Episodic future thinking is defined as the ability to mentally project oneself into the future into a specific time and place. Episodic future thinking has been explored extensively in neuroscience. However, it has not been determined whether the measurement of episodic future thinking might be valuable in a clinical neuropsychological setting. The current study examined the relationship between episodic future thinking and instrumental activities of daily living (IADLs), which is a domain of adaptive functioning frequently assessed by neuropsychologists to examine independent living potential including the ability to handle finances, prepare food, complete household duties, and manage medications. A secondary aim was to examine whether episodic future thinking is related to IADLs over and above standard measures of cognition. 61 older adults with heterogeneous neurological conditions and 41 healthy older adults completed a future thinking task (the adapted Autobiographical Interview), two measures of IADLs (an informant report measure called the Everyday Cognition Scale and a performance-based measure called the Independent Living Scales), and standard measures of memory and executive functioning. Episodic future thinking was significantly associated with performance-based IADLs when accounting for age, education, gender, and depression (r=.26, p=.010). Episodic future thinking significantly predicted performance-based IADLs over and above executive functioning (R2=.025, p=.030). Episodic future thinking was not predictive of performance-based IADLs over and above memory (p=.157). Episodic future thinking was not significantly associated with informant reported IADLs when accounting for age, education, gender, and depression (p=.284). This study suggests that episodic future thinking is significantly associated with IADLs, beyond what can be accounted for by executive functioning. Episodic future thinking may provide information about IADLs to clinical neuropsychologists so they can improve their recommendations for independent living.

The prostheses used by the majority of persons with upper limb amputations today offer a limited range of motion. Relative to anatomical joints transradial (below the elbow) prosthesis users lose at least two of the three degrees of freedom provided by the wrist and forearm. Some myoeletric prostheses currently allow for forearm pronation and supination (rotation about an axis parallel to the forearm) and the operation of a powered prosthetic hand. Body-powered prostheses, incorporating hooks and other cable driven terminal devices, have even fewer active degrees of freedom. In order to perform activities of daily living, an amputee must use a greater than normal range of movement from other anatomical body joints to compensate for the loss of movement caused by the amputation. By studying this compensatory motion of prosthetic users, the mechanics of how they adapt to the loss of range of motion in a given limb and specific tasks were analyzed. The purpose of this study is to create a robotic based kinematic model that can predict the compensatory motion of a given task using given subject data in select tasks. The tasks used in this study are the activities of daily living: opening a door, drinking from a cup, lifting a box, and turning a steering wheel. For the model the joint angles necessary to accomplish a task are calculated by a simulation for a set of prostheses and tasks. The simulation contains a set of configurations that are represented by parameters that consist of the joint degrees of freedom provided by each prosthesis, and a set of task information that includes joint constraints and trajectories. In the simulation the hand or prosthesis follows the trajectory to perform the task. Analysis of tasks is done by attaching prosthetic constraints to one of the arms of the upper body model in the simulation, other arm maintains an anatomical configuration. By running the model through this simulation with different configurations the compensatory motions were found. Results can then be used to select the best prosthesis for a given user, design prostheses that are more effective at selected tasks, and demonstrate some possible compensations given a set of residual joint limitations with certain prosthetic components, by optimizing the configuration of the prostheses to improve their performance.

Individuals with disabilities yearn for an increased level of independence, seeking to supplement their missing function(s) and to carry on with their lives with minimal or no assistance from another person. A review of the existing assistive-care products has revealed that many of the defects in these devices, particularly in wheelchair-mounted robots, can be alleviated. Surveys have also identified tasks that users would like to perform by themselves, but are constrained from doing so by using currently available devices. An attempt has been made here to try to resolve these issues by developing a prototype of a marsupial robot that can dock into the powered wheelchair that is used for manipulation purposes. The primary function of this system is to assist the user in his/her daily tasks such as pick-up small objects and place them as per the user's commands, push to open/close doors and remove obstacles from the wheelchair path. It is with the objective of providing an enhanced quality of life to a person with impairment(s) that a proposal for a simple, safe and inexpensive approach to assist him/her in performing an activity is made here.

Improvement of prostheses requires knowledge of how the body adapts. A transradial prosthesis without a dynamic wrist component may cause awkward compensatory motion leading to fatigue, injury or rejection of the prosthesis. This work analyzed the movements of shoulder, elbow and torso during four tasks: drinking from a cup, opening a door, lifting a box and turning a steering wheel. The main purpose of this study was to determine if using a basic transradial prosthesis that lacks motion of the forearm and wrist would cause significant compensatory motion of the shoulder, elbow and torso during the tasks. The second purpose of the study was to determine if the location of added mass would affect compensatory movements during these tasks. A group of able-bodied participants were asked to complete the tasks, without and with a brace, simulating a basic transradial prosthesis to determine if bracing is an appropriate way to study prosthetic use. Transradial prosthesis wearers also completed the tasks without and with added mass at the elbow or at the wrist to determine if distribution of mass has an effect on the motions. Using a motion capture system movements of the shoulder, elbow and torso were analyzed. For the bilateral tasks, the degree of asymmetry (DoA) was calculated for each subject. Statistical analysis was completed within subject comparing the mass interventions and between subjects comparing the control, braced and prosthesis wearing groups. While opening a door and lifting a box, prosthesis users compensated predominantly by bending the torso sideways toward affected side. During the steering wheel task, amputees used more elbow flexion to accommodate for the lack of forearm rotation. While drinking from a cup, compensation occurred by bending the cervical spine, although this was not measured. Adding mass increased the joint forces and moments during the box lift. This research can be used for transradial prosthesis design improvements as well as improving methods of prosthesis fitting and therapeutic training by providing quantitative data of compensatory motion. The data from this study is being used to develop a model for an upper limb prosthesis.

<p>Epilepsi är en av de vanligaste neurologiska sjukdomarna som beror på en elektrisk överstimulering av hjärnans neuron. Att leva med epilepsi påverkar många områden i livet; fysiska, psykiska, sociala, emotionella aspekter är bara några av de som berörs.</p><p>Syftet med studien var att beskriva hur livskvaliteten i det dagliga livet påverkas av att ha epilepsi. Studien utfördes som en litteratur-studie där resultatet bygger på 14 vetenskapliga artiklar. Två aspekter kom fram i resultatet, sociala och emotionella. I dessa vi-sades det bland annat att personer med epilepsi är rädda att berätta om sin sjukdom för omgivningen av rädsla att bli behandlade an-norlunda. Anfallsfrekvensen påverkar familjebildning negativt och de personer som står på medicinering med antiepileptika har löper risk att vara arbetslösa. Känslor som upplevs i samband med sjuk-domen är bland annat skuld, skam, sorg, oro. De som har epilepsi kan se på sin sjukdom på olika sätt, några av dessa är; en fysisk sjukdom, ett handikapp, ett straff, en mental sjukdom med mera. För att öka samhällets kunskap om epilepsi är information av nö-den. Sjuksköterskan kan fungera som ett stöd för patienter med epilepsi och höja livskvaliteten genom att se hela patienten, inte bara de fysiska problemen.</p> / <p>Epilepsy is one of the most common neurological disorders, and is due to an electrical overstimulation of neurons in the brain. Living with epilepsy effects many areas of life; physical, psychological, social and emotional aspects are only some of them. The purpose of this study was to describe how quality of life in everyday life is affected by the epilepsy. The study was carried out as a literature review and the result is based on 14 research articles. Two aspects came from the result, social and emotional. They show that people hide their epilepsy from others in fright of being treated different-ly. Seizure frequency is affecting family formation in a negative way and persons under medication of antiepileptic drugs are more likely to be unemployed. Emotions connected to the epilepsy are among other things guilt, shame, sorrow, worry. People with epi-lepsy can view their condition in a number of different ways, some of these are; a physical illness, a punishment, a mental disturbance etcetera. To increase society’s knowledge of epilepsy, information is of the essence. The nurse can act as a support for the patient and increase the quality of life by seeing the whole patient, not just the physical concerns.</p>

<p><strong>Bakgrund: </strong>Risken för att drabbas av depression någon gång i livet är 50 % för kvinnor och 20 % för män. Orsaken till varför en depression utvecklas hos en del människor kan bero på olika faktorer, så som ärftlighet och av olika påfrestningar under uppväxten. <strong>Syfte:</strong> Syftet var att belysa upplevelser hos män och kvinnor som lever med depression. <strong>Metod: </strong>En systematisk litteraturstudie genomfördes och baserades på nio vetenskapliga artiklar. <strong>Resultat: </strong>Det visade sig att depression var något individuellt. Något som var återkommande i studierna var hur upplevelser och faktorer i barndomen kunde ha lett till depression och många personer upplevde ett lidande och en smärta i samband med sin depression. Det visade sig även att personer hanterade sin depression på olika sätt. <strong>Diskussion: </strong>I diskussionen lades det vikt på tre huvudfynd; att leva upp till höga krav i barndomen, att inte bli förstådd av omgivningen och skillnaden i hur män och kvinnor uttryckte sin depression. <strong>Slutsats:</strong><strong> </strong>Efterhand som depression blir allt vanligare i vårt samhälle är det av vikt för vårdpersonal att få en ökad förståelse för området för att kunna ge en god individanpassad omvårdnad.</p> / <p><strong>Background:</strong> The risk of suffering from depression at some point in life is 50% for women and 20% for men. The reason why depression develops in some people may depend on various factors, such as heredity and the various strains while growing up. <strong>Aim: </strong>The aim was to illuminate the experiences of men and women living with depression. <strong>Method: </strong>A systematic literature review was conducted and was based on nine scientific papers. <strong>Result: </strong>It was found that depression was something individually. Something that was recurring in the studies was how the experiences and factors in childhood might have led to depression and many people experienced a suffering and pain associated with their depression. It appeared also that people manage their depression differently. <strong>Discussion:</strong> The discussion was the emphasis on three key findings, to live up to high demanding in childhood, not to be understood by the environment, and the difference in how men and women expressed their depression. <strong>Conclusion:</strong> As depression becomes more and more common in our society, it is important that the personnel in healthcare gets a better understanding of the individual to provide good quality personalized care.</p>

<p>Multipel skleros är en sjukdom som påverkar kroppen på många olika sätt både fysiskt och psykiskt<strong>. </strong>Många unga drabbas och det påverkar hela livssituationen. Syftet med studien var att beskriva faktorer som påverkar livskvalité i det dagliga livet hos personer med Multipel skleros. Metoden utgjordes av en litteraturstudie där Polit och Becks (2008) åtta steg har använts. Studien är baserad på 10 kvalitativa och vetenskapliga artiklar. Artiklarna identifierades genom elektronisk sökning i databaserna CINAHL och PubMed. Betydande delar i artiklarnas resultat, som svarade på studiens syfte, markerades för att finna likheter och skillnader, dessa organiserades sedan i huvudkategorier och underkategorier. Resultatet visar att stöd kan upplevas både positivt och negativt och detta påverkar på det sättet livskvaliten. Att ha ett arbete, sociala relationer och känna en känsla av oberoende genom självständighet och kontroll är viktiga faktorer som påverkar livskvaliten.</p>

<p>The general aim of this work was to evaluate the outcome of specialised stroke rehabilitation and to examine the relation between both subjectively perceived and objectively assessed balance and impairments and some activity limitations. A further, integrated aim was to establish some psychometric properties and the usability of a newly developed Falls-Efficacy Scale, Swedish version (FES(S)) in stroke rehabilitation.</p><p>Seventy-three patients younger than 70 years of age with a first stroke and reduced walking ability were randomised into an intervention group (walking on a treadmill with body weight support) and a control group (walking on the ground). Time points of assessment were: on admission for rehabilitation, at discharge and 10 months after stroke. Walking training on a treadmill with body weight support and walking training on the ground were found to be equally effective in the early rehabilitation. The patients in both groups improved their walking velocity, motor function, balance, self-efficacy and ADL performance.</p><p>In a geriatric sample of 37 stroke patients examined at similar time points, significant improvements in self-efficacy, motor function, balance, ambulation and ADL occurred from admission to discharge independently of age. In comparison with observer-based balance measures, FES(S) at discharge was the most powerful predictor of ADL performance 10 months after onset of stroke.</p><p>In 30 patients with stable stroke, the overall test-retest reliability of FES(S) was found to be adequate. The internal consistency confirmed that FES(S) has an adequate homogeneity.</p><p>In a subsample of 62 patients from the original sample and in the geriatric sample, FES(S) correlated significantly with Berg’s balance scale, the Fugl-Meyer balance scale, with motor function and with gait performance. In the relatively younger group ADL (measured by the Functional Independence Measurement) correlated significantly with FES(S) on admission and at 10 months follow-up, while at discharge none of the FES(S) measures correlated significantly with ADL. In this subsample effect size statistics for detecting changes in FES(S) demonstrated very acceptable responsiveness of this scale during the early treatment period and during the total observation period</p><p>In the light of these findings assessment and treatment of self-efficacy seems relevant in stroke rehabilitation. </p>

Background: Among the instruments commonly used by occupational therapists working in the area of rehabilitation of persons with neurological disorders are evaluations of both occupation, such as activities of daily living (ADL), and body functions. While persons with neurological diagnoses typically have symptoms that represent diminished neurobehavioral functions, the resulting pattern of neurobehavioral impairments affecting ADL performance often differs among diagnostic groups. Usually, neurobehavioral impairments are evaluated in a context that is separate from and not natural for ADL task performance. The A-ONE is a unique instrument that can be used to evaluate both ADL performance (ADL scale) and, in the natural context of the ADL task performance, the underlying neurobehaviors that cause diminished ADL task performance among persons with neurological disorders (Neurobehavioral scale). The scales of the instrument are of ordinal type, and in their existing form, do not have measurement properties. Measurement properties are a requirement of evidence-based and quality assured rehabilitation services. The overall aim of this doctoral study was to further develop and validate the A-ONE. This included (a) internal validation to explore the potential for converting the ordinal scales of the instrument to interval scales, (b) examination of which of the neurobehavioral items would be most beneficial and clinically useful for constructing a new Neurobehavioral Impact (NBI) scale for evaluating persons with different neurological diagnoses, and (c) exploration of whether persons with right and left cerebrovascular accidents (RCVA, LCVA) differ in mean NBI measures.  Methods: This thesis is comprised of four studies which all contribute in different ways to the validation of the scales of the A-ONE. In the first three studies, Rasch analyses, a widely accepted modern test theory methodology, was used to examine internal validity of the scales and the reliability of the A-ONE measures. In the fourth study, ANCOVA was used to explore between group differences, and Pearson correlation coefficients were used to explore relations between person measures from the different A-ONE scales. Results: The first study of 209 persons diagnosed with CVA and dementia provided support for converting the ordinal ADL scale to an interval scale that has potential to be used to measure change in ADL performance over time. The second and third studies, including 206 and 422 persons respectively, indicated that it is possible to construct several unidimensional versions of a new NBI scale from the neurobehavioral items of the instrument, each with different item content and hierarchical item structure. Further, some of these NBI scales could be used across different diagnostic groups. When exploring differences between 215 persons with RCVA and LCVA on the NBI scale developed for CVA, results of the ANCOVA (with ADL ability as a covariate) indicated that there is no significant difference between groups in their mean NBI measures, despite known differences in patterns of neurobehavioral impairments. Conclusions: The results of this thesis indicate that the A-ONE, although developed by traditional psychometric methods for the purpose of providing useful information for intervention planning, now also has the potential to be used to measure change and compare diagnostic groups. This additional feature will likely enhance both clinical and research potential of the instrument. In order to make the results of the study accessible for clinicians, conversion tables need to be developed.

The general aim of this work was to evaluate the outcome of specialised stroke rehabilitation and to examine the relation between both subjectively perceived and objectively assessed balance and impairments and some activity limitations. A further, integrated aim was to establish some psychometric properties and the usability of a newly developed Falls-Efficacy Scale, Swedish version (FES(S)) in stroke rehabilitation. Seventy-three patients younger than 70 years of age with a first stroke and reduced walking ability were randomised into an intervention group (walking on a treadmill with body weight support) and a control group (walking on the ground). Time points of assessment were: on admission for rehabilitation, at discharge and 10 months after stroke. Walking training on a treadmill with body weight support and walking training on the ground were found to be equally effective in the early rehabilitation. The patients in both groups improved their walking velocity, motor function, balance, self-efficacy and ADL performance. In a geriatric sample of 37 stroke patients examined at similar time points, significant improvements in self-efficacy, motor function, balance, ambulation and ADL occurred from admission to discharge independently of age. In comparison with observer-based balance measures, FES(S) at discharge was the most powerful predictor of ADL performance 10 months after onset of stroke. In 30 patients with stable stroke, the overall test-retest reliability of FES(S) was found to be adequate. The internal consistency confirmed that FES(S) has an adequate homogeneity. In a subsample of 62 patients from the original sample and in the geriatric sample, FES(S) correlated significantly with Berg’s balance scale, the Fugl-Meyer balance scale, with motor function and with gait performance. In the relatively younger group ADL (measured by the Functional Independence Measurement) correlated significantly with FES(S) on admission and at 10 months follow-up, while at discharge none of the FES(S) measures correlated significantly with ADL. In this subsample effect size statistics for detecting changes in FES(S) demonstrated very acceptable responsiveness of this scale during the early treatment period and during the total observation period In the light of these findings assessment and treatment of self-efficacy seems relevant in stroke rehabilitation.