PubMed Health⌕ Search

Biomedical subjects

I Nydevik

Publications and source records attributed to I Nydevik.

11 recordsLinked to original sources
PubMed2004

Recovery from unilateral neglect after right-hemisphere stroke.

PURPOSE: To show the recovery process for different forms of unilateral neglect (UN)--including personal neglect and neglect of far space--in relationship to impairment, disability, cognition and mood. METHOD: Patients were tested at 2-4 weeks, at 6 months and at 1 year. We used the Behaviour Inattention Test and a test for personal neglect. We also used the NIH Stroke Scale, the Functional Independence Measure (FIM), the Mini-Mental State Evaluation and the Geriatric Depression Scale. RESULTS: Peripersonal neglect diminishes within 6 months, but complete recovery occurred in only 13%. The prognosis for personal neglect and neglect of far space is better, with a recovery ratio at 6 months of 52% and 46%, respective. The correlations between UN and FIM are high. A few patients deteriorate in the absence of recurrent stroke. CONCLUSIONS: For clinical purposes, it is practical to postpone UN evaluation until a couple of weeks after a stroke. Many of the patients who then have UN are likely to retain their UN, although many will improve. Patients with UN should receive special attention in the rehabilitation phase, as well as at discharge. One explanation of the worsening of UN seen in some patients, may be continuing cerebral atherosclerosis.

Activities of Daily Living↗
PubMed2003

Assessing unilateral neglect: shortcomings of standard test methods.

INTRODUCTION: When investigating the incidence of unilateral neglect in a first-ever stroke population, we found that some patients showed clinical signs of neglect, but managed to pass our tests. The purpose of this paper is to describe the nature of such signs, and analyse why test instruments were insufficiently corresponding to those signs. METHOD: One hundred and thirty-one consecutive patients with first-ever stroke in a community-based sample were evaluated for the presence of unilateral neglect. We used a test battery consisting of tests for visuo-spatial neglect, personal neglect, and anosognosia. Twenty cases of neglect were discovered by standard methods. We asked our collaborators at the wards to report any behavioural abnormality reminiscent of neglect present in patients who had normal test results. Such patients were evaluated clinically. RESULTS: Nine cases with neglect-like symptoms were discovered. Our clinical evaluation of the nine patients indicated several possible explanations for their behavioural abnormalities, including motor neglect, neglect for far extrapersonal space, disturbances of proprioception, and spatial disturbances other than neglect. CONCLUSION: Standard neglect tests do not cover all clinical forms of neglect. It is therefore important not to rely completely on test instruments when diagnosing neglect. More versatile test instruments are desired.

Aged↗
PubMed1999

[For whom is training after stroke most beneficial? Selection method exists and should be used].

In the light of recent Swedish health care cost cuts, this review addresses the need of limiting stroke rehabilitation to those it will benefit most. In many prognostic stroke studies, end-points have been adopted that vary as to time and place--e.g., duration of hospitalisation or discharge to a nursing home. Even modest improvement in ability may significantly enhance quality of life, but is not necessarily associated with beneficial effects on lifestyle or the length of hospital stay. Accordingly, we need to use reliable tests with more realistic end-points. The use of the Functional Independence Measure (FIM) and the Katz ADL scale as prognostic instruments is discussed.

Activities of Daily Living↗
PubMed1994

Stroke patients in long-term care--the relatives' conception of functional capacity and appropriate care.

The closest relatives of 29 permanently institutionalized stroke patients were interviewed about their relationship to the patient before and after stroke, the functional ability of the patient before and after stroke, and their opinion of an appropriate care setting for the patient. The patients had all been independent before stroke, but were now dependent on help with most primary activities of daily living. Twelve patients had severe communicative difficulties. Most relatives could not suggest a realistic alternative to nursing home care, due to the patients' severe disabilities and extensive need for care. One patient was, however, later discharged to a sheltered living facility in accordance with her relative's wishes. One-third of the relatives expressed need for more information and support and wanted to take part in a support group. The nursing staff need high competency in providing good care for the patients and offering psychological support to the relatives, and should include the relatives in the overall treatment plan.

Activities of Daily Living↗
PubMed1993

Functional status of stroke patients in long-term care--a basis for development of rehabilitation and care.

Thirty persons who had remained in long-term care for one year or more post-stroke were assessed with respect to motor function, cognitive, perceptual, and communication ability and ADL capacity. Before the stroke they had lived an independent life, although 40% suffered from cardiovascular disease. At the follow-up, all patients had severe impairments due to the brain damage. None could walk or stand independently, ten could not call for help or attract attention in any way, and 13 could not take part in a conversation. Eleven patients had severe pain in spite of treatment with analgesics. Pain treatment and training methods that can reduce dependence and improve the quality of life for patients like these need to be developed. More appropriate assessment instruments for this patient group have to be constructed to make evaluation of training and care possible.

Activities of Daily Living↗
PubMed1992

Sickness impact after stroke. A 3-year follow-up.

In order to study change in disability and sickness impact after stroke, 36 patients were followed during a period of three years. ADL-status (Activities of Daily Living) was assessed by means of Katz' ADL Index. Interviews according to the Sickness Impact Profile (SIP) were carried out 6-9 months and 3 years post-stroke. The results showed an increased sickness impact over time in physical as well as psychosocial aspects. Mobility and home management were the categories that deteriorated most. The highest sickness impact was found in home management, and recreation and pastimes activity. The SIP scores were strongly correlated to the level of ADL-dependence, although the ADL-status had not deteriorated between the two assessments. Subjective measures of disability together with objective measures are recommended for planning of long-term rehabilitation after stroke.

Activities of Daily Living↗
PubMed1991

Subjective dysfunction after stroke. A study with sickness impact profile.

In 1986, the functional capacity of 124 patients with an acute stroke was assessed one week after admission to Södertelje hospital, Sweden. In order to analyse health-related quality of life, interviews were undertaken to determine sickness impact 6-9 months after stroke. 57 of the 91 surviving patients could participate. 53 persons were living in their own homes. 70% had a clinically significant subjective dysfunction, which correlated both to the objective functional capacity and to age. Sickness Impact Profile was a useful measure, yielding information of value for planning of long-term rehabilitation and home care.

Activities of Daily Living↗
PubMed1991

Early prognosis of stroke outcome by means of Katz Index of activities of daily living.

The predictive validity of Katz' Index of ADL (Activities of Daily Living) regarding length of hospital stay, discharge to own home or death within one month, and its reproducibility in clinical practice was studied prospectively in Södertälje and in Enköping, Sweden. The Södertälje study included 124 consecutive patients, who were all assessed on days 5-7 after stroke by an occupational therapist. The Enköping study included 106 consecutive patients, who were assessed similarly by trained nurses. Ninety-six and 94%, respectively, of patients in grades A-C on days 5-7 after stroke were discharged to their own homes within one month. Ninety-six and 92%, respectively, of patients in grades D-G stayed in hospital longer than one month or died. Sixty-two and 68%, respectively, of patients in grade G died within one month. The instrument is now used as a valid tool for early prognosis of stroke outcome in order to facilitate the planning of care and rehabilitation in clinical practice.

Activities of Daily Living↗