intervention group (n = 43) was introduced to and had access to the COPD Web in addition to usual care, while the control group (n = 40) received usual care alone.

    MAIN OUTCOME MEASURES:

    The feasibility of the COPD Web (i.e., if and how the COPD Web was used) was automatically collected through the website, while outcomes on health, conceptual knowledge, and physical activity (PA) were collected through questionnaires at baseline, 3 months and 12 months.

    RESULTS:

    At 3 months, 77% of the intervention group was considered users, and the majority of time spent on the site was related to PA and exercises and was spent during the first month (>80%). In addition, the intervention group reported increased PA (odds ratio [OR] = 4.4, P < .001), increased conceptual knowledge in five domains (OR = 2.6-4.2, all P < .05), and altered disease management strategies (e.g., increased PA) (OR ≥ 2.7 P < .05) in comparison to the control group. The latter was also different between groups at 12 months (OR = 3.7, P = .044). Knowledge of PA was correlated with level of PA (ρ = .425-.512, P < .05) as well as to the use of PA as a strategy to manage their disease (χ2 = 11.2-32.9, P < .05).

    CONCLUSION:

    Giving patients with COPD access to the COPD Web in addition to their ordinary primary care might be an effective shorter term (3 month) strategy to promote self-management. However, these results needs to be confirmed in a definitive large-scale trial. Key points Even though self-management strategies are an important part of chronic obstructive pulmonary disease (COPD) management, access to support for such strategies are limited for a large part of the COPD-population. Promoting self-management through the COPD Web might increase short-term levels of physical activity, promote conceptual knowledge and alter disease management strategies. The primary care COPD population in this study experienced limited impact of the disease in daily life, limited exertional dyspnea, and high generic quality-of-life, but vastly reduced levels of physical activity. A future large scale study should include strategies to encourage greater exposures to the COPD Web, including an extended analysis of factors associated with using or not using the tool over time and its impact on outcome measures, objective measures of conceptual knowledge, and physical activity, and it should include a large enough sample size to enable sub-group analyses and strategies to enhance recruitment.

  • 7.
    Åberg, Anna Cristina
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Geriatrik.
    Generell Motorisk Funktionsbedömning: GMF Manual2011Bok (Övrigt vetenskapligt)
  • 8.
    Åberg, Anna Cristina
    et al.
    The Swedish School of Sport and Health Sciences, Box 5626, SE-114 86 Stockholm, Sweden ; Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala Science Park, SE-751 85 Uppsala, Sweden.
    Elmgren Frykberg, Gunilla
    Uppsala universitet, Rehabiliteringsmedicin.
    Halvorsen, Kjartan
    Uppsala universitet, Reglerteknik; Swedish School of Sport and Health Sciences, Stockholm, Sweden.
    Medio-lateral stability of sit-to-walk performance in older individuals with and without fear of falling2010Ingår i: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 31, nr 4, s. 438-443Artikel i tidskrift (Refereegranskat)
  • 9.
    Åberg, Anna Cristina
    et al.
    The Swedish School of Sport and Health Sciences, Stockholm, Sweden ; Department of Public Health and Caring Sciences/Geriatrics, Uppsala, Sweden.
    Thorstensson, Alf
    The Swedish School of Sport and Health Sciences, Stockholm, Sweden.
    Tarassova, Olga
    The Swedish School of Sport and Health Sciences, Stockholm, Sweden.
    Halvorsen, Kjartan
    Uppsala universitet, Avdelningen för systemteknik ; School of Technology and Health, KTH-Royal Institute of Technology, Stockholm, Sweden.
    Calculations of mechanisms for balance control during narrow and single-leg standing in fit older adults: a reliability study2011Ingår i: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 34, nr 3, s. 352-357Artikel i tidskrift (Refereegranskat)
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