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Widehammar, Cathrine
Publications (10 of 14) Show all publications
Widehammar, C., Lidström-Holmqvist, K., Pettersson, I. & Hermansson, L. (2019). Attitudes is the most important environmental factor for use of powered mobility devices - users' perspectives. Scandinavian Journal of Occupational Therapy
Open this publication in new window or tab >>Attitudes is the most important environmental factor for use of powered mobility devices - users' perspectives
2019 (English)In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014Article in journal (Refereed) Epub ahead of print
Abstract [en]

Introduction: Different factors in the environment influence the use of powered wheelchairs or powered scooters, i.e. powered mobility devices (PMDs), but there is limited knowledge about how these factors interact and if any factor has a greater impact. According to the ICF the environment consists of five areas.

Aim: To describe users' experiences of how environmental factors from all ICF areas influence the use of PMDs.

Methods: Descriptive qualitative design including 14 interviews with PMD users, analyzed using inductive qualitative content analysis.

Findings: Use of PMDs means a conditional freedom depending on the interaction of several environmental factors. Regardless of environmental factor the societal attitudes were always present, directly or indirectly, and influenced the participants' feeling of being included and involved in society. The environmental factors and how they influence PMD use are described in four categories, comprising the following subjects: societal attitudes, the service delivery process, accessibility to the physical environment and financial resources.

Conclusion: The findings show that societal attitudes influence all other factors, directly by others people's attitudes, or indirectly by how legislation and guidelines are formulated, interpreted and applied. Therefore, a change of societal attitudes seems necessary to increase accessibility and participation for PMD users.

Place, publisher, year, edition, pages
Taylor & Francis, 2019
Keywords
Powered mobility devices, environment, qualitative research, assistive technology, powered scooters, powered wheelchairs
National Category
Occupational Therapy Other Health Sciences
Identifiers
urn:nbn:se:oru:diva-71766 (URN)10.1080/11038128.2019.1573918 (DOI)000472909700001 ()30856033 (PubMedID)
Note

Funding Agencies:

Uppsala-Örebro Regional Research Council  

Research Committee of Örebro County Council, Sweden 

Available from: 2019-01-23 Created: 2019-01-23 Last updated: 2020-02-24Bibliographically approved
Widehammar, C., Lidström, H. & Hermansson, L. (2019). Environmental barriers to participation and facilitators for use of three types of assistive technology devices. Assistive technology, 31(2), 68-76
Open this publication in new window or tab >>Environmental barriers to participation and facilitators for use of three types of assistive technology devices
2019 (English)In: Assistive technology, ISSN 1040-0435, E-ISSN 1949-3614, Vol. 31, no 2, p. 68-76Article in journal (Refereed) Published
Abstract [en]

The aim was to compare the presence of environmental barriers to participation and facilitators for assistive technology (AT) use and study the relation between barriers and AT use in three different AT devices. A cross-sectional survey was conducted. Inclusion criteria were ?one year of experience as a user of myoelectric prosthesis (MEP), powered mobility device (PMD), or assistive technology for cognition (ATC) and age 20-90 years. Overall, 156 participants answered the Swedish version of the Craig Hospital Inventory of Environmental Factors and a study-specific questionnaire on facilitating factors. Non-parametric tests were used for comparisons. Barriers to participation were lowest in MEP users (md = 0.12; p < 0.001), and highest in ATC users (md = 1.56; p < 0.001) with the least support for AT use (p < 0.001 - p = 0.048). A positive correlation between fewer barriers and higher use of MEP was seen (r = 0.30, p = 0.038). The greatest barriers to participation were Natural environment, Surroundings and Information, and the most support came from Relatives and Professionals. Support, training and education are vital in the use of AT. These factors may lead to a more sustained and prolonged use of AT and may enable increased participation. Future research should focus on interventions that meet the needs of people with cognitive disabilities.

Place, publisher, year, edition, pages
Taylor & Francis, 2019
Keywords
Electronic aids to daily living, information technology and telecommunications, prosthetics, service delivery, wheelchair transportation, wheeled mobility aids
National Category
Nursing Other Health Sciences
Identifiers
urn:nbn:se:oru:diva-61735 (URN)10.1080/10400435.2017.1363828 (DOI)000458565800002 ()28783455 (PubMedID)2-s2.0-85029455687 (Scopus ID)
Note

Funding Agency:

Research Committee of Örebro County Council, Sweden  OLL-590701  OLL-615061  OLL-642141  OLL-685701

Available from: 2017-11-06 Created: 2017-11-06 Last updated: 2019-06-19Bibliographically approved
Widehammar, C., Eriksson, K. & Hermansson, L. (2018). Designing a new training method for advanced hand prostheses. In: Book of Abstracts: . Paper presented at The International Central European ISPO Conference,Portorož, Slovenia, 20th-22nd September, 2018 in Portorož, Slovenia (pp. 66-66). Ljubljana, Slovenia: ISPO Slovenia
Open this publication in new window or tab >>Designing a new training method for advanced hand prostheses
2018 (English)In: Book of Abstracts, Ljubljana, Slovenia: ISPO Slovenia , 2018, p. 66-66Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

INTRODUCTION: New prosthetic hands with advanced technology making it possible to perform many different grasps and positions are now available on the market. This new advanced technology is also difficult for users to control, and studies have shown that the new hand functions are not used to the extent expected (1).

The Örebro Centre for Limb Deficiency and Arm Prostheses has a long experience of prosthetic fitting for both children and adults. About 80% of the adults report daily prosthesis use (2). Today, many prosthesis users find the advanced prosthetic hands interesting and wish to have one. However, when introducing a new prosthetic hand with questionable merits, the reasons for these results need to be considered. In light of our experience from fittings in Örebro, we decided that the training programs for the new hand models were not comprehensive enough, and there was a need for the development of a new method for training.

AIMS: To design a training method for advanced hand prosthetic hands.

METHODS: We performed a review of existing training programs for advanced myoelectric prosthetic hands and combined this with a structured training program, and a treatment philosophy with early fitting and regular follow up used in Örebro.

RESULTS AND CONCLUSIONS: The training method comprises control training and performance of ADL’s. It follows a structured program based on the 14 steps described in the Skills Index Ranking Scale. The control training focuses on control of all different grasps available with the body in different positions: sitting, standing; with and without support of the arm. The ADL’s are chosen individually through a Canadian Occupational Performance Measure interview. The capacity to use different grasps and integrating the new prosthesis when performing ADL’s is evaluated through the Assessment of Capacity for Myoelectric Control. The method is based on regular support and feedback from an occupational therapist, with follow-ups weekly the first month and then monthly the following 3-6 months. The method has been used on patients with good results.

CONCLUSION: A new method is designed to fit the new multifunctional prosthetic hands. The method can be applied upon prescription of advanced multifunctional prosthetic hands to enhance the functional use of the hands.

Place, publisher, year, edition, pages
Ljubljana, Slovenia: ISPO Slovenia, 2018
National Category
Medical and Health Sciences Orthopaedics
Identifiers
urn:nbn:se:oru:diva-71770 (URN)978-961-288-734-6 (ISBN)
Conference
The International Central European ISPO Conference,Portorož, Slovenia, 20th-22nd September, 2018 in Portorož, Slovenia
Available from: 2019-01-23 Created: 2019-01-23 Last updated: 2019-01-28Bibliographically approved
Lendaro, E., Hermansson, L., Burger, H., van der Sluis, C. K., McGuire, B. E., Pilch, M., . . . Ortiz-Catalan, M. (2018). Phantom motor execution as a treatment for phantom limb pain: protocol of an international, double-blind, randomised controlled clinical trial. BMJ Open, 8(7), Article ID e021039.
Open this publication in new window or tab >>Phantom motor execution as a treatment for phantom limb pain: protocol of an international, double-blind, randomised controlled clinical trial
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2018 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, no 7, article id e021039Article in journal (Refereed) Published
Abstract [en]

Introduction: Phantom limb pain (PLP) is a chronic condition that can greatly diminish quality of life. Control over the phantom limb and exercise of such control have been hypothesised to reverse maladaptive brain changes correlated to PLP. Preliminary investigations have shown that decoding motor volition using myoelectric pattern recognition, while providing real-time feedback via virtual and augmented reality (VR-AR), facilitates phantom motor execution (PME) and reduces PLP. Here we present the study protocol for an international (seven countries), multicentre (nine clinics), double-blind, randomised controlled clinical trial to assess the effectiveness of PME in alleviating PLP.

Methods and analysis: Sixty-seven subjects suffering from PLP in upper or lower limbs are randomly assigned to PME or phantom motor imagery (PMI) interventions. Subjects allocated to either treatment receive 15 interventions and are exposed to the same VR-AR environments using the same device. The only difference between interventions is whether phantom movements are actually performed (PME) or just imagined (PMI). Complete evaluations are conducted at baseline and at intervention completion, as well as 1, 3 and 6 months later using an intention-to-treat (ITT) approach. Changes in PLP measured using the Pain Rating Index between the first and last session are the primary measure of efficacy. Secondary outcomes include: frequency, duration, quality of pain, intrusion of pain in activities of daily living and sleep, disability associated to pain, pain self-efficacy, frequency of depressed mood, presence of catastrophising thinking, health-related quality of life and clinically significant change as patient’s own impression. Follow-up interviews are conducted up to 6 months after the treatment.

Ethics and dissemination: The study is performed in agreement with the Declaration of Helsinki and under approval by the governing ethical committees of each participating clinic. The results will be published according to the Consolidated Standards of Reporting Trials guidelines in a peer-reviewed journal.

Trial registration number: NCT03112928; Pre-results.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2018
Keywords
neurological pain, clinical trials, rehabilitation medicine
National Category
Occupational Therapy Other Medical Engineering
Identifiers
urn:nbn:se:oru:diva-66722 (URN)10.1136/bmjopen-2017-021039 (DOI)000446181900099 ()30012784 (PubMedID)2-s2.0-85050255576 (Scopus ID)
Funder
VINNOVA, 2016-02290
Note

Funding Agencies:

Promobilia foundation  F16501 

EFIC Grunenthal Grant  358041552 

Integrum AB 

Available from: 2018-04-24 Created: 2018-04-24 Last updated: 2018-10-22Bibliographically approved
Lendaro, E., Hermansson, L., Burger, H., van der Sluis, C., McGuire, B. E., Pilch, M., . . . Catalan, M. O. (2018). Phantom Motor Execution as a treatment for Phantom Limb Pain: Protocol of an international, double-blind, randomised, controlled clinical trial. In: Burger, Helena & Mlakar, Maja (Ed.), Book of Abstracts: . Paper presented at International Central European ISPO Conference 2018, Portoroz, Slovenien, September 20-22, 2018 (pp. 14-14). Ljubljana, Slovenien: ISPO Slovenaia
Open this publication in new window or tab >>Phantom Motor Execution as a treatment for Phantom Limb Pain: Protocol of an international, double-blind, randomised, controlled clinical trial
Show others...
2018 (English)In: Book of Abstracts / [ed] Burger, Helena & Mlakar, Maja, Ljubljana, Slovenien: ISPO Slovenaia , 2018, p. 14-14Conference paper, Oral presentation with published abstract (Refereed)
Place, publisher, year, edition, pages
Ljubljana, Slovenien: ISPO Slovenaia, 2018
National Category
Orthopaedics
Identifiers
urn:nbn:se:oru:diva-73831 (URN)978-961-288-734-6 (ISBN)
Conference
International Central European ISPO Conference 2018, Portoroz, Slovenien, September 20-22, 2018
Available from: 2019-04-16 Created: 2019-04-16 Last updated: 2019-04-17Bibliographically approved
Widehammar, C., Pettersson, I., Janeslätt, G. & Hermansson, L. (2018). The influence of environment: experiences of users of myoelectric arm prosthesis - a qualitative study. Prosthetics and orthotics international, 42(1), 28-36
Open this publication in new window or tab >>The influence of environment: experiences of users of myoelectric arm prosthesis - a qualitative study
2018 (English)In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 42, no 1, p. 28-36Article in journal (Refereed) Published
Abstract [en]

Background: Prostheses are used to varying degrees; however, little is known about how environmental aspects influence this use.

Objectives: To describe users" experiences of how environmental factors influence their use of a myoelectric arm prosthesis.

Study design: Qualitative and descriptive.

Methods: A total of 13 patients previously provided with a myoelectric prosthetic hand participated. Their age, sex, deficiency level, etiology, current prosthesis use, and experience varied. Semi-structured interviews were audiotaped, transcribed, and analyzed through inductive content analysis.

Results: Four categories were created from the data: "Prosthesis function," "Other people's attitudes," "Support from family and healthcare," and "Individual's attitude and strategies." The overarching theme, "Various degrees of embodiment lead to different experiences of environmental barriers and facilitators," emerged from differences in individual responses depending on whether the individual was a daily or a non-daily prosthesis user. Environmental facilitators such as support from family and healthcare and good function and fit of the prosthesis seemed to help the embodiment of the prosthesis, leading to daily use. This embodiment seemed to reduce the influence of environmental barriers, for example, climate, attitudes, and technical shortcomings.

Conclusion: Embodiment of prostheses seems to reduce the impact of environmental barriers. Support and training may facilitate the embodiment of myoelectric prosthesis use.

Clinical relevance: For successful prosthetic rehabilitation, environmental factors such as support and information to the patient and their social network about the benefits of prosthesis use are important. Local access to training in myoelectric control gives more people the opportunity to adapt to prosthesis use and experience less environmental barriers.

Place, publisher, year, edition, pages
Sage Publications, 2018
Keywords
Upper limb prosthetics; prosthetics; rehabilitation of prostheses users; rehabilitation; qualitative methods; rehabilitation; environment; amputation; upper extremity deformities; congenital
National Category
Orthopaedics
Identifiers
urn:nbn:se:oru:diva-59041 (URN)10.1177/0309364617704801 (DOI)000424669100005 ()28470129 (PubMedID)
Note

Funding Agencies:

Uppsala-Örebro Regional Research Council  

Research committee of Örebro County Council, Sweden 

Available from: 2017-08-02 Created: 2017-08-02 Last updated: 2018-08-16Bibliographically approved
Widehammar, C., Lidström, H. & Hermansson, L. (2017). Environmental barriers to participation and facilitators for use of three types of assistive technology devices. In: MEC 2017 - A Sense of What´s to Come: Myoelectric Controls and Upper Limb Prosthetics Symposium. Paper presented at MEC'17, Fredericton, Canada, 15-18 Aug., 2017 (pp. 36-36). Fredericton, New Brunswick, Canada: University of New Brunswick
Open this publication in new window or tab >>Environmental barriers to participation and facilitators for use of three types of assistive technology devices
2017 (English)In: MEC 2017 - A Sense of What´s to Come: Myoelectric Controls and Upper Limb Prosthetics Symposium, Fredericton, New Brunswick, Canada: University of New Brunswick , 2017, p. 36-36Conference paper, Oral presentation with published abstract (Refereed)
Place, publisher, year, edition, pages
Fredericton, New Brunswick, Canada: University of New Brunswick, 2017
National Category
Medical and Health Sciences Occupational Therapy Other Health Sciences
Identifiers
urn:nbn:se:oru:diva-64754 (URN)978-1-55131-190-6 (ISBN)
Conference
MEC'17, Fredericton, Canada, 15-18 Aug., 2017
Available from: 2018-02-01 Created: 2018-02-01 Last updated: 2018-08-14Bibliographically approved
Widehammar, C., Lidström, H. & Hermansson, L. (2017). Environmental barriers to participation and facilitators for use of three types of assistive technology devices. In: Nobelday Festivities Orebro University: . Paper presented at Nobelday Festivities Orebro University, Örebro, Sweden,7 December, 2017.
Open this publication in new window or tab >>Environmental barriers to participation and facilitators for use of three types of assistive technology devices
2017 (English)In: Nobelday Festivities Orebro University, 2017Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Background: In rehabilitation, assistive technology (AT) is prescribed in order to improve activity and participation for individuals with disability. Research shows that many devices are not used to the extent or to the benefits expected. The aim of this study was to compare the presence of environmental barriers to participation and facilitators for AT use and study the relation between barriers and AT use in three different types of AT devices.

Methods: A cross-sectional survey was conducted. Inclusion criteria were: ≥1 year experience as user of myoelectric prosthesis (MEP), powered mobility device (PMD), or assistive technology for cognition (ATC) and age 20-90 years. The survey contained the Swedish version of Craig Hospital Inventory of Environmental Factors and a study-specific questionnaire focusing on facilitating factors. Overall, 156 participants answered the survey. Non-parametric tests were used for comparisons.

Results: Barriers to participation were significantly lowest in MEP users (md=0.12; p<0.001), and highest in ATC users (md=1.56; p<0.001-p=0.048). A positive correlation between fewer barriers and higher use of MEP was seen (r=0.30, p=0.038). Compared to the other groups, users of ATC with more use reported more barriers for participation. The greatest barriers to participation were: Natural environment, Surroundings, and, Information. Most support came from Relatives and Professionals.

Conclusions: There is a difference in how users of different AT devices experience the environment in terms of barriers for participation and facilitators for use. The environment may facilitate AT use but barriers in the environment can still restrict participation in AT users. Future research should comprise the influence of AT use on participation.

National Category
Medical and Health Sciences Other Health Sciences Occupational Therapy
Identifiers
urn:nbn:se:oru:diva-64784 (URN)
Conference
Nobelday Festivities Orebro University, Örebro, Sweden,7 December, 2017
Available from: 2018-02-05 Created: 2018-02-05 Last updated: 2018-09-19Bibliographically approved
Widehammar, C., Lidström, H. & Hermansson, L. (2017). Use of assistive technology and barriers for participation in everyday activities: environmental influence on use of three types of assistive technology devices. In: : . Paper presented at Nordic Network on Disability Research, NNDR 14th research Conference, Örebro, Sweden, May 3-5, 2017.
Open this publication in new window or tab >>Use of assistive technology and barriers for participation in everyday activities: environmental influence on use of three types of assistive technology devices
2017 (English)Conference paper, Oral presentation only (Refereed)
National Category
Occupational Therapy
Identifiers
urn:nbn:se:oru:diva-59042 (URN)
Conference
Nordic Network on Disability Research, NNDR 14th research Conference, Örebro, Sweden, May 3-5, 2017
Available from: 2017-08-02 Created: 2017-08-02 Last updated: 2018-08-01Bibliographically approved
Ortiz-Catalan, M., Gudmundsdottir, R. A., Kristoffersen, M. B., Zepeda-Echavarria, A., Caine-Winterberger, K., Kulbacka-Ortiz, K., . . . Hermansson, L. (2016). Phantom motor execution facilitated by machine learning and augmented reality as treatment for phantom limb pain: a single group, clinical trial in patients with chronic intractable phantom limb pain. The Lancet, 388(10062), 2885-2894
Open this publication in new window or tab >>Phantom motor execution facilitated by machine learning and augmented reality as treatment for phantom limb pain: a single group, clinical trial in patients with chronic intractable phantom limb pain
Show others...
2016 (English)In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 388, no 10062, p. 2885-2894Article in journal (Refereed) Published
Abstract [en]

Background: Phantom limb pain is a debilitating condition for which no eff ective treatment has been found. We hypothesised that re-engagement of central and peripheral circuitry involved in motor execution could reduce phantom limb pain via competitive plasticity and reversal of cortical reorganisation.

Methods: Patients with upper limb amputation and known chronic intractable phantom limb pain were recruited at three clinics in Sweden and one in Slovenia. Patients received 12 sessions of phantom motor execution using machine learning, augmented and virtual reality, and serious gaming. Changes in intensity, frequency, duration, quality, and intrusion of phantom limb pain were assessed by the use of the numeric rating scale, the pain rating index, the weighted pain distribution scale, and a study-specifi c frequency scale before each session and at follow-up interviews 1, 3, and 6 months after the last session. Changes in medication and prostheses were also monitored. Results are reported using descriptive statistics and analysed by non-parametric tests. The trial is registered at ClinicalTrials. gov, number NCT02281539.

Findings: Between Sept 15, 2014, and April 10, 2015, 14 patients with intractable chronic phantom limb pain, for whom conventional treatments failed, were enrolled. After 12 sessions, patients showed statistically and clinically signifi cant improvements in all metrics of phantom limb pain. Phantom limb pain decreased from pre-treatment to the last treatment session by 47% (SD 39; absolute mean change 1 . 0 [0 . 8]; p= 0 . 001) for weighted pain distribution, 32% (38; absolute mean change 1 . 6 [1 . 8]; p= 0 . 007) for the numeric rating scale, and 51% (33; absolute mean change 9 . 6 [8 . 1]; p= 0 . 0001) for the pain rating index. The numeric rating scale score for intrusion of phantom limb pain in activities of daily living and sleep was reduced by 43% (SD 37; absolute mean change 2 . 4 [2 . 3]; p= 0 . 004) and 61% (39; absolute mean change 2 . 3 [1 . 8]; p= 0 . 001), respectively. Two of four patients who were on medication reduced their intake by 81% (absolute reduction 1300 mg, gabapentin) and 33% (absolute reduction 75 mg, pregabalin). Improvements remained 6 months after the last treatment.

Interpretation: Our fi ndings suggest potential value in motor execution of the phantom limb as a treatment for phantom limb pain. Promotion of phantom motor execution aided by machine learning, augmented and virtual reality, and gaming is a non-invasive, non-pharmacological, and engaging treatment with no identifi ed side-eff ects at present.

Place, publisher, year, edition, pages
Elsevier, 2016
National Category
General Practice
Identifiers
urn:nbn:se:oru:diva-54312 (URN)10.1016/S0140-6736(16)31598-7 (DOI)000389631700033 ()2-s2.0-85003707590 (Scopus ID)
Funder
VINNOVA
Note

Funding Agencies:

Promobilia Foundation

Jimmy Dahlstens Fond

PicoSolve

Innovationskontor Väst

Available from: 2017-01-10 Created: 2017-01-09 Last updated: 2018-07-23Bibliographically approved
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