Polio and post-polio syndrome in non-Western immigrants: A new challenge for the healthcare system in Norway

Objective: To explore the health situation and identify specific health challenges in non-Western immigrants with polio in Norway, by comparing their status with Western immigrants with polio and native Norwegians with polio. Design: A questionnaire covering demographics, polio history, life satisfaction, medical, psychological and social conditions was answered by 1,408 persons with polio, among them 34 immigrants from non-Western countries and 32 immigrants from Western countries. Results: The non-Western immigrant polio group had a mean age of 46 years, were highly educated, reported high frequency of mental health problems and only one-third was working. Mean age for contracting polio was 2.8 years. Only 30% was hospitalized in the acute phase and 80% reported severe leg weakness. Use of a powered wheelchair was reported by 72%. Post-polio symptoms had started at a mean age of 31 years. The non-Western immigrant group reported more fatigue, pain and loneliness, and a high proportion reported insufficient assistance from the public health system. Conclusion: The group of non-Western immigrants with polio in Norway reported more health and social problems than the group of Western immigrants with polio or the native Norwegian group with polio, even though they were younger and more highly educated. Their complex psychological and social situation requires active intervention from the health system, and health professionals need extra skills to deal most effectively with their situation.publishedVersio

A multicenter study on transfer, walking and stair climbing in persons with stroke admitted to specialized rehabilitation

Background: Walking on even surface and stair walking capacity are prerequisites for independence, and these capacities are often referred to as primary goals in rehabilitation after stroke

Specialized stroke rehabilitation services in seven countries

Background There is a lack of defined levels of rehabilitation, indicating possibly random content and access to specialized services. Aims and/or hypothesis The aim of the study was to perform a multinational descriptive study of specialized rehabilitation in persons with stroke, to elucidate what the different centers define as prerequisites for specialized rehabilitation, and to analyze whether these descriptions map to currently applied standards or constructs of specialized rehabilitation. A secondary aim was to look for similarities and differences between therapies and services for persons with stroke in the sub-acute stage in the different institutions. Methods Descriptive data of the collaborating centers regarding structure and processes of services were recorded and compared with the British Society of Rehabilitation Medicine and Specialized Services National Definitions sets. Results Comparisons of the definitions

Senior fitness test; a useful tool to measure physical fitness in persons with acquired brain injury

Objectives: To evaluate the feasibility and usability of the senior fitness test (SFT) in persons with acquired brain injury (ABI). Methods: A pilot cohort design with a convenience sample of persons with ABI was used. Results: Persons with ABIs (n = 47) were younger than their healthy counterparts (n = 172) were but performed significantly worse on sit to stand, 6-min walk test (6MWT) and 2.45-m up and go. This difference was accentuated in the age groups >60 years of age. Persons with ABIs, divided into subgroups traumatic brain injury (TBI; n = 12) and cerebral insult (CI; n = 35), showed significant differences in leg strength, upper extremity flexibility and walking capacity. Persons with CI were weaker, less flexible in upper and lower extremities, walked shorter distance and were less mobile. CI but not TBI performed significantly worse when compared to healthy elderly persons. Conclusion: This study indicates that SFT is feasible, safe and useful tool for persons with ABI, to evaluate physical capacity, endurance, strength and flexibility. The submaximal test was well tolerated and could be performed by all participants irrespective of age or diagnosis. The distribution of test scores indicates responsiveness to change and no ceiling or floor effects

Senior fitness test; a useful tool to measure physical fitness in persons with acquired brain injury

Objectives: To evaluate the feasibility and usability of the senior fitness test (SFT) in persons with acquired brain injury (ABI). Methods: A pilot cohort design with a convenience sample of persons with ABI was used. Results: Persons with ABIs (n = 47) were younger than their healthy counterparts (n = 172) were but performed significantly worse on sit to stand, 6-min walk test (6MWT) and 2.45-m up and go. This difference was accentuated in the age groups >60 years of age. Persons with ABIs, divided into subgroups traumatic brain injury (TBI; n = 12) and cerebral insult (CI; n = 35), showed significant differences in leg strength, upper extremity flexibility and walking capacity. Persons with CI were weaker, less flexible in upper and lower extremities, walked shorter distance and were less mobile. CI but not TBI performed significantly worse when compared to healthy elderly persons. Conclusion: This study indicates that SFT is feasible, safe and useful tool for persons with ABI, to evaluate physical capacity, endurance, strength and flexibility. The submaximal test was well tolerated and could be performed by all participants irrespective of age or diagnosis. The distribution of test scores indicates responsiveness to change and no ceiling or floor effects

Return to work after specialized rehabilitation-An explorative longitudinal study in a cohort of severely disabled persons with stroke in seven countries: The Sunnaas International Network stroke study.

Introduction: Stroke may impose disabilities with severe consequences for the individual, with physical, psychological, social, and work‐related consequences. The objective with the current study was to investigate to what extent persons with stroke were able to return to work, to maintain their financial situation, and to describe the follow‐up services and participation in social networks and recreational activities. Methods: The design was a prospective, descriptive study of specialized stroke rehabilitation in nine rehabilitation centers in seven countries. Semistructured interviews, which focused on the return to work, the financial situation, follow‐up services, the maintenance of recreational activities, and networks, were performed 6 and 12 months post discharge from rehabilitation. Results: The working rate before the onset of stroke ranged from 27% to 86%. At 12 months post stroke, the return to work varied from 11% to 43%. Consequently, many reported a reduced financial situation from 10% to 70% at 6 months and from 10% to 80% at 12 months. Access to postrehabilitation follow‐up services varied in the different countries from 24% to 100% at 6 months and from 21% to 100% at 12 months. Physical therapy was the most common follow‐up services reported. Persons with stroke were less active in recreational activities and experienced reduced social networks. Associations between results from the semistructured interviews and related themes in LiSat‐11 were small to moderate. The study shows that education, age, and disability are predictors for return to work. Differences between countries were observed in the extent of unemployment. Conclusions: In this international multicentre study, return to work after severe stroke and specialized/comprehensive rehabilitation was possible, depending on the extent of the disability, age, and education. Altered financial situation, reduced social networks, and reduced satisfaction with life were common psychosocial situations for these patients

Return to work after specialized rehabilitation-An explorative longitudinal study in a cohort of severely disabled persons with stroke in seven countries: The Sunnaas International Network stroke study.

Introduction: Stroke may impose disabilities with severe consequences for the individual, with physical, psychological, social, and work- related consequences. The objective with the current study was to investigate to what extent persons with stroke were able to return to work, to maintain their financial situation, and to describe the follow- up services and participation in social networks and recreational activities. Methods: The design was a prospective, descriptive study of specialized stroke rehabilitation in nine rehabilitation centers in seven countries. Semistructured interviews, which focused on the return to work, the financial situation, follow- up services, the maintenance of recreational activities, and networks, were performed 6 and 12 months post discharge from rehabilitation. Results: The working rate before the onset of stroke ranged from 27% to 86%. At 12 months post stroke, the return to work varied from 11% to 43%. Consequently, many reported a reduced financial situation from 10% to 70% at 6 months and from 10% to 80% at 12 months. Access to postrehabilitation follow- up services varied in the different countries from 24% to 100% at 6 months and from 21% to 100% at 12 months. Physical therapy was the most common follow- up services reported. Persons with stroke were less active in recreational activities and experienced reduced social networks. Associations between results from the semistructured interviews and related themes in LiSat- 11 were small to moderate. The study shows that education, age, and disability are predictors for return to work. Differences between countries were observed in the extent of unemployment. Conclusions: In this international multicentre study, return to work after severe stroke and specialized/comprehensive rehabilitation was possible, depending on the extent of the disability, age, and education. Altered financial situation, reduced social networks, and reduced satisfaction with life were common psychosocial situations for these patients

Polio and post-polio syndrome in non-Western immigrants: A new challenge for the healthcare system in Norway

Objective: To explore the health situation and identify specific health challenges in non-Western immigrants with polio in Norway, by comparing their status with Western immigrants with polio and native Norwegians with polio. Design: A questionnaire covering demographics, polio history, life satisfaction, medical, psychological and social conditions was answered by 1,408 persons with polio, among them 34 immigrants from non-Western countries and 32 immigrants from Western countries. Results: The non-Western immigrant polio group had a mean age of 46 years, were highly educated, reported high frequency of mental health problems and only one-third was working. Mean age for contracting polio was 2.8 years. Only 30% was hospitalized in the acute phase and 80% reported severe leg weakness. Use of a powered wheelchair was reported by 72%. Post-polio symptoms had started at a mean age of 31 years. The non-Western immigrant group reported more fatigue, pain and loneliness, and a high proportion reported insufficient assistance from the public health system. Conclusion: The group of non-Western immigrants with polio in Norway reported more health and social problems than the group of Western immigrants with polio or the native Norwegian group with polio, even though they were younger and more highly educated. Their complex psychological and social situation requires active intervention from the health system, and health professionals need extra skills to deal most effectively with their situation