Dynamic ankle-foot orthoses in children with spastic diplegia : interview and experimental studies

Dynamic ankle-foot orthosis (DAFO) is a thin supra malleolar orthosis used as a compliment to the total treatment program in children with cerebral palsy (CP) in order to facilitate function in sitting, standing and walking. The DAFO keeps the foot in a functional position and is said to provide the child with proprioceptive feedback for balance- and postural control. The aim of the present thesis was to explore how parents of children with spastic diplegia experience the use of DAFOs and to determine the effects of DAFOs in standing during a reaching movement, in relation to postural orientation, anticipatory- and compensatory postural adjustments, and the quality of the reaching movement. The parents of 15 children, aged 4-18 years, who had spastic diplegia and wore DAFOs were interviewed with a broad research question "How do you perceive that DAFO influence your child" and analysed with content analysis. Children with spastic diplegia, aged 5-12 years, (n=6 in studies II and IV and n=4 in study III) classified at level II-IV according to Gross Motor Function Classification System (GMFCS) and typically developing children (controls) (n=8 in study III and n=6 in study IV) in the same age-group performed a voluntary reaching movement towards a target while standing on force plates. This allowed for registration of forces, movement and muscle activity (EMG). Children with spastic diplegia used DAFOs and/or shoes during the experiment while controls used shoes only. The parents experienced that DAFOs with their stabilizing effect on the foot and ankle enabled postural control and alignment, which contributed to functional activities under more favourable physical conditions. Moreover, psychosocial aspects such as a feeling of security, safety and freedom were regarded by the parents as being as important as the physical effects. Our findings showed that children with more severe spastic diplegia applied their body weight in standing more evenly between the legs and improved extension of the knee using DAFOs compared to wearing shoes alone. To initiate the reaching movement, despite different support conditions, children with spastic diplegia wearing DAFOs, as well as the controls make use of anticipatory postural adjustments. Furthermore, during the acceleration and deceleration phase of the reaching movement, children with spastic diplegia make use of compensatory postural adjustments characterized by co-contraction of tibialis anterior (TA) and lateral gastrocnemius (LG) muscles bilaterally. The postural adjustments in the controls were characterized by increased TA activity on the reach side during the acceleration phase and increased LG activity on the non-reach side during the deceleration phase. Movement quality in reaching in children with spastic diplegia showed that coordination between upward and forward reach velocity differed regarding temporal phasing and amplitudes of velocity peaks compared to the controls. According to parents´ perceptions DAFOs can be regarded as a part of treatment that improves stability, balance and functional skills. Children with severe spastic diplegia wearing DAFOs can, in spite of different support conditions, practice standing with a more evenly distributed body weight on the feet. The practice of reaching movements while standing with DAFOs can promote motor learning of postural adjustments and thereby improve the ability to use the hands in daily activities.Godkänd; 2007; 20070504 (ysko

Arbetslivsinriktad rehabilitering på Testa : en intervjustudie

I denna rapport redovisas resultaten av intervjuer med ett antal personer som varit inskrivna i Testa, ett arbetsmarknadsprojekt som bedrivits i Jönköpings kommun. Studien har genomförts av Luppen kunskapscentrum med inriktning mot individ och familj, Kommunförbundet i Jönköpings län. Testa är ett arbetsmarknadsprojekt som drivs i samverkan mellan Jönköpings socialförvaltning, Jönköpings kommuns arbetsmarknadsavdelning, försäkringskassan och arbetsförmedlingen. Projektet har fått ekonomiskt stöd från EU Mål 3. Målgruppen för projektet har varit arbetssökande i behov av arbetsträning och arbetsprövning. Målsättningen med projektet har varit att deltagarna efter deltagande i Testa ska erhålla anställning på den reguljära arbetsmarknaden eller påbörja utbildning inom det reguljära utbildningsväsendet. Det har ansetts viktigt att projektet utvärderas för att ta tillvara erfarenheter och använda det som varit verkningsfullt även efter projekttidens slut. Utöver intervjuer utifrån deltagares personliga erfarenheter ska också en studie av de samhällsekonomiska effekterna av Testa analyseras och redovisas. De samhällsekonomiska effekterna redovisas i en annan rapport. Syftet med denna studie är att fånga de intervjuades uppfattningar och upplevelser av deltagandet i Testa

Arbetslivsinriktad rehabilitering på Testa : en intervjustudie

I denna rapport redovisas resultaten av intervjuer med ett antal personer som varit inskrivna i Testa, ett arbetsmarknadsprojekt som bedrivits i Jönköpings kommun. Studien har genomförts av Luppen kunskapscentrum med inriktning mot individ och familj, Kommunförbundet i Jönköpings län. Testa är ett arbetsmarknadsprojekt som drivs i samverkan mellan Jönköpings socialförvaltning, Jönköpings kommuns arbetsmarknadsavdelning, försäkringskassan och arbetsförmedlingen. Projektet har fått ekonomiskt stöd från EU Mål 3. Målgruppen för projektet har varit arbetssökande i behov av arbetsträning och arbetsprövning. Målsättningen med projektet har varit att deltagarna efter deltagande i Testa ska erhålla anställning på den reguljära arbetsmarknaden eller påbörja utbildning inom det reguljära utbildningsväsendet. Det har ansetts viktigt att projektet utvärderas för att ta tillvara erfarenheter och använda det som varit verkningsfullt även efter projekttidens slut. Utöver intervjuer utifrån deltagares personliga erfarenheter ska också en studie av de samhällsekonomiska effekterna av Testa analyseras och redovisas. De samhällsekonomiska effekterna redovisas i en annan rapport. Syftet med denna studie är att fånga de intervjuades uppfattningar och upplevelser av deltagandet i Testa

Inter Active movement : on equal terms but different abilities

Conference Theme: Social and service innovation in working life.Introduction: People with disabilities express positive effects and experiences of a new rehabilitation method, individually tailored martial arts for health and ability. This method has been developed through the common competence and creativity of physioterapists, a physical education teacher and the role model, a person with unique experience of personal disability and practice of Martial arts. The method acknowledges disabled people’s need for effective rehabilitation methods, and is suitable in a social context. The exercise is performed on equal terms despite the participants’ different prerequisites. Purpose: The project aimed to study the effects of this new rehabilitation method for social interaction through movement. Methods: Data from observations and interviews with participants were analysed using theoretical models of movement and social cognitive models including the theory of self-efficacy. Results and conclusion: Preliminary data indicate increased postural control, balance and performance of daily activities. The participants’ quality of movement and self-efficacy beliefs in a social context will be discussed, as well as the method as a social innovation.Conference Theme: Social and service innovation in working life. Introduction: People with disabilities express positive effects and experiences of a new rehabilitation method, individually tailored martial arts for health and ability. This method has been developed through the competence and creativity of the role model, a person with unique experience of personal disability and practice of Martial arts. The method acknowledges disabled people’s need for effective rehabilitation methods, and is suitable in a social context. The exercise is performed on equal terms despite the participants’ different prerequisites. Purpose: The project aimed to study the effects of this new rehabilitation method for social interaction through movement. Methods: Data from observations and interviews with participants were analysed using theoretical models of movement and social cognitive models including the theory of self-efficacy. Results and conclusion: Preliminary data indicate increased postural control, balance and performance of daily activities. The participants’ quality of movement and self-efficacy beliefs in a social context will be discussed, as well as the method as a social innovation.Godkänd; 2013; 20130913 (agnlar

Budo practice as a means for post-stroke rehabilitation : case studies

The presentation gives a brief exposé of the practice conducted within the area of budo for the disabled in Japan and Sweden, and brief results from the first trial in this area performed at Luleå university of technology - physical training based om principles from Japanese martial arts as means for post-stroke rehabilitation. For information about this research, contact Annika Näslund at Luleå university of technology.Godkänd; 2013; 20130913 (agnlar)Pilotprojekt - budo som rehabilitering efter strok

Reach performance and postural adjustments in children with severe spastic diplegia wearing Dafos

Godkänd; 2007; Bibliografisk uppgift: Titel på proceedings: Abstraktbok Sjukgymnastdagarna 10-12 oktober 2007 Sider: 4; 20071019 (andbra

Lean and/or agile supply chain management: Model application for the service industry

Various forms of supply chain management (SCM) research have been carried out in many different manufacturing or industrial settings over the last decades. However, less research exist concerning supply chain management in the service industry. Yet, definitions of supply chain management as they pertain to the service industry are only slightly different than those definitions of SCM in manufacturing. In manufacturing SCM research, most definitions emphasize the coordination of activities, as well as information sharing, cross functions and cross firms. Service SCM also focuses on processes, but regard it as difficult to measure performance, since services are non-tangible. Among several concepts and frameworks used in the traditional SCM research; the concepts of lean and agile have recently been focused with regards to how they can improve supply chain performance. Therefore, the aim of this paper is to illustrate supply chain management implications, based on the lean and agile concepts, for the service industry in general and the facility management industry specifically. The paper illustrates how both “lean” and “agile” supply chain management models and concepts can be used in order to enhance both effectiveness and efficiency in the service providing supply chain. The article is based on an action research case study which illustrates how the concepts of lean and agile have been applied to improve the service supply chain. The paper also provides concrete results of process improvements gained in a facility management organization where these new concepts for customer relations and interactions were established

Incidence and seasonality of falls amongst old people receiving home help services in a municipality in northern Sweden

Artikkelen omhandler en studie hvor hensikten var å undersøke forekomst, inkludert variasjoner ad sesonger, omstendigheter og skader relatert til fall hos eldre som bor hjemme og mottar hjemmesykepleie, samt undersøke om det er en sammenheng mellom fall og type/omfang hjelp fra hjemmesykepleien.Objectives: falls among old people is a well-documented phenomenon; however, falls among people living in the community and receiving home help services have been under-researched. The aim of this study was to investigate the incidence, including possible seasonal variation, circumstances and injuries related to falls among community living home help receivers, and to investigate whether fall incidence is associated with the type and amount of home help services received. Study design: Prospective cohort study. Methods: all 614 persons aged 65 and over who were living in a particular northern Swedish community and receiving municipality home help were included. Data on age, sex and home help service use were collected from home help service records, and falls were reported by staff on report forms specifically designed for the study. Results: a total number of 264 falls were recorded among 122 participants. The overall fall incidence was 626 per 1,000 PY, and incidence rate ratios were significantly correlated to the total amount of services used (p<0.001), as well as to the degree of help for I-ADL needs (p<0.001), P-ADL needs (p<0.001) and escort service (p=0.007). The proportion of falls reported as resulting in injury was 33 %. The monthly fall incidence was significantly associated to daylight photoperiod, however it was not associated to temperature. Conclusions: fall incidence among home help receivers aged 65 and over seems correlated to the amount of services they receive. This is probably explained by the fact that impairments connected to ADL limitations and home help needs also are connected to an increased risk of falls. This implies that fall prevention should be considered when planning home help care for old people with ADL limitations. Further research on the connection between daylight photoperiod and fall incidence in populations at different latitudes is needed

Projekt: Hälsa och säkerhet i vård- och socialt servicearbete, i ett samhällsperspektiv

Syftet med projektet är att utveckla metoder där förebyggande insatser med satsning på ett förbättrat säkerhetsklimat och en ökad fysisk kompetens blandpersonal inom vård- och social service integreras i verksamhetsutvecklingen.Publikationer: Perceptions of health and risk management among home care workers in Sweden; Identifying work ability promoting factors for home care aides and assistant nurses; Promoting a safety climate and safety activities for health and work ability in home care services workers; Identifying, describing and promoting health and work ability in a workplace context; Effects of work ability and health promoting interventions for women with musculoskeletal symptoms: a 9-month prospective study; Status: Avslutat; Period: 01/01/2011 → 31/12/2015</p